Parents Of Males Research Articles

Call the experts: identifying stakeholders in the long-term care of youth with hypospadias.

Long-term follow-up for individuals with hypospadias remains a critical area of need, yet evidence-based guidelines for such follow-up are lacking, and the role of involvement of relevant experts is not yet established. Using our hypospadias-specific health-related quality of life conceptual framework and a subsequent qualitative study of prepubertal males and parents of males with hypospadias, we identified potential priorities for long-term follow-up of youth with hypospadias. Using thematic codes from our patient and parent interviews, we searched PubMed for relevant articles and identified the specialties represented by all the authors of these articles. Our search strategy revealed consistent expertise across HRQOL themes and subthemes, including pediatric and adult urology, health psychology, psychiatry, endocrinology, genetics, and social work. Communication experts, as well as patients and families, were also represented in our literature search. Using these findings, we compiled a comprehensive list of potential stakeholders to inform the development of holistic care guidelines for individuals with hypospadias. By engaging these stakeholders, we aim to develop consensus-based, long-term follow-up guidelines and tools to address the evolving physical and psychosocial needs of people with hypospadias over a lifetime. The use of qualitatively derived thematic codes to search for relevant literature is an accessible approach to identifying relevant stakeholders. These findings underscore the importance of involving diverse, multidisciplinary expertise to ensure comprehensive, patient-centered care in complex genitourinary conditions.

Parental regret following decision for sons to undergo elective post-neonatal circumcision

The reasons for performing a circumcision among males after the neonatal period are usually cultural or medical. We aimed to evaluate parental regret for providing consent and to identify factors associated with such regret. Included were the parents of males aged 6 months to 18 years who underwent circumcision under general anesthesia at a single center between 2/2017 and 01/2023. Those who underwent additional surgical procedures during the same session were excluded. Parents responded telephonically to the Decision Regret Scale (DRS) questionnaire. Regret was classified as none (0 points), mild (1-25) or moderate-to-strong (26-100). Surgical and demographic data were retrieved for comparison to DRS scores and identification of predictors of parental regret. In total, 201 of the 265 suitable patients met the inclusion criteria. Parents of 130 patients (65% response rate) whose average age was 5.06 (IQR 1.58,7.53) years completed the DRS questionnaire (study group). The average time since surgery was 41.8 (IQR 25.4,59.3) months. Forty surgeries were undertaken for cultural reasons and 90 for medical considerations. Eighteen parents reported regret (15 mild and 3 moderate-to-strong) for their decision to consent to their son's circumcision. The time from responding since surgery was the only significant variable in the DRS scores, with a 33-month gap predicting no regret (p=0.02 compared to shorter gaps). The reasons for circumcision did not significantly differ between the "regret" and "no-regret" groups (p=0.23). Our current investigation revealed a lower incidence of parental regret when compared to previous reports following distal hypospadias repair, likely attributable to the lower complication rate associated with circumcision. Our data reflect the experience of a single center in a country where neonatal male circumcision is routinely performed for cultural and religious reasons, thus precluding the generalization of our findings to places where post-natal circumcision is less commonplace. Consent to their son's post-neonatal circumcision was regretted by 13.8% of parents. Time since surgery significantly influenced the reduction of their negative attitudes.

The Impact of COVID-19 on Parental Perception of Oral Health-Related Quality of Life of Children: A Comparison of a Sample from Saudi Arabia and Kuwait.

OHRQoL was measured using a a validated Arabic version of the Child Oral Health Impact Profile (COHIP). Parents of children aged between 5 and 9 years were administered questionnaire during the COVID-19 pandemic. The responses were compared across the different domains of the questionnaire between the two countries using the Mann-Whitney U test. Differences were also tested between the parents of males and females separately in each city. The correlation of the COHIP scores with the age of the child was done using the Spearman's rho. No significant differences in overall COHIP scores were found between the parents in Riyadh and Kuwait City (p > 0.05). There were significant gender differences observed across domains in Kuwait (p = 0.030) but not in Riyadh (p = 0.295). There was also a significant negative correlation between the different COHIP domains in Kuwait but not Riyadh. There is a greater gender difference and age correlation of OHRQoL among the population studied in Kuwait City when compared to those in Riyadh.

