Abstract
Objectives
Parent-youth Sexual and Reproductive Health (SRH) conversations are critical to reducing
adolescent pregnancy, yet many parents do not discuss contraception before youth become
sexually active. We aim to describe parental perspectives about when and how to initiate
contraception discussions, characterize motivators to discuss contraception, and explore
the role of healthcare providers in supporting contraception communication with youth.
Methods
We conducted semi-structured interviews with 20 parents of female youth ages 9-20
recruited from areas of Dallas, TX, with high rates of racial and ethnic disparities
in adolescent pregnancy. We analyzed interview transcripts with a combined deductive
and inductive approach, with discrepancies resolved by consensus.
Results
Parents were 60% Hispanic, 40% non-Hispanic Black, and 45% were interviewed in Spanish.
Most identified as female (90%). Many initiated contraception discussions based on
age, physical development, emotional maturity, or perceived likelihood of sexual activity.
Some expected daughters to initiate SRH discussions. Cultural avoidance of SRH discussion
often motivates parents to improve communication. Other motivators included reducing
pregnancy risk and managing anticipated youth sexual autonomy. Some feared that discussing
contraception could encourage sex. Parents trusted and wanted pediatricians to serve
as a bridge to discuss contraception with youth before sexual debut through confidential,
comfortable communication.
Conclusions
Tension between the desire to prevent adolescent pregnancy, cultural avoidance, and
fear of encouraging sexual behaviors causes many parents to delay contraception discussions
prior to sexual debut. Healthcare providers can serve as a bridge between sexually
naïve adolescents and parents by proactively discussing contraception using confidential
and individually-tailored communication.
Keywords
Abbreviations:
SRH (Sexual and Reproductive Health), LARC (Long-Acting Reversible Contraception)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric and Adolescent GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis.JAMA Pediatr. Jan 2016; 170: 52-61https://doi.org/10.1001/jamapediatrics.2015.2731
- Understanding the Decline in Adolescent Fertility in the United States, 2007–2012.J Adolesc Health. Nov 2016 2016; 59: 577-583https://doi.org/10.1016/j.jadohealth.2016.06.024
- Sexual Activity and Contraceptive Use Among Teenagers in the United States, 2011-2015.Natl Health Stat Report. Jun 2017; : 1-23
- Sexual initiation, contraceptive use, and pregnancy among young adolescents.Pediatrics. May 2013; 131: 886-891https://doi.org/10.1542/peds.2012-3495
Centers for Disease Control and Prevention. Reproductive Health: Teen Pregnancy - Birth Rates for Females Aged 15 to 19 Years, by Race and Hispanic Origin of Mother: United States, 2018 and 2019. Accessed December 10, 2022. https://www.cdc.gov/teenpregnancy/about/index.htm
Akers AY, Schwarz EB, Borrero S, Corbie-Smith G. Family Discussions About Contraception And Family Planning: A Qualitative Exploration Of Black Parent and Adolescent Perspectives. Perspectives on Sexual and Reproductive Health. Sept 2010;42(3):160-167. doi:10.1363/4216010
- Overwhelming Support for Sexual Health Education in U.S. Schools: A Meta-Analysis of 23 Surveys Conducted Between 2000 and 2016.Journal of Adolescent Health. 2022; 70: 598-606https://doi.org/10.1016/j.jadohealth.2021.05.016
- Support for Comprehensive Sexuality Education: Perspectives from Parents of School-Age Youth.Journal of Adolescent Health. Apr 2008 2008; 42: 352-359https://doi.org/10.1016/j.jadohealth.2007.09.019
- Messages About Abstinence, Delaying Sexual Debut and Sexual Decision-Making in Conversations Between Mothers and Young Adolescents.J Pediatr Adolesc Gynecol. Apr 2018; 31: 107-115https://doi.org/10.1016/j.jpag.2017.10.007
- The influence of individual characteristics and contraceptive beliefs on parent-teen sexual communications: a structural model.J Adolesc Health. Jun 2006; 38 (753.e9-18)https://doi.org/10.1016/j.jadohealth.2005.08.015
Pluhar EI, DiIorio CK, McCarty F. Correlates of sexuality communication among mothers and 6-12-year-old children. Child Care Health Dev. May 2008;34(3):283-90. doi:10.1111/j.1365-2214.2007.00807.x
- Parent-Teen Communication about Sexual and Reproductive Health: Cohort Differences by Race/Ethnicity and Nativity.Int J Environ Res Public Health. Mar 7 2019; 16https://doi.org/10.3390/ijerph16050833
