Parenting Outcome Expectancy Scale

1. Abstract

The Parenting Outcome Expectancy Scale (POES) is an established psychometric instrument designed to measure a parent’s subjective beliefs and anticipations regarding the outcomes of discussing human sexuality, reproductive health, and risk-reduction behaviors with their adolescent offspring. Grounded in Albert Bandura‘s Social Cognitive Theory, the scale operationalizes outcome expectancy—a cognitive construct reflecting the judgment of probable consequences of an enacted behavior—specifically within the dyadic domain of parent-adolescent sexual communication. The POES evolved from an initial 15-item research version into a refined, comprehensive 23-item self-report questionnaire. Respondents evaluate statements using a 5-point Likert scale anchored from 1 (Strongly Disagree) to 5 (Strongly Agree), yielding total composite scores between 23 and 115.

Psychometrically, the POES assesses three principal, interconnected dimensions: Cognitive Self-Evaluative Outcome Expectancies (parental moral alignment, fulfillment of normative caretaking duties, and perceived responsibility), Emotional Self-Evaluative Outcome Expectancies (anticipated affective states such as parental embarrassment, discomfort, shame, or emotional relief), and Social Outcome Expectancies (the adolescent’s interpersonal reception, behavioral adherence, retention of guidance, and downstream risk reduction, such as lower adolescent pregnancy rates and delayed sexual debut). Validation studies demonstrate strong internal consistency reliability, with Cronbach’s alpha coefficients consistently ranging from .82 to .85 across diverse cohorts of mothers and fathers of preadolescents and early adolescents. Factor analyses confirm a coherent multidimensional structure accounting for substantial common variance. Construct, convergent, and predictive validities have been established through significant associations with parent-child general communication, sexual communication frequency, parental self-efficacy, and self-esteem. The POES remains a vital measurement tool in pediatric psychology, family studies, adolescent health initiatives, and public health interventions targeting sexually transmitted infection (STI) and human immunodeficiency virus (HIV) prevention.

2. Keywords

Parenting Outcome Expectancy Scale, POES, Social Cognitive Theory, outcome expectancy, parent-adolescent communication, sexual communication, adolescent sexual health, pediatric psychology, psychometrics, parental self-efficacy

3. Authors

The Parenting Outcome Expectancy Scale was developed by Colleen DiIorio, Ph.D., RN, FAAN, along with distinguished research collaborators in nursing, behavioral sciences, and public health.

• Colleen DiIorio, Ph.D., RN, FAAN: Professor Emerita, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States. Correspondence Address: Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road NE, Atlanta, GA 30322; Email: [email protected].
• William N. Dudley, Ph.D.: Quantitative Methodologist and Biostatistician, School of Nursing, Emory University / University of North Carolina at Greensboro.
• Dawn T. Wang, M.P.H.: Research Associate, Rollins School of Public Health, Emory University.
• Judith Wasserman, Ph.D., RN: Clinical Research Scientist, School of Nursing, Emory University.
• Marianne Eichler, M.D.: Adolescent Medicine Specialist and Pediatrician, Emory University School of Medicine.
• Lisa Belcher, Ph.D.: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
• Frances McCarty, Ph.D.: Biostatistician and Co-investigator on subsequent psychometric expansions, Emory University.

4. Purpose

The overarching purpose of the Parenting Outcome Expectancy Scale (POES) is to quantify the cognitive and affective value parents assign to initiating open, substantive dialogues about sexuality, puberty, contraception, and sexual safety with their adolescent children. In public health and adolescent developmental psychology, parent-child sexual communication is recognized as one of the most potent protective factors against early sexual initiation, unintended adolescent pregnancy, and transmission of sexually transmitted infections (STIs), including HIV. Despite broad empirical consensus supporting early parental engagement, significant barriers prevent parents from initiating these vital discussions. Parents frequently report crippling fears of awkwardness, apprehension that discussions will stimulate premature sexual experimentation, or resignation that adolescents will simply disregard their counsel.