Effects and Social Validation of Remote Parent Training and Implementation of the Cool Versus Not Cool Behavior Intervention

Adolescents with autism spectrum disorder (ASD) often experience challenges with social skill interactions that may affect their quality of life. Given that parents are often the most frequent and constant presence in their child’s life, parents serve a vital role in their child’s social and behavioral development. For this reason, children may substantially benefit from effective and efficient parent-implemented behavior intervention to teach social skills. Using a multiple-baseline design, the Cool versus Not Cool (CNC) behavior intervention was taught via telehealth to three parents of adolescent-aged males with ASD. Parents then subsequently implemented the CNC intervention to teach parent-selected social skills to their children. For all three parent–adolescent dyads, the CNC behavior intervention was implemented with fidelity by parents, and adolescents showed intervention gains. Findings maintained and generalized during probes and social validity outcomes reported by both parents and adolescents were favorable.

Sexual Function and Fertility in Males With Vascular Malformations of the Genitourinary Tract and Pelvis

Objectives: A subset of males with vascular malformations (VM) have involvement of their genitourinary (GU) tract. The purpose of this study was to survey males with VM to investigate whether patients with GU involvement experience problems with sexual function and fertility. Methods: An anonymous survey was designed based on modifications of Patient-Reported Outcomes Measurement Information System and International Index of Erectile Function surveys to examine sexual interest, function, satisfaction, and fertility. Surveys were sent electronically to 709 males 18 years or older (or parents of minor males under age 18) with VM through the Klippel-Trenaunay Support Group, the CLOVES Syndrome Community, and the Lymphangiomatosis & Gorham’s Disease Alliance. Results: Evaluable responses were received from 42 surveys (5.9%). Thirty-three of the 42 responses (79%) were from males with VM involving the GU tract (4.6% of surveys sent). Of the 33 with GU VM, 17 (52%) reported one or more problems including pain with masturbation and/or intercourse, bleeding with masturbation and/or intercourse, lack of interest in sex, and erectile dysfunction. Fourteen of 33 reported that they had fathered children. There was no statistically significant difference in these symptoms compared with responses from men with VM not involving the pelvis. Conclusion: Males with VM involving or not involving the GU system may experience problems with sexual function and satisfaction. While prospective studies are needed to clarify the prevalence and extent of these symptoms, providers should be aware that such symptoms can occur in this patient population.

Parents ASSIST: Acceptability and Feasibility of a Video-Based Educational Series for Sexuality-Inclusive Communication between Parents and Gay, Bisexual, and Queer Sons.

Young men who have sex with men (YMSM) between the ages of 13 and 24 are a key population for HIV prevention. The parents of gay, bisexual, and queer (GBQ) adolescent males and the sex communication they have with their sons has yet to be explored as an HIV prevention intervention. We developed an online video series called Parents ASSIST (Advancing Supportive and Sexuality-Inclusive Sex Talks) to educate parents about sexual health topics pertinent to GBQ males. We pilot tested the series with a sample of 54 parents of GBQ males using a single-group post-test design. Participants viewed the videos and completed a survey measuring the acceptability and feasibility of an online video series to educate parents. Most of the parents (70.4%) believed that the videos would make parents more likely to initiate talking about sex with their sons. The results suggest that online videos are an acceptable way for parents to learn about GBQ sexual health topics.

Parental stress and depression of children with learning disabilities: preliminary results from Crete

Abstract Past research has identified high levels of stress among parents of children with learning disabilities, which negatively affects children's well-being. The current presentation aims at reporting on parental stress experienced by individuals who utilised the newly introduced services of a mobile unit offering diagnostic and counselling services to children with learning difficulties in the region of Crete. Individuals in the current study represent a non-clinical sample from community settings across a region of 600.000 residents. More specifically, a university mobil unit was set in mid 2020 with funds raised by the Region of Crete, aiming at diagnosing learning difficulties in children aged 8-12yrs old as well as offering tailor-made biopsychosocial counselling to their families, at no cost. The mobil unit employs a pioneering child-in-environment perspective aiming to improve child's well-being through interventions targeting the family system. The staff consists of special education tutors, child and school psychologists, social workers, speech therapists and nurses offering a full range of diagnostic services, with up to date psychometric tools and literacy tests. Upon detection of stress/depression symptoms (Beck Anxiety Inventory,BAI; Beck Depression Inventory,BDI), parents receive a brief CBT or family therapy intervention of 4 sessions with a psychologist and/or a social worker via teleconference. Preliminary analysis of parental records (53 BDI,46 BAI) indicates 12 (22,6%) being above the cut off point for depression (7 mild to moderate, 5 moderate to severe) and 13 (28,2%) meeting the criteria for moderate anxiety disorder. 9 cases scored within the clinical range for both disorders. Symptoms of anxiety disorder were recorded only in parents of males. Comparisons between individuals with and without symptomatology will be presented in terms of personal and family profiles. The study has serious implications for health and educational policy. Key messages Coping with parental stress can be a challenge, but is also a skill that can be learned. Strength-based family support services should be considered at community level.

