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Guilamo-Ramos V, Thimm-Kaiser M, Benzekri A. Paternal Communication and Sexual Health Clinic Visits Among Latino and Black Adolescent Males With Resident and Nonresident Fathers. J Adolesc Health 2023; 73:567-573. [PMID: 37330708 DOI: 10.1016/j.jadohealth.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/06/2023] [Accepted: 04/17/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Latino and Black adolescent males experience sexual health inequities, and their engagement in sexual health services remains low. Parents shape adolescent sexual health behavior and other youth outcomes. However, the role of Latino and Black fathers in promoting male adolescent sexual health is understudied, in part because about one in four fathers resides apart from their children and nonresident fathers are presumed to be less influential. We examined associations of paternal communication with sexual health service use and perceived paternal role modeling among Latino and Black adolescent males with resident and nonresident fathers. METHODS We recruited 191 Latino and Black adolescent males aged 15-19 years and their fathers in the South Bronx, New York City, using area sampling methods; dyads completed surveys. We estimated bivariate and adjusted associations of paternal communication with adolescent male sexual health service use and perceived paternal role modeling using logistic and linear regressions. Effect measure modification by paternal residence was assessed. RESULTS A unit increase on a five-point paternal communication scale was associated with approximately twice and 1.7 times the likelihood of clinical sexual health service use during adolescent males' lifetime and in the past 3 months, respectively; there was no significant effect measure modification by paternal residence. Paternal communication was associated with increased levels of perceived paternal role modeling and usefulness of paternal advice, with stronger associations for nonresident fathers. DISCUSSION Both resident and nonresident Latino and Black fathers warrant greater consideration as partners in promoting male adolescent sexual health service use.
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Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina; School of Nursing, Duke University, Durham, North Carolina; Department of Family Medicine and Community Health, Department of Infectious Diseases, School of Medicine, Duke University, Durham, North Carolina; Presidential Advisory Council on HIV/AIDS, US Department of Health and Human Services, Washington, D.C..
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina; School of Nursing, Duke University, Durham, North Carolina
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina; School of Nursing, Duke University, Durham, North Carolina
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Guilamo-Ramos V, Benzekri A, Thimm-Kaiser M. Evaluating the efficacy of an online, family-based intervention to promote adolescent sexual health: a study protocol for a randomized controlled trial. Trials 2023; 24:181. [PMID: 36906589 PMCID: PMC10008101 DOI: 10.1186/s13063-023-07205-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/28/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Adolescents in the U.S. experience significant negative sexual health outcomes, representing a public health priority in the U.S. Research shows that while parents play an influential role in shaping adolescent sexual behavior, surprisingly few programs engage parents in existing programming. Moreover, most efficacious parent-based programs focus on young adolescents, and few utilize delivery mechanisms that facilitate broad reach and scale-up. To address these gaps, we propose to test the efficacy of an online-delivered, parent-based intervention adapted to address both younger and older adolescent sexual risk behavior. METHODS In this parallel, two-arm, superiority randomized controlled trial (RCT), we propose to evaluate Families Talking Together Plus (FTT+), an adaptation of an existing and efficacious FTT parent-based intervention, in shaping sexual risk behavior among adolescents aged 12-17 and delivered via a teleconferencing application (e.g., Zoom). The study population will include n=750 parent-adolescent dyads recruited from public housing developments in the Bronx, New York. Adolescents will be eligible if they are between the ages of 12 and 17 years of age, self-report as Latino and/or Black, have a parent or primary caregiver, and are South Bronx residents. Parent-adolescent dyads will complete a baseline survey, after which they will be assigned to either the FTT+ intervention condition (n=375) or the passive control condition (n=375) in a 1:1 allocation ratio. Parents and adolescents in each condition will complete follow-up assessments 3 and 9 months post-baseline. The primary outcomes will include sexual debut and ever sex, and the secondary outcomes will include the frequency of sex acts, number of lifetime sexual partners, number of unprotected sex acts, and linkage to health and educational/vocational services in the community. We will utilize intent-to-treat analyses of 9-month outcomes and single degree of freedom contrasts comparing the intervention to the control group for primary and secondary outcomes. DISCUSSION The proposed evaluation and analysis of the FTT+ intervention will address gaps in the current cadre of parent-based programs. If efficacious, FTT+ would represent a model for scale-up and adoption of parent-based approaches designed to address adolescent sexual health in the U.S. TRIAL REGISTRATION ClinicalTrials.gov NCT04731649. Registered on February 1, 2021.