The POES was created to illuminate the cognitive and motivational mechanisms that dictate whether a parent will translate general intentions into tangible communicative behavior. Grounded in the premise that individuals do not act solely on confidence (self-efficacy), but also on anticipated consequences (outcome expectancies), the POES serves several critical empirical and applied functions:

• Epidemiological and Behavioral Diagnostics: It enables researchers to identify specific parental fears and misconceptions (e.g., anticipated adolescent rebellion or personal shame) that hinder sexuality-related discourse across diverse sociocultural cohorts.
• Intervention Design and Curriculum Tailoring: Community-based family health programs, such as evidence-based father-son or mother-daughter HIV prevention workshops, utilize the POES to identify baseline cognitive hesitations, tailoring curricular modules to dismantle anticipated negative social and emotional costs while reinforcing positive expectations.
• Outcome Evaluation in Clinical Trials: The instrument functions as a sensitive pre- and post-intervention outcome measure in randomized controlled trials (RCTs) testing parent-training and family-strengthening programs. Demonstrating an increase in positive outcome expectancies serves as a verifiable mediator for increased conversational frequency, depth, and duration.
• Pediatric and Family Counseling: In family medicine, pediatric primary care, and clinical social work, clinicians can administer the POES to gauge parental readiness for anticipatory guidance discussions, enabling targeted counseling that transforms parental anxiety into proactive health education.

5. Psychological Construct

The POES operationalizes the construct of Outcome Expectancy (OE) within the paradigm of family health communication. An outcome expectancy represents an individual’s contingent belief that a given behavior will inevitably precipitate specific internal or external outcomes. Unlike parental self-efficacy—which measures an individual’s self-assessed capability to execute the behavior (e.g., “Can I clearly explain condom use without freezing?”)—outcome expectancy reflects the probabilistic calculation of the consequence of that execution (e.g., “If I clearly explain condom use, will my child actually utilize protection or simply feel uncomfortable?”). Bandura posited three primary domains of outcome expectancies: physical, social, and self-evaluative. Because verbal communication lacks direct, immediate sensory or physical effects, the POES specifically captures self-evaluative and social outcome dimensions, operationalized across three empirically delineated subscales:

1. Cognitive Self-Evaluative Outcome Expectancies

This subscale captures the parent’s internal moral, ethical, and normative judgments regarding their parental role. Cognitive self-evaluation centers on perceived duty, parental responsibility, and the satisfaction of upholding moral standards. Parents who register high scores on this dimension expect that initiating discussions about sex will affirm their identity as protective, conscientious caregivers. Items reflect judgments such as feeling like a responsible parent, feeling that one did the “right thing,” and knowing one has fulfilled fundamental parenting obligations (e.g., Item 2: “If I talk with [my child] about sex topics, I will feel like a responsible parent”; Item 18: “If I talk with [my child] about sex topics, I will have done what parents should do”).

2. Emotional Self-Evaluative Outcome Expectancies

In contrast to intellectual appraisals of duty, this dimension assesses the anticipated affective and somatic-emotional reactions that parents project onto the communicative act. Sexuality is laden with cultural taboos, personal modesty, and vulnerability. Consequently, parents frequently anticipate distressing emotions such as acute embarrassment, deep-seated shame, interpersonal awkwardness, or psychological distress. Conversely, positive emotional outcome expectations encompass prospective feelings of relief, comfort, and pride upon concluding the dialogue. This subscale incorporates several reverse-scored negative indicators alongside positive affective forecasts (e.g., Item 4: “If I talk with [my child] about sex topics, I will be embarrassed”; Item 9: “If I talk with [my child] about sex topics, I will feel ashamed”; Item 15: “If I talk with [my child] about sex topics, I will feel relieved”).

3. Social Outcome Expectancies

The social outcome expectancy domain represents the parent’s appraisal of external, relational, and behavioral reactions from the adolescent and the surrounding social environment. It encompasses three interrelated sub-facets:

• Adolescent Receptivity and Relational Dynamics: Anticipation of whether the child will actively listen, acknowledge the parent’s goodwill, express gratitude, or alternatively react with defensive withdrawal, anger, or secondary embarrassment (e.g., Item 6: “…I think [my child] will listen”; Item 17: “…[my child] will not want to talk to me”; Item 20: “…[my child] will appreciate my willingness to provide further information”).
• Longitudinal Information Retention and Norm Clarification: The belief that the adolescent will encode, remember, and internalize parental values regarding sexual abstinence or delayed sexual debut into later developmental stages (e.g., Item 19: “…[my child] will remember the discussion when [my child] is older”; Item 23: “…[my child] will know where I stand on teens having sex”).
• Protective Behavioral Efficacy: The distal expectation that parental guidance will directly strengthen the adolescent’s ability to navigate peer pressure, delay sexual intercourse, prevent unintended pregnancy, and reduce STI/HIV vulnerability (e.g., Item 11: “…[my child] will be less likely to have sexual intercourse as a young teen”; Item 22: “…[my child] will be more able to resist peer pressure to have sex”).

