Concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents: a qualitative study

Adolescent Barriers to Sexual Communication with Their Parents: Differences by Sexual and Gender Identity

Parent-adolescent sexual communication has important health benefits for adolescents, yet not all families openly communicate about sex. In particular, adolescents often report various barriers to engaging in sexual communication with their parents. The purpose of this study was to address gaps in past research by examining barriers to communication with both mothers and fathers, separately, as well as to explore the unique barriers to communication among queer and trans adolescents. Participants were recruited via Instagram (n = 566; Mage = 16.0; 57.6% cisgender girls; 41.4% heterosexual). The most endorsed barrier to communicating with mothers was the adolescent believing they already knew enough about sexual topics. The most endorsed barrier for communicating with fathers was embarrassment. The least endorsed barriers included mother's lack of knowledge, and perceptions of anger from fathers when discussing sexuality. Several differences emerged by sexual and gender identity: cisgender girls and trans adolescents tended to agree more with barriers to communication with parents compared to cisgender boys. Additionally, queer adolescents tended to agree more with barriers to communication with parents than their heterosexual peers, although group differences depended on the particular barrier. These findings highlight specific barriers to parent-adolescent sexual communication faced by various groups of youth.

The effect of sexuality education based on the information, motivation, and behavioral skills model on improving the teachers' professional competence

Introduction

Professional competence is the basic need of teachers in effective sexuality education. Therefore, the aim of this study was to evaluate the impact of school-based sexuality education (SBSE) on teachers' professional competence (TPC), using the information, motivation, and behavioral skills (IMB) model, in boys' schools.

Methods

A randomized controlled field trial was conducted on 60 teachers who taught adolescents aged 11-19 years and were selected from 12 public boys' schools in Sari, northern Iran. Two groups (intervention and control) were assigned using a multi-stage stratified random sampling method. Researchers utilized a self-reported socio-demographic questionnaire and an IMB model-based questionnaire to assess the effects of the educational program. Four groups of 6-8 people underwent six 2-h training sessions based on an IBM model. Teachers were assessed before, immediately, and six weeks after the intervention to evaluate the outcome variables. The data were analyzed using the software SPSS-V19 and Chi-square test, Independent t-test, One-way ANOVA, and Repeated Measure ANOVA.

Results

There were no significant differences between intervention and control groups at the baseline in socio-demographic characteristics and TPC (p > 0.05). The mean scores of TPC in sexuality education in every three dimensions of knowledge (P = 0.001), skill (P = 0.002), and attitude (P = 0.007) were significantly higher in the intervention group than in the control group.

Conclusions

The results of this study show that by using the SBSE program based on the IMB model, the TPC for teaching sexual issues can be improved.

How Family Sex Talks Can Increase Daughters' Intentions to Engage in Sexual Health Protective Behavior: Mediating Roles of Parents' Direct and Indirect Sexual Communication

The family environment is essential but underused for promoting sexual and reproductive health protective behaviors (SHPB). However, previous literature had no consistent findings regarding how families can efficiently provide sex education and what aspects of family communication may facilitate SHPB. Based on family communication patterns theory (FCPT) and new research that segments family conformity orientation into four sub-dimensions (i.e., respecting parental authority, experiencing parental control, adopting parents' values, and questioning parents' beliefs), we explored the roles that family communication patterns (FCP) and parents' (direct and indirect) sexual communication play in influencing adult daughters' intentions to engage in SHPB. Using survey data from 234 female participants, path analysis suggested that daughters' SHPB intentions were associated with more direct and indirect sexual communication, higher conversation orientation, higher parental control, and less adoption of parental values. Also, parents' direct sexual communication mediated the impact of conversation orientation on SHPB intentions. Additionally, parents' indirect sexual communication mediated the path from parental value adoption to SHPB intentions, mitigating the negative direct impact of parental value adoption. Theoretical and practical implications are discussed.

Encouraging Parental Sexual Communication with Teen Sons: A Social Norms Experiment

Parent-child sexual communication is associated with myriad positive sex-related outcomes for young people, but these conversations tend to be infrequent and limited in scope. Using the Social Norms Approach, we hypothesized that learning that other parents talk with their children about sex-related topics would motivate parents to talk about more sex-related topics with their son. In an online experiment, parents in the United States (N = 378) with a son aged 13-16 were asked how many of 30 sex-related topics they had discussed with their son after exposure to one of the two SNA messages or a control. A 30-day follow-up study repeated these questions. The experiment revealed no significant differences between the three conditions, but all three conditions resulted in greater intentions to discuss more topics with their son in the future. Regardless of condition, parents who identify their sons as gay or bisexual talked about more sex-related topics than parents of sons who identify their sons as straight. The results from this study suggest that social norms messages are not more effective at increasing parents' communication intentions. Parents in all conditions planned to discuss more sex-related topics with their son, suggesting that simply bringing these topics to parents' attention may be enough to increase intentions to have these conversations. Findings are discussed in light of motivating and equipping parents to handle these conversations and tailoring educational materials for parents based on their child's sexual and romantic orientation.

