Health care providers and parents have been valuable partners in managing adolescent sexual and reproductive health. But research has been limited concerning the efficacy of “triadic” interventions, or those implemented with parents and providers with the goal of reducing adolescent sexual risk behavior.
Now, a randomized clinical trial carried out under a grant by the National Institutes of Health shows the efficacy of a triadic intervention to postpone adolescent sexual debut and to promote condom use among adolescents aged 11 to 14 years.
Published in Pediatrics, the study – “A Triadic Intervention for Sexual Health: A Randomized Clinical Trial” – was conducted by Vincent Guilamo-Ramos, director of the Center for Latino Adolescent and Family Health (CLAFH) at the Silver School of Social Work at New York University and a nurse practitioner specializing in adolescent sexual and reproductive health care at the Adolescent AIDS Program at Children’s Hospital at Montefiore.
The study’s coauthors include Adam Benzekri (CLAFH); Marco Thimm-Kaiser (CLAFH and the CUNY School of Public Health and Health Policy); Patricia Dittus (Centers for Disease Control and Prevention, Division of STD Prevention); Yumary Ruiz (Purdue University and CLAFH); Charles M. Cleland (NYU Langone), and Dr. Wanda McCoy (Morris Heights Health Center, Bronx, NY).
The researchers evaluated Families Talking Together (FTT), a triadic intervention developed by Dr. Guilamo-Ramos and colleagues designed to reduce adolescent sexual risk behavior and address persistent disparities in unplanned teen pregnancies as well as sexually transmitted infections such as HIV/AIDS.
Adolescents aged 11-14 and their female caregivers were recruited from a Bronx, N.Y., pediatric clinic, and 900 families enrolled in the study. The Families Talking Together intervention consists of a 45-minute face-to-face session for mothers, health care provider endorsement of the intervention content, FTT family communication workbook for families, and a booster phone call for mothers.
To evaluate the FTT intervention, assessments were conducted initially (baseline), three months later, and a year later, asking whether adolescents engaged in vaginal intercourse, made their sexual debut within the past 12 months, and used a condom in their last sexual encounter.
- At 12-month follow-up, 5.2% of adolescents in the experimental group (those participating in the Families Talking Together intervention program) reported having had sexual intercourse, compared to 18.0% of adolescents in the control groups, who did not receive the FTT intervention.
- In the experimental group, 4.7% of adolescents reported sexual debut within the past 12 months, compared to 14.7% of adolescents in the control group.
- In the experimental group, 74.2% of sexually active adolescents indicated using a condom at last sex, compared to 49.1% of sexually active adolescents in the control group.
“The research suggests that the FTT triadic intervention is efficacious in delaying sexual debut and reducing sexual risk behavior among adolescents,” according to the study.
The findings are particularly important since FTT addresses the important role of parents in shaping adolescent sexual and reproductive health while respecting adolescent autonomy and confidentiality in healthcare, making FTT an innovative solution to respond to calls from parents and national health organizations for more parental involvement in adolescent SRH care.
It is worth noting that parenting involving LGBTQIA youth is reported to be harder.
For instance, a 2018 study – which included 44 parents of LGBT teens between the ages of 13 and 17 – noted how parents faced many challenges in trying to educate their teens about sex, including their general discomfort in talking about it, and feeling unable to offer accurate advice about safe LGBT sex.
Meanwhile a 2019 study noted that as it is, parent-child discussions about sexual health and sexual identity are complicated, but this is even more particular with a male teen who identifies as gay, bisexual, or queer (GBQ). The research from the University of Pennsylvania shows that even as parents become savvier in these conversations, departing from gender stereotypes and embracing more accepting attitudes, factors beyond the home will still affect the message parents convey and their child hears.