The effects of framing and fear on ratings and impact of antimarijuana PSAs.

A laboratory experiment, funded by the U.S. National Institutes of Health, involved 243 U.S. undergraduate students and employed a 2 (gain-framed vs. loss-framed) × 2 (high vs. low threat) plus control group pretest-posttest experimental design to assess the combined effects of frame (gain vs. loss) and level of threat of public service announcements (PSAs) about marijuana on attitudes, beliefs, and intentions related to marijuana, as well as the relationship of message condition to ratings of PSAs. Results suggest that loss-framed messages may lead to greater perceived threat, as well as reactance, and gain-framed messages may lead to a greater reduction in positive attitudes toward marijuana than loss-framed messages. Finally, frame and threat may interact in a complex way. Further research is suggested to replicate these findings. A substantial body of carefully crafted and systematic research studies examining both content and features of messages increasingly informs mass media prevention efforts, including the development of public service announcements (PSAs). Although the significance of messages on commercial broadcast stations may be diminishing with the increasing role and impact of new media, many of the basic questions addressed by this research are likely to apply across media channels. Nonetheless, important questions about what makes a message effective in changing an individual's attitudes or behavior remain to be answered. In this paper, the authors focus on two theoretically derived strategies that offer possibilities for developing persuasive messages: framing and threat.

Intimate partner violence among adolescents in Cape Town, South Africa.

This study aimed to describe potentially preventable factors in intimate partner violence (IPV) perpetration and victimization among South African 8th grade students. Data were collected during a pilot evaluation of a classroom 8th grade curriculum on gender-based violence prevention in nine public schools in Cape Town through self-completed interviews with 549 8th grade students, 238 boys and 311 girls. Structural equation models (SEM) predicting IPV were constructed with variables a priori hypothesized to be associated. The majority of students (78.5 %) had had a partner in the past 3 months, and they reported high rates of IPV during that period (e.g., over 10 % of boys reported forcing a partner to have sex, and 39 % of girls reported physical IPV victimization). A trimmed version of the hypothesized SEM (CFI = .966; RMSEA = .051) indicated that disagreement with the ideology of male superiority and violence predicted lower risk of IPV (p < .001), whereas the frequency of using negative conflict resolution styles (e.g., walking off angrily, sending angry text messages, or refusing to talk to them) predicted high IPV risk (p < .001) and mediated the impact of heavy alcohol drinking on IPV (Sobel test, z = 3.16; p < .001). The model fit both girls and boys, but heavy drinking influenced negative styles of resolving conflict more strongly among girls than boys. Findings suggest that interventions to reduce IPV among South African adolescents should challenge attitudes supportive of male superiority and violence; encourage use of positive conflict resolution styles; and discourage heavy alcohol use among both boys and girls.

Development and implementation of mass media campaigns to delay sexual initiation among African American and White youth.

Reducing new HIV/STD infections among at-risk adolescents requires developing and evaluating evidence-based health communication approaches. Research overwhelmingly supports the conclusion that early sexual initiation is associated with STDs and other negative outcomes in later years (e.g., unintended pregnancy). The authors' research group secured funding from the National Institute of Mental Health to develop, implement, and rigorously evaluate televised mass media campaigns to delay initiation of sexual intercourse among African American and White adolescents in two cities in the Southeastern United States. The focus of the present study is on the development and implementation of the campaigns, including (a) rationale and theoretical underpinnings; (b) collection, screening, and assessment of existing public service announcements; (c) development of new public service announcements; (d) study design and campaign airing plan; and (e) message exposure achieved in the campaigns. Health communication campaigns hold much promise in reaching at-risk adolescent populations with targeted, timely, and relevant risk-reduction messages.

The impact of Thai family matters on parent-adolescent sexual risk communication attitudes and behaviors.

This article reports on a combined family-based substance abuse and HIV-prevention intervention targeting families with 13-14-year-old children in Bangkok, Thailand. Families (n = 340) were randomly and proportionally selected from 7 districts in Bangkok with half randomly assigned to an experimental or control condition. Families in the intervention condition were exposed to 5 interactive booklets about adolescent substance use and risky sexual behavior. Trained health educators followed up by phone to encourage completion of each booklet. Primary outcomes reported in this article include whether the intervention increased the frequency of parent-child communication in general or about sexual risk taking in particular as well as whether the intervention reduced discomfort discussing sexual issues. The authors also tested to see whether booklet completion was associated with communication outcomes at the 6-month follow-up. Multivariate findings indicate that the intervention had a significant impact on the frequency of general parent-child communication on the basis of child reports. The intervention had a marginal impact on the frequency of parent-child communication about sexual issues on the basis of parent reports. Booklet completion was associated with reduced discomfort discussing sex and was marginally associated with frequency of parent-child discussion of sex on the basis of parent reports only. These findings indicate that a family-based program can influence communication patterns.

