Promoting Parent – Child Communication related to Sexual

Promoting Parent – Child Communication related to Sexual and Reproductive Health

Preliminary results from the PREPARE Kampala trialpresented at the PREPARE meeting, Bergen May 6-9, 2014

Objectives of the study

The main

objective:

D

evelop

an intervention which will improve the

quality

and

frequency

of parent-child communication on sexuality and mobilize parental support for healthy sexual practices among adolescents (12-14 years of age) in Kampala

.

Specific objectives:

To

develop a school-based intervention aimed at increasing parent-child communication on issues of sexual and reproductive

health

T

o assess the impact of the intervention on a range of outcome variables

among

learners and their parents

with

respect

to

promoting healthy sexual

practices

(Investigate

congruency of reports by parents and adolescents dyads regarding frequency and perceived quality of

this communication)

Intervention to:-increase knowledge and awareness, promote healthy sexual practices-improve parenting practices/communication in terms of quality and frequency

Parental outcomes: --increase knowledge/awareness -self-efficacy to communicate about sexuality -positive parenting practices (monitoring, relationship building, reinforcement, communication about sexuality, values and expectations)

Adolescent outcomes :-increase knowledge, foster positive attitudes about delay of sex/condom use/monogamy -influence norms and social expectancies about sex -develop self-efficacy and skills to communicate -impact behavioral intentions -sexual behavior

Adapted from Dittus et al., 2004

Parent-child sexuality communication and adolescent sexual decision making

Moderating variables

-

sex-education-SES-rural/urban residence-religion-family structure-sexual experience-parent-child relationship-parenting style-perception of parental legitimacy/ credibility-other risk behaviors-knowledge-communication skills, content, timing, frequency, comfort, confidence, quality

Norms concerning parent-child sexuality communication

Attitudes towards sexuality communication

Self-efficacy to communicate

Intention to communicate

Parent-child communication &

adolescent sexual decision making

Scale adaptation

Scales adapted from:

Families Matter! study (Vandenhoudt et al. 2010)

Barber et al. (2008)

Brown, Mounts, Lambourn & Steinberg (1993)

Darling and Dowdy (2010)

Darling, Cumsille, &

Peña-

Alampay

(2005

)

Feldman & Rosenthal (2000)

Huebner & Howell (2003)

Jaccard

,

Dittus

& Gordon (2000)

Scales

Communication Frequency:

In the last 3 months

, how often have you discussed these topics with your child/parent?

Perceived communication quality:

Perceived quality of , helpfulness and satisfaction with communication

Both communication in general and sexuality communication

I am satisfied with the communication I have with my parents about sex-related topics.

I can

satisfactorialy

answer the questions my child has about sex-related topics

Scales

Parent-child relationship

:

I am happy with how my

child (

parent/guardian) and I get along.

I hide things I do from my parent/guardian that I know they disapprove of

Parental monitoring of child activity:

How often does your parent/guardian...

know where you go when you are not at home?

know what you do when you are not at home?

Parental legitimacy regarding rule setting:

In your opinion, is it ok for your parent/guardian to set rules for you about...

what you

og

after school?

what you watch on TV or videos?

Scales

Parental «encouragement» of sex:

I think if I talk to my child about sex-related topics, this will encourage him/her to have sex

I think my child is still too young to learn about sex-related topics

Parental value of communication (responsiveness):

It is my duty to make sure my child knows about sex-related topic

The PREPARE Kampala trial

Eligible schools were restricted to public day schools with both boys and girls attending

A

total of 22 selected

schools from Kampala and

Wakiso

districts were

randomly allocated to an intervention arm and a delayed, control

condition

Learners were sampled in order to achieve a total sample of 1700 (sampled in proportion to the total number of eligible learners at each school)

n

at baseline ranged from 22 to

201 at participating schools

Baseline survey conducted with parents and learners in

March 2012

The

intervention program included

7 + 7

school

sessions (each 90 minutes in English and CRE (Christian Religious Education)

and a total of 3 parental meetings

The intervention program was i

mplemented during a 5 week period (

April into June)

Follow-up

data

were collected

in

July 2012

Demographic characteristics at baseline: Parents

Females (n=905)Males (n=578)P-valueAge (mean; range)39.1 (18-72)42.4 (18-82).000Religion Christian Muslim64.316.572.214.6.020Socio-economic status % w/ higher educ * Possessions at home **64.03.866.43.9nsns

*

Parents

reporting

having attended secondary school education or

college/university education

**

Parents

reporting whether or not 9 items are present at home (scale 0-9)

Demographic characteristics at baseline: Learners

Females (n=776)Males (n=725)P-valueAge (mean; range)13.8 (11-18)14.3 (11-20).000Religion Christian Muslim80.316.179.418.1nsSocio-economic status % w/ mother w/ higher educ * % w/father w/ higher educ Possessions at home **60.664.83.857.062.53.8nsnsns

* Learners reporting parent having attended secondary school education or

college/university education

** Learners reporting whether or not 9 items are present at home (scale 0-9)

Included scales - Parents

No.

of

items

Cronbach

alpha

Mean

Test-retest

Communication

frequency

11

.90

1.88

Perceived communication quality

11

.89

3.79

Parent-child

relationship

7

.80

4.50

Parental monitoring

of child activity

5

.80

2.29

Parental

legitimacy regarding rule setting

7

.73

2.07

Parental «encouragement»

of sex

4

.67

2.44

Perceived value

of communication

4

.72

3.87

Included scales - Learners

No.

of

items

Cronbach

alpha

Mean

Test-retest

Communication

frequency

11

.89

1.74

Perceived communication quality

11

.91

3.41

Parent-child

relationship

7

.70

3.49

Parental monitoring

of child activity

5

.79

2.36

Parental

legitimacy regarding rule setting

7

.64

0.71

Parental «encouragement»

of sex

4

.68

2.40

Perceived value

of communication

4

.65

3.76

Preliminary outcome results Parents

Intervention

group

Control

group

Effect

size

P-

value

Communication

frequency

2.14

1.98

.21

.023

Perceived communication quality

4.03

3.74

.37

.000

Parent-child

relationship

4.53

4.44

.21

.019

Parental monitoring

of child activity

2.32

2.31

ns

Parental

legitimacy regarding rule setting

2.25

2.10

.32

.000

Parental «encouragement»

of sex

2.13

2.33

.23

.003

Perceived value

of communication

4.13

3.89

.29

.000

Preliminary outcome results Learners

InterventiongroupControl groupEffect sizeP-valueCommunication frequency2.021.77.35.000Perceived communication quality3.733.48.27.000Parent-child relationship3.553.44.17.003Parental monitoring of child activity2.442.36.16.003Parental legitimacy regarding rule setting0.720.70nsParental «encouragement» of sex2.182.42.26.002Perceived value of communicationPros of delaying sex until I am olderSocial norms of delaying sexMyths related to HIV/AIDS3.964.414.412.273.774.304.282.42.21.13.16.22.000.059.025.004

No

observed

effects

for

condom-related

outcomes