Despite Published Recommendations, Adults’ Routine Health Care Often Lacks Attention to STD Prevention
The closeness of a parent-adolescent relationship and the quality of communication within that relationship are important predictors of teenagers’ sexual risk-taking; evidence from a study of a program aimed at enhancing parent-child sexual communication suggests that parents’ repetition of sex-related information may be a more important predictor of those relationship characteristics than the breadth of sexual communication.1 The number of topics that teenagers said their parents addressed repeatedly in discussions related to sex was positively associated with the adolescents’ perceptions of closeness with their parents, their ability to communicate with them in general and on sexual topics, and the openness of their sexual communication. By contrast, the number of topics covered was positively associated only with openness of sexual communication.
The eight-week communication program was conducted between 2002 and 2005 at 13 California worksites; employees were eligible to participate if they were parents who lived with at least one child in grades 6–10. After participants and their eligible children completed baseline surveys, the parents were randomly assigned to attend the program or to remain in the study as members of the control group. One month, three months and nine months after the intervention ended, all participants from both the intervention and the control groups, as well as their children, completed follow-up surveys. Analysts used data from the 312 teenagers in the control group who completed all surveys to assess associations between characteristics of parents’ and children’s sexual communication and characteristics of their relationship.
In the baseline survey, teenagers were asked if they had ever discussed each of 22 sex-related topics with their participating parent; at every follow-up, they were asked if they had discussed each of the same topics since the previous survey. The number of new topics discussed during the study period was used as an indicator of breadth of communication, and the number discussed more than once as a measure of repetition of communication. At baseline and the final follow-up, adolescents also were asked to rate their overall relationship with the parent in the study, their closeness with that parent, their ability to talk to that parent in general and about sexual topics, and the openness with which they and their parent discuss sexual topics.
On average, teenagers in the sample were roughly 13 years old, and their participating parents were 44. Adolescents were about evenly divided by gender; 70% of the parents were mothers. Nearly half of the parents were white, and most of the rest were black, Asian or Latino; 56% had at least a college education.
In initial analyses, parent’s gender was associated with all of the sexual communication measures: Mothers had discussed significantly more sex-related topics with their children than fathers had before baseline (means, 7.9 and 5.2, respectively), introduced more topics during the study period (3.1 vs. 2.2) and repeated more topics during follow-up (12.2 vs. 5.7). Other demographic characteristics had fewer associations with communication: Male adolescents reported more new topics during follow-up than did females (3.3 and 2.4, respectively). Parent-child pairs of the same gender had covered fewer topics before baseline than had those of opposite gender (6.3 vs. 8.0). And the parent’s level of schooling was negatively correlated with both the number of topics already discussed by baseline and the number repeated during follow-up (correlation coefficients, –0.20 and –0.13, respectively).
Linear regression, controlling for adolescents’ and parents’ ages, was used to examine associations between parent-child sexual communication and teenagers’ perceptions of their relationship and communication with their parents. Results showed that repetition of sexual communication was positively associated with four of the five measures of teenagers’ perceptions: The more repetition adolescents reported, the more highly they rated their closeness with their parent, their ability to communicate generally and about sexual topics, and the openness of their sexual communication (coefficients, 0.15–0.24). Breadth of communication was associated only with perceived openness (0.14), and number of topics discussed before baseline was not related to any perceptions about parent-child relationships or communication. Adolescents’ age was negatively associated with perceived openness of sexual communication, and parents’ age was positively associated with this measure.
The analysts comment that their findings “do not imply that the breadth of sexual communication is unimportant,” but that parents who have just one “big talk” about sex with their children are not likely to be as effective as those who “introduce new sexual topics and then develop them through repeated discussions.” Although they acknowledge that additional work is necessary to flesh out the role of parent-child relationship characteristics in teenagers’ risk-related behavior, they recommend that clinicians encourage parents to have repeated discussions about sex-related topics with their children.
1. Martino SC et al., Beyond the “big talk”: the roles of breadth and repetition in parent-adolescent communication about sexual topics, Pediatrics, 2008, 121(3):e612–e618.