A Triadic Intervention for Adolescent Sexual Health: A Randomized Clinical Trial.

OBJECTIVES: In this study, we evaluate the efficacy of Families Talking Together (FTT), a triadic intervention to reduce adolescent sexual risk behavior. METHODS: Adolescents aged 11 to 14 and their female caregivers were recruited from a pediatric clinic; 900 families were enrolled; 84 declined. Families were randomly assigned to FTT or 1 of 2 control conditions. The FTT triadic intervention consisted of a 45-minute face-to-face session for mothers, health care provider endorsement of intervention content, printed materials for families, and a booster call for mothers. The primary outcomes were ever having had vaginal intercourse, sexual debut within the past 12 months, and condom use at last sexual intercourse. Assessments occurred at baseline, 3 months post baseline, and 12 months post baseline. RESULTS: Of enrolled families, 73.4% identified as Hispanic, 20.4% as African American, and 6.2% as mixed race. Mean maternal age was 38.8 years, and mean adolescent grade was seventh grade. At the 12-month follow-up, 5.2% of adolescents in the experimental group reported having had sexual intercourse, compared with 18% of adolescents in the control groups (P < .05). In the experimental group, 4.7% of adolescents reported sexual debut within the past 12 months, compared with 14.7% of adolescents in the control group (P < .05). In the experimental group, 74.2% of sexually active adolescents indicated using a condom at last sexual intercourse, compared with 49.1% of adolescents in the control group (P < .05). CONCLUSIONS: This research suggests that the FTT triadic intervention is efficacious in delaying sexual debut and reducing sexual risk behavior among adolescents.

A parent-based intervention to reduce sexual risk behavior in early adolescence: building alliances between physicians, social workers, and parents.

PURPOSE: To evaluate the efficacy of a parent-based intervention to prevent sexual risk behavior among Latino and African American young adults. This was delivered to mothers while waiting for their adolescent child to complete an annual physical examination. METHODS: A randomized clinical trial was conducted with 264 mother-adolescent dyads in New York City. Adolescents were eligible for the study only if they were African American or Latino and aged 11-14 years, inclusive. Dyads completed a brief baseline survey and were then randomly assigned to one of the following two conditions: (1) a parent-based intervention (n = 133), or (2) a "standard care" control condition (n = 131). Parents and adolescents completed a follow-up survey nine months later. The primary outcomes included whether the adolescent had ever engaged in vaginal sexual intercourse, the frequency of sexual intercourse, and the frequency of oral sex. RESULTS: Relative to the control group, statistically significant reduced rates of transitioning to sexual activity and frequency of sexual intercourse were observed, with oral sex reductions nearly reaching statistical significance (p < .054). Specifically, sexual activity increased from 6% to 22% for young adults in the "standard of care" control condition, although it remained at 6% among young adults in the intervention condition at the 9-month follow-up. CONCLUSIONS: A parent-based intervention delivered to mothers in a pediatric clinic as they waited for their child to complete a physical examination may be an effective way to reduce sexual risk behaviors among Latino and African American middle-school young adults.

The feasibility of a clinic-based parent intervention to prevent HIV, sexually transmitted infections, and unintended pregnancies among Latino and African American adolescents.

The purpose of the present study was to examine the feasibility of conducting a parent-based intervention in a pediatric health clinic to prevent HIV, sexually transmitted infections (STIs), and unintended pregnancies among urban African American and Latino youth. Eight focus groups were conducted with health care providers, adolescent patients and the mothers of adolescent patients (n = 41) from December 2007 to February 2008. All participants were recruited from a community-based pediatric health clinic in the Bronx, New York. Content analysis of focus group transcripts identified results in three primary areas: (1) the role of parents and providers in preventing HIV, STDs and unintended pregnancies among adolescents, (2) feasibility of the intervention in the clinic setting; and (3) optimal recruitment, retention and intervention delivery strategies. Study results suggest that a parent-based intervention delivered in a community-based pediatric health clinic setting is feasible. Focused recommendations for intervention recruitment, delivery, and retention are provided.