Parents and caregivers play an important role in sexual socialization of youth, often serving as the primary source of information about sex. For African American rural youth who experience disparate rates of HIV/sexually transmitted infection, improving caregiver–youth communication about sexual topics may help to reduce risky behaviors. This study assessed the impact of an intervention to improve sexual topic communication.
Design:
A Preintervention–postintervention, quasi-experimental, controlled, and community-based trial.
Setting:
Intervention was in 2 rural North Carolina counties with comparison group in 3 adjacent counties.
Subjects:
Participants (n = 249) were parents, caregivers, or parental figures for African American youth aged 10 to 14.
Intervention:
Twelve-session curriculum for participating dyads.
Measures:
Audio computer-assisted self-interview to assess changes at 9 months from baseline in communication about general and sensitive sex topics and overall communication about sex.
Analysis:
Multivariable models were used to examine the differences between the changes in mean of scores for intervention and comparison groups.
Results:
Statistically significant differences in changes in mean scores for communication about general sex topics (P < .0001), communication about sensitive sex topics (P < .0001), and overall communication about sex (P < .0001) existed. Differences in change in mean scores remained significant after adjusting baseline scores and other variables in the multivariate models.
Conclusions:
In Teach One Reach One intervention, adult participants reported improved communication about sex, an important element to support risk reduction among youth in high-prevalence areas.
OhlMEPerencevichE. Frequency of human immunodeficiency virus (HIV) testing in urban vs. rural areas of the United States: results from a nationally-representative sample. BMC Public Health. 2011;11(1):681.
MetzgerICooperSMZarrettNFloryK. Culturally sensitive risk behavior prevention programs for African American adolescents: a systematic analysis. Clin Child Fam Psychol Rev. 2013;16(2):187–212.
6.
BrodyGHMurryVMGerrardM. The strong African American families program: translating research into prevention programming. Child Dev. 2004;75(3):900–917.
7.
Maticka-TyndaleEBarnettJP. Peer-led interventions to reduce HIV risk of youth: a review. Eval Program Plann. 2010;33(2):98–112.
8.
GoeslingBColmanSTrenholmCTerzianMMooreK. Programs to reduce teen pregnancy, sexually transmitted infections, and associated sexual risk behaviors: a systematic review. J Adolesc Health. 2014;54(5):499–507.
9.
CaruthersASVan RyzinMJDishionTJ. Preventing high-risk sexual behavior in early adulthood with family interventions in adolescence: outcomes and developmental processes. Prev Sci. 2014;15(1)59–69.
10.
KoganSMBrodyGHMolgaardVK. The strong African American families-teen trial: rationale, design, engagement processes, and family-specific effects. Prev Sci. 2012;13(2):206–217.
11.
SalesJMilhausenRDiClementeRJ. A decade in review: building on the experiences of past adolescent STI/HIV interventions to optimise future prevention efforts. Sex Transm Infect. 2006;82(6):431–436.
12.
SuttonMYLasswellSMLanierYMillerKS. Impact of parent-child communication interventions on sex behaviors and cognitive outcomes for Black/African-American and Hispanic/Latino youth: a systematic review, 1988-2012. J Adolesc Health. 2014;54(4):369–384.
13.
WightDFullertonD. A review of interventions with parents to promote the sexual health of their children. J Adolesc Health. 2013;52(1):4–27.
14.
Corbie-SmithGAkersABlumenthalC. Intervention mapping as a participatory approach to developing an HIV prevention intervention in rural African American communities. AIDS Educ Prev. 2010;22(3):184–202.
15.
CavaleriMAOlinSSKimAHoagwoodKEBurnsBJ. Family support in prevention programs for children at risk for emotional/behavioral problems. Clin Child Fam Psychol Rev. 2011;14(4):399–412.
16.
MillerKSFasulaAMDittusPWiegandREWyckoffSCMcNairL. Barriers and facilitators to maternal communication with preadolescents about age-relevant sexual topics. AIDS Behav. 2009;13(2):365–374.
17.