- 21st Century Parent-Child Sex Communication in the United States: A Process Review.J Sex Res. May-Jun 2017; 54: 532-548https://doi.org/10.1080/00224499.2016.1267693
- Discussion of Potentially Sensitive Topics With Young People.Pediatrics. Feb 2019; 143https://doi.org/10.1542/peds.2018-1403
- Understanding Primary Care Providers' Perceptions and Practices in Implementing Confidential Adolescent Sexual and Reproductive Health Services.J Adolesc Health. Oct 2020; 67: 569-575https://doi.org/10.1016/j.jadohealth.2020.03.035
- Will you ask? Will they tell you? Are you ready to hear and respond?: barriers to physician-adolescent discussion about sexuality.JAMA Pediatr. 2014; 168 (Feb): 111-113https://doi.org/10.1001/jamapediatrics.2013.4605
- Theory-based interventions for contraception.Cochrane Database Syst Rev. Nov 2016; 11 (Cd007249)https://doi.org/10.1002/14651858.CD007249.pub5
Bandura A. Health promotion by social cognitive means. Health Educ Behav. Apr 2004;31(2):143-64. doi:10.1177/1090198104263660
- Parent and Adolescent Interest in Receiving Adolescent Health Communication Information From Primary Care Clinicians.J Adolesc Health. Aug 2016; 59: 154-161https://doi.org/10.1016/j.jadohealth.2016.03.001
- Sexuality talk during adolescent health maintenance visits.JAMA Pediatr. 2014; 168 (Feb): 163-169https://doi.org/10.1001/jamapediatrics.2013.4338
- Identifying types of sex conversations in adolescent health maintenance visits.Sex Health. 2016; 13 (Feb): 22-28https://doi.org/10.1071/sh15080
American Academy of Pediatrics. Bright Futures: Guidelines for Health Supervision Of Infants, Children, and Adolescents. 4th ed ed. Elk Grove Village, IL:; 2017.
Centers for Disease Control and Prevention. Youth Risk Behavior Survey Questionnaire. Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Accessed April 1, 2022. www.cdc.gov/yrbs
- Sexual and Reproductive Health Discussions During Preventive Visits.Pediatrics. 2021; 148https://doi.org/10.1542/peds.2020-049411
United States Census Bureau. Dallas City, Texas, Quick Facts. Accessed March 27, 2022. https://www.census.gov/quickfacts/dallascitytexas
Centers for Disease Control and Prevention. CDC Natality Request 2007-2020. Updated August 11, 2022. https://wonder.cdc.gov/controller/datarequest/D66
The Texas Campaign to Prevent Teen Pregnancy. Teen Birth in Texas, Teen Birth Rate by County, 1991 - 2020. Accessed August 11, 2022. https://txcampaign.org/research-data/teen-birth-in-texas/
Healthy North Texas TDoSHS. Teen Births, Dallas: 2017. Accessed 4/4/22, https://www.healthyntexas.org/indicators/index/view?indicatorId=431&localeId=2631
- Qualitative data analysis for health services research: developing taxonomy, themes, and theory.Health Serv Res. Aug 2007; 42: 1758-1772https://doi.org/10.1111/j.1475-6773.2006.00684.x
- We're Not Going to Have This Conversation, But You Get It”: Black Mother–Daughter Communication About Sexual Relations.Women's Studies in Communication. 2012; 35 (Jan 2012): 204-223https://doi.org/10.1080/07491409.2012.724525
- Parents' communication with adolescents about sexual behavior: A missed opportunity for prevention?.Journal of Youth and Adolescence. 2006; 35 (Dec): 893-902https://doi.org/10.1007/S10964-006-9093-Y
- Parent-based adolescent sexual health interventions and effect on communication outcomes: a systematic review and meta-analyses.Perspect Sex Reprod Health. 2015; 47 (Mar): 37-50https://doi.org/10.1363/47e2415
- El Sexo no es Malo": Maternal Values Accompanying Contraceptive Use Advice to Young Latina Adolescent Daughters.Sex Res Social Policy. Jun 2010; 7: 118-127https://doi.org/10.1007/s13178-009-0001-6
- Latino Parents' Plans to Communicate About Sexuality With their Children.Journal of Health Communication. Aug 2013; 18: 931-942https://doi.org/10.1080/10810730.2012.757397
- Misalignment of sexual and reproductive health priorities among older Latino adolescents and their mothers.Contraception. 2019; 99 (Mar): 179-183https://doi.org/10.1016/j.contraception.2018.11.011
- Exploring African-American and Latino Teens' Perceptions of Contraception and Access to Reproductive Health Care Services.J Adolesc Health. 2017; 60 (Mar): S57-s62https://doi.org/10.1016/j.jadohealth.2016.12.006
- Call to Action: Healthcare Providers Must Speak Up for Adolescent Abortion Access.Journal of Adolescent Health. 2022; 70: 189-191https://doi.org/10.1016/j.jadohealth.2021.11.010
Article info
Publication history
Accepted:
February 25,
2023
Received in revised form:
February 17,
2023
Received:
December 23,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
