Healthy Teen Development Teleconference II

Jay's Introduction

Several people attended a two-day teleconference that focused on current research regarding healthy teen development. The following abstract was drawn from a presentation by Robert Wm. Blum, MD, MPH, PhD.

Abstract

While teen pregnancy in the US has declined every year since 1991, it continues to be the highest in the industrialized world, costing us $6.9 billion a year.

What has been learned about adolescent pregnancy prevention programs?

• Sex education increases short-term knowledge but has minimal effect on whether adolescents initiate sex or use contraception.
• Sexual education does not increase the likelihood of initiating sexual activity.
• With very few exceptions, programs focused on sex education or the provision of contraceptives alone have little or no impact.
• Family planning services reduce unwanted adolescent births through contraception and abortion.
• School-based clinics have not been shown consistently to reduce sexual activity or pregnancy.
• Abstinence-only prevention programs have not been shown to reduce sexual activity.
• Most interventions are not based on theory; when they are, they appear to have more impact.
• Most interventions have not been informed by research and most do not evaluate what they do.

What do we know about the influence of parent-teen communications?

• Parent/child connectedness (support, closeness, warmth) is associated with an older age of first intercourse and a lower frequency of sex during adolescence.
• Parent attitudes and values disapproving of adolescent sexual intercourse (or unprotected intercourse) is associated with later age of sexual initiation.
• The research is less clear as to the role of parental supervision/regulation. Some studies suggest it is associated with a delay in the onset of intercourse while other studies show that strict parenting is associated with a higher risk of early sexual initiation.

It is uncertain to what extent and how parent/teen communication about sex and contraception affects adolescent sexual behaviors.

Recent research from
the National Longitudinal Study of Adolescent Health (Add Health)

What questions does the present research address?

• Are teens aware of their mother's disapproval of their having sex? Of the mothers who strongly disapprove of their teens having sex, 70% of their daughters and 54% of their sons were aware of it. 56% of daughters and 71% of sons were aware if their mother's disapproval was LESS strong.
• Do mother's know if their teens have had sex? If their teens had NOT had sex, 97% of mothers were correct in saying they had not. If the teens had sex, only 49% of mothers were correct in saying their teens had sex.
• Do mothers talk to their teens about sex and birth control? The more strongly they disapproved of teens having sex, the more likely they were to talk to their teens about it. Mothers are more likely to talk a "great deal" about sex and birth control with their daughters than with their sons. Interestingly, mothers are also more uncomfortable about talking about sex and birth control with their daughters than with their sons.

Things that were learned from the study:

• It is what teens believe their parents believe about sex and birth control that makes the difference.
• Teen perceptions are influenced by what parents say, but so many more things influence their perceptions.
• Younger teens and older boys who feel connected to their mothers are less likely to have early sex.
• When it comes to delaying the initiation of sexual intercourse, caring and connectedness are important -- especially for younger teens.
• Simply saying that parents disapprove of teen sex is not enough. Clearly, some teens do not get the message. When they do get the message, teens are more likely to delay sexual intercourse.
• While so much is made these days over what we should say to our kids about sex, other aspects of parenting may have a greater influence.
• About 50% of parents seem to be unaware that their teens have started to have sex.
• Mothers may be more oriented toward influencing their daughter's sexual behavior and more oriented to influencing their son's risk of infection and early parenting.
• There are no simple answers for parents when it comes to talking to kids about birth control.
• To the extent that our messages, values, and behaviors as parents are more consistent, teens may be able to comprehend what we believe and what we say.