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A Randomized Controlled Trial

Rex Forehand, PhD; Lisa Armistead, PhD; Nicholas Long, PhD; Sarah C. Wyckoff, MPH; Beth A. Kotchick, PhD; Daniel Whitaker, PhD; Anne Shaffer, MS; Alan E. Greenberg, MD; Velma Murry, PhD; Leslie C. Jackson, PhD; Abesie Kelly, PhD; Lily McNair, PhD; Patricia J. Dittus, PhD; Carol Y. Lin, MPH, PhD; Kim S. Miller, PhD

Arch Pediatr Adolesc Med. 2007;161(12):1123-1129.

Objective  To evaluate the efficacy of a parent-based sexual-risk prevention program for African American preadolescents.

Design  Randomized controlled trial.

Setting  Community-based study conducted in Athens, Georgia; Atlanta, Georgia; and Little Rock, Arkansas from 2001 to 2004.

Participants  From 1545 inquiries, 1115 African American parent-preadolescent dyads (child, aged 9-12 years) formed the analytic sample.

Intervention  Participants were randomized into 1 of 3 study arms: enhanced communication intervention (five 2-hour sessions), single-session communication intervention (one 2-hour session), and general health intervention (control, one 2-hour session).

Outcome Measures  Continuous measures of parent-preadolescent sexual communication and parental responsiveness to sex-related questions at preintervention, postintervention, and at 6- and 12-month follow-ups; and dichotomous measure of preadolescent sexual risk (having engaged in or intending to engage in sexual intercourse at 12-month follow-up).

Results  Using intent-to-treat participants, differences of mean change from baseline for continuous measures and relative risk for the dichotomous measure of sexual risk were calculated. Participants in the enhanced intervention had higher mean changes from baseline scores, indicating more sexual communication and responsiveness to sexual communication at each assessment after intervention for all continuous measures than those in the control intervention and single-session intervention. Preadolescents whose parents attended all 5 sessions of the enhanced intervention had a likelihood of sexual risk at the 12-month follow-up of less than 1.00 relative to those whose parents attended the control (relative risk, 0.65; 95% confidence interval, 0.41-1.03) and single-session (relative risk, 0.62; 95% confidence interval, 0.40-0.97) interventions.

Conclusions  These results provide preliminary evidence for the efficacy of a parenting program designed to teach sexual communication skills to prevent sexual risk in preadolescents.

Trial Registration  clinicaltrials.gov Identifier: NCT00137943

Author Affiliations: University of Vermont, Burlington (Dr Forehand); Georgia State University, Atlanta (Drs Armistead and Jackson); University of Arkansas for Medical Sciences, Little Rock (Drs Long and Kelly); University of North Carolina, Chapel Hill (Ms Wyckoff); Centers for Disease Control and Prevention, Atlanta (Ms Wyckoff and Drs Whitaker, Greenberg, Dittus, Lin, and Miller); Loyola College in Maryland, Baltimore (Dr Kotchick); University of Minnesota, Minneapolis (Ms Shaffer); George Washington University, Washington, DC (Dr Greenberg); University of Georgia, Athens (Dr Murry); and Spelman College, Atlanta (Dr McNair).

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