Intergenerational transmission of religious beliefs and practices and the reduction of adolescent delinquency in urban Thailand.

This study examines the intergenerational transmission of family religion as measured by parent's and adolescent's beliefs and practices in Buddhism, and its relation to delinquent behaviors among early adolescents in Thailand. The data set is from the Thai Family Matters Project 2007, a representative sample of 420 pairs of parents and teens in Bangkok. A structural equation model is employed for the analysis. The intergenerational transmission and the direct and indirect association between parents' and adolescents' beliefs and practices in Buddhism and adolescents' minor and serious delinquent behaviors are revealed to be significant, controlling for secular parental monitoring. Spirituality within the family can play an important role in preventing delinquency among early adolescents. Policies in the areas related to family empowerment and delinquency prevention may need to consider integrating both secular and non-secular program inputs in their implementation design.

The Roles of Perceived Neighborhood Disorganization, Social Cohesion, and Social Control in Urban Thai Adolescents' Substance Use and Delinquency.

Substance use and delinquency in Thai adolescents are growing public health concerns. Research has linked neighborhood characteristics to these outcomes, with explanations focused on neighborhood disorganization, social cohesion, and social control. This study examines the independent associations of these neighborhood constructs with Thai adolescents' substance use and delinquency, through peer deviance, to determine which neighborhood aspects are particularly important. Families (N=420) with adolescents aged 13-14 were randomly selected from 7 districts in Bangkok, Thailand. Structural equation modeling showed that adolescents', but not parents', perceptions of greater disorganization were related to increased rates of both minor and serious delinquency. Surprisingly, greater neighborhood cohesion was related to greater minor delinquency. Peer deviance was unrelated to neighborhood variables. Findings can inform prevention strategies for Thai adolescents, as results suggest that neighborhoods are important for adolescent behaviors regardless of culture. Further work should help communities make use of social cohesion to benefit residents.

Do Thai parents really know about the sexual risk taking of their children? A qualitative study in Bangkok.

This qualitative study explores the perceptions of parents and adolescents toward sexual risk-taking behaviors. In-depth interviews were conducted with 30 parents and 30 adolescents (aged 13-14 years) in Bangkok, and were analyzed by using coding and thematic analysis. The results showed that although parents generally believed that Thai teens begin to have sex at an early age and engage in sexual risk-taking behaviors, they trusted that their teens would follow parental guidance and rules and not engage in sexual activity at this age. Most of the Thai teens reported that their parents were not really aware of their sexual behaviors because of their tendency to keep their sexual stories secret for fear of being scolded, blamed, and punished. The teens also reported that they wanted their parents to listen, give them warmth and more freedom, and be more in touch with their activities. Parents expressed their need for knowledge and skills so that they could help guide their adolescent children to avoid sexual risk-taking behaviors. A family intervention specifically aimed at empowering Thai urban parents is needed.

Successful implementation of Thai Family Matters: strategies and implications.

This article discusses the successful process used to assess the feasibility of implementing the Family Matters program in Bangkok, Thailand. This is important work since adopting and adapting evidence-based programs is a strategy currently endorsed by leading prevention funding sources, particularly in the United States. The original Family Matters consists of four booklets designed to increase parental communication with their adolescent children in order to delay onset of or decrease alcohol, tobacco, and other drug use. As part of the program, health educators contact parents by telephone to support them in the adoption of the program. Each booklet addresses a key aspect of strengthening families and protecting young people from unhealthy behaviors related to alcohol and other drug use. Adaptation of the program for Bangkok focused on cultural relevance and the addition of a unit targeting adolescent dating and sexual behavior. A total of 170 families entered the program, with the majority (85.3%) completing all five booklets. On average, the program took 16 weeks to complete, with families reporting high satisfaction with the program. This article provides greater detail about the implementation process and what was learned from this feasibility trial.

Parent-teen communication about sex in urban Thai families.

This study describes sexual communication among Thai parents and their teens and identifies variables related to communication about sex in urban Thai families. Data were derived from 420 families whose teenage children ages 13-14 years were randomly selected using the probability proportional to size technique. Interviews were conducted with 1 parent and 1 teenage child in each family. In-depth interviews were also conducted in 30 parents and teens drawn from the same 420 families. Results showed that parents were most likely to talk with their teens about body changes and dating; however, less discussion about sex-related issues, birth control, and HIV/AIDS occurred. More daughters than sons reported frequent discussions with their parents about sex. Parents who believed their teens had been involved in sexual activity were more likely to talk about HIV/AIDS and the difficulty of teenagers having babies, instead of talking about sexual intercourse or when to start having sex. Multiple regression analysis indicated that gender of the child (female), parental religiosity, and parental perception of teen sexual activity were significant predictors of increased sexual communication in Thai families. The findings suggest a need for approaches designed to facilitate communication skills about sex-related issues among Thai parents.

