Parent-adolescent Sexual Health Communication Research Articles

Adolescent Pornography Exposure, Condom Use, and the Moderating Role of Parental Sexual Health Communication: Replication in a U.S. Probability Sample

ABSTRACT Following calls for an increase in replication studies in communication science as well as multiple other disciplines, the present study provides a direct replication of a pragmatically and theoretically important investigation of U.S. adolescents’ pornography exposure, parent-adolescent sexual health communication, and condomless sex published in this journal. Parent-adolescent sexual health communication has been suggested as a sexual risk-reduction mechanism, but condomless sex among U.S. adolescents is increasing. Simultaneously, pornography remains an extremely popular media genre and condomless sex is the norm in pornographic depictions. The findings of the present study replicated the findings of the original study, with the most notable replicated finding being an interaction between pornography exposure and parent-adolescent sexual health communication on the likelihood of condomless sex. Both in the original and present study, the association between U.S. adolescents’ pornography exposure and likelihood of condomless sex decreased as parental-adolescent sexual health communication increased. Results are discussed in terms of the challenges to examining these particular relationships among U.S. youth and the state of replication in the pornography effects literature.

Long-Acting Reversible Contraception for Adolescents: A Review of Practices to Support Better Communication, Counseling, and Adherence.

Long-acting reversible contraception (LARC) methods, including levonorgestrel and copper intrauterine devices (IUDs) and the subdermal contraceptive implant, are the most effective reversible forms of contraception and thus are an important aspect of adolescent pregnancy prevention. While LARC efficacy, safety, and appropriateness are supported by major medical organizations and usage rates are increasing, overall LARC uptake among United States (US) adolescents remains lower than uptake of short-acting contraceptive methods. A better understanding of the barriers affecting adolescent LARC uptake and reasons for discontinuation could help facilitate effective communication. For example, learning how to improve adolescent-centered communication, shared decision-making, and motivational counseling strategies may be the first step to improving utilization rates. This narrative review includes three sections. First, this review will describe the history, mechanisms of action, and epidemiology of adolescent LARC use in the US and globally. Next, this review will describe key factors influencing adolescent LARC uptake, reasons for discontinuation, and multilevel barriers specific to adolescent LARC use. Finally, this review will characterize communication techniques and LARC counseling strategies for adolescents in the context of a reproductive justice approach set in the health belief model framework. The distinction between moving away from a presumptive counseling approach towards an adolescent-centered, shared decision-making approach to encourage parent-adolescent sexual health communication to lay the foundation of empowering adolescent reproductive autonomy should be the underpinning of all effective reproductive communication strategies.

Exploring Parent-gender Differences in Parent and Adolescent Reports of the Frequency, Quality, and Content of Their Sexual Health Communication

ABSTRACT Parent-adolescent sexual health communication (SHC) is a protective factor that can reduce adverse adolescent sexual health outcomes, and the frequency, quality, and content of SHC predicts its effectiveness. However, research on this topic has been limited in scope, overwhelmingly focused on mothers; and often has only included the parent or adolescent perspective, not both members of the dyad. Using secondary cross-sectional data, this study used ANCOVA, logistic regression, correlational, and chi-square analyses to investigate parent-gender differences in parent-adolescent SHC. Participants included 341 parent-adolescent dyads. Compared to fathers, mothers rated parent-adolescent SHC as more important and more comfortable, and had greater self-efficacy for and fewer reservations about SHC than fathers. Mothers also reported talking more frequently and more broadly with their child about sexual health than fathers. Adolescent-reported frequency, quality, and content of parent-adolescent SHC did not differ significantly by parent gender, except for one sexual health topic. Dyadic analyses revealed that mothers and their children tended to agree more in their reports of parent-adolescent SHC than fathers and their children. These findings suggest that fathers may need additional resources to help them confidently engage in effective parent-adolescent SHC.

Associations between Parent-Child Communication on Sexual Health and Drug Use and Use of Drugs during Sex among Urban Black Youth.