Feasibility and acceptability of a telehealth model for autism diagnostic evaluations in children, adolescents, and adults

AbstractThis study examined the feasibility and acceptability of a telehealth diagnostic model deployed at an autism center in the southwestern United States to safely provide autism spectrum disorder (ASD) diagnostic evaluations to children, adolescents, and adults during the COVID‐19 pandemic. Participants included all clients for whom a telehealth diagnostic evaluation was scheduled at the diagnostic clinic (n = 121) over a 6‐month period. Of 121 scheduled clients, 102 (84%) completed the telehealth evaluation. A diagnostic determination was made for 91% of clients (93 out of 102) using only telehealth procedures. Nine participants (two females; ages 3 to 11 years) required an in‐person evaluation. Responses from psychologist and parent acceptability surveys indicated the model was acceptable for most clients. Psychologist ratings suggested that telehealth modalities used in the current study may be less acceptable for evaluating school‐aged children with subtle presentations compared to children in the early developmental period, adolescents, and adults. Parents of females reported higher acceptability than parents of males. Findings contribute to the small but growing literature on feasibility and acceptability of telehealth evaluations for ASD and have implications for improving access to care during and after the COVID‐19 pandemic.Lay SummaryThis study described telehealth methods for evaluating children, adolescents, and adults for autism spectrum disorder. Telehealth methods were generally acceptable to psychologists conducting the evaluations and parents of diagnostic clients. Psychologists reported the methods to be less acceptable for school‐aged children and parents of males found the methods less acceptable than parents of females. The telehealth methods described may help to increase access to diagnostic professionals and reduce wait times for evaluations during and after the COVID‐19 pandemic.

Symptom profiles and correlates of anxiety and depression among parents of autistic girls and boys

BackgroundAlthough it has been reported for some time that parenting an autistic child is associated with elevated anxiety and depression, no direct comparison has been published regarding the relative anxiety and depressive states of parents of an autistic son versus an autistic daughter. AimsTo investigate the presence of differences in anxiety and depression in parents of autistic girls and boys, and to identify if there were any meaningful child-based correlates of those states. Methods and proceduresA sample of 51 parents of young autistic males (M age = 10.2 yr, SD = 2.8 yr, range to 6–17 yr) and 51 parents of autistic females (M age = 10.1 yr, SD = 2.7 yr, range to 6–17 yr) completed the GAD7 and PHQ9. Autistic children were assessed for IQ and autism severity. Outcomes and resultsAlthough there were no significant differences between the two sets of parents’ GAD7 or PHQ9 total scores, there were significant and meaningful differences at the individual GAD7 and PHQ9 item level. Moreover, when examined at the within-child-sex subgroup level, different aspects of the autistic sons’ and daughters’ age and IQ were correlated with specific items from the GAD7 and PHQ9. Conclusions and implicationsBecause these items were somatic in nature, implications are discussed for possible treatment strategies with these parents.

Exploring gender differences in infant motor development related to parent’s promotion of play

This study explored how parents’ promotion of play may impact gender differences in motor development of six-nine month old infants. Twenty-nine infants between six-nine months of age and their primary caregivers took part in assessments of anthropometry, motor development, video observations of play and a qualitative interview. Results revealed females had significantly higher scores for fine motor skills and significantly higher incidence of touching toys in an individual play scenario compared to males. Males had a higher intensity level of play during both play scenarios. Qualitative explorations found that parents perceived other adults such as surrounding family and friends to promote gender differences but not themselves; however, parents’ verbal interactions with infants did appear to differ by gender. Parents of males more frequently made statements to promote gross motor skills while parents of females more frequently made statements to promote fine motor skills. While biological influences are suggested to play a role on gender differences of motor development early in life, environmental explanations related to socialization, gender-differentiated expectations and experiences amplify these differences to a greater degree than may have been previously considered during this time period.

Parents ASSIST (Advancing Supportive and Sexuality-Inclusive Sex Talks): Iterative Development of a Sex Communication Video Series for Parents of Gay, Bisexual, and Queer Male Adolescents.

Effective parent-child sex communication enhances heterosexual youths' efficacy to engage in health promotive behaviors, yet there is scarce research on parent-child sex communication with gay, bisexual, and queer (GBQ) sons during adolescence. Our aim is to describe the development of Parents ASSIST, a web-based series of animated videos for parents of GBQ adolescent males focused on (a) parental education about sexual health topics pertinent to this population's same-sex concerns, (b) modeling of communication skills for parents to broach and sustain inclusive discussions at home, and (c) norming the role of providers as reliable sources of support when parents seek GBQ-related health information. Community-based advisory boards, comprised of parents and health care providers, respectively, informed the intervention development. Based on study notes and the research team's reflections, we present lessons learned that focus on content-based and logistical challenges that arose during the intervention development process. This study extends practice and patient education by providing an innovative, primary intervention that partners with parents of an underserved youth population.

Amputation Versus Staged Reconstruction for Severe Fibular Hemimelia: Assessment of Psychosocial and Quality-of-Life Status and Physical Functioning in Childhood.

Background:Fibular hemimelia, a congenital disorder characterized by the partial or complete absence of the fibula, tibial growth inhibition, and foot and ankle deformity and deficiency, is the most common deficiency of long bones. The purpose of the present study of children with congenital fibular hemimelia was to examine the functional and psychosocial outcomes at a minimum of 2 years after treatment either with amputation and a prosthesis or with reconstruction and lengthening.Methods:Twenty children who were managed with primary amputation were compared with 22 children who were managed with staged limb reconstruction. The average age of the patients at the time of evaluation was 9 years (range, 5 to 15 years). Patients and parents completed psychosocial, quality-of-life, and satisfaction surveys. Patients underwent instrumented gait analysis and a timed 25 or 50-yard dash. The number and nature of surgical procedures were recorded from a retrospective chart review.Results:Families of children managed with amputation had lower economic and educational levels and were more ethnically diverse compared with the families of children managed with limb reconstruction. Scores on psychosocial and quality-of-life surveys were comparable with those from healthy patient populations. Parents of males treated with amputation perceived a lower school-related quality of life for their child; socioeconomic and ethnic differences between groups might account for this finding. Statistically but not clinically significant differences were measured during instrumented gait analysis at a self-selected walking speed and during a timed 25 or 50-yard dash. The majority of patients and parents reported satisfaction with the treatment method selected and would select the same treatment method again.Conclusions:At this interim stage of growth, there were no significant functional or psychological differences between groups. Both groups were satisfied with the outcome in mid-childhood, irrespective of the selection of amputation or limb reconstruction.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Parents Speak: A Needs Assessment for Community Programming for Black Male Youth

Although adolescence can be a difficult developmental period for all children, negative environmental forces make this period particularly risky for many inner-city black males. As part of the Center for Healthy African American Men through Partnerships, this project is utilizing community-based participatory concepts to design and implement programs to address risk-taking behaviors among middle school black males. In 2014, parents of black males between the ages of 11 and 14years were recruited from an urban middle school to participate in focus group discussions. Letters were provided to the school to be mailed to parents inviting them to participate in discussion groups. Four focus groups were conducted. Data analyses were conducted fall 2014. Twenty-one parents participated. The major issue affecting the well-being and future success of young black males reported by parents was the lack of social support. Other areas of concern included negative peer pressure, bullying, violence, and lack of opportunities. Across groups, parents identified the lack of male parental presence in households and the subsequent perceived need by the young males to assume leadership roles, anger among the young males, and the lack of licensed counselors to address mental health issues as barriers to success and well-being. Parents emphasized the needs of the individual, family, and community for social support, positive role models, self-esteem, and respect. The present data can inform prevention programs designed to reduce disparities, such as educational underachievement, exposure to violence, and premature mortality experienced by black males. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Using Intervention Mapping to Develop and Adapt Two Educational Interventions to Increase HPV Vaccination Among Hispanic Adolescents

