Talking Parents, Healthy Teens: A Worksite-based Program for Parents to Promote Adolescent Sexual Health (original) (raw)
2014
The "sex talk" is often one of the most challenging conversations for parents and children during adolescence. Research has established that parent-adolescent communication about sex can greatly reduce adolescents' sexual risk . However, many parents still avoid these conversations due to uncertainty or lack of confidence in how to best educate their children on topics such as sexual health and relationships. Plus, little is known about family communication about sex from the adolescent perspective. In order to develop more comprehensive strategies for parents to engage in these challenging conversations, the present dissertation examined adolescents' perceptions of parent-adolescent communication about sex, including what adolescents report that their parents say about sex, the degree to which these messages are perceived as effective and competent by adolescents, and how parental messages as well as the larger family environment relates to sexual risk. One hundred and fifty-nine high school adolescents (M age = 16.66 years) completed an online survey about actual and ideal parent-child conversations about sex, as well as adolescents' perceptions of attitudes, behaviors, and family communication climate related to sexual risk. Through inductive analyses, six parent-adolescent conversation themes emerged, including safety, underdeveloped/unsuccessful, warning/threat, no talk, comprehensive-talk, and wait. Adolescents' perceived comprehensive-talk and safety conversations as most competent and effective compared to other conversation themes. In addition, results revealed five themes related to ways parents could have made the conversations ideal, including no change, be more specific/provide guidance, talk to me, collaborate, and appropriateness. Besides assessing these themes as separate units of information, further analyses revealed distinct patterns between the actual and ideal conversation themes. The analyses also showed that perceived parental communication competence and effectiveness were the strongest negative predictors of adolescents' permissive sexual attitudes and sexual risk-taking; whereas peer communication frequency was a significant positive predictor in adolescents' permissive sexual attitudes and sexual risk-taking. Overall, family communication climate (e.g. conversation orientation and conformity orientation) was unrelated to adolescents' sexual risk. The implications for these findings are provided, as well as limitations and future recommendations for researchers and parents. CHAPTER ONE RATIONALE AND PREVIOUS RESEARCH One way to provide strategies to parents that can help them feel more comfortable engaging in parent-adolescent communication about sex, is for researchers to spend less time on what communication strategies parents believe are effective and focus more efforts on how adolescents perceive these conversations. As such, the purpose of the present study is to examine adolescents' perceptions of parent-adolescent communication about sex, including what the adolescents' parents say about sex, what types of messages adolescents perceive as effective and competent, and how those parental messages as well as the larger family environment relates to sexual risk. Prior to the present study, limited attention has been given to adolescents' perceptions surrounding parent-adolescent communication about sex-related topics. This is true even though scholars have argued that in order to develop a comprehensive understanding of family communication the voices of children need to be a priority in current research efforts (Miller-Day, Pezalla, & Chesnut, 2013; Socha & Yingling, 2011). Communication research needs to "pay more attention to the ways in which communication is organized and experienced during the teenage years" and how adolescents perceive communication from adults (Williams & Thurlow, 2005, p. 10). In research on adolescents' substance abuse, for example, communication scholars have used adolescents' experiences with drug offers and drug resistance strategies as the foundation to develop and implement successful interventions (e.g., keepin' it REAL) with parents, adolescents, and school leaders (see Hecht & Miller-Day, 2007 for review). Thus, knowing how adolescents successfully resisted drug offers, researchers were able to design interventions to help parents and teens.
Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior
JAMA Pediatrics, 2016
IMPORTANCE Parent-adolescent sexual communication has received considerable attention as a factor that can positively affect safer sex behavior among youth; however, the evidence linking such communication to youth contraceptive and condom use has not been empirically synthesized. OBJECTIVES To examine the effect of parent-adolescent sexual communication on safer sex behavior among youth and explore potential moderators of this association. DATA SOURCES A systematic search of studies published from database inception through June 30, 2014, using the MEDLINE, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles yielded 5098 studies, of which 52 studies with 25 314 adolescents met the study eligibility criteria. Analysis was conducted from July 1, 2014, to July 27, 2015. STUDY SELECTION Studies were included if they sampled adolescents (mean sample age Յ18 years), included an adolescent report of sexual communication with one or both parents, measured safer sex behavior, and were published in English. DATA EXTRACTION AND SYNTHESIS Correlation coefficients (r) and 95% CIs were computed from studies and meta-analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Safer sex behavior, including use of contraceptives or condoms. RESULTS Fifty-two articles, including 71 independent effects representing more than 3 decades of research on 25 314 adolescents (weighted mean age, 15.2 years) were synthesized. Across studies, there was a significant weighted mean effect (r = 0.10; 95% CI, 0.08-0.13) linking parent-adolescent sexual communication with safer sex behavior, which was statistically heterogeneous (Q = 203.50, P < .001, I 2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = 0.12) than boys (r = 0.04) and among youth who discussed sex with their mothers (r = 0.14) compared with their fathers (r = 0.03). Effects did not differ for contraceptive vs condom use or among longitudinal vs cross-sectional studies, indicating that parent sexual communication had a similar effect across study designs and outcomes. Several methodological issues were identified in the literature; future studies can improve on these issues by measuring parent-adolescent communication with robust, multi-item measures, clearly specifying the target parent, and applying multimethod longitudinal designs. CONCLUSIONS AND RELEVANCE Sexual communication with parents, particularly mothers, plays a small protective role in safer sex behavior among adolescents; this protective effect is more pronounced for girls than boys. We discuss the implications for practice and make suggestions for future research on parent-adolescent sexual communication.