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Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, NC USA
- School of Nursing, Duke University, 307 Trent Dr, Durham, NC 27710 USA
- School of Medicine, Department of Family Medicine and Community Health, Department of Infectious Diseases, Duke University, 40 Duke Medicine Circle, Durham, NC USA
- Presidential Advisory Council on HIV AIDS, U.S. Department of Health and Human Services, Washington, D.C., USA
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, NC USA
- School of Nursing, Duke University, 307 Trent Dr, Durham, NC 27710 USA
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, NC USA
- School of Nursing, Duke University, 307 Trent Dr, Durham, NC 27710 USA
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Richards A, Raymond-Flesch M, Hughes SD, Zhou Y, Koester KA. Lessons Learned with a Triad of Stakeholder Advisory Boards: Working with Adolescents, Mothers, and Clinicians to Design the TRUST Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:483. [PMID: 36980041 PMCID: PMC10047518 DOI: 10.3390/children10030483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023]
Abstract
Optimal care for pediatric and adolescent patients is carried out under a triadic engagement model, whereby the patient, caregiver, and clinician work in collaboration. Seeking input from all triad members in the development and implementation of clinical trials and interventions may improve health outcomes for children and adolescents. Sufficient evidence demonstrating how to effectively engage stakeholders from all branches of this triadic model is lacking. We address this gap by describing the successes and challenges our team has encountered while convening advisory groups with adolescent patients, parent stakeholders, and their clinicians to assist in the development and deployment of a technology-based intervention to promote the utilization of sexual and reproductive health services by increasing adolescent-clinician alone-time. Each stakeholder group contributed in unique and complementary ways. Working with advisors, our team aligned the priorities of each group with the goals of the research team. The results were improvements made in the content, design, and delivery of the TRUST intervention. While we were largely successful in the recruitment and engagement of adolescent patients and clinicians, we had less success with parents. Future research will need to explore additional strategies for recruitment and engagement of parents, particularly in rural, minority, and underserved communities.
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Affiliation(s)
- Alexis Richards
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California San Francisco, San Francisco, CA 94107, USA
| | - Marissa Raymond-Flesch
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94107, USA
| | - Shana D. Hughes
- Vitalant Research Institute and Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94105, USA
| | - Yinglan Zhou
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA 94158, USA
| | - Kimberly A. Koester
- Department of Medicine, Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA 94158, USA
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Willoughby JF, Guilamo-Ramos V. Designing a Parent-based National Health Communication Campaign to Support Adolescent Sexual Health. J Adolesc Health 2022; 70:12-15. [PMID: 34756519 DOI: 10.1016/j.jadohealth.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Jessica Fitts Willoughby
- Edward R. Murrow College of Communication, Washington State University, Pullman, Washington; Committee on Prevention and Control of Sexually Transmitted Infections in the United States, National Academies of Sciences, Engineering, and Medicine, Washington, DC.