Background: HPV vaccination among Hispanic adolescents falls below the national goal. Tailored interventions to increase vaccination among Hispanic populations are needed to reach national goals and to reduce HPV-related cancer disparities. Aim: We used the intervention mapping (IM) framework to develop and adapt two educational interventions, a print fotonovela and a tailored interactive multimedia intervention (TIMI), targeting Hispanic parents of adolescents to increase HPV vaccine uptake. Methods: To develop the interventions, we followed IM steps 1-6 to 1) develop a logic model of the problem and identify modifiable factors associated with vaccination by conducting literature reviews, focus groups, and in-depth interviews with Hispanic parents; 2) develop behavioral outcomes, identify determinants, and develop a matrix of change objectives; 3) develop a program theme and program components, identify theoretical methods, and operationalize methods as practical applications; 4) develop an intervention design plan; 5) develop implementation strategies; and 6) evaluate the interventions. To adapt the interventions, we followed steps 1-6 for the new target population, Hispanic parents of adolescent males. Throughout the adaptation process, we assessed the outputs from the original intervention development process to identify needed adaptations. Results: Through formative research in step 1, we identified modifiable determinants associated with parental decision-making about vaccinating their daughters. In step 2, we crossed performance objectives with these factors to produce a matrix of change objectives that served as a blueprint for program development. We then identified tailoring and targeting, framing and anticipated regret, modeling, skill building, and education and counseling as theoretical methods to address the determinants and create behavior change. We produced two program components, a print fotonovela and TIMI, with the theme “For Our Daughters.” Our implementation plan identified lay health workers as implementers. A logic model of change guided evaluation planning. We later adapted the intervention content for parents of Hispanic adolescent males and changed the theme to “For Our Children.” We identified new knowledge gaps as parents were less informed about the HPV vaccine for males. We made surface adaptations including filming new scenes to produce a new fotonovela and TIMI. We conducted content analysis to ensure intervention messages corresponded to change objectives. Conclusion: IM provided a systematic methodology for program development and adaptation to produce two educational interventions to increase HPV vaccination among Hispanic adolescents. Tasks in each step built upon one another integrating findings from the literature, previous research, qualitative findings, and theory. The systematic process allowed us to develop messages and materials targeting factors beyond HPV knowledge or awareness to create behavior change.

Family Impact Module and Type 1 Diabetes

Introduction: The Pediatric Quality of Life Family Impact Module (FIM) measures different domains of family functioning. Its use in type 1 diabetes (T1D) has not been widely explored. The objective of this study is to assess if baseline demographics can predict the impact of T1D on family function as measured by FIM score. Methods: Parents of children with T1D completed the FIM during a medical appointment. Parents also completed the Holmes and Rahe (H and R) questionnaire as a measure of stressful life events. Results: The sample included 33 parents. The children (13 males), had a median age of 13.6 years (range: 5.7-20.7), median age at diagnosis of 7.9 years (range: 1-15), median diagnosis duration of 5 years (range: 1-16) and median A1c of 8.4% (range: 6.5-11.4). The median FIM total score was 73.3 (range: 16-100) and impact on function was strongly correlated with a higher H and R score (r= -0.44, p < 0.01 after excluding one outlier). Predictive characteristics were noted in some individual domains (univariate analysis, adjusting for H and R score): poorer outcomes in parent cognitive function (p=0.02) for those with a child with additional medical conditions, more communication challenges (p=0.003) for parents of males, and more worry (p=0.05) in parents with more than 1 child with T1D. Child’s gender, A1c, pump use, CGM use, age, age at diagnosis and disease duration were not significant predictors of total FIM score or FIM subscale scores. Conclusion: Although sample size is small, our results suggest more impact in specific domains of function for families with the following: a child with more than one medical condition, a male child, and multiple children with T1D. This requires further study. While no demographic data predicted total FIM score, the score did correlate with stressful life events. It is important to screen families for stressful life events as well as level of function. Future study will also include a larger sample size and collection of data from a local healthy community sample. Disclosure J. Ilkowitz: None. M. Gallagher: None. B. Lois: None. M.L. Pacheco: None. A. Zeleniuch-Jacquotte: None.

Using Intervention Mapping to Develop and Adapt Two Educational Interventions for Parents to Increase HPV Vaccination Among Hispanic Adolescents.

Introduction: Effective interventions to increase HPV vaccination are needed to reach national vaccination goals and to reduce later HPV-related cancer disparities. We used Intervention Mapping (IM) to develop and adapt a theory- and evidence-based educational intervention targeting parents of Hispanic adolescents to increase HPV vaccination.Methods: We followed IM steps 1–6 to: (1) develop a logic model and identify modifiable factors associated with vaccination among Hispanic adolescents by conducting literature reviews, focus groups, and in-depth interviews with Hispanic parents; (2) develop outcomes, write performance objectives, and develop a matrix of change objectives; (3) develop and identify a program theme, program components, theoretical methods, and practical applications; (4) develop an intervention design plan; (5) develop implementation strategies; and (6) develop an evaluation plan. We completed Steps 1–6 for to develop an intervention targeting parents of females, and we followed the steps again to adapt the program once HPV vaccine recommendations included males.Results: The program Por Nuestras Hijas (For Our Daughters) included two components: a print fotonovela and a tailored interactive multimedia intervention (TIMI). The program utilized the methods tailoring, targeting, framing, anticipated regret, modeling, skill building, and education and counseling to target the following determinants: parental knowledge, attitudes, self-efficacy, skills, perceived benefits/barriers, perceived susceptibility, perceived norms, and outcome expectations as modifiable factors influencing HPV vaccination. Lay health workers implemented the program in community clinics. A logic model of change guided evaluation planning. We later adapted the outcome and intervention content for parents of Hispanic adolescent males and changed the theme to Por Nuestros Hijos (For Our Children). Throughout the development and adaptation processes, we relied on theory, empirical evidence, and new data to make decisions.Discussion: IM provided a systematic methodology for program development and adaptation. Tasks in each step built upon one another integrating findings from the literature, previous research, qualitative findings, and theory to develop two educational programs for parents to increase HPV vaccination. The systematic process allowed us to develop messages and materials targeting factors beyond HPV knowledge or awareness to create behavior change.

Adolescents Spending Time Alone With Pediatricians During Routine Visits: Perspectives of Parents in a Primary Care Clinic

PurposeTo increase understanding of parental perspectives on time alone and of factors that influence adolescent communication with physicians in a pediatric clinic. MethodsThe sample consisted of 91 parents of adolescents aged 14–17 years who attended a well child visit at one primary care pediatric practice and completed a 2-week follow-up phone call as part of a larger study on adolescent health and communication. Parents reported whether their child met alone with the pediatrician, rated the importance of him or her having time alone with the physician, and responded to open-ended questions regarding barriers and facilitators of adolescent-physician communication. Bivariate and multivariate analyses tested associations of parent and adolescent characteristics with perceived parental importance of time alone. We conducted content analyses of responses to open-ended questions. ResultsSlightly more than half of parents (n = 53, 58%) indicated that it was “a lot” important for their adolescents to meet alone with the pediatrician; parents of males were more likely than parents of females to select this highest rating (73% vs. 43%, χ2(1) = 8.34, p = .004; adjusted odds ratio 4.88, 95% confidence interval 1.84–12.96). Responses to open-ended questions identified numerous adolescent, parent, and provider factors that parents perceived to influence adolescent-physician communication during well child visits, such as preparation for visit, rapport and familiarity with the pediatrician, privacy concerns, time alone with the pediatrician, emotional comfort, trust, and support. ConclusionsMost parents thought time alone was highly important for their own adolescent in a primary care setting, and parents described additional strategies to facilitate adolescent communication.

Direct-to-adolescent text messaging for vaccine reminders: What will parents permit?

BackgroundDirect-to-adolescent text messaging may be a consideration for vaccine reminders, including human papilloma virus (HPV), but no studies have explored the minimum age at which parents would allow adolescents to receive a text message. MethodsWe distributed a survey to parents of 10–17 year olds during any office visit in two practice based research networks in South Carolina and Oklahoma. We asked about parental preference for receiving vaccine reminders for their adolescent, whether they would allow the healthcare provider to directly message their adolescent, and if so, what would be the acceptable minimum age. ResultsIn 546 surveys from 11 practices, parents of females were more supportive of direct-to-teen text message reminders than were parents of males, (75% v. 60%, p < .001). The median age at which parents would allow direct text messages from physicians’ offices was 14 in females compared to 15 in males, p = .049. We found a correlation between the child’s age and the youngest age at which parents would allow a direct text message. Of the parents who permitted a text message directly to their adolescent, most reported an allowable age higher than their adolescent’s current age until the age of 15. ConclusionOur study suggests that direct-to-adolescent text messaging would be allowed by parents for older adolescents. This supports an intervention aimed at older adolescents, such as for receipt of MCV4 dose #2, delayed HPV vaccine series completion and annual influenza vaccination.

