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Journal of Family Psychology 2010, Vol. 24, No. 6, 731–739

© 2010 American Psychological Association

DOI: 10.1037/a0021760

0893-3200/10/$12.00

How Can Parents Make a Difference? Longitudinal Associations With Adolescent Sexual Behavior

Daneen P. Deptula

Fitchburg State University

Michael E. Schoeny

University of Chicago

David B. Henry

University of Illinois at Chicago

Parents have the potential to protect against adolescent sexual risk, including early sexual behavior, inconsistent condom use, and outcomes such as pregnancy and sexually transmitted infections (STIs). Identification of the specific parenting dimensions associated with sexual risk in adolescence and young adulthood is necessary to inform and focus prevention efforts. The current study examined the relation of proximal (e.g., discussions of sexual costs) and distal (e.g., parental involvement, relationship quality) parenting variables with concurrent and longitudinal adolescent sexual behavior. The National Longitudinal Study of Adolescent Health (Add Health) provided a nationally representative sample with information about the family using adolescent and parent informants. Longitudinal information about sexual risk included adolescent condom use and adolescent sexual initiation, as well as young adult unintended pregnancy, reports of STIs, and biological assay results for three STIs. Higher parent–adolescent relationship quality was asso- ciated with lower levels of adolescent unprotected intercourse and intercourse initiation. Better relationship quality was also associated with lower levels of young adult STIs, even when accounting for prior sexual activity. Unexpectedly, more parent reports of communication regard- ing the risks associated with sexual activity were negatively associated with condom use and greater likelihood of sexual initiation. These results demonstrate that parents play an important role, both positive and negative, in sexual behavior, which extends to young adulthood, and underscores the value of family interventions in sexual risk prevention.

Keywords: parents, sexual activity, sexually transmitted infections, unintended pregnancy

Adolescent sexual activity is a risk factor for teenage pregnancy (Wellings et al., 2001) and sexually transmitted

Daneen P. Deptula, Department of Behavioral Sciences, Fitch- burg State University; David B. Henry, Institute for Health Re- search and Policy University of Illinois at Chicago, University of Illinois at Chicago; Michael E. Schoeny, Chapin Hall at the Uni- versity of Chicago, University of Chicago. Support for this research was provided by National Institute on Child Health and Human Development Grant R01-HD052444 to David B. Henry. This article is based on a 2009 presentation at the biennial meeting of the Society for Research in Child Development. This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Persons inter- ested in obtaining data files from Add Health should contact Add Health, Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC 27516-2524 (addhealth@unc.edu). No direct support was received from Grant P01-HD31921 for this analysis. Correspondence concerning this article should be addressed to Daneen P. Deptula, Department of Behavioral Sciences, Fitchburg State University, 160 Pearl Street, Fitchburg, MA 01420-2697. E-mail: ddeptula@fitchburgstate.edu

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infections (STIs; Lewis, Melton, Succop, & Rosenthal, 2000). Early sexual initiation is associated with failure to use birth control, condoms in particular, as well as having multiple sexual partners over time (Langille & Curtis, 2002). Adolescents are particularly vulnerable to contract- ing an STI, with 48% of new infections occurring in those 15–24 years of age (Weinstock, Berman, & Cates, 2004). In part, these rates are due to a lack of condom use, with condom usage decreasing with age (Centers for Disease Control and Prevention, 2008). Rates of chlamydia, a treat- able but often undetected STI, have recently increased, with 15- to 19-year-old females reporting the highest rates of infection (Centers for Disease Control and Prevention, 2009). Adolescent STI history is also a risk factor for future STIs. A study of 15- to 19-year-old African American males found that prior STI history was the strongest predictor of later infections (Wagstaff, Delamater, & Havens, 1999). A better understanding of the factors that lower the risk of adolescent STIs is needed to inform prevention efforts. Ecological theory (e.g., Bronfenbrenner, 1986) suggests that sexual behavior, like other behaviors, is influenced by multiple factors in multiple levels of an adolescent’s social life. These factors include individual characteristics, parent– child relations, peer relations, school, and neighborhood features. Ecodevelopmental theory (Perrino, Gonzalez-

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DEPTULA, HENRY, AND SCHOENY

Soldevilla, Pantin, & Szapocznik, 2000) incorporates eco- logical, developmental, and system influences in under- standing adolescent risk. Specifically, it identifies the family as the ideal mechanism for prevention and change given the family’s proximal position to the individual as well as the level of interaction between families and other systems, such as the school, neighborhood, and peers. There are several different mechanisms through which parenting may affect adolescent sexual outcomes. First, the conversations that parents have with their adolescents about sex may play an important role in sexual risk protection. For instance, parents may provide important factual information and values, which then serve to buffer adolescents from peer influence (Whitaker & Miller, 2000). Evidence from the 1990s suggests that early adolescents, defined as those be- tween the ages of 13 to 15, are more likely to discuss sexual matters with their parents than with their friends (DiIorio, Kelley, & Hockenberry-Eaton, 1999). In addition, talking openly and skillfully with parents about sexual risk, includ- ing topics such as STIs, condom use, and reproduction, is related to having these same conversations with their sexual partner (Whitaker, Miller, May, & Levin, 1999). Second, parents may play a role in adolescent sexual risk through more distal factors such as parental monitoring, parental involvement, educational aspirations, and allowed independence. For instance, higher levels of parental mon- itoring have been associated with fewer sexual partners, lower levels of sexual activity, and more consistent condom use (Borawski, Ievers-Landis, Lovegreen, & Trapl, 2003; Miller, Forehand, & Kotchick, 1999; Rodgers, 1999). Lower educational aspirations, held by parents and adoles- cents, are associated with more risky adolescent sexual attitudes and behavior (Miller & Sneesby, 1988). Parental involvement, such as sharing dinner time with their adoles- cents, is associated with lower levels of sexual initiation (Pearson, Muller, & Frisco, 2006). Finally, allowed inde- pendence has been found to be related to sexual risk for certain groups such as Caucasian adolescents (Lam, Russell, Tan, & Leong, 2008) or those from advantaged neighbor- hoods (Roche et al., 2005). In summary, parental attitudes and behaviors unrelated to sexuality play a role in adoles- cent sexual risk. Third, parent–adolescent relationship factors may pro- vide protection against adolescent sexual risk. These rela- tionship factors may include overall communication quality (i.e., not specific to sexuality) and the quality of the parent– child relationship. Across multiple studies, close parent– child relationships have been associated with delays in sexual intercourse and more consistent contraception use (see Fisher, 2004; Miller, Benson, & Galbraith, 2001, for reviews). For instance, Borawksi, Ievers-Landis, Loveg- reen, & Trapl (2003), found that perceived parental trust was linked with lower levels of female sexual activity. General communication is also important, as positive, high- quality overall communication between mothers and ado- lescents is associated with fewer sexual partners and less frequent intercourse (Karofsky, Zen, & Kosorok, 2000; Miller et al., 1999).