| | - Vincent Guilamo-Ramos
- Committee on Prevention and Control of Sexually Transmitted Infections in the United States, National Academies of Sciences, Engineering, and Medicine, Washington, DC; Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, North Carolina; US Presidential Advisory Council on HIV/AIDS, US Department of Health and Human Services (HHS), Washington, DC
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Rogers AA, Padilla-Walker LM, Hurst JL. Development and Testing of the Parent-Child Sex Communication Inventory: A Multidimensional Assessment Tool for Parent and Adolescent Informants. JOURNAL OF SEX RESEARCH 2022; 59:98-111. [PMID: 32660280 DOI: 10.1080/00224499.2020.1792398] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Parent-child sex communication is a complex and multidimensional construct, and effective measurement tools that reflect this complexity are scarce. The purpose of this study was to develop and test an assessment tool of parent-child sex communication that reflects the multidimensional nature of the construct and which can be flexibly administered between both parent and adolescent informants. Using two large national samples from the United States involving adolescents (N = 2,044; Mage = 16.19, SD = 1.71) and unrelated parents of adolescents (N = 2,081), we psychometrically tested the Parent-Child Sex Communication Inventory (PCSCI). Validity evidence (i.e., construct, discriminant, convergent, and divergent) supported a 30-item measure that consisted of three overarching dimensions distributed along seven subscales: Frequency of sex communication (about sexual risk, about sex physiology, and about the positive aspects of sex); the Quality of sex communication (open communication versus parent controlled communication); and Child Managed sex communication (involving disclosure and secrecy). The PCSCI is an assessment tool for tapping multiple fundamental dimensions of parent-child sex communication that is quick and easy to administer. Further, it can be administered to both parent and adolescent informants. Therefore, it represents a significant methodological advancement for continuing research on parent-child sex communication.
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Guilamo-Ramos V, Thimm-Kaiser M, Prado GJ. Parent-Based Sexual Health Promotion and Sexually Transmitted Infections Prevention for Youth. JAMA Pediatr 2021; 175:1100-1102. [PMID: 34369974 DOI: 10.1001/jamapediatrics.2021.2429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Vincent Guilamo-Ramos
- School of Nursing, Duke University, Durham, North Carolina.,Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina
| | - Guillermo J Prado
- School of Nursing and Health Studies, University of Miami, Miami, Florida
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Santa Maria D, Markham C, Misra SM, Coleman DC, Lyons M, Desormeaux C, Cron S, Guilamo-Ramos V. Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake. BMC Public Health 2021; 21:585. [PMID: 33761920 PMCID: PMC7992324 DOI: 10.1186/s12889-021-10534-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement. METHODS Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11-14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level. RESULTS Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period. CONCLUSION A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02600884 . Prospectively registered September 1, 2015.
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Affiliation(s)
- D Santa Maria
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA.
| | - C Markham
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, USA
| | - S M Misra
- Baylor College of Medicine, Texas Children's Hospital, 8080 North Stadium Drive, Suite 250, Houston, TX, USA
| | - D C Coleman
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA
| | - M Lyons
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA
| | - C Desormeaux
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - S Cron
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - V Guilamo-Ramos
- Center for Latino Adolescent and Family Health, New York University, New York, NY, USA
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Shegog R, Armistead L, Markham C, Dube S, Song HY, Chaudhary P, Spencer A, Peskin M, Santa Maria D, Wilkerson JM, Addy R, Tortolero Emery S, McLaughlin J. A Web-Based Game for Young Adolescents to Improve Parental Communication and Prevent Unintended Pregnancy and Sexually Transmitted Infections (The Secret of Seven Stones): Development and Feasibility Study. JMIR Serious Games 2021; 9:e23088. [PMID: 33502323 PMCID: PMC7875699 DOI: 10.2196/23088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/03/2020] [Accepted: 11/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Early adolescent unintended pregnancy and sexually transmitted infection prevention are significant public health challenges in the United States. Parental influence can help adolescents make responsible and informed sexual health decisions toward delayed sexual debut; yet parents often feel ill equipped to communicate about sex-related topics. Intergenerational games offer a potential strategy to provide life skills training to young adolescents (aged 11-14 years) while engaging them and their parents in communication about sexual