Parental communication and youth sexual behaviour
Journal of Adolescence, 2007
The role of parental communication and instruction concerning sexual behaviour were studied in a community-based sample of 1083 youth aged 13-17 (mean age of 15 years; 51% girls, 49% White). The Youth Asset Survey was administered along with items measuring demographics and youth risk behaviours. After controlling for demographic factors, multivariate analysis revealed that youth were much less likely to have initiated sexual intercourse if their parents taught them to say no, set clear rules, talked about what is right and wrong and about delaying sexual activity. If youth were sexually active, they were more likely to use birth control if taught at home about delaying sexual activity and about birth control. Having only one sexual partner was associated with having an adult role model who supports abstinence, being taught at home about birth control, and being taught at home how to say no. If parents reported talking with youth about birth control and sexually transmitted disease (STD) prevention, youth were significantly more likely to use birth control. Our conclusion is that parents have the opportunity and ability to influence their children's sexual behaviour decisions. r
The Role of Parents in Early Adolescent Sexual Risk-Taking Behavior
The Open Psychology Journal, 2011
The primary purpose of this study was to better understand the role of parents in early adolescents' sexual attitudes and behavior, as parents are ecologically an important proximal factor. Predictor variables included were mother and father approval of premarital sex, parent-adolescent communication about sexuality, and parental social support. Religiosity was also included. The participants were 194, male (n=89) and female (n=105) students in the 7 th and 8 th grades (ages 12-15, mean=13.24), primarily African-American and Mexican-American and of lower socioeconomic status, from two middle schools in an urban school district of a large city in the Midwest of the U.S.A.. Variance in most criterion variables was significantly explained by various combinations of these parenting variables. However, none of these parenting variables predicted adolescents' intentions to avoid pregnancy, plans sexual intercourse debut, or plans for continuing sexual intercourse if already started (n=34). Contributions to existing literature, as well as implications for prevention and intervention, are discussed.
Assessment of Parent-Based Interventions for Adolescent Sexual Health
JAMA Pediatrics, 2019
Parent-based sexual health interventions have received considerable attention as one factor that can increase safer sexual behavior among youth; however, to our knowledge, the evidence linking parent-based interventions to youth sexual behaviors has not been empirically synthesized. OBJECTIVE To examine the association of parent-based sexual health interventions with 3 primary youth outcomes-delayed sexual activity, condom use, and parent-child sexual communication-as well as several secondary outcomes. We also explored potential moderators of intervention effectiveness. DATA SOURCES A systematic search was conducted of studies published through March 2018 using MEDLINE, PsycINFO, Communication Source, and CINAHL databases and relevant review articles. STUDY SELECTION Studies were included if they: (1) sampled adolescents (mean age, Յ18 years), (2) included parents in a key intervention component, (3) evaluated program effects with experimental/quasi-experimental designs, (4) included an adolescent-reported behavioral outcome, (5) consisted of a US-based sample, and (6) were published in English. DATA EXTRACTION AND SYNTHESIS Standardized mean difference (d) and 95% confidence intervals were computed from studies and meta-analyzed using random-effects models. A secondary analysis evaluated potential moderating variables. MAIN OUTCOMES AND MEASURES The primary outcomes were delayed sexual activity, condom use, and sexual communication. RESULTS Independent findings from 31 articles reporting on 12 464 adolescents (mean age = 12.3 years) were synthesized. Across studies, there was a significant association of parent-based interventions with improved condom use (d = 0.32; 95% CI, 0.13-0.51; P = .001) and parent-child sexual communication (d = 0.27; 95% CI, 0.19-0.35; P = .001). No significant differences between parent-based interventions and control programs were found for delaying sexual activity (d = −0.06; 95% CI, −0.14 to 0.02; P = .16). The associations for condom use were heterogeneous. Moderation analyses revealed larger associations for interventions that focused on younger, compared with older, adolescents; targeted black or Hispanic youth compared with mixed race/ethnicity samples; targeted parents and teens equally compared with emphasizing parents only; and included a program dose of 10 hours or more compared with a lower dose. CONCLUSIONS AND RELEVANCE Parent-based sexual health programs can promote safer sex behavior and cognitions in adolescents, although the findings in this analysis were generally modest. Moderation analyses indicated several areas where future programs could place additional attention to improve potential effectiveness.