It is important to note that not all studies have supported

a link between parental factors and adolescent sexual risk

protection (e.g., reviews by Fisher, 2004; Miller et al., 2001). For instance, Perkins, Luster, Villarruel, and Small (1998) found no relation between either parental monitoring or family support and adolescent sexual activity. Some studies have found that parental factors, such as maternal involvement, actually increase adolescent sexual risk (Davis & Friel, 2001). In other cases, a curvilinear relationship is observed, such as with allowed independence. Although generally related to lower pregnancy risk, restricted inde- pendence can be problematic if it is coercive or intrusive (Miller et al., 2001). Research findings have been particu- larly inconsistent with respect to the effects of sexual com-

munication on sexual activity (Fisher, 2004). For instance, Casper (1990) found no relation between parent–adolescent communication about pregnancy and sexual initiation. These contradictory findings may be due to differences in measurement, such as examining frequency versus quality of discussion (Fisher, 2004). Researchers have also pro- posed that some studies have neglected to consider key variables, such as parental disapproval of sexual activity (see review by Zimmer-Gembeck & Helfand, 2008) or parental comfort and confidence in talking to teens about sex (see review by Fisher, 2004). The goal of the present study was to consider multiple parenting factors that might be associated with sexual ac- tivity to explore the specific mechanisms through which parents might protect adolescents from sexual risk. Ecode- velopmental theory stresses that research should consider

multiple variables representing different dimensions of the family system (Perrino et al., 2000) given that the effect of

a single dimension might be inflated if examined individu-

ally (Magnusson, Andersson, & Törestad, 1993, p. 212). We used data from the National Longitudinal Study of Adolescent Health (Add Health), which provided three waves of data collection with a nationally representative sample. Scant longitudinal and multi-informant research has compared the effect of general parenting characteristics, such as parental involvement, with those of more targeted parental behaviors, such as communication about sex. As the current study includes data from mothers and fathers, it differs from most other Add Health research in that it does not exclusively study maternal factors (e.g., Dittus & Jac- card, 2000; Lam et al., 2008; McNeely et al., 2002; Usher- Seriki, Bynum, & Callands, 2008). Other Add Health stud- ies have focused on different measures of sexual activity such as noncoital sexual behavior (Lam et al., 2008) or examined a subset of adolescents in terms of age (McNeely et al., 2002), race (Lam et al., 2008; Usher-Seriki et al., 2008) or family structure (Regnerus & Luchies, 2006). Longitudinal studies using Add Health have focused on early sexual initiation (Pearson et al., 2006; Regnerus & Luchies, 2006; Roche et al., 2005). The current study is unique in its examination of both concurrent and longitudi- nal sexual risk, extending into the young adult years with the assessment of unintended pregnancy and STIs. Demographic differences may interact with parenting factors in their role in sexual behavior. For instance, in their

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PARENTING FACTORS

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observational study of parents and early adolescents, Whalen, Henker, Hollingshead, and Burgess (1996) found that parents engaged in more reciprocity with female ado- lescents but were more directive with their sons. This di- rectiveness decreased for older adolescents. Similarly, the use of psychological control (e.g., guilt, limited adolescent autonomy) was associated with female but not male risky sexual behavior (Rodgers, 1999). Some studies have failed to find interactions between parenting factors and ethnicity in predicting sexual risk (Miller et al., 1999; Perkins et al., 1998). More research is needed to better understand how ethnicity might interact with parental factors to protect against adolescent sexual risk; however, that analysis was beyond the scope of this article. We included demographic variables, specifically age, gender, and ethnicity, as covari- ates in all analyses, and based on evidence of differences in parenting effects, included interactions with gender and age. Interactions involving ethnicity were not included as a pos- sible interaction effect given the complexity of the model and the lack of a cohesive theory concerning the role of ethnicity in the relation between parenting and adolescent sexual risk. In this study, we explored the key parenting factors associated with risky sexual behavior by examining the unique variance associated with each parenting dimension, controlling for the others. We addressed the following re- search questions. First, what specific parenting factors are cross-sectionally associated with condom use? We expected that all parenting factors would have stronger effects on concurrent risk (e.g., condom nonuse) than on longitudinal risk outcomes (e.g., young adult STIs) because the impact of parents’ behavior and attitudes would be attenuated over time. Second, what is the role of parents with respect to sexual initiation? Finally, we considered the role of parent- ing factors on young adult sexual outcomes, specifically unintended pregnancy and STI diagnoses. In general, we expected that more positive parent–adolescent relationship quality and engaging in specific communication with teen- agers about sex would be related to lower risk for all of the measures of young adult sexual outcomes. We also expected that more general parenting factors, such as parental edu- cational aspirations for the adolescent or allowed indepen- dence, would not have longitudinal implications for adoles- cent sexual outcomes when controlling for the more proximal factors such as sexual communication.