health. Objective This study aims to describe the development of a web-based online sexual health intergenerational adventure game, the Secret of Seven Stones (SSS), using an intervention mapping (IM) approach for developing theory- and evidence-based interventions. Methods We followed the IM development steps to describe a theoretical and empirical model for young adolescent sexual health behavior, define target behaviors and change objectives, identify theory-based methods and practical applications to inform design and function, develop and test a prototype of 2 game levels to assess feasibility before developing the complete 18-level game, draft an implementation plan that includes a commercial dissemination strategy, and draft an evaluation plan including a study design for a randomized controlled trial efficacy trial of SSS. Results SSS comprised an adventure game for young adolescent skills training delivered via a desktop computer, a text-based notification system to provide progress updates for parents and cues to initiate dialogue with their 11- to 14-year-old child, and a website for parent skills training and progress monitoring. Formative prototype testing demonstrated feasibility for in-home use and positive usability ratings. Conclusions The SSS intergenerational game provides a unique addition to the limited cadre of home-based programs that facilitate parent involvement in influencing young adolescent behaviors and reducing adolescent sexual risk taking. The IM framework provided a logical and thorough approach to development and testing, attentive to the need for theoretical and empirical foundations in serious games for health.
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Affiliation(s)
- Ross Shegog
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Sara Dube
- The Widen Lab, University of Texas at Austin, Austin, TX, United States
| | - Hsing-Yi Song
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Pooja Chaudhary
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Angela Spencer
- Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Washington, DC, United States
| | - Melissa Peskin
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Diane Santa Maria
- School of Nursing, University of Texas Health Science Center Houston, Houston, TX, United States
| | - J Michael Wilkerson
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Robert Addy
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Susan Tortolero Emery
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
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Aventin Á, Gough A, McShane T, Gillespie K, O'Hare L, Young H, Lewis R, Warren E, Buckley K, Lohan M. Engaging parents in digital sexual and reproductive health education: evidence from the JACK trial. Reprod Health 2020; 17:132. [PMID: 32854734 PMCID: PMC7450800 DOI: 10.1186/s12978-020-00975-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/06/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Research evidence and international policy highlight the central role that parents play in promoting positive sexual behaviour and outcomes in their children, however they can be difficult to engage in sexual and reproductive health (SRH) education programmes. Digital health promotion that uses online and mobile technologies (OMTs) to promote parent-child communication may offer an innovative solution to reach parents, however, few programmes have used OMTs to involve parents in SRH, and none have reported lessons learned in relation to optimising engagement. This study addresses this gap in the literature by reporting acceptability and feasibility of using OMTs to engage parents in SRH education. Findings will be relevant for those wishing to develop and implement digital SRH programmes with parents internationally. METHODS The Jack Trial is a UK-wide cluster randomised controlled trial recruiting over 8000 adolescents from 66 socially and religiously diverse post-primary schools. An embedded mixed-methods process evaluation explored user engagement with parent components of the If I Were Jack SRH education programme, which include online animated films and a parent-teen homework exercise. RESULTS A total of 109 adolescents, teachers, parents and SRH policy experts took part in semi-structured interviews and focus groups, 134 parents responded to an online survey, and 3179 adolescents completed a programme engagement and satisfaction questionnaire. Parents who accessed the materials were positive about them; 87% rated them as 'good or excellent' and 67% said they helped them have conversations with their child about SRH. Web analytics revealed that 27% of contacted parents accessed the digital materials, with 9% viewing the animated films. Only 38% of teachers implemented the homework exercise, mainly because they assumed that students would not complete it or it might result in backlash from parents. CONCLUSIONS While digital parental materials show promise for engaging parents in SRH education, this study suggests that in order to optimise engagement, parental components that give parents the necessary skills to have conversations with their children about sex should be coupled with efforts to increase school and teacher confidence to communicate with parents on sensitive topics. TRIAL REGISTRATION ISRCTN99459996 .