Annals of Behavioral Medicine, 2007
Background: The incidence and prevalence of pregnancy and sexually transmitted infections among American adolescents remain unacceptably high. Purpose: This research examines adolescent intentions to have sexual intercourse, their expectancies about having sexual intercourse, and maternal communication about the expectancies of engaging in sexual intercourse. Methods: Six hundred sixty-eight randomly selected inner-city middle school students and their mothers completed self-administered questionnaires. Adolescents reported their intentions to have sexual intercourse and the perceived positive and negative expectancies of doing so. Both mothers and adolescents reported on the frequency of communication about these expectancies. Results: Boys reported higher intentions, more positive expectancies, and lower levels of maternal communication than did girls. Expectancies statistically significantly associated with intentions focused on the positive physical, social, and emotional advantages of having sex rather than on concerns about pregnancy and HIV=AIDS. With some exceptions, maternal communication was associated with adolescents' expectancies about engaging in sexual intercourse. However, only modest correlations between maternal and adolescent reports of communication were observed. Conclusions: Results indicate that intervention programs should address the positive expectancies youth have about having sex, not just the threat of pregnancy and HIV=AIDS, and should address potential gender differences in expectancies between boys and girls.
Parent-Adolescent Communication About Contraception and Condom Use
JAMA Pediatrics, 2016
A significant number of sexually active youth experience poor sexual and reproductive health outcomes, including unplanned pregnancy, sexually transmitted infections, and human immunodeficiency virus infection. 1 Nearly half (47%) of all high school students in the United States have ever had sex and more than one-third (34%) are sexually active. 1 Every year, more than 600 000 pregnancies occur among teens, 2 and approximately half of all new sexually transmitted infections are attributed to youth aged 15 to 24 years. 3 Youths who are racial, ethnic, and sexual minorities are disproportionately affected by these negative sexual and reproductive health outcomes. 3 Public health efforts have targeted adolescents through a variety of prevention strategies, including efforts to strengthen parentadolescent communication about sexual behavior. 4 Extensive scientific literature suggests that parents play an important role in shaping sexual behavior among adolescents. However, there is a tendency in this research to prioritize delaying adolescent sexual debut, with less attention devoted to correct and consistent condom and contraceptive use. 5 The limited studies that have addressed parental influences on adolescent condom and contraceptive use report inconsistent results. 5 In this issue of JAMA Pediatrics, the metaanalysis by Widman et al 6 examines correlations between parent-adolescent sexual communication and adolescent use of contraceptives and condoms (hereafter referred to as safer sex behavior). Widman et al highlight that parental communication is positively linked to safer sex behavior among adolescents. The meta-analysis identified sex of the parent and sex of the adolescent as moderators of this association. The magnitude of the overall correlation (r = 0.10) can be interpreted as modest, so issues of magnitude warrant more attention. Although researchers long ago noted that even small correlations can represent societally important effects when one considers population size (>40 million adolescents) and the seriousness of the outcome (unintended pregnancy, human immunodeficiency virus infection), 7 we expand on the findings by Widman et al 6 by highlighting conceptual and methodological issues that bolster the effect and association of parent-adolescent communication on adolescent contraception and condom use.
Parenting Skills Determinant in Preventing Adolescents’ Sexual Health Risk Behavior
Open Journal of Preventive Medicine, 2017
Parenting skill is one of the crucial needs that parents must have in caring adolescents' sexual health risk behavior. Present study aims to determine predictors of parenting skills in preventing adolescents' sexual health risk behavior. A cross sectional study was conducted among adolescents' parents who attended government health clinics in a semi-urban district, West Malaysia. Data were collected by systematic random sampling using validated questionnaire from eight government health clinics based on routine daily outpatient services. There were 386 respondents participated with 98.9% of response rate. Parental skill is categorized as appropriate or inappropriate based on Trans-Theoretical Model (TTM) staging. Eighteen independent variables were used: parental socioeconomic status, adolescent characteristic, parenting style, parent-adolescent communication, parental stress, perception on adolescent sexual risk, comfortable in discussing sexual issues, knowledge in sexual reproductive health (SRH) and knowledge in HIV/AIDS. Assessment of parenting skills using the TTM stage showed 139 respondents (36%) had inappropriate parenting skills, in which they were in pre contemplation, contemplation or preparedness stages, while 247 respondents (64%) showed appropriate parenting skills when they were in action and maintenance stages of TTM. Older parent, late adolescent, low parental education level, extended family living arrangement, comfortable in discussing sexual issues, good parent-adolescent communication and higher knowledge in HIV/AIDS were found significant in bivariate analysis. Multivariate logistic regression analysis identified older parent (AOR = 1.927, 95% CI = 1.889-1.966, p < 0.001), lower parental education (AOR = 2.394, 95% CI = 1.348-4.254, p = 0.003), comfortable in discussing sexual issues (AOR = 3.810, 95% CI = 1.622-8.948, p = 0.002), good parent-adolescent communication (AOR = 4.741, 95% CI = 2.478-9.071, p ≤ 0.001) and having higher knowledge on HIV/AIDS (AOR = 2.804, 95% CI = 1.528-5.147, p = 0.001) as significant predictors for appropriate parenting skills in preventing adolescent sexual health risk behavior. In conclusion, more than one third of parents were still not ready in preventing ado-How to cite this paper: