Transcript Action Research

Mother-Daughter Communication
about Sex in Afro-Caribbean Population
Cynthia Archibald, PhD, RN
Associate Professor
This project was supported by the National institute of Health
Award Number K01NR10685
from the National Institute of Nursing Research
Background
(Archibald, 2007, 2010)
• Silence about sex in this population
• Adolescents learn from sleeping in
overcrowding environments
• Matriarchal dominance in the Caribbean
home.
• Female teens are briefed about menarche
• Some are still fearful that the onset of
menarche means sexual involvement
Specific Aims
• Develop a safe choice, culturally tailored
HIV/AIDS risk reduction program for AfroCaribbean adolescents through community
collaboration.
• Test the effect of the risk reduction program
on mother-daughter communication about
sex, from pre-intervention to immediately
post-intervention to three months postintervention.
Hypothesis
• Mothers in the MPCCS! group will have
significantly greater improvement in their
communication skills about sex than their
counterparts in the Comparison group
Method
• Community-based participatory approach
– Stringer’s model- look-think-act sequence
– Developed a Community Partnership Steering
Committee
• Members of the Afro-Caribbean Community
• members of Afro-Caribbean church
Method
• Culturally tailored Jemmott’s Making Proud
Choices! To be specific for the Afro-Caribbean
adolescents.
• Making Proud Choices-Caribbean Style
(MPCCS)
Sample
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Phase I – 20 mothers and daughters
Phase II – 120 mother-daughter dyads
Adolescents 13-17
Caribbean parent(s)
Live in US
Actively involved in church
Attending school or college
• Experimental and Comparison Groups
• Experimental group received the Making
Proud Choices Caribbean Style! HIV
prevention Intervention.
• Comparison Group received a General Health
Education program
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Conducted learning and skills sessions
Provided mother–daughter activities
Assigned mother–daughter homework
Video-taped role play activities
View/ Review Activities
Qualitative Results
• “ It was embarrassing at first to talk to my
daughter, most times I was looking away from
her.”
• “Oh my god! I can’t believe I signed up for
this.”
• “My daughter and I have become very close…
this three week seminar was so good”.
Qual. Results (Cont’d)
• “ I couldn’t wait to hear my mother say certain
words”.
• “I felt bad for my mother as I knew it was hard
for her…I already know what she was
struggling to tell me”
• “I was proud of her”
• “I feel like I can talk to her now”
Qual. Results (cont’d)
• Feelings of
– “Mission accomplished”(mothers)
– Embarrassment to listen (daughters)
– “like talking to stranger” (mothers)
• Reluctant to say certain words such as penis,
condoms etc.
• Mutual pride.
Quantitative Results
• To test the average change differences
between groups, independent t-test were
utilized.
Quant. Results (con’d)
• First differences between groups were tested
on change scores between Time 1 and Time 2.
• Then the differences between the treatment
and comparison groups were tested on
change scores between Time 1 and Time 3.
Quant. Results (con’d)
• Stigma to HIV decreased
• Mother daughter sexual communication
increased
• Afro-Caribbean churches are discussing sex
and risky sexual behaviors
• Adolescents are using the information gained
through this study to present at their high
schools
• Community is anxiously awaiting the followup study to include male adolescents
• Growing interest for this work to be extended
to the Caribbean where HIV is second to SubSahara Africa.
• Archibald, C.M. (2007). Knowledge, attitudes and risky sexual
behaviors in Afro-Caribbean youth. JANAC
• Archibald, C. M. ( 2010). HIV/AIDS-Associated stigma among
Afro-Caribbean people living in United States. Archives of
Psychiatric Nursing,24(5), 362-364.
• Hutchinson, M.K., Jemmott, J. B., Jemmott, L.S., Braverman, P.,
& Fong, G. (2003). The role of mother-daughter sexual risk
communication in reducing sexual risk behaviors among
urban adolescent females: A prospective study. Journal of
Adolescent Health, 33(2), 98-107.
• Jemmott, L.S., & Jemmott, J.B., & McCaffree, K. (1995). Be
proud! Be responsible! Strategies to empower youth to reduce
their risk for AIDS. NY: Select Media Productions.
• Lowe, J. (2007). The need for historically grounded HIV/AIDS
prevention research among Native Americans. Journal of the
Association of Nurses in AIDS Care, 18(2), 15-17.
• Stringer, E.T. (1999). Action Research (2nd ed.). Thousand
Oaks: Sage.
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