Abstract
Purpose
To assess the effectiveness of interventions involving parents or carers intended
to improve the sexual health of their children.
Methods
Eleven databases were searched for evaluations of interventions with some parental
involvement and with outcomes related to the sexual health of the parents' children.
Studies had to be experimental, quasi-experimental, or of the before-and-after type.
Results were analyzed in a narrative systematic review, taking account of methodological
quality.
Results
We identified adequately robust evaluations of 44 programs, delivered in diverse settings.
In nearly all cases, the parenting component focused on improving parent–child communication
about sex. In general, where measured, parent–child interaction and adolescents' knowledge
and attitudes improved, but sexual behavior outcomes only improved in approximately
half the studies. Three programs in which the parenting component made up at least
one-fourth of the overall program were found, through randomized controlled trials,
to modify some aspect of adolescents' sexual behavior. All programs involved parents
for at least 14 hours, were community-based, and encouraged delayed sex.
Conclusions
Targeted programs with intensive parental involvement can modify adolescents' sexual
behavior, although the review was limited by the lack of rigorous evaluations. Few
programs addressed behavioral control, parent–child connectedness, or parental modeling,
all suggested by observational research.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Adolescent HealthAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Interventions to reduce unintended pregnancies among adolescents: Systematic review of randomised controlled trials.Br Med J. 2002; 324: 1426-1430
- Effectiveness of HIV prevention for youth in sub-Saharan Africa: Systematic review and meta-analysis of randomized and nonrandomized trials.AIDS. 2010; 24: 1193-1202
- Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: Final results of cluster randomised trial.Br Med J. 2007; 334: 133-135
- School based sex education: Evaluating teacher-delivered (SHARE) and peer-delivered (RIPPLE) programmes.in: Baker P. Guthrie K. Hutchinson C. Teenage Pregnancy and Reproductive Health. Royal College of Obstetricians and Gynaecologists, London, UK2007: 263-274
- Parent–child communication about sexuality: A review of the literature from 1980–2002.J HIV/AIDS Prev Educ Adolescents Child. 2003; 5: 7-28
- Family relationships and adolescent pregnancy risk: A research synthesis.Dev Rev. 2001; 21: 1-38
- Promoting positive adolescent sexual health and preventing teenage pregnancy—A review of recent effectiveness research.Crisis Pregnancy Agency, Dublin, Ireland2004
- Parent-child connectedness.ETR Associates, Santa Cruz, CA2004
- Helping parents in developing countries improve adolescents health.Department of Child and Adolescent Health and Development, Geneva, Switzerland2007
- Family influences on male sexuality: The mediational role of self restraint.Soc Dev. 1993; 4: 15-35
- Teenage family life, lifestyles, and lifechances.Int J Law Policy Fam. 1998; 12: 15-46
- Parental presence and adolescent reproductive health among the Nairobi.J Adolesc Health. 2003; 33: 369-377
- Parental influences on young people's sexual behaviour: A longitudinal analysis.J Adolesc. 2006; 29: 473-494
- The potential protective effects of youth assets from adolescent sexual risk behaviors.J Adolesc Health. 2004; 34: 356-365
- Ten years of longitudinal research on U.S. adolescent sexual behavior: Developmental correlates of sexual intercourse, and the importance of age, gender and ethnic background.Dev Rev. 2008; 28: 153-224
- Lone motherhood, employment and outcomes for children.Int J Law Policy Fam. 1996; 10: 233-249
- Mothers' influence on teen sex: Connections that postpone sexual intercourse, Vol 90.in: Center for Adolescent Health and Development, Minneapolis, MN2002: 1879-1884
- Family connectedness and sexual risk-taking among urban youth attending alternative high schools.Perspect Sex Reprod Health. 2003; 35: 174-179