Parents’ approaches to sexuality education of their adolescent boys: a qualitative study in Ahvaz, Iran

Background

Despite its important role in adolescent sexual health, sexuality education remains one of the most challenging responsibilities of families, especially those living in Muslim communities which experience the transition to modernity. There is little information about sexuality education of boys in Iran. This study aimed to explore parents’ approaches to sexuality education of adolescent boys in Ahvaz, southwest of Iran.

Methods

This qualitative study was conducted in 2017 in Ahvaz, Iran. Participants were selected through purposeful sampling with maximum variation. Qualitative data were collected by conducting semi-structured in-depth interviews and focused group discussions with 27 parents from middle/high social class who had adolescent boys aged between 10 and 19. Data were analyzed using conventional qualitative content analysis.

Results

Parents’ approaches to sexuality education of their boys emerged in six categories: Extreme monitoring and restricting; abstinence as the main content of sexuality education; struggling to establish peace and achieve tolerance; criticizing the cultural taboos; hoping for spontaneous learning; and uncertainty and confusion. The theme “Transition from tradition to modernity” emerged from these categories.

Conclusion

Parents’ approaches to sexuality education ranged from a restrictive traditional manner to approaches with some degree of modern attitudes. Parents are facing uncertainty and confusion regarding sexuality education. Abstinence is an underlying assumption in their sexuality education style. Educating parents through culturally-appropriate methods is a priority that is more acceptable at the policy level. Lack of understanding of the need for sexuality education of children in some parents can threaten the sexual health of children.

Children’s sexuality education has an important role in adolescent sexual behaviors and health. However, it is one of the most challenging dimensions of education in families, especially in Muslim communities experiencing the transition to modernity. There is little information about sexuality education of adolescent boys in Iran. In this study we aimed to explore parents’ experiences and perceptions of communicating sexuality education with their sons. Data were collected through individual interview with 11 parents and group discussion with 8 fathers and 8 mothers who had sons aged 10–19, living in Ahvaz, in south west of Iran. We summarized and categorized parents’ approaches to sexuality education in categories including: Extreme monitoring and restricting; abstinence as the main content of sexuality education; struggling to establish peace and achieve tolerance; criticizing the cultural taboos; hoping for spontaneous learning; and uncertainty and confusion. Parents’ approaches to sexuality education ranged from a restrictive traditional manner to some degree of modern conduct. Findings imply that parents are facing challenges regarding sexuality education: uncertainty about the necessity of it, and confusion between religious teachings and modernity. Abstinence is still a central assumption and pre-marital sex is off-limits in their sexuality education. They hoped that they could enhance the children’s adherence to family’s values regarding sexuality, by establishing a peaceful relationship with them. These findings provide evidence for culturally-appropriate educational programs for parents to improve their skills and knowledge about sexuality education. These findings highlighted the fact that Iranian parents are experiencing a “Transition from tradition to modernity”.

Comparing the effect of two educational interventions on mothers' awareness, attitude, and self-efficacy regarding sexual health care of educable intellectually disabled adolescent girls: a cluster randomized control trial

BACKGROUND

Sexual problems of intellectually disabled adolescents are associated with their inability to understand sexuality. Given the important role of parents in forming the attitude of their adolescents towards sexuality, the present study aimed to compare the effect of two educational interventions on mothers' awareness, attitude and self-efficacy regarding sexual health care of intellectually disabled adolescent girls.

MATERIALS AND METHODS

This cluster randomized control trial was conducted in six intellectually disabled adolescent education centers in Isfahan, Iran in 2018. The centers were randomly assigned to intervention groups (group training and training through booklet) and control group. Mothers of educable intellectually disabled adolescent girls (n = 81) were entered into the three groups using convenience sampling and their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls were assessed using questionnaires before and after the educational intervention. Data were analyzed using descriptive and inferential statistical methods.

