Effectiveness of Parent Participation in a Technology-Based Adolescent Sexuality Education Program: A Randomized Control Trial

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Monrudee Chokprajakchad
Rutja Phuphaibul
Renee E. Sieving
Srisamorn Phumonsakul


             Adolescent sexual risk behavior is considered a severe problem worldwide. A technology-based program is a practical tool for increasing parents’ sexual communication when it has been implemented to reduce sexual risk behaviors. This randomized control trial investigated the effects of parent participation in a technology-based adolescent sexuality education program on outcomes of parental sexual communication behavior and adolescent sexual abstinence intention. Eighty seventh-grade students and their parents in a secondary school in Bangkok, Thailand were recruited and randomly assigned to either the experimental (n= 41) or the comparison group (n=39). The experimental group received the Parent Participation in a Technology-Based Adolescent Sexuality Education Program, whereas in the comparison group only adolescent received a Technology-Based Adolescent Sexuality Education Program. Data were collected by Adolescent Sexual Risk Behavior questionnaires and Parent Sexual Communication Behavior questionnaires. Generalized Estimating Equations were used to evaluate differences in parent and adolescent outcomes by intervention condition.
          Results showed that attitudes, norms, intention, and sexual communication behavior of parents in the experimental group were higher than the comparison group. Adolescents’norms about sexual abstinence in the experimental group were higher than the comparison group. Additionally, adolescents’ reports of communicating with their parents about sexual health topics in the experimental group also were higher than the comparison group.Nurses should work with parents to improve parents’ sexual communication and also promote adolescents’ sexuality education.

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Chokprajakchad M, Phuphaibul R, Sieving RE, Phumonsakul S. Effectiveness of Parent Participation in a Technology-Based Adolescent Sexuality Education Program: A Randomized Control Trial. PRIJNR [Internet]. 2020 Mar. 14 [cited 2023 Jan. 31];24(2):219-33. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/190660
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Centers for Disease Control and Prevention. Sexual risk behaviors: HIV, STD, & teen pregnancy prevention [Internet] 2016. [cited 2018 Jun 15]. Available from https://www.cdc.gov/ healthyyouth/yrbs/pdf/us_overview.

Chin, H. B., Sipe, T. A., Elder, R., Mercer, S. L., Chattopadhyay, S. K., Jacob, V., Griffith, M. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services. Am J Prev Med. 2012; 42(3): 272−294.

UNFPA. Motherhood in children. Advance printing service company limited [Internet] 2013. [cited 2018 Jun 10]. Available from: https://thailand.unfpa.org/sites/default/ files/pubpdf/State%20of%20Thailand%20Population% 20report%202013-Motherhoodin Childhood_th.pdf.

World Health Organization. Adolescents: health risks and solutions [Internet] 2016. [cited 2018 Jul 10]. Available from: https://www.who.int/mediacentre/factsheets/fs345/en.

Bureau of Reproductive Health, Department of Health Ministry of Public Health. The situation of reproductive among adolescents and youth. Ministry of Public Health. Nonthaburi, Thailand. 2017.

Thai Health Organization. Worrisome situation Thai teenagers are more HIV positive. [Internet] 2018. [cited 2017 Jun 20]. Available from: https://www.thaihealth. or.th/Content/41145.

Chokprajakchad, M., Phuphaibul, R., & Sieving, R.E. Sexual health interventions among early adolescents. An integrative review. J Health Res. 2018; 32(6): 467-477.

Gavin LE, Williams JR, Rivera MI, Lachance CR. Programs to strengthen parent adolescent communication about reproductive health: a systematic review. AmJ Prev Med. 2015 49; (2): S65-72.

Aherrera, C., Davis, L., Gardinier, S., Kim, N. L., Paisancharoenwong, P., Pongprajakkul, C., Kinicki, R. Preventing Thai teen pregnancy through digital media. An interactive Qualifying Project Report (Unpublished bachelor’s project report) Faculty of Worcester Polytechnic Institute and Chulalongkorn University, Bangkok. 2015.

Puntang, P., Toonsiri, C., & Junpraasert, S. Factors influencing intention to prevent sexual risk behaviors of female secondary school students under the Department of General Education, the Secondary Educational Service Area Office 2 in Chonburi Province. Faculty of Nursing, Burapha University 2016 [in Thai].

Thaweephon, C. Parent adolescent sexual communication for teenage pregnancy prevention (Master’s thesis) Mahidol University, Bangkok. 2012 [in Thai].

Rogers, A. A., Ha, T., Stormshak, E. A., & Dishion, T. J. Original article: Quality of parent–adolescent conversations about sex and adolescent sexual behavior: An observational study. J Adolesc Health. 2015; 57: 174-178.

Suvarnakuta, P., Congkhaow, T., & Nichachotesalid, P. Effects of program to develop mother's skills in communication about sex with early adolescent daughters. Journal of Prapokklao Nursing College. 2015; 26(1): 1-16 [in Thai].

