Program

Oct 16, 2012

OVERVIEW

Families Talking Together is a parent-based intervention program focused on improving parent-child communication and parental monitoring, with the goal of delaying sexual initiation and preventing risky sexual behavior among middle-school-aged, inner-city youth.

An experimental evaluation comparing Families Talking Together with a control group found positive impacts on sexual initiation and sexual frequency; specifically, the 9-month follow-up found that those in the Families Talking Together group were less likely to initiate sexual intercourse and, among those who had already initiated sexual intercourse, had less frequent sexual intercourse. The adolescents in the Families Talking Together group were also less likely to have oral sex (though this impact was only marginally significant).

A second evaluation compared Families Talking Together with an adolescent-only program called Making a Difference! and a combined Families Talking Together and Making a Difference! intervention.  There were no differences between intervention groups in sexual initiation at the 12-month follow-up or, among those who had initiated sex, in frequency of sex.  However, those in the Families Talking Together group and the combined group had higher reports of maternal monitoring, expertise, and trustworthiness as well as higher reports of satisfaction with the mother-adolescent relationship.

DESCRIPTION OF PROGRAM

Target population: Middle-school-aged, inner-city, Latino and black adolescents and their mothers.
Families Talking Together consists of a brief, initial facilitator-led session (or sessions) with the mothers.  At the completion of this session, the mothers are provided with a manual that includes modules geared towards improving parent-adolescent communication and monitoring strategies that might work to delay sexual initiation.  These modules include the following topics: adolescent development and self-esteem; parental self-efficacy to communicate; strategies for reducing adolescent sexual risk-taking; strategies for improving the parent-adolescent relationship; adolescent assertiveness skills for resisting peer pressure; adolescent sexual behavior; health consequences of adolescent sexual activity; and birth control. The mothers are also provided with two modules to be given to the adolescents and two sets of parent-adolescent homework assignments designed to reinforce the aforementioned content areas. The manuals are available in English (with versions tailored to Latino families and to black families) and in Spanish.

Following the intervention, mothers get two “booster” calls; the first call is one month after the intervention and the second is five to six months after the intervention. During the calls, mothers are asked if they have reviewed the intervention materials and if they have completed the homework assignments.  The facilitators also answer any questions from the mother and provide any additional assistance with the intervention material.

EVALUATION(S) OF PROGRAM

Guilamo-Ramos, V., Bouris, A., Jaccard, J., Gonzalez, B., McCoy, W., & Aranda, D. (2011). A parent-based intervention to reduce sexual risk behavior in early adolescence: Building alliances between physicians, social workers, and parents. Journal of Adolescent Health, 48, 159-163.

Evaluated population: The evaluated population included 264 Latino and African American mother-adolescent dyads (a “mother” was defined as the primary female caregiver of the adolescent who lived with the adolescent). Based on the mother’s report, he sample was 85 percent Latino and 16 percent black. Of the adolescents, 71 percent were foreign-born, and 63 percent reported speaking mostly Spanish at home. The average age of the parents was 40.7 years, and the average age of the adolescents was 12.9 years.

Approach: The mother-adolescent dyads were recruited by a bilingual researcher in the waiting room of a community pediatric clinic in the Bronx neighborhood of New York City. As they came into the clinic, 133 dyads were assigned to the Families Talking Together group, and 131 dyads to the control group.  The Families Talking Together content was delivered during a 30-minute meeting between the mother and a social work interventionist; specifically, the content focused on effective communication strategies and on strategies for reducing sexual risk behavior. After the intervention, the mother was given materials to help start a discussion with their child about sexual activity.  The mother was also provided with an endorsement of the program by the clinic physician.  Following the initial session, mothers received two “booster” calls, one at one-month following the intervention and the second at five-months following the intervention.

Data on the adolescents’ sexual behavior was collected with self-administered surveys at enrollment and at nine months after the parent intervention. Information was collected at both time points on whether the adolescent had ever had vaginal sexual intercourse, the frequency with which they had vaginal sexual intercourse, and whether they had ever performed or received oral sex from a member of the opposite sex. Mothers also completed a survey when enrolled into the study about their parenting practices.

Results: At the 9-month follow-up, adolescents in the Families Talking Together group were less likely to have initiated sex than those in the control groups.  Among those who had initiated sex, those in the Families Talking Together group reported less frequent sex in the past 30 days than those in the control group. Those in the treatment group were also less likely to report having had oral sex, though this difference was only marginally significant.

