Issued Quarterly

June 2004

FR 7-3

06/04

ABSTRACT

IMPORTANCE OF COMMUNICATION ABOUT SEXUALITY BETWEEN PARENTS AND ADOLESCENTS

Prepared by:   Rachel Neal, Ph.D.

                        333 HES

                        CEFCS-OSU

                        Stillwater, OK 74078-6111

                        405-744-6231

                        nrachel@okstate.edu

Lederman, R. P., & Mian, T. S. (2003). The Parent-Adolescent Relationship Education (PARE) program: A curriculum for prevention of STDs and pregnancy in middle school youth. Behavioral Medicine, 29, 33-41.

OVERVIEW

Literature reports indicate that adequate family communication may delay the onset of adolescent sexual activity, cigarette smoking, and alcohol and marijuana use. Although there are many school-based sex education and STD prevention curricula, those that offer both knowledge and skill training to adolescents and their families are extremely rare.

The Parent-Adolescent Relationship Education (PARE) Program, designed for parents and middle school students, focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy, HIV, and other STDs. The program includes content about reproduction, STDs and AIDS, contraception, sex risks, and safe-sex behaviors. The course uses social learning and cognitive behavioral concepts to enhance decision-making, refusal, and resistance skills.

Recent research findings:

• Adolescents have the highest age-specific risk for many STDs and the highest age-specific proportion of unintended pregnancy in the United States.
• Researchers cite poor contraceptive use as a primary reason for high pregnancy rates in the United States.
• Only 52.8% of teens used a condom during their last intercourse.
• Approximately 4 in 10 girls become pregnant at least once before age 20.
• Younger teens are more likely to have a shorter interval between first and second births than older teens.
• Chlamydia and gonorrhea are the most common curable STDs among teens.
• It is common to see more than 5% of young men and 5-10% of young women infected with Chlamydia.

§         Of the more than 350,000 16- to 21-year-olds tested, more than 2:1,000 were HIV-infected, with rates among young African American women exceeding 5:1,000.

• African American women had the highest HIV infection rate of any group.

THE PROGRAM

The Parent-Adolescent Relationship Education (PARE) curriculum was developed to target youth aged 12-14 years, and encourage the involvement of parents in the education of their children. The curriculum is based on findings that teens, particularly early teens, need parental support and communication to develop healthy psychosocial and sexual behaviors and to counteract powerful pressures for unsafe behaviors. Parental behaviors, particularly attitudes and statements of approval and disapproval of preteen behaviors, determine to a great extent the attitudes held by preteens entering adolescence. It is expected that parental influence is greater in the preteen school years than in the high school years, when the peer group assumes more influence.

The PARE curriculum includes activities to personalize information about sexuality and reproduction, and provides training in problem solving, decision-making, and assertive communication skills. Practice opportunities are provided for applying these skills in difficult situations. Class sessions for parents and youth include content on adolescent development, reproductive changes during puberty, peer and media pressures, the consequences and responsibilities of sexual behavior, resistance training, role-playing, communication with peers and parents, practice exercises, and behavioral reinforcement, all important components of behavior change. In addition, abstinence, and methods to prevent pregnancy and STDs also were discussed. The course targets youth at a period when the greatest increase in initiation of sexual behavior occurs and focuses on strengthening family communication overall, particularly on teen sexuality.

The PARE program is a 4-week course that meets once each week. During the first half of each class session, parents and youth attend a 1 1/2-hour class separately; during the last half of each session, parents and youth attend a 1 1/2 hour class together. Each session includes a brief review of the prior session and builds upon that content to enhance communication. The second half of each session consists of a combined parent-adolescent education unit. During these classes, parents and teens have the opportunity to process together what they have learned independently and to practice their new skills. Role-playing opportunities are included in every joint parent-child experimental class session.

PARTICIPANTS

The participants in the project are 150 parent-child dyads recruited from 5 middle schools in 2 different school districts in southeast Texas. Parents and students in each school participate in one of 2 randomly assigned conditions: (1) an experimental treatment group (n = 75), or (2) an attention-control group (n = 75). The treatment group receives the social learning teaching approach described below, whereas the attention-control group receives similar factual content taught in a traditional didactic approach and without social learning exercises.

CONCLUSION

The research project on teen pregnancy and STD/HIV prevention and the PARE curriculum developed by project personnel is novel in several respects.

• The project targeted middle school youth (vs high school youth), and parents and students together in both separate and dyadic learning sessions.
• The program has a distinctive focus on family interaction and parent-teen communication skills.
• After school and early evening classes are offered for both parents and youth.
• Maintenance or booster sessions at 6-month intervals are provided after the initial intervention class series to review content and skills, reinforce prevention messages to reduce and manage risk, and foster continued parent-teen communication and interaction.

Of the 5 Centers for Disease Control approved programs for teen pregnancy and HIV/AIDS prevention, only 1 is for middle schools, and none use a joint parent-teen educational format.