Black youth and their families living in urban settings may experience unique stressors that contribute to underlying issues due to the environmental context. Such factors may exacerbate and promote drug use and engagement in risky sexual behaviors, unknowingly. Little is known about how family factors, peer pressure, condom use, and other related factors are associated with substance use and engaging in sexual behaviors while on drugs among urban African American youth aged 12–22 (N = 638). We used regression models to examine associations between parental bonding, parent–adolescent sexual health communication, condom use, peer pressure on substance use, and having sex while on drugs. Multivariate results indicated that parental bonding was statistically significant and associated with drug use (OR: 1.36, 95%CI: 1.36). Our study highlights that parental bonding plays a critical role in youth using drugs while living in urban environments.

Adolescent Condom Use, Parent-adolescent Sexual Health Communication, and Pornography: Findings from a U.S. Probability Sample

ABSTRACT Sexual scripts in pornography rarely include condoms. Many teenagers in the U.S. are exposed to pornography and have unprotected sex. Despite this, only a few studies have investigated whether greater pornography exposure is associated with condomless sex among U.S. teenagers, and these were conducted using clinical, convenience samples, many years ago, with data collections at a single location. This paper reports contemporary results on U.S. teenagers’ exposure to pornography, parent-adolescent sexual health communication, and condom use from the National Survey of Porn Use, Relationships, and Sexual Socialization (NSPRSS), a U.S. population-based probability study. Although the correlations were in the expected direction, neither pornography exposure nor parent-adolescent sexual health communication were related at the bivariate level to teenagers’ use of condoms. However, consistent with the sexual script acquisition, activation, application model (3AM) of sexual media socialization, pornography exposure interacted with parent-adolescent sexual health communication to predict condomless sex. Pornography exposure was associated with an increased probability of condomless sex only when parents engaged in little to no sexual health communication with their children. When parent-adolescent sexual health communication was high, pornography use was unrelated to teenagers’ engagement in condomless sex. These results are consistent with the public health position that pornography can be a risk factor for condomless sex, the theoretical position that the socializing impact of sexual media depends on consumers’ existing sexual scripts, and the pedagogical position that parent-adolescent sexual health communication can buffer youth against detrimental effects of sexual media.

A Review of Parent-Based Barriers to Parent–Adolescent Communication about Sex and Sexuality: Implications for Sex and Family Educators

Although adolescents' sexual health is generally better when parents and adolescents communicate about sex and sexuality, researchers have found parents can be reluctant to engage adolescents in conversations about those topics. To better understand why, we reviewed prior literature and identified four types of parent-based barriers to communication with adolescents about sex: limited sexual health knowledge, believing adolescents are not ready to discuss sex, discomfort discussing sex, and demographic factors. We then used the Theory of Planned Behavior to develop recommendations for how health educators can address these barriers, thereby increasing parent–adolescent sexual health communication.

Congruence in reported frequency of parent-adolescent sexual health communication: A study from Mexico.

Most studies on parent-adolescent sexual health communication come from developed countries and are based on either parents' or children's reports. In developing countries, there is little evidence about the agreement among reports of all parties involved in parent-adolescent sexual health communication. The objective of this study is to explore the congruence (agreement) between adolescents and their parents about how frequently they discuss on selected sexual health topics. A total of 1606 parent-adolescent dyads of adolescents attending the first year in public high schools and their parents, in Morelos, Mexico were sampled in this study. The participants completed a self-administered questionnaire that included the frequency of parent-adolescent communication about eight sexual health topics. An ordinal logistic threshold model was used to estimate intra-class correlation coefficients within parent-adolescent dyads (as a measure of congruence) and to test if thresholds were equal between parents and adolescents. Congruence in reported frequency of parent-adolescent sexual health communication ranged from 0.205 (menstruation) to 0.307 (condoms) for mother-adolescent dyads, and from 0.103 (ejaculation) to 0.380 (condoms) for father-adolescent dyads. The thresholds (i.e., the cutoff points that define the categories in the observed ordinal variable) differed between parents and adolescents for each of the sexual health topics explored (p<0.05 for father-adolescent dyads and p<0.001 for mother-adolescent dyads). Our findings suggest a low congruence between parents' and adolescents' reports on parent-adolescent sexual health communication. This might be due to interpretation of frequency and intensity of sexual health communication which differs between parents and adolescents.