Method

Participants

The Add Health project collected information from a nationally representative sample using three waves of data collection. The sample for the current study consisted of 16,980 adolescents with complete Wave I information. Sample characteristics consisted of approximately equal distributions of males and females (males 8,441, 49.7%) with an average age of 16.01 years. Ethnicity was coded using the following categories: Caucasian, non-Hispanic White (n 9,432, 55.5%); African American (n 3,636,

21.4%); Hispanic (n 2,732, 16.1%); Asian (n 870,

5.1%); American Indian (n 158, 0.9%); and other (n 152, 0.9%). Multiethnic individuals were coded on the basis of their self-reported primary ethnicity.

In addition to adolescent interviews, one parent or guard-

ian from each family also provided information as part of the Wave I in-home portion of the Add Health data collec- tion. The Add Health protocol was to select a female pa- rental figure as the preferred respondent because it was assumed that female caregivers would be more extensively involved in the adolescent’s life. Past research has found

that adolescents of either gender were more likely to discuss sexual matters with their mothers than fathers (DiIorio et al., 1999; Dutra, Miller, & Forehand, 1999; Guzman et al., 2003). In addition, mothers’ but not fathers’ sexual com- munication has been related to adolescent engagement in risky sexual behavior (Dutra et al., 1999). Over 93% of the parental survey was completed by female parents or other female caregivers (e.g., stepmother, grandmother, foster mother, adoptive mother).

A subsample of the Wave I data collection participated in

Wave II and Wave III data collections. Wave II sexual history information was collected via self-report from the adolescents approximately 1 year after Wave I data collec- tion. A total of 12,436 adolescents (73.2%) in the current sample provided information at Wave II. Approximately 6 years later, Wave III information was collected from the (then) young adult participants. Wave III information for the purposes of the current study consisted of self-reported STI diagnoses (n 12,634, 74.4%), STI assay results (n 10,324, 60.8%), and reports of unintended pregnancies (n 6,082, 35.8%).

Procedure

At Wave I, the Add Health study recruited a nationally representative sample of students in grades 7 to 12 from 132 schools (Bearman, Jones, & Udry, 1997). The in-home administration was completed between September 1994 and April 1995, with most interviews taking place in the respon- dents’ homes. Sensitive items, such as those assessing sex- ual activity, were administered via headphones, with the adolescent entering the information directly into the laptop (audio-CASI). This approach reduced biases due to inter- viewer or parental influence. Depending on the participant’s experiences, the interview required 1 to 2 hr to complete. Information was also collected from one parent at Wave I. Wave II data collection occurred between April 1996 and August 1996. Participants in 12th grade at Wave I were not included in the Wave II sample. Data collection procedures matched those described above, with most interviews con- ducted in respondents’ homes. Wave III data collection occurred between August 2001 and April 2002. In addition to the laptop interview, biological specimen data were col- lected from the participants. Although respondents outside of the United States were excluded from Wave III partici- pation, efforts were made to interview participants housed in correctional facilities. Both the Add Health study and this

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DEPTULA, HENRY, AND SCHOENY

secondary data analysis were approved by the Institutional Review Boards of the respective academic institutions.

Measures

Demographic variables. Adolescent ethnicity and gender were assessed using self-reported data collected at Wave I. The participant’s age was calculated by subtracting the reported birth date from the questionnaire administration date. Because the average age for the adolescent participants was 16.01 years, age was dichotomized for those older and younger than 16 years to aid in interpretability of interac- tions involving age. Parenting variables. Seven parenting measures were collected at Wave I. The interview was structured so that adolescents could report on their relationships with the individual they considered to be their parent, which in- cluded biological, foster, adoptive, and step parents. Parent reports of sexual communication with the adolescent were collected from one parent at Wave I. Parent reports were not collected in subsequent waves.

Adolescents reported

their perception of the overall quality of their relationships with their parents. Their relationships with their mother and father were each assessed with five items. Exemplary items were, “Overall, you are satisfied with the way you and your mother/father communicate with each other” and “You are satisfied with your relationship with your mother/father.” Higher scores indicated more positive perceptions. To max- imize the sample size and to preserve information from adolescents with a single parent, we used information from only one parent in the analyses. When adolescents reported

on their relationship with both parents, information reflect- ing the most positive, or higher quality, relationship was retained for these analyses based on the theory that the protective effects, if any, of the parent–adolescent relation- ship would be determined by the adolescent’s stronger relationship. In other words, having a high-quality parent– adolescent relationship with one parent would be superior with respect to risk prevention compared with two lower quality parent–adolescent relationships. Cronbach alpha re- liabilities were .85 for relationship with mother and .89 for relationship with father. There was a moderate correlation between reports of relationship quality with mothers and fathers, r (14,448) .46, p .001. Parental involvement. Adolescents reported on the ex- tent of their mothers’ and fathers’ involvement in their lives using 10 yes–no items for each relationship. Items assessed involvement in activities such as sports, shopping, and viewing movies, as well as discussing problems. Cronbach alpha reliabilities were .55 for mother involvement and .57 for father involvement. To maximize sample size, we used the highest score for adolescents who rated both parents’ levels of involvement. The correlation between parental involvement for mothers and fathers was small but signifi- cant, r (20,774) .29, p .001. Educational aspirations. Educational aspirations were assessed by asking the adolescents how disappointed their parent would be should the adolescent fail to graduate from

Parent–adolescent relationship.

high school or college. Reports of perceived aspirations for the adolescent were rated on a 5-point scale for each parent. These four items demonstrated good internal consistency reliability, with Cronbach’s alpha .75. The measure was scored so that higher educational aspiration scores indicated a stronger perceived focus on the adolescent completing his or her education. Allowed independence. Adolescents were asked seven yes–no questions that assessed the extent to which they were allowed to make their own decisions regarding friends, clothing, television, and eating habits. The seven items were averaged to form one score, with higher values indicating greater allowed independence. Internal consistency of this measure was .63 as measured by Cronbach’s alpha.