6. Theoretical Framework

The conceptual foundation of the POES is rooted in Albert Bandura‘s Social Cognitive Theory (SCT), first articulated extensively in his seminal 1986 treatise, Social Foundations of Thought and Action: A Social Cognitive Theory, and refined in his 1997 volume, Self-Efficacy: The Exercise of Control. Bandura’s model posits a triadic reciprocal causation framework in which human functioning is shaped by continuous, dynamic interactions between cognitive/personal factors, behavioral patterns, and environmental influences.

Within this reciprocal architecture, human agency is governed by two complementary cognitive precursors to action:

1. Efficacy Expectations (Self-Efficacy): An individual’s subjective conviction that they can successfully execute the precise behaviors required to produce desired outcomes.
2. Outcome Expectations: An individual’s judgment of the likely consequences, whether positive or negative, that will follow the performance of that specific behavior.

Bandura argued that while self-efficacy and outcome expectancies often correlate, they are conceptually and functionally distinct constructs. For instance, a parent may possess high self-efficacy regarding their biological knowledge and communicative clarity (“I am fully capable of explaining how barrier contraception prevents HIV transmission”), yet exhibit low behavioral engagement because of deeply unfavorable outcome expectancies (“If I raise this topic, my teenager will suspect I distrust them, react with anger, and proceed to experiment sexually regardless of what I say”). Conversely, a parent may believe passionately that parental communication prevents teenage pregnancy (high positive outcome expectancy) while feeling utterly incapable of overcoming personal stuttering, ignorance, or embarrassment (low self-efficacy).

Bandura categorized outcome expectations into three structural classes:

• Physical Outcomes: Pleasurable sensory sensations or physical discomforts resulting from action. In verbal parent-child communication, direct physical impacts are generally negligible, justifying their intentional exclusion from the POES.
• Social Outcomes: Social approval, relational intimacy, social rejection, ostracization, or adolescent behavioral compliance. The POES comprehensively integrates this dimension through items examining adolescent listening behaviors, parental relationship preservation, and protective risk avoidance.
• Self-Evaluative Outcomes: Internal self-regulatory mechanisms governing self-worth, self-respect, moral pride, or alternatively, self-reproach, guilt, and shame. Human beings actively avoid behaviors that provoke anticipated self-censure and pursue actions that elicit self-pride and moral congruence.

In developing the POES, Colleen DiIorio and her research team translated these SCT constructs into an operational model of adolescent health promotion. By integrating social and self-evaluative expectations into an assessment tool, the POES bridges cognitive psychological theory and empirical health behavior change, clarifying why cognitive anticipation dictates whether family-based risk reduction takes place.

7. Validity

The psychometric validity of the POES has been substantiated through extensive empirical evaluations utilizing diverse urban, suburban, and community cohorts of parents of preadolescent and adolescent youth.

Content and Face Validity

Content validity was established during initial scale construction through qualitative grounded inquiry and formal expert consensus panel reviews (DiIorio et al., 2001). The original item pool was generated directly from comprehensive literature reviews on adolescent sexual development alongside structured qualitative focus groups conducted with parents of adolescents aged 11 to 14. An independent panel of clinical and measurement specialists in adolescent health, pediatric nursing, and psychometrics evaluated item clarity, clinical relevance, and alignment with Bandura’s conceptual definition of outcome expectancies. All items meeting content criteria were refined and retained, establishing strong content validity.

Construct and Convergent Validity

Construct validity of the 15-item and expanded 23-item instruments was initially verified within a validation sample of 491 mothers of adolescents (DiIorio et al., 2001). Bivariate correlation analyses confirmed statistically significant associations in theoretically predicted directions across multiple convergent measures:

• Parent-Adolescent Sexual Communication: POES total scores correlated positively and significantly with validated indices measuring the frequency, breadth, and depth of parent-child discussions regarding human sexuality, puberty, and contraception (Pluhar, DiIorio, & McCarty, 2008). Mothers demonstrating more positive outcome expectancies engaged in significantly more frequent dialogues.
• General Family Communication: Significant positive correlations were documented between the POES and standardized measures of general parent-child openness and communicative warmth, demonstrating that positive sexual communication expectations align with broader dyadic communicative competence.
• Parenting Self-Efficacy: POES scores correlated positively with the Parenting Self-Efficacy Scale (PSES; DiIorio et al., 2001), corroborating Bandura’s theoretical premise that self-efficacy and outcome expectations represent correlated yet distinct components of personal agency.
• Parental Self-Esteem: POES demonstrated a positive correlation with validated self-esteem inventories, confirming that parents with stronger self-worth anticipate more positive self-evaluative outcomes when engaging in difficult conversations.