Thipsungwan, K., Srisuriyawet, R., & Homsin, P. Effects of mother−participating program on sexual communication between mother and early female adolescents. The Public Health Journal of Burapha University. 2014; 8(2): 69−80 [in Thai].

Hattakitpanichakul K, Phuphaibul R, Viwatwongkasem C, Phumonsakul S. The effects of the dual approach program on parent’s sexual communication and sexual abstinence intention among Thai grade 7 female adolescents. J Health Res. 2019; 33(4): 280-292

Wendeman, D., & Rotheram-Borus, M. J. Innovation in sexually transmitted disease and HIV prevention: Internet and mobile phone delivery vehicles for global diffusion. Curr Opin Psychiatry. 2010; 23(2): 139−144.

Chu, S. K. W., Kwan, A. C., Reynolds, R., Mellecker, R. R., Tam, F., Lee, G., Leung, C. Y. Promoting sex education among teenagers through an interactive game: Reasons for success and implications. Games Health J. 2015; 4(3): 168−174.

Peskin, M. F., Shegog, R., Markham, C. M., Thiel, M., Baumle, E. R., Addy, R. C., Emery, S. T. Efficacy of It's Your Game-Tech: A computer−based sexual health education program for middle school youth. J Adolesc Health. 2015; 56(5): 515−521

Neranon, W., Phuphaibul, R., & Kongsaktrakul, C. Effects to the activity package computer game media on attitude norm and perceived behavior control on sexual abstinence of 7th grade students. KCN-Journal. 2018; 25(1): 73-98 [in Thai].

Wilson, C. Adolescent sexual risk reduction and the Theory of Planned Behavior: Moderation effects and the role of previous experience (Master’s thesis) Georgia State University. 2015.

Kirby. Reducing adolescent sexual risk a theoretical guide for developing and adapting curriculum-based programs. California: ETR Associates 2011.

Chaikoolvatana, C., Powwattana, A., Lagampan, S., Jirapongsuwan, A., & Bennet, T. Development of a school-based pregnancy prevention model for early adolescent female Thais. Pacific Rim Int J Nurs Res. 2013; 17(2): 131-147 [in Thai].

Phuphaibul, R., Chokprajakchad, M., & Phuphaibul, P. Attitude changes among adolescents after viewing the television series “Hormones”. Journal of Behavioral Science for Development. 2015; 7(1): 153-168 [in Thai].

Guilamo-Ramos, V., Lee, J. J., & Jaccard, J. Parentadolescent communication about contraception and condom use. JAMA Pediatr. 2016; 170(1): 14-16.

Cupp, P. K., Atwood, K. A., Byrnes, H. F., Miller, B. A., Fongkaew, W., Chamratrithirong, A., Chookhare, W. The impact of Thai family matters on parent-adolescent sexual risk communication attitudes and behaviors. J Health Commun. 2013; 18(11).

Butcharoen, W., Pichayapinyo, P., & Pawwattana, A. Factors related to sexual Risk behavior among Thai secondary school students. J Public Health. 2012; 42(1): 30−40.

Bo, W., Xiaoming, L., Deveaux, L., Stanton, B., & Lunn, S. Dynamic Relationships between parental monitoring, peer risk involvement and sexual risk behavior among Bahamian Mid-Adolescents. Int Perspect Sex Reprod Health. 2015; 4(2): 89-98.

Suh, M. M., & Hsieh, G. Designing for future behaviors: understanding the effect of temporal distance on planned behaviors. Paper presented at the proceedings of the 2016 CHI Conference on Human Factors in Computing Systems. 2016.

Glanz, K., Rimer, B. K., & Viswanath, K. Health behavior and health education: theory, research, and practice. John Wiley & Sons. 2018.

Taikhanong, K. The factors influencing of the intention of sexual risk behavior amongst high school students. Christian University of Thailand Journal 2012 17(1): 168-193. [in Thai]

Ajzen, I. The theory of planned behavior. Organizational behavior and human decision processes. 1991; 50(2): 179−211.

Diggle P, Heagerty P, Liang K-Y, et al: Analysis of Longitudinal Data, (2nd ed.). Oxford University Press, 2002, pp 126e140.

Heednakram, U., Kasatpibal, N., & Viseskul, N. Effect of parent communication skill development on communication about HIV prevention between parents and early adolescents. Nursing Journal. 2015; 42: 13−24 [in Thai].

Pongnimitporn, S. Kaewkajorn, S, Somboon, L MA & Thaiyapirom N. Parental knowledge and perceived selfefficacy in teaching sex education to young children. Nursing Journal. 2017; 44(2): 28-37 [in Thai].

Ajzen, I., & Timko, C. Correspondence between health attitudes and behavior. Basic Appl Soc Psych. 1986; 7(4): 259−276.

Niamkan, S. & Sornchai, S. (2013). Factors related to communication regarding sex matter between parents and their puberty children. Journal of Phrapokklao Nursing College. 2013; 24(2): 36-46 [in Thai].