City Research Online

Abstract

Purpose: Sexual development is a core biopsychosocial process in adolescence. Lack of brief measures of sexual wellbeing for this age group limits understanding of the impact of these processes on broader mental health and wellbeing. This study aimed to develop and validate a brief measure of sexual wellbeing for mid-to-late adolescents (aged 14-19), suitable for use in population surveys. Methods: Measure development was informed by seven agenda-setting workshops with young people (n = 28, aged 14-23), parents (n = 4), and professionals (n = 11) followed by five online focus groups with adolescents (n = 38, aged 14-19). New items were tested and iteratively refined via cognitive interviews with adolescents (n = 18) and expert review (n = 4). Data from a web-based survey of UK adolescents (n = 1710; aged 14-19) were used to assess and eliminate poor performing items. Exploratory and confirmatory factor analyses assessed latent structure, model fit, measurement invariance, and associations with external validation criteria to ensure standardisation and applicability. Results: An initial 33-item pool was reduced to 13 items representing four first-order factors: support, comfort/respect, safety/agency, and self-esteem, The final model showed good fit (RMSEA 0.064; CFI 0.954; TLI 0.941). Measurement invariance was supported across age groups but only partially across gender. Higher overall sexual wellbeing scores were positively associated with body image, general wellbeing, and sexual and reproductive empowerment, and negatively associated with depression and anxiety. Conclusion: The 13-item Adol-SW is the first validated, brief measure of adolescent sexual wellbeing explicitly designed for population surveys to improve understanding of links between adolescent sexual development and mental wellbeing.

Publication Type:	Article
Additional Information:	© 2026 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Publisher Keywords:	Sexual wellbeing, Sexuality, Adolescents, Scale development, Validation, Co-production, Mental health & wellbeing
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments:	School of Policy & Global Affairs School of Policy & Global Affairs > Violence and Society Centre
SWORD Depositor:	Symplectic Administrator

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