RESULTS

The mean score of mothers' awareness, attitude and self-efficacy in each of the "group training", "training through booklet group" and "control group" was significantly different after the intervention compared to before the intervention (p < 0.05). The mean score of mothers' awareness and self-efficacy after the intervention in the "group training" was higher than the "control group" and "training through booklet group" (p < 0.001). The mean score of mothers' awareness and self-efficacy after the intervention in the "training through booklet group" was higher than in "control group" (p = 0.005, p = 0.02). Also, after the intervention, the mean score of mothers' attitude in the "group training" was higher than the "control group" and the "training through booklet group" (p < 0.001), but there was no significant statistical difference between the mean score of mothers' attitude in "control group" and "training through booklet group" (p > 0.05).

CONCLUSION

Implementation of the group training intervention for mothers of intellectually disabled adolescent girls in comparison with training through booklet was associated with a greater increase in their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls. Therefore, group training is suggested as a suitable way to educate mothers about sexual health care of intellectually disabled adolescent girls. Trial registration IRCT, IRCT20160224026756N5. Registered 22 June 2018, https://en.irct.ir/user/trial/31704/view .

Stakeholders' perspectives of comprehensive sexuality education in Iranian male adolescences

Background

A coherent sexuality education program for adolescents is part of their sexual and reproductive rights and can help them have a healthier future. Therefore, the aim of this study was to explore the perspectives and intervention preferences of Iranian stakeholders regarding comprehensive sexuality education (CSE) in male adolescents based on the IMB model (information, motivation, behavioral skills).

Methods

This study was a qualitative study that was analyzed through a directed content analysis approach. Individual interviews and focused group discussions (FGDs) were used for data collection. The data were collected through in-depth semi-structured interviews with stakeholders in two schools and the Education Department in Sari and the Ministry of Health and Ministry of Education in Tehran from March 2019 to August 2019. Data saturation was achieved after 28 interviews and 1 FGDs with 9 participants. Finally, two sets of data were coded and analyzed using directed content analysis.

Results

In this study, five themes emerged as (1) role of institutions; (2) role of organizations; (3) need for stakeholder’s partnership; (4) need for adolescent sexuality socialization management; and (5) need for enhancing the teachers’ professional competence, which seemed to influence the implementation of CSE in male adolescents. Participants also expressed a number of intervention preferences for CSE. The most important of these was the change in macro policies, helping to create a culture against all forms of violence and breaking the taboo of sexuality education for children and adolescents.

Conclusions

The results of this study revealed the need for a CSE program for adolescents' sexuality socialization. The finding showed that teachers required training to enhance their professional competence about sexuality issues. Therefore, it is necessary to design and implement culture-appropriate skill based programs to enhance the teachers’ professional competence regarding the adolescents’ sexual health.

Evaluation of effectiveness of a sexuality education program for parents of male adolescents: promoting of parent-adolescent sexual communication

Objectives Parents play a significant role in promoting of healthy sexuality in adolescents. The purpose of the present study was to assess the effectiveness of a sexuality education intervention program to enhance parent-adolescent sexual communication. Methods This study was a randomized controlled field trial. Parents of male adolescent aged 13-16 years were recruited from eight public all-boys high schools in Karaj, Iran. A multi-stage stratified random sampling method was used and 102 parents were assigned into intervention and control groups. The recruitment and data collection process lasted from February to November 2019. Self-report demographic questionnaire and six general parenting and parent-adolescent sexual communication measures were used to assess the impact of intervention. Sexuality education program was presented for the parents of intervention group, in the form of four weekly 2-h sessions. Parents were assessed at the baseline, within one week post-intervention, and three-month follow-up to evaluate the outcome variables. The data were analyzed using the Chi-square test, two-sample t-test, general linear model analyses, and Bonferroni test. Results In terms of parent-adolescent general communication, parental monitoring, parent-adolescent communication about sex-related topics, parent's sexual communication skills, parent's self-efficacy, and responsiveness to sexual communication. There were no significant differences between intervention and control groups at the baseline (p>0.05). Compared to controls, intervention parents reported more improvement in general communication across the time; however, significant differences were not observed regarding general communication and parental monitoring (p=0.94, p=0.95). Parents in the intervention group significantly differed from those in the control group for the mean scores of parent-adolescent communication about sex-related topics (p=0.04), parent's sexual communication skills (p=0.04), parent's self-efficacy (p=0.002), and responsiveness (p<0.001) to sexual communication at each follow-up. Conclusions We identified the educational program as a promising tool for improving parent-adolescent communication regarding sexuality-related issues. This program provides the evidence for implementation of parent-based sexuality education programs.