At Wave I, parents

were asked five questions regarding communication with their adolescent on the topic of sex. These items were determined to reflect an overall sense of comfort, compe- tence, and need for sexual communication between parents and adolescents. Sample items included “It would embar- rass [child’s name] to talk to you about sex and birth control” and “[child’s name] will get the information some- where else so you don’t really need to talk to (him/her) about sex and birth control.” The items, rated on a 5-point scale ranging from strongly agree to strongly disagree, were averaged and coded so that higher scores indicated greater comfort. Cronbach’s alpha for this scale was .80.

Discussions of sexual costs. Four items assessed the dis-

cussion of specific sexual consequences, including the dan- gers of getting an STI, the negative impact on their social life due to a loss of peer respect, the moral issues of not having sex, and the negative consequences of pregnancy. The response format was a 4-point scale of agreement (ranging from not at all to a great deal). For instance, parents were asked how often they had discussed sexual intercourse with their adolescent and the negative or bad things that would happen if [he got someone/she got] preg- nant? Due to the tone of these items, the variable was named discussions of sexual costs and coded so that higher scores indicated more parental discussion of the risks and potential negative consequences of sexual activity (Cronbach’s al- pha .87). Parental disapproval. Parents’ opinions regarding their adolescents’ sexual activity were assessed using one item. Using a 5-point scale, parents rated their agreement (from strongly agree to strongly disagree) with the following statement: “You disapprove of [child’s name] having sexual intercourse at this time in [his/her] life.” The variable was coded so that higher scores indicated more disapproval of the prospect of the adolescent having sex.

Sexual risk and outcome variables. Four measures of

sexual risk, incorporating information across three waves of data collection, were included in the present study. Sexual activity. At Waves I and II, adolescent partici- pants were asked whether they had ever engaged in sexual intercourse. Answers consisted of either a “yes” or a “no” response.

Sexual communication attitudes.

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PARENTING FACTORS

735

Intercourse without a condom. At Wave I, the adolescents

who reported engaging in sexual activity were asked, for each reported partner, if they had engaged in vaginal sexual intercourse without using a condom during the past year. Up to six partners were queried, resulting in a maximum pos- sible score of 6. Adolescents who did not report engaging in intercourse received a score of 0. This measure of condom nonuse was used because Add Health did not ask adoles- cents to provide condom use information for each sexual incident. Unintended pregnancy. At Wave III, young adult partic- ipants were asked a series of questions for each of their reported relationships in the years since the Wave II data collection. For each relationship, respondents were asked whether a pregnancy had occurred in the context of the relationship. If the answer was “yes” and the respondent reported that he or she did not want to have a child at that time, or that he or she did not want the relationship partner to be the child’s parent, then the pregnancy was coded as unintended. Respondents were coded 1 if they had a history of any unintended pregnancy, and 0 otherwise. STIs. This variable reflected biological assay results and self-report data. Participants were tested for three STIs at Wave III: chlamydia, gonorrhea, and trichomoniasis. Par- ticipants could obtain their biological specimen results by calling a toll-free number and providing their password. Additional information can be found in the Add Heath Biomarker Team (n.d.) documentation. In addition, they were asked to disclose whether they had received a diagno- sis of chlamydia, gonorrhea, trichomoniasis, syphilis, HIV, or other infections from a health professional in the past 12 months. It is important to note that chlamydia, gonorrhea, and trichomoniasis are treatable STIs. Although it is tempt- ing to consider STI assay results as a “gold standard” measure free from the distortion of social desirability, it is possible that participants who correctly recognized their symptoms or were tested previously had already obtained treatment resulting in a negative assay result with a positive self-report. Therefore, we included self-report data in our measure of STIs, with either a positive assay result or positive reports of STI history coded as positive for a history of STIs. The vast majority of tested participants tested negative for all three STIs (n 9,594, 92.9%). A total of 676 participants (6.5%) were positive for one of the three STIs, 49 (0.5%) were positive for two, and five ( 0.1%) partic- ipants were positive for all three STIs. Self-report data indicated that the majority (91.4%) of the sample denied receiving any STI diagnoses during the specified time pe- riod. As expected, the overlap between assay results and self-reports was minimal but significant, 2 (24, N 10,282) 72.94, p .001.

Analyses

We used logistic regression to explore the relations be- tween parenting variables and adolescent sexual behavior. Four logistic regression analyses were conducted, one for each sexual outcome variable, including all of the predictor

variables (demographic factors, family main effects, and interactions) in the model. Therefore, the result for each variable indicates the unique variance accounted for by the variable. Although we indicate effects that were significant at p .05 in the tables, we focus our interpretations on those that were significant at p .01 because of the large number of effects tested in the model. All continuous variables were mean-centered to aid in interpretability. PROC SURVEYLOGISTIC in SAS 9.1 allowed us to include grand sampling weights and cluster variables for either concurrent analyses, Wave I to II lon- gitudinal analyses, or Wave I to III longitudinal analyses. In addition, we also included a region stratification variable (Northeast, Midwest, South, West) in the analyses. A de- scription of these sampling variables can be found in the Add Health documentation (Bearman, Jones, & Udry, 2003; Chantala & Tabor, 1999). Because the continuous parenting variables were mea- sured using different scales, the scores were standardized using the semi-interquartile range to allow the reader to compare effects across variables (Steyerberg, 2009). This approach does not equalize the variances as common stan- dardization does. It removes the effects of outliers, allows for comparison across variables, and does not change the significance values compared with those obtained with the raw scores (Harrell, 2001; Steyerberg, 2009). As a result, the reported odds ratios represent the change in risk asso- ciated with a 25 percentile difference in the parenting vari- able (e.g., allowed independence changing from 25th to 50th percentile). In addition to the parenting variables, main effects for age, gender, and ethnicity were included in the regression models. Age and gender interactions with the parenting variables were also investigated.

