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John A. Sieverding, MD, MPH; Nancy Adler, PhD; Stephanie Witt, MPH; Jonathan Ellen, MD

Arch Pediatr Adolesc Med. 2005;159:724-729.

Objective  To explain the influence of parental monitoring on adolescent sexual initiation within the context of a cognitive behavioral model.

Design, Setting, and Participants  Virginal youth (N = 307) recruited from a health maintenance organization adolescent medicine clinic were interviewed at baseline and at 6 months about parental monitoring and other known cognitive factors associated with the initiation of sexual behavior. Participants were followed up at 6 months and potentially at 12 months to assess the initiation of sexual intercourse.

Results  Adolescents reporting successful parental monitoring (accurately knowing the adolescents’ whereabouts and activities outside the home) significantly expressed cognitions less favorable of initiating intercourse, while adolescents reporting more unrestricted time were more likely to express cognitions that favored initiating intercourse. In adjusted analysis, cognitions (attitudes, perceived peer behaviors, and subjective norms) that favored intercourse significantly predicted a greater intention to engage in intercourse. However, adolescents who reported successful parental monitoring significantly expressed less sexual intention, and successful parental monitoring moderated the effect of attitude on the intention to initiate intercourse among female subjects. Overall, behavioral intention was the only significant predictor of actual sexual onset.

Conclusions  These findings are useful in directing further research and in designing interventions to delay the onset of sexual intercourse in adolescence. More research is required to understand how attitudes toward sexual initiation are formed during adolescence and how parents may facilitate the formation of these attitudes. Parental interventions that promote successful communication and support effective parental monitoring may be an important component of interventions designed to delay sexual initiation during adolescence.

Author Affiliations: Division of Adolescent Medicine, Department of Pediatrics (Dr Sieverding), and Department of Psychiatry (Dr Adler), University of California, San Francisco; and Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics (Ms Witt and Dr Ellen), The Johns Hopkins University, Baltimore, Md. Dr Sieverding is now in private practice.

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