Neighborhood perceptions and parent outcomes in family based prevention programs for Thai adolescents: the role of program engagement.

Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = .52) in Bangkok, Thailand in a prevention program for adolescent substance use and sexual risk. Neighborhoods were related to engagement, which was critical to outcomes. Neighborhood disorganization was related to confidence in program effects and program completion. Completion was related to increased ATOD communication. Neighborhood cohesion was related to less program enjoyment, while neighborhood social control was related to more enjoyment. Enjoyment was related to increased ATOD communication and formation and monitoring of alcohol rules. Prevention strategies should focus on neighborhood contexts and enhancing engagement.

Classroom Goal Structures and HIV/Pregnancy Prevention Education in Rural High School Health Classrooms.

Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV/pregnancy instruction, three months after instruction, and one year after instruction). Results indicated that classroom goal structures were related to both proximal and distal knowledge, attitudes, intentions, and efficacy beliefs. Results in particular indicate that the perception of a mastery goal structure in health education classrooms fosters knowledge, improved attitudes, enhanced efficacy beliefs, and lower intentions to have sexual intercourse.

Thai Parenting Practices, Family Rituals and Risky Adolescent Behaviors: Alcohol Use, Cigarette Use and Delinquency.

Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics.

Spirituality within the family and the prevention of health risk behavior among adolescents in Bangkok, Thailand.

This study investigates the influences of a family's spiritual beliefs and practices on substance use and sexual risk behaviors among young adolescents 13-14 years old in Bangkok, Thailand. Independent predictor variables are the parents' and teens' spiritual beliefs and practices in Buddhism and parental monitoring behaviors. The study uses data from the 2007 Baseline Survey of the Thai Family Matters Project, which adapted a U.S. based family prevention program for Thai culture. A representative sample of 420 pairs of parents and teens from the Bangkok metropolitan area was recruited to participate in the study. Structural equation models indicate that positive direct and indirect associations of the spirituality of parents and teens within a family and the prevention of adolescent risk behaviors are significant and consistent.

Parenting and adolescent problem behaviors: a comparative study of sons and daughters in Thailand.

OBJECTIVE: Investigates parenting practices and the reported sexual and delinquent behaviors among Thai adolescents, by focusing on the difference between sons and daughters. MATERIAL AND METHOD: Data were derived from 420 families whose adolescents aged 13-14 were randomly selected from seven districts in Bangkok using the probability proportional to size (PPS) method. Interviews were conducted with one parent and one adolescent. RESULTS: Female adolescents reported higher levels of parental monitoring, parental rules, communication about sex, and parental disapproval of sex, as compared to males. There were no gender differences in the reported sexual and delinquent behaviors among the adolescents. For males, high levels of parental monitoring, greater perception of parent disapproval of sex, and being raised by authoritative parents were associated with less delinquent behaviors. Among females, parental monitoring and parental closeness served as protective factors against sexual and delinquent behaviors. CONCLUSION: The findings from the present study point to the importance of promoting family institution and parents' childrearing. These findings should be useful for developing a body of knowledge and understanding on adolescent rearing among Thai parents.

Beginning the Thai Family Matters Project: An Areal Analysis of Bad Neighborhoods and Adolescents' Problematic Behaviours in Thailand.

Under the Thai Family Matters program initiative, this study investigates an association between neighborhood characteristics and problematic behaviors including alcohol and drug use, and sexual and delinquent behaviors among Thai adolescents. Data were derived from 420 families whose children aged 13-14 were selected from 30,471 households enumerated and listed from 245 blocks in seven districts in Bangkok Metropolis including Min Buri, Pathum Wan, Bangkok Noi, Bang Kho Laem, Sai Mai, Wang Thonglang and Suan Luang. Probability Proportional to Size method (PPS) was used in the sample selection process. Interviews were conducted with one parent and one adolescent in each household. Areal analysis shows that adolescents' problematic behaviors are significantly related to the districts where they live as well as the bad neighborhood characteristics that they reported. The study confirmed that any micro - level family program to prevent or correct problematic behaviors of adolescents need to also take into account the macro - level approach to manage the difficult neighborhoods as well as to deal with the bad environment in the broader areas of Bangkok Metropolis where the adolescents live.