Known-Groups and Discriminant Validity

Known-groups validity was evidenced by systematic variations reflecting documented sociocultural communication patterns. In the baseline validation study, mothers of adolescent daughters exhibited significantly higher POES scores than mothers of adolescent sons ($p < .05$), mirroring established developmental findings that maternal figures anticipate greater ease, social receptivity, and urgency when discussing reproductive health with female offspring (DiIorio et al., 2001). Furthermore, longitudinal intervention analyses demonstrated that the POES was sensitive to change over time following targeted family training programs, confirming its utility for evaluative intervention tracking (DiIorio, McCarty, & Denzmore, 2006).

8. Reliability

The reliability of the POES has been examined across multiple developmental investigations, evaluating both maternal and paternal cohorts, diverse child age spans (middle childhood through early adolescence), and various experimental trial designs.

Internal Consistency Reliability

In the primary psychometric validation study conducted by DiIorio et al. (2001) involving 491 mothers of 11- to 14-year-old adolescents, the initial 15-item POES achieved an overall Cronbach’s alpha of .83, indicating robust internal consistency. Corrected item-to-total correlations ranged from .24 to .61, with an average correlation of .27. Individual item means spanned from 3.15 to 4.50, with standard deviations ranging between .60 and 1.25. One item assessing adolescent obstinacy (original Item 8: “Your adolescent will do what he/she wants no matter what you say”) yielded the lowest item-to-total correlation (.24) and demonstrated weak inter-item correlations ($r < .10$), pinpointing an area subsequently fortified through scale expansion.

Subscale reliability coefficients for the initial 15-item model revealed moderate to acceptable internal consistency:

• Cognitive Self-Evaluative Subscale: $\alpha = .82$
• Emotional Self-Evaluative Subscale: $\alpha = .77$
• Social Outcome Expectancy Subscale: $\alpha = .67$

To address the modest internal consistency of the initial social subscale and strengthen the cognitive domain, DiIorio and colleagues authored eight supplementary items (one cognitive self-evaluative item and seven social outcome expectancy items), expanding the instrument to 23 items. In a longitudinal randomized controlled trial evaluating an HIV prevention program targeting 277 fathers and their adolescent sons, the 23-item POES demonstrated an overall Cronbach’s alpha of .83 (DiIorio, McCarty, & Denzmore, 2006). Similarly, in a cross-sectional study of mothers of children aged 6 to 12 years, the POES exhibited comparable internal consistency ($\alpha = .85$; Pluhar et al., 2008), confirming stable reliability across diverse samples and administration contexts.

9. Factor Analysis

The structural dimensionality of the POES was systematically examined through exploratory factor analysis (EFA) to verify whether empirical item clustering aligned with Social Cognitive Theory.

Exploratory Factor Structure

DiIorio et al. (2001) conducted an exploratory common factor analysis utilizing maximum likelihood estimation paired with an oblique (Promax) rotation to accommodate expected theoretical correlations among latent dimensions. The initial unconstrained extraction identified four factors displaying eigenvalues exceeding 1.0, accounting for 59.6% of the cumulative variance. However, Factor 4 retained only a single item with an acceptable loading, representing an over-extracted structural artifact.

Consequently, a three-factor solution was specified. This model demonstrated clean interpretability and parsimony, accounting for 52.6% of the total common variance. The self-evaluative construct cleanly bifurcated into cognitive and emotional components, while social items consolidated into an external interpersonal factor:

The addition of eight items in the 23-item revision resolved structural vulnerabilities identified in the 15-item version by bolstering the cognitive subscale and stabilizing the social outcome dimension. Confirmatory analytic models in subsequent studies have reaffirmed the structural validity of this multidimensional framework across maternal and paternal respondents (DiIorio et al., 2006).

