Talking Parents, Healthy Teens: A Worksite-based Program for Parents to Promote Adolescent Sexual Health (original) (raw)
Related papers
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 (Guilamo-Ramos et al., 2012; Miller, Benson, & Galbraith, 2001). 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. iv DEDICATION This dissertation is dedicated to the love of my life and best friend, Will. v AUTHOR'S ACKNOWLEDGEMENTS This dissertation study would not have been possible without the numerous individuals that provided encouragement, guidance, insights, and love throughout this amazing journey. I owe this accomplishment to all of you. First of all, I am grateful to the community of individuals at the University of Nebraska-Lincoln who shaped me into a scholar. My deepest graduate goes towards my dissertation advisor and role model, Jody Koenig Kellas. Jody, thank you for inspiring me to do "meaningful research" and for your steadfast support and intellectual guidance in my development as a researcher, teacher, writer, and person. There were several occasions where I remember feeling disheartened and stumped about the direction of my study, but inevitably a conversation with you always changed my enthusiasm and spirits immeasurably. I have learned so much from you during this process, and your influence will stay with me throughout my career. Thank you for being my person. I would also like to acknowledge the other members of my dissertation committee, Jordan Soliz, Dawn O. Braithwaite, and Lisa Crockett. Jordan, thank you for always believing in me and pushing me to find my unique voice as a student and scholar. You have an uncanny ability to read minds and know exactly what to say in moments of struggle and success. Dawn, thank you for always being one of my biggest supporters, convincing me to come to Nebraska, and instilling in me the importance of our disciplinary roots. Lisa, your important work on adolescents' sexuality has always been an inspiration to me and I am honored that such an influential scholar was a part of this dissertation. vi Along side my dissertation committee, I have been surrounded by absolutely amazing students, colleagues, and friends in Lincoln. There are many individuals who have had a positive influence during my time here, but a few in particular that deserve recognition. Thank you to my research assistants Hillary Naumann and Danielle Buschkoetter for your hard work in analyzing the adolescents' conversation data. To my cohort, Jessy Ohl, Audra Nuru, and Jenna Stephen-Abetz, thank you for embarking on this Ph.D. quest with me. Yay, we did it together! I would also like to extend a special thank you to my academic soul sisters Kristen Carr, Sarah Wilder, Colleen Colaner, and Allision Thorson. I have learned so much from watching you four handle transitions in academic life with immense pose and grace. And thank you to my lady pals-Maggie Yancey, Emily Greise, Chelsi Klentz Davis, Paige Lembeck, and Jen Strickland-for showing me what it means to be loyal friends and amazing women. Our mutual love for wine, popcorn, and reality television has forever bonded us. It is times with you all that I can completely be myself. Finally, I would like to thank my amazing friend Haley Kranstuber Horstman. Haley, you have filled my life with joy, laughter, and kindness. You have taught me the true meaning of friendship, adventure, and husker pride. You will forever be my favorite road-tripping buddy and best friend. Do not tell Riley! To the 159 high school adolescents who so kindly provided their invaluable perspectives and experiences surround communication about sex. I obviously could not have completed this dissertation without you and it is my career goal to make sure that your perspectives and suggestions are the cornerstone of creating positive parent-child communication. I am also extremely thankful for to the Lincoln Public School district and Lake Park-Audubon School district for opening your minds and doors to my vii dissertation project. Thank you to all the superintendents, principals, teachers, and councilors who so generously helped me organize participant recruitment and data collection. Working with you and your students was the most humbling and rewarding part of this dissertation process. To my family, thank you for a lifetime of prayers, love, and support as I followed me dreams. To my sassy little pup Riley, you have taught me about independence, selflessness, and unwavering loyalty. A special thanks to my parents, Rick and Janet Olson, for instilling in me a love for education and the value of working hard to achieve my goals. Mom, you are the most kindhearted and generous person in this world. Thank you for encouraging my "strong-willed" nature and showing me unconditional loveeven during adolescence-when I was not so loveable. Dad, you are my hero. My love for football, popcorn, animals, and the outdoors are because of you. Thank you for teaching me the "art of napping" and that a day in nature is the best cure-all for any bad day. To my amazing siblings Carrie Olson-Manning, Emma Olson, and Joey Olson, you three continually inspire me to achieve greatness. Carrie and Emma, thank you for showing me that intelligence and fun are not mutually exclusive. You two are the strongest women I know. Joey, thank you for teaching me the healing power of laughter and that no dream is impossible. You have always been my number one fan growing up and I still need to get you an honorary metal for attending every dolphin basketball game. To Bill, Heidi, and Avery Holman, I am blessed to be apart of your family and your love was felt throughout this process. To my husband Will Holman, you have been my source of strength throughout this journey. Thank you for your unyielding support toward my Ph.D. dream. You are the viii single best thing that has ever happened to me. Thank you for telling me that what I want is possible, and for all the sacrifices you have made for me to reach my goals. I was continually amazed by your willingness to proof read countless pages of my dissertation and reminding me the importance of my work. I am honored you choose me as a worthy companion for your forever love. It is my hope that one day I can learn to be more like you-calm, patient, and kindhearted. There is so little I understand about life and I am in no hurry to make sense of everything, but the one thing that has always made sense to me is YOU. I believe that your hugs are just the universe's way of reminding me that I am on the right track and to enjoy the journey. I love you and cannot wait to write the rest of our lifelong love letter together. Finally, to my sweet little spirit, you will always be my favorite "what if." ix
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.