Comparing the efficacy of permanent classroom teachers to temporary health educators for pregnancy and HIV prevention instruction.

Ninth grade health education classrooms were randomly assigned to conditions in which a 14-lesson unit on HIV and pregnancy prevention was provided either by the permanent classroom teacher or by a temporary health educator. Student data were collected prior to the lessons and approximately 3 weeks after the completion of the unit. Results indicate that students who learned the unit from the classroom teacher reported that that the instructor was more likeable and credible and that the classrooms were more motivational. Sexually active adolescents with regular classroom teachers reported greater increases in frequency of class discussion.

Sexual self-concept and sexual self-efficacy in adolescents: a possible clue to promoting sexual health?

This study examined the associations between sexual self-concept (sexual esteem and sexual anxiety) and sexual self-efficacy (situational and resistive) in a sample of 388 high school students (59% Caucasian, 28% African American). Males reported lower sexual esteem and lower sexual self-efficacy than females. Males and African Americans reported higher levels of sexual anxiety and lower levels of resistive self-efficacy than females and Caucasians. In regression models, higher sexual self-esteem uniquely predicted higher sexual self-efficacy scores, even after controlling for demographic variables, knowledge of sexual risk, and previous coital experience. In post hoc analyses, sexual self-esteem mediated the relation between knowledge of sexual risk and both types of sexual self-efficacy. Results suggest the need for interventions to promote male sexual self-efficacy and sexual esteem and the need for longitudinal research that explicates models of sexual health in adolescence.

Effects of a school-based, theory-driven HIV and pregnancy prevention curriculum.

CONTEXT: Although a number of interventions are effective at reducing risky adolescent sexual behavior, it may be possible to make them even more effective by addressing adolescents' approaches to risk-taking. METHODS: Schools were assigned to teach one of three curricula in a quasi-experimental intervention study: the school's standard pregnancy and HIV prevention curriculum; the Reducing the Risk curriculum; or a modified Reducing the Risk curriculum, adapted for high sensation seekers and impulsive decision makers. A sample of 1,944 students from 17 schools was surveyed at three time points between 1995 and 1997. Mixed models regression and logistic regression were used to examine the difference in impact among curricula. RESULTS: Differences in the impact of the original and modified Reducing the Risk interventions were not significant for the total sample or for high sensation seekers and impulsive decision makers separately. Students from both intervention groups demonstrated short-term improvements in knowledge; students who received their schools' standard curriculum were significantly more likely than those assigned to either intervention to have initiated sexual intercourse by the third time point (odds ratio, 2.4). CONCLUSION: More work is necessary to understand the best ways to design classroom messages that will be effective in reducing the risk behaviors of high sensation seekers and impulsive decision makers.

The effects of a computer-based pregnancy, STD, and HIV prevention intervention: a nine-school trial.

A computer-based intervention was designed to change perceived threat, perceived efficacy, attitudes, and knowledge regarding pregnancy, STD, and HIV prevention in rural adolescents. The intervention, which was guided largely by the extended parallel process model (Witte, 1992), was implemented and evaluated in nine rural high schools using an institutional cycle pretest-posttest control-group design (Campbell & Stanley, 1963; Cook & Campbell, 1979). Eight-hundred eighty-seven ninth-graders completed the survey at both points in time. Process evaluation results indicated that the intervention was implemented as intended, and that over 91% of students in the treatment group completed at least one of the six computer-based activities (M = 3.46, SD = 1.44 for those doing at least one activity). Two-way mixed-model repeated-measures analysis of variance revealed that students in the treatment group outperformed students in the control group on knowledge, condom self-efficacy, attitude toward waiting to have sex, and perceived susceptibility to HIV. These results suggest that computer-based programs may be a cost-effective and easily replicable means of providing teens with basic information and skills necessary to prevent pregnancy, STDs, and HIV.

Longitudinal test of a multiple domain model of adolescent condom use.

A comprehensive multiple domain model (MDM) to understand condom use in adolescents was proposed and tested using structural equation modeling of data at three time points. The proposed model integrates social psychological theory, demographic and personality factors, social environment, and situational/contextual variables. Adolescents who were sexually active at time 2 (6 months after baseline) and time 3 (1 year after time 2) and completed surveys at all three time points were included in the analyses (N = 511). An iterative process of model testing resulted in a structural equation model that provided a good fit to the data (CFI = .92, RMSEA = .04). Models comparing gender and race as moderators also were calculated and supported the generalizability of the model. Results provide support for an MDM that goes beyond traditional social psychological models for a broader understanding of condom use in adolescents. Implications for further theory testing and safer sexual interventions are discussed.