Results

We sought to identify the parenting factors associated with sexual activity and health at three time points: concur- rent sexual activity, initiation over 1 year, and sexual health outcomes in young adulthood. Means, standard deviations, and correlations among the parenting predictor variables are reported in Table 1. Although most correlations between parenting factors were statistically significant, the parenting factors represented fairly independent aspects of the family system.

Predictors of Intercourse Without a Condom

Of the 6,512 adolescents engaging in intercourse at Wave I, 2,265 (34.8%) reported engaging in intercourse without a condom. The first analysis was a regression model that examined the parenting factors associated with concurrent (Wave I) condom nonuse controlling for age, gender, and ethnicity. Table 2 displays the main effects as well as any significant age or gender interaction effects. There were significant interactions with age for parent–adolescent rela- tionship quality and allowed independence. We found that parenting factors were more strongly associated with con-

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Table 1 Family Variable Correlations

DEPTULA, HENRY, AND SCHOENY

Variable

M

SD

1

2

3

4

5

67

1. Parent–adolescent relationship a

4.47

0.57

1.00

2. Parental involvement a

4.14

1.99

.23

1.00

3. Educational aspirations a

4.35

0.87

.11

.12

1.00

4. Allowed independence a

0.74

0.22

.07

.03

.00

1.00

5. Parental disapproval

b

4.27

1.16

.07

.08

.06

.08

1.00

6. Discussions of sexual costs b

2.90

0.83

.04

.09

.02

.01

.02

1.00

7. Sexual communication attitudes b

4.16

0.74

.08

.13

.06

.04

.10

.37

1.00

a Adolescent report. b Parent report. p .05. p .01.

dom nonuse for younger adolescents. Specifically, lower parental relationship quality and higher levels of allowed independence were more strongly associated with condom nonuse for younger adolescents compared with adolescents older than 16 years. Significant main effects indicated that lower levels of educational aspirations and perceived paren- tal disapproval were associated with more condom nonuse. It is interesting that more discussions of sexual costs were also associated with greater likelihood of condom nonuse.

Initiation of Sexual Activity

The next set of analyses focused on a subsample of adolescents who, at Wave I, reported not engaging in sexual activity. Of the 8,203 Wave I adolescents who denied en- gaging in sexual intercourse prior to Wave I, 6,554 (79.9%) continued to report abstinence from sexual intercourse at Wave II. Table 3 displays the results of the regression analyses predicting Wave II initiation within this sub- sample. No gender or age interactions were significant. Lower levels of parent–adolescent relationship quality, lower levels of parental educational aspirations, and more perceived parental disapproval were related to sexual inter- course initiation. Higher levels of parental involvement,

Table 2 Main Effects and Significant Interaction Terms for Concurrent Condom Nonuse Analysis

Variable

OR

95% CI

0.76, 0.84

Parental involvement a 1.06 1.00, 1.11

0.91, 0.97

Parental disapproval Discussions of sexual costs b Sexual communication attitudes b Age Parent–Adolescent Relationship a

Age Allowed Independence a 0.93 0.89, 0.97

0.89, 0.94

1.19, 1.38

0.91, 1.01

1.05, 1.15

0.85, 0.98

1.11, 1.23

Parent–adolescent relationship a

Educational aspirations a 0.94 Allowed independence a 1.17

0.80

0.91

1.28

0.96

1.10

0.91

b

Age Discussions of Sexual Costs b

Note. OR odds ratio; CI confidence interval. Analyses included the appropriate sample weights, age, gender, and ethnic- ity. Full tables, including the statistics for the main effects and the nonsignificant interaction terms, are available from the first author on request. a Adolescent report. b Parent report. p .05. p .01. p .001.

allowed independence, and discussions of sexual costs were significantly associated with initiation. Similar to the find- ings of the analysis for concurrent condom nonuse, parental attitudes about sexual communication were not related to sexual intercourse initiation.

Unintended Pregnancy

The Wave III analyses included Wave I engagement in sexual intercourse in addition to the parenting and demo- graphic variables. As expected, engagement in sexual inter- course at Wave I was positively associated with reports of unintended pregnancy at Wave III. No age or gender inter- actions emerged. In addition, no family factors were signif- icant at p .01 (see Table 3).

STI Diagnoses

In the logistic regression analyses for Wave III STI diagnoses, measured by combining self-reports and assay results, several Wave I parenting variables were significant predictors (see Table 3). With Wave I sexual intercourse entered in the model, an age by discussions of sexual costs interaction emerged, indicating that discussions of sexual costs at Wave I with younger adolescents were more strongly and positively associated with Wave III STI diag- noses. In addition, Wave III STI diagnoses were negatively related to parent–adolescent relationship quality and paren- tal educational aspirations.

Discussion

How can parents promote adolescent safer sexual behav- iors? What specific parenting factors relate to later sexual risk and STIs? We addressed these questions for several risk factors across time (i.e., concurrent risk, sexual initiation, longitudinal sexual risk). The overall quality of the parent–adolescent relationship was found to be a key variable in adolescent risky sexual behavior and was associated with lower levels of unpro- tected intercourse, particularly for younger adolescents, in- tercourse initiation, and STI diagnosis. These findings add to a body of literature demonstrating the importance of the parent–adolescent relationship (e.g., see review by Luster & Small, 1994; Miller et al., 2001; Small & Luster, 1994;

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PARENTING FACTORS

737

Table 3 Main Effects and Significant Interaction Terms for Longitudinal Outcome Analyses