Guilamo-Ramos, V., Jaccard, J., Bouris, A., Gonzalez, B., Casillas, E., & Banspach, S. (2011). A comparative study of interventions for delaying the initiation of sexual intercourse among Latino and black youth. Perspectives on Sexual and Reproductive Health, 43(4), 247-254.

Evaluated Population: The evaluated population consisted of 2,016 Latino and black mother-adolescent dyads from five middle schools in the New York neighborhoods of Harlem and the Bronx.  Dyads included a Latino or black adolescent enrolled in 6th or 7th grade at the time of enrollment and a mother (defined as an adult female who lived in the household with and who was a primary caregiver of the adolescent). Of the dyads, 75 percent were Latino, and 25 percent were black.  Of the adolescents, 77 percent were native-born, and 32 percent reported speaking Spanish as a primary language at home.  Half of the adolescents were male. The mothers had a mean age of 40.1 and the adolescents had a mean age of 12.2.

Approach: The dyads were randomly assigned via a computer program to one of three intervention groups: a parent-adolescent Families Talking Together group, an adolescent-only Making a Difference! group (more information about this program can be found here ), and a combined parent-adolescent Making a Difference! + Families Talking Together (MAD+FTT) group. Of the evaluated sample, 666 mother-adolescent dyads were assigned to the Families Talking Together intervention, 679 to the Making a Difference! intervention, and 671 to the MAD+FTT intervention.

On the first day of the school-based intervention, the Families Talking Together manual was distributed to the mothers in that intervention group, and the corresponding modules were discussed.  During the same time, the first five modules of Making a Difference! were implemented to that intervention group and to the combined intervention group.  For the Families Talking Together group, the second program day included a review of content and a focus on the homework assignments.  On the second day, those in the Making a Difference! group and the combined group covered the remaining modules.  Those in the Families Talking Together group also received one- and six-month “booster” calls. Mother-adolescent dyads who could not attend the school-based sessions were provided with a home visit to complete the interventions.

Self-administered questionnaires were completed at baseline and at a 12-month follow-up to assess sexual initiation, frequency of sex in the past 30 days, and four measures of mother-adolescent relationship: maternal monitoring or supervision, maternal expertise, maternal trustworthiness, and satisfaction with mother-adolescent relationship.

Results: At baseline, eight percent of those in the Families Talking Together had initiated sex, five percent in the Making a Difference! group, and eight percent of the MAD+FTT group.  Among those who had had sex, the mean frequency of sex in the past month was just over two times for each of the three groups.  At 12-month post-intervention, there were no differences in sexual initiation, comparing those in the Families Talking Together group, the Making a Difference! group, and the MAD+FTT group.  There were also no differences in frequency of sex, among those who had already initiated sex at baseline.  There were no differences between the Families Talking Together group and the MAD+FTT group.

However, there were differences between groups in terms of mother-adolescent communication about sex: the adolescents in either of the two Families Talking Together groups were more likely than those in the adolescent-only Making a Difference! group to have ever talked with their mother about sex.  Those in either of the two Families Talking Together groups also rated their mothers higher on maternal monitoring or supervision, maternal expertise, maternal trustworthiness, and satisfaction with their mother-adolescent relationship than those in the Making a Difference! group.  There were no differences between the Families Talking Together group and the MAD+FTT group.

SOURCES FOR MORE INFORMATION

Guilamo-Ramos, V., Bouris, A., Jaccard, J., Gonzalez, B., McCoy, W., & Aranda, D. (2011). A parent-based intervention to reduce sexual risk behavior in early adolescence: Building alliances between physicians, social workers, and parents. Journal of Adolescent Health, 48, 159-163.

Guilamo-Ramos, V., Jaccard, J., Bouris, A., Gonzalez, B., Casillas, E., & Banspach, S. (2011). A comparative study of interventions for delaying the initiation of sexual intercourse among Latino and black youth. Perspectives on Sexual and Reproductive Health, 43(4), 247-254.

Websites:

http://www.clafh.org/resources-for-parents/parent-materials/

http://www.clafh.org/resources-for-parents/teen-materials/

KEYWORDS: Adolescence (12-17), Middle School, Clinic/Provider-based, School-based, Urban, Black/African American, Hispanic/Latino, Abstinence Education, Sexual Activity, Parent-Child Relationship, Manual is Available.

 

Program information last updated 10/16/12

 

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