Parent-targeted interventions in primary care improve parent-teen communication on alcohol and sex

Researchers from Children's Hospital of Philadelphia published the study today in JAMA Network Open.

"Community, school and home-based interventions involving direct contact between staff and parents or caregivers can favorably influence parent-teen communication and a wide range of adolescent risk-associated behaviors," said Carol A. Ford, MD, an adolescent medicine physician at Children's Hospital of Philadelphia and lead author of the study. "The purpose of this study was to see if these interventions could be shaped to also work out of a busy pediatric clinic."

This randomized, controlled trial, conducted between January 2016 and April 2018 in a busy primary care pediatric practice, involved 118 parents and caregivers and their 14- to 15-year-old adolescents. Almost all of the parents were female. Adolescent participants were evenly split by gender and age. Race and ethnicity of the adolescents reflected the practice's demographics: 53 percent black, 39 percent white and 94 percent non-Hispanic. At the start of the study, 13 percent of the adolescents reported a history of sex and 14 percent reported a history of drinking alcohol.

The parent-teen pairings were divided into three groups: sexual health intervention, alcohol intervention and a control group. During wellness visits, parents in the sexual health and alcohol intervention groups received coaching to discuss written materials encouraging parent-teen communication about sex or alcohol use, and their doctor endorsed these messages. Two weeks later, a health coach followed up with a phone call. The control group received standard medical care.

When the researchers followed up with the participants four months later, adolescents in both the sex intervention group and alcohol group reported more parent-teen communication about sex and alcohol than those in the control group. Parent-reported frequency of the parent-teen communication about sex or alcohol did not differ by group.

"Our study was not sufficiently long enough or large enough to test influences of parent-teen communication on adolescent behaviors," Ford said. "However, we adapted and tested interventions to show improvements in both parent-teen communication and associated risk-taking behaviors." This suggests doctors and nurses may have an important role in guiding parents and teens to discuss sensitive health topics, like sexual health and alcohol use, in a way that helps teens make healthy choices as they grow up."