10. Instrument / Measurement Tool

• Complete Instrument Name: Parenting Outcome Expectancy Scale (POES)
• Primary Author: Colleen DiIorio, Ph.D., RN, FAAN (Emory University)
• Construct Assessed: Parental anticipated cognitive, emotional, and social consequences of discussing sexuality-related topics with adolescent children
• Underlying Framework: Social Cognitive Theory (Bandura, 1997)
• Test Format: Self-administered paper-and-pencil questionnaire, face-to-face structured interview, or Computer-Assisted Interview (CAI)
• Administration Time: Approximately 5 to 10 minutes
• Target Population: Parents, legal guardians, and primary caregivers of preadolescents and adolescents (ages 6 to 16 years)
• Total Number of Items: 23 items in the full expanded instrument (15 items in the legacy research version)
• Item Stem: Every item begins with or is governed by the common stem: “If I talk with [my child] about sex topics…” (In computer-assisted or clinical interview formats, the target child’s legal or preferred first name is substituted for [my child])
• Response Format: 5-point Likert scale:
  • 1 = Strongly Disagree
  • 2 = Disagree
  • 3 = Neither Disagree nor Agree
  • 4 = Agree
  • 5 = Strongly Agree
• Item Valence and Polarity:
  • Positively Worded Items (15 items): Items 1, 2, 3, 6, 7, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23.
  • Negatively Worded Items (8 items – marked with asterisk *): Items 4, 5, 8, 9, 12, 16, 17, 21.
• Scoring Instructions:
  1. Reverse Scoring: Prior to aggregate calculation, invert the numerical scores for all 8 negatively phrased items (Items 4, 5, 8, 9, 12, 16, 17, and 21) such that: $1 \rightarrow 5$, $2 \rightarrow 4$, $3 \rightarrow 3$, $4 \rightarrow 2$, and $5 \rightarrow 1$.
  2. Total Score Calculation: Sum all 23 individual item responses (incorporating reverse-coded values). Total composite scores range from a minimum of 23 to a maximum of 115.
  3. Score Interpretation: Higher composite numerical values reflect more positive, adaptive outcome expectancies regarding parent-child sexual communication. Lower scores indicate elevated anticipated barriers, heightened emotional discomfort, fear of adolescent rejection, and feelings of parental futility.
  4. Subscale Scores (Optional): Subscale sums or mean item scores may be calculated independently for Cognitive Self-Evaluative (Items 1, 2, 3, 18), Emotional Self-Evaluative (Items 4, 5, 7, 9, 12, 14, 15), and Social Outcome Expectancy dimensions (Items 6, 8, 10, 11, 13, 16, 17, 19, 20, 21, 22, 23).

11. Permissions & Fee and Test Year

• Initial Publication Year: 2001 (Initial 15-item validation in Journal of Nursing Measurement); expanded 23-item application published in 2006 (Journal of Pediatric Psychology).
• Copyright Status: The instrument was developed with public federal research support from the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). Original psychometric articles are copyrighted by Springer Publishing Company and Oxford University Press.
• Usage Permissions: The POES is available for educational, academic, and non-commercial public health research purposes. Researchers, healthcare providers, and clinical scholars wishing to administer, modify, or embed the scale into computer-assisted survey instruments are encouraged to review the primary literature or contact the primary author for formal institutional tracking: Dr. Colleen DiIorio, Rollins School of Public Health, Emory University, Atlanta, GA (Email: [email protected]).
• User Fees: The POES is a non-proprietary instrument; there are no licensing fees, test royalty fees, or commercial charges associated with its standard academic or non-profit research utilization.

12. References

• Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
• Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman and Company.
• DiIorio, C., Dudley, W. N., Wang, D. T., Wasserman, J., Eichler, M., Belcher, L., & Team, F. (2001). Measurement of parenting self-efficacy and outcome expectancy related to discussion about sex. Journal of Nursing Measurement, 9(2), 135–149. PubMed: 11758414
• DiIorio, C., McCarty, F., & Denzmore, P. (2006). An exploration of social cognitive theory mediators of father-son communication about sex. Journal of Pediatric Psychology, 31(9), 917–927. https://doi.org/10.1093/jpepsy/jsj101
• DiIorio, C., Pluhar, E., & Belcher, L. (2003). Parent-child communication about sexuality: A review of the literature. Journal of HIV/AIDS Prevention & Education for Adolescents & Children, 5(3–4), 7–32. https://doi.org/10.1300/J129v05n03_02
• Pluhar, E. I., DiIorio, C. K., & McCarty, F. (2008). Correlates of sexuality communication among mothers and 6–12-year-old children. Child: Care, Health and Development, 34(3), 283–290. https://doi.org/10.1111/j.1365-2214.2007.00801.x

13. Items of the Scale (Questionnaire)