Promoting Parent – Child Communication related to Sexual and Reproductive Health

1. Promoting Parent – Child Communication related to Sexual and Reproductive Health Preliminary results from the PREPARE Kampala trial presented at the PREPARE meeting, Bergen May 6-9, 2014

2. Objectives of the study The main objective: • Develop an intervention which will improve the quality and frequency of parent-child communication on sexuality and mobilize parental support for healthy sexual practices among adolescents (12-14 years of age) in Kampala. Specific objectives: • To develop a school-based intervention aimed at increasing parent-child communication on issues of sexual and reproductive health • To assess the impact of the intervention on a range of outcome variables among learners and their parents with respect to promoting healthy sexual practices • (Investigate congruency of reports by parents and adolescents dyads regarding frequency and perceived quality of this communication)

3. Adapted from Dittus et al., 2004 Intervention to: -increase knowledge and awareness, promote healthy sexual practices -improve parenting practices/communication in terms of quality and frequency Parental outcomes: --increase knowledge/awareness -self-efficacy to communicate about sexuality -positive parenting practices (monitoring, relationship building, reinforcement, communication about sexuality, values and expectations) • Adolescent outcomes : • -increase knowledge, foster positive attitudes about delay of sex/condom use/monogamy • -influence norms and social expectancies about sex • -develop self-efficacy and skills to communicate • -impact behavioralintentions • -sexual behavior

4. Parent-child sexuality communication and adolescent sexual decision making Moderating variables -sex -education -SES -rural/urban residence -religion -family structure -sexual experience -parent-child relationship -parenting style -perception of parental legitimacy/ credibility -other risk behaviors -knowledge -communication skills, content, timing, frequency, comfort, confidence, quality Attitudes towards sexuality communication Norms concerning parent-child sexuality communication Parent-child communication & adolescent sexual decision making Intention to communicate Self-efficacy to communicate

5. Scale adaptation Scales adapted from: • Families Matter! study (Vandenhoudt et al. 2010) • Barber et al. (2008) • Brown, Mounts, Lambourn & Steinberg (1993) • Darling and Dowdy (2010) • Darling, Cumsille, & Peña-Alampay (2005) • Feldman & Rosenthal (2000) • Huebner & Howell (2003) • Jaccard, Dittus & Gordon (2000)

6. Scales Communication Frequency: • In the last 3 months, how often have you discussed these topics with your child/parent? Perceived communication quality: • Perceived quality of , helpfulness and satisfaction with communication • Both communication in general and sexuality communication • I am satisfied with the communication I have with my parents about sex-related topics. • I can satisfactorialy answer the questions my child has about sex-related topics

7. Scales Parent-child relationship: • I am happy with how my child (parent/guardian) and I get along. • I hide things I do from my parent/guardian that I know they disapprove of Parental monitoring of child activity: • How often does your parent/guardian... • know where you go when you are not at home? • know what you do when you are not at home? Parental legitimacy regarding rule setting: • In your opinion, is it ok for your parent/guardian to set rules for you about... • what you og after school? • what you watch on TV or videos?

8. Scales Parental «encouragement» of sex: • I think if I talk to my child about sex-related topics, this will encourage him/her to have sex • I think my child is still too young to learn about sex-related topics Parental value of communication (responsiveness): • It is my duty to make sure my child knows about sex-related topic

9. The PREPARE Kampala trial • Eligible schools were restricted to public day schools with both boys and girls attending • A total of 22 selected schools from Kampala and Wakiso districts were randomly allocated to an intervention arm and a delayed, control condition • Learners were sampled in order to achieve a total sample of 1700 (sampled in proportion to the total number of eligible learners at each school) • n at baseline ranged from 22 to 201 at participating schools • Baseline survey conducted with parents and learners in March 2012 • The intervention program included 7 + 7school sessions (each 90 minutes in English and CRE (Christian Religious Education) and a total of 3 parental meetings • The intervention program was implemented during a 5 week period (April into June) • Follow-up data were collected in July 2012

11. Demographic characteristics at baseline: Parents * Parents reporting having attended secondary school education or college/university education ** Parentsreporting whether or not 9 items are present at home (scale 0-9)

12. Demographic characteristics at baseline: Learners * Learners reporting parent having attended secondary school education or college/university education ** Learners reporting whether or not 9 items are present at home (scale 0-9)

13. Included scales - Parents

14. Included scales - Learners

15. Preliminary outcome results Parents

16. Preliminary outcome results Learners No observedeffects for condom-relatedoutcomes