National Trends in Parental Human Papillomavirus Vaccination Intentions and Reasons for Hesitancy, 2010-2015.

Human papillomavirus (HPV) vaccination uptake remains lower than other recommended adolescent vaccines in the United States. Parental attitudes are important predictors of vaccine uptake, yet little is known about how they have changed over time. Participants included US residents aged 13-17 years with documented vaccination status who had received <3 doses of HPV vaccine whose parents responded to the National Immunization Survey-Teen, 2010-2015. Of the 76971 participants, 63.0% were male, 58.8% were non-Hispanic white, and 14.4 years was the median age. The percentage of unvaccinated teens decreased from 2010 to 2015, yet, annually, parents of unvaccinated teens of both sexes most often reported that they were "not likely at all" to vaccinate their teen. The percentage decreased significantly from 41.5% to 31.2% (P < .001) for parents of unvaccinated females from 2010 to 2015 but did not change among parents of males from 2012 to 2015. Conversely, parents of undervaccinated teens of both sexes reported higher and increasing vaccination intent over time. In 2015, nearly one-third of parents of unvaccinated teens reported that the vaccine was "not needed/necessary." Concerns about vaccine safety and side effects declined among parents of unvaccinated females but increased among parents of males (7.3% to 14.8%; P < .001). Although parental vaccination intent and knowledge improved over time, intent remains low and many parents still have significant concerns about HPV vaccination, even after series initiation. Multiple strategies are needed to improve series initiation and completion in the United States.

#MeToo, Statutory Rape Laws and the Persistence of Gender Stereotypes

In the late 1970’s and early 1980’s, feminists pushed for reform of statutory rape laws. At that time, states’ laws explicitly provided that only males could be charged with the crime of having sexual intercourse with a female below a certain age. The victims of statutory rape were always female. Feminists advocated that the law should be rewritten in gender-neutral terms. They hoped that formal equality in statutory rapes laws would lead to the recognition that both males and females have sexual agency and greater equality in society as a whole. Unfortunately, the prosecutorial discretion granted by the language of these laws perpetuate rather than abolishes traditional male/female stereotypes. In October 2017, a social movement erupted out of the unacceptable exercise by men of their power over female subordinates. The #MeToo movement exposed the widespread prevalence of sexual harassment, sexual abuse, and sexual violence that women experience in the workplace. The #MeToo movement’s objective is not dissimilar to the goal of proponents of gender-neutral statutory rape laws, which seek to have men and women treated equally. Unfortunately, #MeToo and state adoption of gender-neutral statutory rape laws share another phenomenon. Both the #MeToo movement and the practical enforcement of gender-neutral laws create a “victimology paradigm.” It seems that recognizing inequality among genders requires conceding perceived female frailties. Using the example of statutory rape laws, this article explains how movements for increased equality between men and women can fail to meet their stated goals. The article begins by exploring traditional statutory rape laws, which stereotypically gendered perpetrators and victims. It follows with a discussion of the political forces behind the nation-wide change to neutralize gendered statutes. The article dedicates significant attention to the flaws of gender-neutral statutory rape laws, which, by removing gender designations of victims and perpetrators, grant prosecutors unchecked discretion to choose which partner to charge in cases of mutual consent to the same prohibited conduct. Today prosecutors are three times more likely to charge males with statutory rape than they are to charge females with the crime. Parents of females’ alert authorities of prohibited sexual activity of their daughters at a rate that is largely disproportionate to that of parents of males. Prosecutorial stereotyping as it pertains to prohibited sexual intimacy between consenting teens has created an unfortunate return to the female-victim paradigm that proponents of gender-neutral statutory rape laws sought to erase. The article concludes with a recommendation for achieving a more balanced application of gender-neutral laws. Cultural movements can have unintended consequences. This article explains how the women’s rights movement’s campaign to neutralize gendered statutory rape laws failed to achieve its goal of an equal society. Today, a growing number of voices suggest that #MeToo, like the practical application of gender-neutral statutory rape laws, disempowers women. This article exposes the pernicious effects of the legislative shift to gender neutrality and explains how it serves as a cautionary tale to the #MeToo movement and the fight for workplace equality.