BangpanMOperarioD. Understanding the role of family on sexual-risk decisions of young women: a systematic review. AIDS Care. 2012;24(9):1163–1172.
18.
MillerBC. Family influences on adolescent sexual and contraceptive behavior. J Sex Res. 2002;39(1):22–26.
19.
ShortMBRosenthalSL. Psychosocial development and puberty. Ann N Y Acad Sci. 2011;1135(1):36–42.
20.
MillerKSLevinMLWhitakerDJXuX. Patterns of condom use among adolescents: the impact of mother-adolescent communication. Am J Public Health. 1998;88(10):1542–1544.
21.
DiIorioCDudleyWNKellyMSoetJEMbwaraJSharpe PotterJ. Social cognitive correlates of sexual experience and condom use among 13-through 15-year-old adolescents. J Adolesc Health. 2001;29(3):208–216.
22.
ClawsonCLReese-WeberM. The amount and timing of parent-adolescent sexual communication as predictors of late adolescent sexual risk-taking behaviors. J Sex Res. 2003;40(3):256–265.
23.
ParkesAHendersonMWightDNixonC. Is parenting associated with teenagers’ early sexual risk-taking, autonomy and relationship with sexual partners?Perspect Sex Reprod Health. 2011;43(1):30–40.
24.
FoxGLInazuJK. Patterns and outcomes of mother-daughter communication about sexuality. J Soc Issues. 1980;36(1):7–29.
25.
OrfalyRAFrancesJCCampbellPWhittemoreBJolyBKohH. Train-the-trainer as an educational model in public health preparedness. J Public Health Manag Pract. 2005;11(6):S123–S127.
26.
US Census Bureau. State and county QuickFacts 2008: small area income and poverty estimates. 2008. https://www.census.gov/quickfacts/. Accessed 2016.
GillmoreMRArchibaldMEMorrisonDM. Teen sexual behavior: applicability of the theory of reasoned action. J Marriage Fam. 2002;64(4):885–897.
29.
CollazoAA. Theory-based predictors of intention to engage in precautionary sexual behavior among Puerto Rican high school adolescents. J HIV/AIDS Prev Child Youth. 2004;6(1):91–120.
30.
KinsmanSBRomerDFurstenbergFFSchwarzDF. Early sexual initiation: the role of peer norms. Pediatrics. 1998;102(5):1185–1192.
31.
SieverdingJAAdlerNWittSEllenJ. The influence of parental monitoring on adolescent sexual initiation. Arch Pediatr Adolesc Med. 2005;159(8):724–729.
32.
FloresLYO’BrienKM. The career development of Mexican American adolescent women: a test of social cognitive career theory. J Couns Psychol. 2002;49(1):14.
33.
MarínBCoyleKKGómezCACarvajalSCKirbyDB. Older boyfriends and girlfriends increase risk of sexual initiation in young adolescents. J Adoles Health. 2000;27(6):409–418.
34.
TeitlerJOWeissCC. Effects of neighborhood and school environments on transitions to first sexual intercourse. Soc Educ. 2000;73:112–132.
35.
StantonBLiXBlackM. Sexual practices and intentions among preadolescent and early adolescent low-income urban African-Americans. Pediatrics. 1994;93(6):966–973.
36.
NahomDWellsEGillmoreMR. Differences by gender and sexual experience in adolescent sexual behavior: implications for education and HIV prevention. J Sch Health. 2001;71(4):153–158.
37.
WattsGFNagyS. Sociodemographic factors, attitudes, and expectations toward adolescent coitus. Am J Health Behav. 2000;24(4):309–317.
38.
CarvajalSCParcelGSBasen-EngquistK. Psychosocial predictors of delay of first sexual intercourse by adolescents. Health Psychol. 1999;18(5):443.
39.
SantelliJSKaiserJHirschLRadoshASimkinLMiddlestadtS. Initiation of sexual intercourse among middle school adolescents: the influence of psychosocial factors. J Adolesc Health. 2004;34(3):200–208.