Intercourse initiation

Unintended pregnancy

Sexually transmitted

infections

Variable

OR

95% CI

OR

95% CI

OR

95% CI

Wave I sexual intercourse Parent–adolescent relationship a Parental involvement a Educational aspirations a Allowed independence a Parental disapproval Discussions of sexual costs b Sexual communication attitudes b Age Parent–Adolescent Relationship a Age Discussions of Sexual Costs

b

b

N/A

1.52

1.38, 1.68

1.20

1.08, 1.33

0.85

0.79, 0.91

0.95

0.89, 1.02

0.90

0.85, 0.95

1.10

1.03, 1.17

0.92

0.86, 0.99

1.05

0.98, 1.12

0.93

0.89, 0.98

0.94

0.89, 1.00

0.93

0.88, 0.97

1.10

1.03, 1.18

1.05

0.96, 1.15

1.00

0.94, 1.06

0.93

0.89, 0.97

0.98

0.94, 1.02

1.00

0.96, 1.04

1.20

1.08, 1.34

1.12

1.01, 1.23

1.03

0.94, 1.13

0.95

0.87, 1.04

1.06

0.98, 1.14

0.99

0.92, 1.07

1.09

1.01, 1.18

ns

ns

ns

ns

0.88

0.80, 0.97

Note. OR odds ratio; CI confidence interval. Analyses included the appropriate sample weights, age, gender, and ethnicity. Full tables, including the statistics for the main effects and the nonsignificant interaction terms, are available from the first author on request. a Adolescent report. b Parent report. p .05. p .01. p .001.

Smith, 1997) and adds relevant information for a young adult sample. Our results suggest that high-quality parent– adolescent relationships are associated with better young adult sexual outcomes (e.g., lower risk for STI diagnoses) even when considering history of previous sexual activity and other parenting variables. In particular, parenting fac- tors such as parent–adolescent relationship quality appeared to function as a promotive factor reducing early engagement in risky sexual behavior. Parents may find it counterintuitive that having more discussions about sexual risk would be positively related to sexual risk behaviors. However, as pointed out in the intro- duction section, the literature in this area has revealed inconsistent findings (e.g., Fisher, 2004). Studies based on Add Health data are also inconsistent. For instance, Lam et al. (2008) found that more Wave I discussions of sexual costs were associated with more Wave II noncoital sexual behavior. In contrast, Usher-Seriki et al. (2008) found that teenage girls were less likely to be sexually active when their mothers reported more discussions of sexual costs. However, the Usher-Seriki study excluded the costs item about STIs and examined a subsample of middle-class Af- rican American females, resulting in both measurement and sample differences. Extent of communication about sex in and of itself may not be as important as the quality of the discussion (Wilson & Donenberg, 2004). In the current study, we lacked infor- mation about the emotional tone as well as the specific content of the conversations. With respect to emotional tone, Dutra et al. (1999) found that open and receptive communication about sex was associated with lower levels of sexual risk. In addition, Mueller and Powers (1990) found that warm and friendly adolescent perceptions of parents’ general communication were associated with lower levels of sexual activity and higher levels of contraceptive use. Dominant, contentious, and dramatic parenting com- munication styles were related to more risky adolescent sexual behavior. An interesting result of the current study was that parental reports of comfort and confidence in

communicating with their teens was not related to sexual risk. Instead, adolescents’ perceptions of the nature of the conversation may be more important. Although we know that the type of communication as- sessed by Add Health was primarily discouraging in nature, focusing on STI risk and the moral implications of sexual behavior, we do not know the specific content of the con- versations. Kim and Ward (2007) as well as DiIorio, Pluhar, and Belcher (2003) provide examples of studies that more specifically assess the content of the conversations. For the current study, we do not know whether the discussion of STI risk included information about condom use or was focused on abstinence. It appears from these results that parental communication focused solely on discouraging risky behavior does not serve as a protective factor for adolescent sexual behavior. In fact, such discussions may do more harm than good. These findings suggest that parents may need specific guidance on how to talk to their adoles- cent or how not to talk to their teenager. In the current study, comfort with sexual communication was not related to concurrent unprotected sexual intercourse and sexual initi- ation. Therefore, parents should be encouraged to talk to their teens despite their comfort level, with the goal of holding warm, open, and receptive conversations. Parent reports of sexual communication were not col- lected at Wave II or III by the Add Health study. This omission results in the most significant limitation of the current study, particularly in relation to the findings on parental discussions of sexual costs. It is difficult to deter- mine whether adolescent and young adult risky behavior resulted from parental discussions of sexual costs or whether the reverse is true. Similar research using the Add Health data set has found adolescent reports of decreased adolescent–parent closeness both before and after sexual activity (Ream & Savin-Williams, 2005), suggesting a re- ciprocal relationship between family factors and adolescent behavior. Another potential limitation is the low internal consisten- cies of the measures of allowed independence and parental

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738

DEPTULA, HENRY, AND SCHOENY

involvement. However, these measures comprised causal indicators (see Streiner, 2003, for a review) that assess a range of possible facets of allowed independence and pa- rental involvement that may not be correlated. For instance, parents might have restrictions on television watching but not on the selection of peers. Thus, we would not expect high internal consistency in these types of measures (Streiner, 2003). Complicating the results, adolescents may have pro- vided information about a different parent figure than the adult who completed the parental report. Although Add Health attempted to obtain information from the most relevant parent figure, it was not always possible. In addition, although the vast majority of the parent reports were completed by a maternal figure, we chose to include adolescent data for both mothers and fathers. Using data from fathers allowed us to include adolescents from single-father households as well as consider their role in

a two-family household. To assess the effect of allowing

adolescent report of paternal or maternal family factors, we reran the analyses with reports of maternal-only pa- rental involvement and mother–adolescent relationship quality. The results were extremely similar, with one interaction effect significant at p .01. A strong mother– adolescent relationship was protective against sexual ini- tiation among younger adolescents. Because our focus was on parenting practices, we did not include family structure variables such as single-parent homes, which could also be considered a limitation of the study. However, past research has found that process vari- ables are more predictive of sexual risk outcomes for young adolescents than structure variables (Miller et al., 1999). Another potential limitation is the absence of potential “third variables” that might influence sexual risk, such as peer factors, socioeconomic status, or parental education. Another potential limitation is that we did not examine interactions with ethnicity, believing this was beyond the scope of this article. Although we used both parental and adolescent infor- mants in this study, adolescents and their parents often do not agree when asked about their sexual communication (see Fisher, 2004, for review). Future research needs to address this lack of convergence and examine whether different results would be obtained by adolescent report. Finally, future research should consider that the first wave of Add Health data collection occurred in 1994. It is pos- sible that these findings do not hold for the current gener- ation of adolescents and their families.