- Maternal influence on the sexual behaviour of teenage daughters: Direct and indirect sources.J Fam Issues. 1980; 8: 81-102
- Maternal correlates of adolescent sexual and contraceptive behavior.Fam Plann Perspect. 1996; 28: 159-165
- Maternal discussion about pregnancy and adolescents' attitude toward pregnancy.J Adolesc Health. 2003; 33: 84-87
- The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: A prospective study.J Adolesc Health. 2003; 33: 98-107
- Connectedness as a predictor of sexual and reproductive health outcomes for youth.J Adolesc Health. 2010; 46: S23-S41
- Perceived parental monitoring and health risk behaviors among urban low-income African-American children and adolescents.J Adolesc Health. 2000; 27: 43-48
- When and where do youths have sex?.Pediatrics. 2002; 110: 66
- A good time-After school programme to reduce teen pregnancy.Child Trends, Washington, DC2004
- Adolescent sexual behaviour in two ethnic minority samples: The role of family variables.J Marriage Fam. 1999; 61: 85-90
- The impact of social status, family structure, and neighborhood on the fertility of black adolescents.Am J Sociol. 1985; 90: 825-855
- Factors associated with early sexual activity among urban adolescents.Soc Work. 1997; 42: 334-346
- The determinants of first sex by age of 14 in a high-risk adolescent population.Fam Plann Perspect. 1996; 28: 13-18
- Adolescent sexuality and parent-adolescent processes: Promoting healthy teen choices.J Adolesc Health. 2002; 31: 264-279
- Sexual behaviour in Britain: Early heterosexual experience.Lancet. 2001; 358: 1843-1850
- Health behaviour of Scottish school children: Technical report sexual health.University of Edinburgh, Edinburgh, UK1999
- Examining the relationship between adolescent sexual risk-taking and perceptions of monitoring, communication, and parenting styles.J Adolesc Health. 2003; 33: 71-78
- Parental attitudes to the occurrence of early sexual activity.J Marriage Fam. 1986; 48: 777-782
- Parenting practices and adolescent sexual behavior: A longitudinal study.J Marriage Fam. 2008; 70: 97-112
- The amount and timing of parent-adolescent sexual communication as predictors of late adolescent sexual risk-taking behaviors.J Sex Res. 2003; 40: 256-265
- Parent-adolescent communication about sex: The impact of content and comfort on adolescent sexual behavior.J HIV/AIDS Prev Child Youth. 2008; 9: 70-83
- Is parenting associated with teenagers' early sexual risk-taking, autonomy and relationship with sexual partners?.Perspect Sex Reprod Health. 2011; 43: 30-40
- The role of the family in preventing and intervening with substance use and misuse: A comprehensive review of family interventions, with a focus on young people.Drug Alcohol Rev. 2005; 24: 93-109
- Long-term effects of nurse home visitation on children's criminal and antisocial behavior: 15-year follow-up of a randomized trial.JAMA. 1988; 280: 1238-1244
- A pilot intervention to increase pilot-child communication about alcohol avoidance.J Alcohol Drug Educ. 2000; 45: 59-71
- Parenting early intervention pathfinder evaluation.Department for Children Schools and Families, London, UK2008
- What works in parenting support.Department for Education and Skills, London, UK2004
- The Healthy for Life Project: Sexual risk behavior outcomes.AIDS Educ Prev. 1998; 10: 128-148
- Impact of a school-based AIDS prevention program on risk and protective behavior for newly sexually active students.J Sch Health. 1995; 65: 145-151
- Impact of a school based AIDS prevention programme on young adolescents' self-efficiacy skills.Health Educ Res. 1995; 10: 329-344
- Does parental involvement make a difference?.AIDS Educ Prev. 1997; 9: 90-106
- Short-term impact of safer choices: A multicomponent school-based HIV, other STD, and pregnancy prevention program.J Sch Health. 1999; 69: 181-188
- Safer choices: Reducing teen pregnancy, HIV and STDS.Public Health Rep. 2001; 11: S82-S93
