Evaluating programs to promote teen sexual health

Teenagers and young adults represent only 25 percent of the sexually active population in the U.S., but they acquire nearly half of all new sexually transmitted infections, according to the U.S. Centers for Disease Control. In addition, about 3 in 10 girls in the U.S. become pregnant before age 20. Clearly, encouraging the sexual health of young people is an important public health priority. But what’s the best way to go about it?

A new systematic review evaluates interventions parents can take to promote sexual health among children.

The review identified 44 intervention programs involving parents that are designed to improve the sexual health of young people.  The vast majority of the programs focused on improving communication between parents and their children.  All of the programs were community-based, and encouraged young people to delay having sex.

Each of the programs was found to improve participants’ knowledge of and attitudes toward sex.  But only seven measured sexual behavior outcomes among the young people, so it was difficult to know the full effects of the programs.  (Of those seven, four yielded positive changes in sexual behavior, such as increasing condom use or delaying sexual activity.) And in general, the evaluation of programs which were more rigorous in design were less likely to have positive outcomes.

“Understanding how to facilitate positive and productive communication between youth and parents about sexuality is imperative,” explained Janis Whitlock, a research scientist in Cornell’s Bronfenbrenner Center for Translational Research and who focuses on adolescent health and well being.

“Although parents are not the only influence on their child’s sexual behaviors, they are critical role models for authentic communication and healthy sexual development,” she said. “Parent communications with their children cannot always change short-term behavioral choices, but they clearly set the stage for later sex-related expectations and decisions.”

The take-home message:  Programs designed to improve the sexual health of young people do lead to positive changes in sexual behavior. But more thorough research is needed to understand the components of the programs that make the biggest difference.

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