In summary, the current research demonstrates the importance of the overall parent–adolescent relationship, which may also be reflected in the quality of the conver-

sations parents have with their teenagers about sex. Using

a multi-informant, longitudinal approach with a nation-

ally representative sample, the study demonstrates the importance of parenting factors even into young adult- hood. Although many parenting aspects were related to concurrent sexual risk, prevention efforts should focus on adolescent–parent relationship building and developing

the skills to have a positive, open dialogue about sexual activity.

References

Add Health Biomarker Team. (n.d.). Retrieved from http:// www.cpc.unc.edu/projects/addhealth/faqs/aboutdata/index.html/ biomark.pdf Bearman, P. S., Jones, J., & Udry, J. R. (1997). The National Longitudinal Study of Adolescent Health: Research design. Re- trieved from http://www.cpc.unc.edu/addhealth Bearman, P. S., Jones, J., & Udry, J. R. (2003). Wave III Add Health weights. Retrieved from http://www.cpc.unc.edu/projects/

addhealth/codebooks/wave3

Borawski, E. A., Ievers-Landis, C. E., Lovegreen, L. D., & Trapl, E. S. (2003). Parental monitoring, negotiated unsupervised time, and parental trust: The role of perceived parenting practices in adolescent health risk behaviors. Journal of Adolescent Health, 33, 60 –70. doi:10.1016/S1054-139X(03)00100-9 Bronfenbrenner, U. (1986). Ecology of the family as a context for human development: Research perspectives. Developmental Psy- chology, 22, 723–742. Casper, L. M. (1990). Does family interaction prevent adolescent pregnancy? Family Planning Perspectives, 22, 109 –114. Centers for Disease Control and Prevention. (2008). Youth risk behavior surveillance—United States, 2007. MMWR Surveil- lance Summaries, 57, 1–131. Retrieved from http://www.cdc

.gov/mmwr/preview/mmwrhtml/ss5704a1.htm

Centers for Disease Control and Prevention. (2009). Trends in report- able sexually transmitted diseases in the United States, 2007. Re- trieved from http://www.cdc.gov/STI/stats07/trends.htm Chantala, K., & Tabor, J. (1999). Strategies to perform a design- based analysis using the Add Health data. Retrieved from http://

www.cpc.unc.edu/projects/addhealth/data/guides/weight1.pdf

Davis, E. C., & Friel, L. V. (2001). Adolescent sexuality: Disen- tangling the effects of family structure and family context. Jour- nal of Marriage and Family, 63, 669 – 681. DiIorio, C., Kelley, M., & Hockenberry-Eaton, M. (1999). Com- munication about sexual issues: Mothers, fathers, and friends. Journal of Adolescent Health, 24, 181–189. DiIorio, C., Pluhar, E., & Belcher, L. (2003). Parent– child com- munication about sexuality: A review of the literature from 1980 –2002. Journal of HIV/AIDS Prevention and Education for Adolescents and Children, 5, 7–32. Dittus, P. J., & Jaccard, J. (2000). Adolescents’ perceptions of maternal disapproval of sex: Relationship to sexual outcomes. Journal of Adolescent Health, 26, 268 –278. Dutra, R., Miller, K. S., & Forehand, F. (1999). The process and content of sexual communication with adolescents in two-parent families: Associations with sexual risk-taking behavior. AIDS and Behavior, 3, 59 – 66. Fisher, T. D. (2004). Family foundations of sexuality. In J. H. Harvey, A. Wenzel, & S. Sprecher (Eds.), The handbook of sexuality in close relationships (pp. 385– 409). Hillsdale, NJ:

Erlbaum. Guzman, B. L., Schlehofer-Sutton, M. M., Villaneuva, C. M., Stritto, M. E. D., Casad, B. J., & Feria, A. (2003). Let’s talk about sex: How comfortable discussions about sex impact teen sexual behavior. Journal of Health Communication, 8, 583–598.

doi:10.1080/716100416

Harrell, F. E., Jr. (2001). Regression modeling strategies with applications to linear models, logistic regression, and survival analysis. New York: Springer. Karofsky, P. S., Zeng, L., & Kosorok, M. R. (2000). Relationship

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

PARENTING FACTORS

739

between adolescent–parental communication and initiation of first intercourse by adolescents. Journal of Adolescent Health, 28, 41– 45. Kim, J. L., & Ward, L. M. (2007). Silence speaks volumes:

Parental sexual communication among Asian American emerg- ing adults. Journal of Adolescent Research, 22, 3–31. doi:

10.1177/0743558406294916

Lam, A. G., Russell, S. T., Tan, T. C., & Leong, S. J. (2008). Maternal predictors of noncoital sexual behavior: Examining a nationally representative sample of Asian and White American adolescents who have never had sex. Journal of Youth and Adolescence, 37, 62–73. doi:10.1007/s10964-007–9223-1

Langille, D. B., & Curtis, L. (2002). Factors associated with sexual intercourse before age 15 among female adolescents in Nova Scotia. Canadian Journal of Human Sexuality, 11, 91–99. Lewis, L. M., Melton, R. S., Succop, P. A., & Rosenthal, S. L. (2000). Factors influencing condom use and STD acquisition among African American college women. Journal of American College Health, 49, 19 –23. Luster, T., & Small, S. A. (1994). Factors associated with sexual risk-taking behaviors among adolescents. Journal of Marriage and Family, 56, 622– 632. Magnusson, D., Andersson, T., & Törestad, B. (1993). Method- ological implications of a peephole perspective on personality. In

D. C. Funder, R. D. Parke, C. Tomlinson-Keasey, & K. Widaman

(Eds.), Studying lives through time: Personality and development

(pp. 207–220). Washington, DC: American Psychological Asso-

ciation.