- Safer choices: A multicomponent school-based HIV/STD and pregnancy prevention program for adolescents.J Sch Health. 1996; 66: 89-94
- Economic evaluation of safer choices: A school based HIV, Sexually Transmitted Infections, and pregnancy prevention program.Arch Pediatr Adolesc Med. 2000; 154: 1017-1024
- A parent-adolescent intervention to increase sexual risk communication: Results of a randomized controlled trial.AIDS Educ Prev. 2008; 20: 371-385
- Sexual risk, attitudes and intentions of youth aged 12–14.Behav Med. 2004; 30: 155-161
- The Parent-Adolescent Relationship Education (PARE) Program: A curriculum for prevention of STDs and pregnancy in middle school youth.Behav Med. 2003; 29: 33-41
- Project taking charge: An evaluation of an adolescent pregnancy prevention program.Fam Relat. 1991; 40: 373-380
- Project taking charge −6-month follow-up of a pregnancy prevention program for early adolescents.Fam Relat. 1993; 42: 401-406
- Effects of a parent–child communications intervention on young adolescents' risk for early onset of sexual intercourse.Fam Plann Perspect. 2001; 33: 52-61
- Reducing the risk: Impact of a new curriculum on sexual risk-taking.Fam Plann Perspect. 1991; 23: 253-263
- A replication study of Reducing the Risk: A theory based sexuality curriculum for adolescents.J Sch Health. 1998; 68: 243-247
- An evaluation of an abstinence-only sex education curriculum: An 18-month follow-up.J Sch Health. 2006; 76: 414-422
- Evaluation of Choosing the Best.Institute for Research and Evaluation, Salt Lake City, Utah2005
- Evaluating the outcomes of parent–child family life education.An Int J. 1999; 13: 211-234
- Parent, adolescent FLE: An evaluation of five approaches.Fam Life Educ. 1985; 4: 12-15
- Effect of a program to facilitate parent-child communication about sex.Clin Pediatr. 1990; 29: 626-630
- Abstinence education for rural youth: An evaluation of the Life's Walk program.J Sch Health. 2003; 73: 264-270
- Final report of the let's talk program evaluation.ETR Associates, Scotts Valley, CA1993
- Evaluation of a sex education program for children and their parents: Attitude and interactional changes.Fam Coord. 1971; 21: 377-386
- The national evaluation of the Children's Aid Society-Carrera Model Programme to prevent teenage pregnancy.Philliber Research Associates, New York2001
- Preventing teenage pregnancy and improving health care access among teenagers: An evaluation of the Children's Aid Society–Carrera Programme.Perspect Sex Reprod Health. 2002; 34: 244-251
- Keepin' it R.E.A.L.!: Results of a mother-adolescent HIV prevention program.Nurs Res. 2006; 55: 43-51
- “They have opened our mouths”: Increasing women's skills and motivation for sexual communication with young people in rural South Africa.AIDS Educ Prev. 2008; 20: 504-518
- Efficacy of a parent-based sexual risk prevention program for African American pre-adolescents: A randomized controlled trial.Arch Pediatr Adolesc Med. 2007; 161: 1123-1129
- REAL Men: A group-randomized trial of an HIV prevention intervention for adolescent boys.Am J Public Health. 2007; 97: 1084-1089
- “Authors' reply.”.BMJ. 2008; 337: a1595
- Increasing parent involvement in youth HIV prevention: A randomized Caribbean study.AIDS Educ Prev. 2009; 21: 495-511
- Mothers' effectiveness as HIV risk reduction educators for their daughters.J Health Poor Underserved. 2006; 17: 218-239
- Helping mothers discuss sexuality and AIDS with adolescents.Child Dev. 2000; 71: 1383-1394
- Evaluating a peer intervention strategy for the promotion of sexual health-related knowledge and skills in 10- to 14-year-old girls.Am J Health Promot. 2008; 22: 275-281
- Girls incorporated preventing adolescent pregnancy: A development and research project.Girls Incorporated, New York, NY1991
- A comprehensive age phased approach: Girls incorporated.in: Miller B. Card J. Paikoff R. Peterson J. Preventing Adolescent Pregnancy: Models Programs and Evaluations. Sage Publications, Newbury Park, CA1992: 110-138
