Transcript Parental - prepare

Promoting Parent – Child
Communication related to Sexual
and Reproductive Health
Preliminary results from the PREPARE Kampala trial
presented at the PREPARE meeting, Bergen May 6-9, 2014
Objectives of the study
The main objective:
• Develop 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
• To 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)
Adapted from Dittus et al., 2004
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
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
Attitudes
towards
sexuality
communication
Norms
concerning
parent-child
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 implemented during a 5 week period
(April into June)
• Follow-up data were collected in July 2012
Baseline Students
5263 students in 22 schools
Intervention arm - 2633
849 students sampled
735 completed
questionnaire
Comparison arm 2630
Sampled 1700 students
851 students sampled
767 completed
questionnaire
Demographic characteristics at baseline:
Parents
Females (n=905)
Males (n=578)
P-value
39.1 (18-72)
42.4 (18-82)
.000
Religion
Christian
Muslim
64.3
16.5
72.2
14.6
.020
Socio-economic status
% w/ higher educ *
Possessions at home **
64.0
3.8
66.4
3.9
ns
ns
Age (mean; range)
* 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-value
13.8 (11-18)
14.3 (11-20)
.000
Religion
Christian
Muslim
80.3
16.1
79.4
18.1
ns
Socio-economic status
% w/ mother w/ higher educ *
% w/father w/ higher educ
Possessions at home **
60.6
64.8
3.8
57.0
62.5
3.8
ns
ns
ns
Age (mean; range)
* 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
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
Testretest
Included scales -
Learners
No. of items
Cronbach
alpha
Mean
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
Testretest
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
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
ns
Preliminary outcome results
Learners
Intervention
group
Control
group
Effect
size
P-value
Communication frequency
2.02
1.77
.35
.000
Perceived communication quality
3.73
3.48
.27
.000
Parent-child relationship
3.55
3.44
.17
.003
Parental monitoring of child activity
2.44
2.36
.16
.003
Parental legitimacy regarding rule
setting
0.72
0.70
Parental «encouragement» of sex
2.18
2.42
.26
.002
Perceived value of communication
3.96
3.77
.21
.000
Pros of delaying sex until I am older
Social norms of delaying sex
Myths related to HIV/AIDS
4.41
4.41
2.27
4.30
4.28
2.42
.13
.16
.22
.059
.025
.004
No observed effects for condom-related outcomes
ns