CoyleKKirbyDBMarínBVGómezCAGregorichSE. Draw the line/respect the line: a randomized trial of middle school intervention to reduce sexual risk behaviors. Am J Public Health. 2004;94(5):843–851.
42.
CeneCWHaymoreLBEllisD. Implementation of the power to prevent diabetes prevention educational curriculum into rural African American communities: a feasibility study. Diabetes Educ. 2013;39(6):776–785.
43.
LaubyJSmithPStarkMPersonBAdamsJ. A community-level prevention intervention for inner city women: results of the women and infants demonstration projects. Am J Public Health. 2000;90(2):216–222.
44.
Basen-EngquistKMasseLCoyleK. Validity of scales measuring the psychosocial determinants of HIV/STD-related risk behavior in adolescents. Health Educ Res. 1999;14(1):25–38.
45.
JemmottJBJemmottLSBravermanPKFongGT. HIV/STD risk reduction interventions for African American and Latino adolescent girls at an adolescent medicine clinic: a randomized controlled trial. Arch Pediatr Adolesc Med. 2005;159(5):440–449.
46.
SiegelDMAtenMJRoghmannKJEnaharoM. Early effects of a school-based human immunodeficiency virus infection and sexual risk prevention intervention. Arch Pediatr Adolesc Med. 1998;152(10):961–970.
47.
WingoodGMDiClementeRJ. The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. Am J Pub Health. 1997;87(6):1016–1018.
48.
BrownLKHadleyWDonenbergGR. Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment. Psychiatr Serv. 2014;65(3):338–344.
49.
CaldwellCHRaffertyJReischlTMDe LoneyEHBrooksCL. Enhancing parenting skills among nonresident African American fathers as a strategy for preventing youth risky behaviors. Am J Community Psychol. 2010;45(1-2):17–35.
50.
DiiorioCMcCartyFResnicowKLehrSDenzmoreP. REAL men: a group-randomized trial of an HIV prevention intervention for adolescent boys. Am J Public Health. 2007;97(6):1084–1089.
51.
SchusterMACoronaRElliottMN. Evaluation of talking parents, healthy teens, a new worksite based parenting programme to promote parent-adolescent communication about sexual health: randomized controlled trial. BMJ. 2008;337:a308.
52.
ForehandRArmisteadLLongN. Efficacy of a parent-based sexual-risk prevention program for African American preadolescents: a randomized controlled trial. Arch Pediatr Adolesc Med. 2007;161(12):1123–1129.
53.
O’DonnellLStueveAAgronickG. Saving sex for later: an evaluation of a parent education intervention. Perspect Sex Reprod Health. 2005;37(4):166–173.
54.
MarkhamCMLormandDGloppenKM. Connectedness as a predictor of sexual and reproductive health outcomes for youth. J Adolesc Health. 2010;46(3):S23–S41.
TaylorRJMattisJChattersLM. Subjective religiosity among African Americans: a synthesis of findings from five national samples. J Black Psychol. 1999;25(4):524–543.
57.
AkersAYHollandCLBostJ. Interventions to improve parental communication about sex: a systematic review. Pediatrics. 2011;2010–2194.
58.
HutchinsonMKJemmottJBIIISweet JemmottLBravermanPFongGT. The role of mother–daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. J Adolesc Health. 2003;33(2):98–107.
59.
CokerALRichterDLValoisRFMcKeownREGarrisonCZVincentML. Correlates and consequences of early initiation of sexual intercourse. J Sch Health. 1994;64(9):372–377.
60.
LiXStantonBCottrellLBurnsJPackRKaljeeL. Patterns of initiation of sex and drug-related activities among urban low-income African-American adolescents. J Adolesc Health. 2001;28(1):46–54.
61.
DeVoreERGinsburgKR. The protective effects of good parenting on adolescents. Curr Opin Pediatr. 2005;17(4):460–465.
62.
HuebnerAJHowellLW. Examining the relationship between adolescent sexual risk-taking and perceptions of monitoring, communication, and parenting styles. J Adolesc Health. 2003;33(2):71–78.