- Preventing HIV risk exposure in urban communities: The CHAMP family program.in: Pequegnat W. Szapocznik J. Working with Families in the Era of HIV. Sage Publications, Thousands Oaks, CA2000
- Family level impact of the CHAMP family program: A community collaborative effort to support urban families and to reduce youth HIV risk exposure.Fam Proc. 2004; 43: 70-93
- Sexuality education: An evaluation of programmes and their effects.ETR/Network, Santa Cruz, CA1984
- The plain talk implementation.Public/Private Ventures, Baltimore, MD2002
- Plain talk and adolescent sexual behaviour.Public/Private Ventures, Philadelphia, PA1999
- Adult communication and teen sex: Changing a community.Public/Private Ventures, Philadelphia, PA2001
- Evaluation of the parents as primary sexuality educators program.J Adolesc Health. 2005; 37: s94-s99
- Evaluation of a sex education program for parents of young children.J Sex Ther. 1986; 12: 32-36
- College sexuality education promotes future discussions about sexuality between former students and their children.J Sex Educ Ther. 1993; 19: 285-293
- Impact evaluation of facts and feelings—A home-based video sex-education curriculum.Fam Relat. 1993; 42: 392-400
- Sustaining and broadening intervention impact: A longitudinal randomized trial of 3 adolescent risk reduction approaches.Pediatrics. 2003; 111: e32-e38
- Randomized trial of a parent intervention: Parents can make a difference in long-term adolescent risk behaviors, perceptions, and knowledge.Arch Pediatr Adolesc Med. 2004; 158: 947-955
- Parental underestimates of adolescent risk behavior: A randomized, controlled trial of a parental monitoring intervention.J Adolesc Health. 2000; 26: 18-26
- Family/media approach to HIV prevention: Results with a home-based, parent-teen video program.Health Psychol. 1992; 11: 203-206
- Efficacy of a home-based human immunodeficiency virus prevention video for teens and parents.Health Educ Q. 1993; 20: 555-567
- Saving sex for later: An evaluation of a parent education intervention.Perspect Sex Reprod Health. 2005; 37: 166-173
- Efficacy of abstinence promotion media messages: Findings from an online randomized trial.J Adolesc Health. 2009; 45: 409-416
- A multimedia-based approach to increasing communication and the level of AIDS knowledge within families.J Community Psychol. 1990; 18: 361-373
- Impact evaluation of the “not me, not now” abstinence-oriented, adolescent pregnancy prevention communications program, Monroe County, New York.J Health Commun. 2001; 6: 45-60
- A psychoeducational group intervention to train parents to become sexuality educators for their children with mental retardation: An effectiveness study.Diss Abstr Int. 2004; : 64
- An evaluation of a community-based sexuality education program for individuals with developmental disabilities.Electron J Hum Sex. 2002; : 5
- Evaluation of an HIV/AIDS education program for family-based foster care providers.Ment Retard. 1996; 34: 75-82
- Addressing attribution through contribution analysis: Using performance measures sensibly.Can J Program Eval. 2001; 16: 1-24
- The impact of interventions designed to promote parent–child communication about sexuality.New Directions Child Adolesc Dev. 2002; 97: 93-110
- Randomized trials versus observational studies in adolescent pregnancy prevention.J Clin Epidemiol. 2000; 53: 167-174
- Chicago HIV and adolescent mental health project.National Institute of Mental Health, Bethseda, MA1992
- Plain talk: Addressing adolescent sexuality through a community initiative.Public/Private Ventures, Baltimore, MD1999
- Evaluation of Talking Parents, Healthy Teens, a new worksite based parenting programme to promote parent-adolescent communication about sexual health: Randomised controlled trial.BMJ. 2008; 337: a308
- Competence in early adult romantic relationships: A developmental perspective on family influences.J Pers Soc Psychol. 2000; 79: 224-237
Article info
Publication history
Published online: June 08, 2012
Accepted:
April 13,
2012
Received:
October 13,
2011
Identification
Copyright
© 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