McNeely, C., Shew, M. L., Beuhring, T., Sieving, R., Miller, B. C., & Blum, R. W. (2002). Mothers’ influence on the timing of first sex among 14- and 15-year-olds. Journal of Adolescent Health,

31, 256 –265.

Miller, B. C., Benson, B., & Galbraith, K. A. (2001). Family relationships and adolescent pregnancy risk: A research synthe- sis. Developmental Review, 21, 1–38. Miller, B. C., & Sneesby, K. R. (1988). Educational correlates of adolescents’ sexual attitudes and behavior. Journal of Youth and Adolescence, 17, 521–530. Miller, K. S., Forehand, R., & Kotchick, B. A. (1999). Adolescent sexual behavior in two ethnic minority samples: The role of family variables. Journal of Marriage and Family, 61, 85–98. Mueller, K. E., & Powers, W. G. (1990). Parent– child sexual discussion: Perceived communicator style and subsequent behav- ior. Adolescence, 25, 469 – 482. Pearson, J., Muller, C., & Frisco, M. L. (2006). Parental involve- ment, family structure, and adolescent sexual decision making.

Sociological Perspectives, 49, 67–90. Perkins, D. F., Luster, T., Villarruel, F. A., & Small, S. (1998). An ecological risk-factor examination of adolescents’ sexual activity in three ethnic groups. Journal of Marriage and Family, 60, 660 – 673. Perrino, T., Gonzalez-Soldevilla, P. H., Pantin, H., & Szapocznik,

J. (2000). The role of families in HIV prevention: A review.

Clinical Child and Family Psychology Review, 3, 81–96. Ream, G. L., & Savin-Williams, R. C. (2005). Reciprocal associ- ations between adolescent sexual activity and quality of youth– parent interactions. Journal of Family Psychology, 19, 171–179.

doi:10.1037/0893-3200.19.2.171

Regnerus, M. D., & Luchies, L. B. (2006). The parent– child relationship and opportunities for adolescents’ first sex. Journal of Family Issues, 27, 159 –183. doi:10.1177/0192513X05281858

Roche, K. M., Mekos, D., Alexander, C. S., Astone, N. M., Bandeen-Roche, K., & Ensminger, M. E. (2005). Parenting in- fluences on early sex initiation among adolescents: How neigh- borhood matters. Journal of Family Issues, 26, 32–54. doi:

10.1177/0192513X04265943

Rodgers, K. B. (1999). Parenting processes related to sexual risk- taking behaviors of adolescent males and females. Journal of Marriage and Family, 61, 99 –109. Small, S. A., & Luster, T. (1994). Adolescent sexual activity: An ecological, risk-factor approach. Journal of Marriage and Fam- ily, 56, 181–192. Smith, C. A. (1997). Factors associated with early sexual activity among urban adolescents. Social Work, 42, 334 –346. Steyerberg, E. W. (2009). Clinical prediction models. A practical approach to developing, validating, and updating (Statistics for Biology and Health). New York: Springer. doi:10.1007/978-0-

387-77244-8

Streiner, D. L. (2003). Being inconsistent about consistency: When coefficient alpha does and doesn’t matter. Journal of Personality Assessment, 80, 217–222. Usher-Seriki, K. K., Bynum, M. S., & Callands, T. A. (2008). Mother– daughter communication about sex and sexual inter- course among middle- to upper-class African American girls. Journal of Family Issues, 29, 901–909. doi:10.1177/

0192513X07311951

Wagstaff, D. A., Delamater, J. D., & Havens, K. K. (1999). Subsequent infection among adolescent African-American males attending a sexually transmitted disease clinic. Journal of Ado- lescent Health, 25, 217–226. Weinstock, H., Berman, S., & Cates, W., Jr. (2004). Sexually transmitted diseases among American youth: Incidence and prev- alence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36, 6 –10. Wellings, K., Nanchahal, K., Macdowall, W., McManus, S., Erens,

Field, J. (2001). Sexual behavior in

Britain: Early heterosexual experience. Lancet, 358, 1843–1850. Whalen, C. K., Henker, B., Hollingshead, J., & Burgess, S. (1996). Parent–adolescent dialogues about AIDS. Journal of Family Psychology, 10, 343–357.

Whitaker, D. J., & Miller, K. S. (2000). Parent–adolescent discus- sions about sex and condoms: Impact on peer influences of sexual risk behavior. Journal of Adolescent Research, 15, 251–

B., Mercer, C. H.,

273.

Whitaker, D. J., Miller, K. S., May, D. C., & Levin, M. L. (1999). Teenage partners’ communication about sexual risk and condom use: The importance of parent–teenager discussions. Family Planning Perspectives, 31, 117–121. Wilson, H. W., & Doneberg, G. (2004). Quality of parent com- munication about sex and its relationship to risky sexual behavior among youth in psychiatric care: A pilot study. Journal of Child Psychology and Psychiatry, 45, 387–395. Zimmer-Gembeck, M. J., & Helfand, M. (2008). Ten years of longitudinal research on U.S. adolescent sexual behavior: Devel- opmental correlates of sexual intercourse, and the importance of age, gender, and ethnic background. Developmental Review, 28, 153–224. doi:10.1016/jr.dr.2007.06.001

Received January 20, 2010 Revision received September 18, 2010 Accepted September 20, 2010