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Affiliation(s)
- Áine Aventin
- School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Aisling Gough
- School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Theresa McShane
- School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Kathryn Gillespie
- School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Liam O'Hare
- School of Social Sciences, Education and Social Work and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Honor Young
- School of Social Sciences, Cardiff University, Cardiff, Wales, UK
| | - Ruth Lewis
- MRC/CSO Social and Public Health Sciences Unit, Univeristy of Glasgow, Glasgow, Scotland, UK
| | - Emily Warren
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, England, UK
| | - Kelly Buckley
- School of Social Sciences, Cardiff University, Cardiff, Wales, UK
| | - Maria Lohan
- School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, Northern Ireland, UK
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Guilamo-Ramos V, Hidalgo A, Keene L. Consideration of Heterogeneity in a Meta-analysis of Latino Sexual Health Interventions. Pediatrics 2020; 146:e20201406. [PMID: 32522784 PMCID: PMC7329254 DOI: 10.1542/peds.2020-1406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, New York University, New York, New York;
- Adolescent AIDS Program, Children's Hospital at Montefiore Medical Center, Bronx, New York; and
- Presidential Advisory Council on HIV/AIDS, Washington, District of Columbia
| | - Andrew Hidalgo
- Center for Latino Adolescent and Family Health, New York University, New York, New York
| | - Lance Keene
- Center for Latino Adolescent and Family Health, New York University, New York, New York
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Guilamo-Ramos V, Benzekri A, Thimm-Kaiser M, Dittus P, Ruiz Y, Cleland CM, McCoy W. A Triadic Intervention for Adolescent Sexual Health: A Randomized Clinical Trial. Pediatrics 2020; 145:e20192808. [PMID: 32345685 PMCID: PMC7193976 DOI: 10.1542/peds.2019-2808] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES In this study, we evaluate the efficacy of Families Talking Together (FTT), a triadic intervention to reduce adolescent sexual risk behavior. METHODS Adolescents aged 11 to 14 and their female caregivers were recruited from a pediatric clinic; 900 families were enrolled; 84 declined. Families were randomly assigned to FTT or 1 of 2 control conditions. The FTT triadic intervention consisted of a 45-minute face-to-face session for mothers, health care provider endorsement of intervention content, printed materials for families, and a booster call for mothers. The primary outcomes were ever having had vaginal intercourse, sexual debut within the past 12 months, and condom use at last sexual intercourse. Assessments occurred at baseline, 3 months post baseline, and 12 months post baseline. RESULTS Of enrolled families, 73.4% identified as Hispanic, 20.4% as African American, and 6.2% as mixed race. Mean maternal age was 38.8 years, and mean adolescent grade was seventh grade. At the 12-month follow-up, 5.2% of adolescents in the experimental group reported having had sexual intercourse, compared with 18% of adolescents in the control groups (P < .05). In the experimental group, 4.7% of adolescents reported sexual debut within the past 12 months, compared with 14.7% of adolescents in the control group (P < .05). In the experimental group, 74.2% of sexually active adolescents indicated using a condom at last sexual intercourse, compared with 49.1% of adolescents in the control group (P < .05). CONCLUSIONS This research suggests that the FTT triadic intervention is efficacious in delaying sexual debut and reducing sexual risk behavior among adolescents.
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Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, New York University, New York, New York;
- Adolescent AIDS Program, Children's Hospital at Montefiore Medical Center, Bronx, New York
- Presidential Advisory Council on HIV/AIDS, Washington, District of Columbia
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, New York University, New York, New York
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, New York University, New York, New York
- Department of Epidemiology and Biostatistics, School of Public Health and Health Policy, The City University of New York, New York, New York
| | - Patricia Dittus
- Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yumary Ruiz
- Center for Latino Adolescent and Family Health, New York University, New York, New York
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | | | - Wanda McCoy
- Morris Heights Health Center, Bronx, New York
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