Parent-adolescent Sexual Health Communication: Is Parent Knowledge of Adolescent Sexual Behavior a Marker of Communication Quality?

Parent-adolescent Sexual Health Communication: Is Parent Knowledge of Adolescent Sexual Behavior a Marker of Communication Quality?

Cost of Talking Parents, Healthy Teens: A Worksite-based Intervention to Promote Parent–Adolescent Sexual Health Communication

To examine the cost and cost-effectiveness of implementing Talking Parents, Healthy Teens, a worksite-based parenting program designed to help parents address sexual health with their adolescent children. We enrolled 535 parents with adolescent children at 13 worksites in southern California in a randomized trial. We used time and wage data from employees involved in implementing the program to estimate fixed and variable costs. We determined cost-effectiveness with nonparametric bootstrap analysis. For the intervention, parents participated in eight weekly 1-hour teaching sessions at lunchtime. The program included games, discussions, role plays, and videotaped role plays to help parents learn to communicate with their children about sex-related topics, teach their children assertiveness and decision-making skills, and supervise and interact with their children more effectively. Implementing the program cost $543.03 (standard deviation, $289.98) per worksite in fixed costs, and $28.05 per parent (standard deviation, $4.08) in variable costs. At 9 months, this $28.05 investment per parent yielded improvements in number of sexual health topics discussed, condom teaching, and communication quality and openness. The cost-effectiveness was $7.42 per new topic discussed using parental responses and $9.18 using adolescent responses. Other efficacy outcomes also yielded favorable cost-effectiveness ratios. Talking Parents, Healthy Teens demonstrated the feasibility and cost-effectiveness of a worksite-based parenting program to promote parent-adolescent communication about sexual health. Its cost is reasonable and is unlikely to be a significant barrier to adoption and diffusion for most worksites considering its implementation.

Coming of age: how young women in the Northwest Territories understand the barriers and facilitators to positive, empowered, and safer sexual health

Objectives. Compared to other young Canadians, youth in the Northwest Territories (NWT) suffer disproportionately from negative sexual health outcomes, including high rates of sexually transmitted infections and unintended pregnancies. This study aimed to identify the self-perceived barriers and facilitators to positive, empowered, and safer sexual health that impact female youth in the NWT.Study design and methods. A total of 12 females aged 15–19 who live in the NWT were recruited through purposive sampling to participate in semi-structured, face-to-face interviews. Inductive coding and thematic analysis of transcribed data occurred using Atlas.ti.Results. Overall 4 main themes influenced the sexual health of these women: sexual health knowledge, relationships with the self and others, access to quality sexual health resources, and alcohol use/abuse.Conclusion. Recommendations for future action include improving the content and delivery of sexual health education, enhancing parent–adolescent sexual health communication, providing workshops to empower young women to assert themselves within relationships, and supporting an environment that normalizes youth sexuality.

First Steps Toward Successful Communication About Sexual Health Between Adolescents and Parents in Mexico

In this article reporting on our qualitative study, we describe changes in parent-adolescent sexual health communication following an intervention for parents of 10th graders in Mexico. The intervention was aimed to sensitize and develop skills for appropriate parent-child communication about the prevention of sexually transmitted infections (STIs), unplanned pregnancy, and birth control, and focused on encouraging condom use with emergency contraception backup. We conducted 66 in-depth interviews with adolescents and parents after the intervention. Following the principals of grounded theory, we carried out inductive analysis to create codes and organize central themes. Our findings identify previously undefined critical steps or movements important for parent-child communication about sex. When parents are sensitized to the risks their adolescent children face, it is easier to initiate communication about prevention. These initial movements are essential to achieve substantive conversation, and must be considered in future strategies that aim to promote parent-adolescent communication about sexuality and the prevention of STIs and unplanned pregnancy.