In the Journals

Providers can help parents talk to teens about sex, alcohol use

Adolescents more frequently reported communicating with their parents about sex and alcohol use following an intervention in which pediatric primary care providers coached the parents on talking to their kids about the behaviors, according to findings from a randomized clinical trial published in JAMA Network Open.

“Parents can influence adolescents’ risk of unwanted pregnancy, sexually transmitted infection and alcohol-related injury that cause substantial morbidity and mortality among adolescents and young adults,” Carol A. Ford, MD, chief of the Craig-Dalsimer Division of Adolescent Medicine at Children’s Hospital of Philadelphia, and colleagues wrote. “Enthusiasm about these interventions must be balanced with acknowledgement that such programs can be difficult to scale and sustain.”

As part of the intervention, Ford and colleagues coached parents and guardians of teens (n = 118) on how to discuss written materials about sexual health or alcohol use prevention. Parents were urged to discuss sex or alcohol with the teenager within 2 weeks of the visit.

Teens attending well visits at a primary care pediatric practice between Jan. 4, 2016, and April 10, 2017, and their parent or caregiver received either usual care (control; n = 40) or the intervention. During the study period, 38 caregivers received the sexual health intervention and 40 received the alcohol prevention intervention.

After parental coaching, a physician or nurse directly endorsed the messages in the intervention and provided a written prescription reinforcing the key messages for the patient. After 2 weeks, parents received a follow-up call to discuss communication about sex or alcohol with their teen, barriers to using the intervention and how the materials could be used to overcome barriers.

Teens reported both a history of sexual behavior (12.7%) and alcohol use (13.6%) before inclusion in the study. After 4 months, teens’ reported mean frequency score for conversations about sex was higher in those receiving the sexual health intervention (2.32; 95% CI, 1.97-2.66) compared with those in the control group (1.79; 95% CI, 1.5-2.08). It also was higher for conversations about alcohol use prevention among teens in the intervention group (2.93; 95% CI, 2.6-3.25) compared with those in the control group (2.4; 95% CI, 2.08-2.72).

According to the researchers, parent-reported frequency scores did not differ between groups in the sexual health group and the alcohol use prevention group.

“Results suggest that there are innovative strategic opportunities for clinicians in primary care settings to join with parents to effectively achieve better health outcomes among sizable portions of adolescent patients,” Ford and colleagues wrote. “The paucity of existing primary care parent-targeted interventions needs to be addressed, with a focus on developing a portfolio of interventions that effectively address a range of adolescent health issues.” – by Katherine Bortz

Disclosures: Ford reports receiving grants from the Health Resources and Services Administration during the conduct of the study. All other authors report no relevant financial disclosures.

Adolescents more frequently reported communicating with their parents about sex and alcohol use following an intervention in which pediatric primary care providers coached the parents on talking to their kids about the behaviors, according to findings from a randomized clinical trial published in JAMA Network Open.

“Parents can influence adolescents’ risk of unwanted pregnancy, sexually transmitted infection and alcohol-related injury that cause substantial morbidity and mortality among adolescents and young adults,” Carol A. Ford, MD, chief of the Craig-Dalsimer Division of Adolescent Medicine at Children’s Hospital of Philadelphia, and colleagues wrote. “Enthusiasm about these interventions must be balanced with acknowledgement that such programs can be difficult to scale and sustain.”

As part of the intervention, Ford and colleagues coached parents and guardians of teens (n = 118) on how to discuss written materials about sexual health or alcohol use prevention. Parents were urged to discuss sex or alcohol with the teenager within 2 weeks of the visit.

Teens attending well visits at a primary care pediatric practice between Jan. 4, 2016, and April 10, 2017, and their parent or caregiver received either usual care (control; n = 40) or the intervention. During the study period, 38 caregivers received the sexual health intervention and 40 received the alcohol prevention intervention.

After parental coaching, a physician or nurse directly endorsed the messages in the intervention and provided a written prescription reinforcing the key messages for the patient. After 2 weeks, parents received a follow-up call to discuss communication about sex or alcohol with their teen, barriers to using the intervention and how the materials could be used to overcome barriers.

Teens reported both a history of sexual behavior (12.7%) and alcohol use (13.6%) before inclusion in the study. After 4 months, teens’ reported mean frequency score for conversations about sex was higher in those receiving the sexual health intervention (2.32; 95% CI, 1.97-2.66) compared with those in the control group (1.79; 95% CI, 1.5-2.08). It also was higher for conversations about alcohol use prevention among teens in the intervention group (2.93; 95% CI, 2.6-3.25) compared with those in the control group (2.4; 95% CI, 2.08-2.72).

According to the researchers, parent-reported frequency scores did not differ between groups in the sexual health group and the alcohol use prevention group.

“Results suggest that there are innovative strategic opportunities for clinicians in primary care settings to join with parents to effectively achieve better health outcomes among sizable portions of adolescent patients,” Ford and colleagues wrote. “The paucity of existing primary care parent-targeted interventions needs to be addressed, with a focus on developing a portfolio of interventions that effectively address a range of adolescent health issues.” – by Katherine Bortz

Disclosures: Ford reports receiving grants from the Health Resources and Services Administration during the conduct of the study. All other authors report no relevant financial disclosures.