Adolescent communication with Family and Reproductive Health

摘要 危险的性行为会带来很高的个人、社会和经济成本。关于性的家庭沟通可以 减少危险的性行为，但大多数研究只集中在青少年父母二人组。高水平的扩展- 家庭参与育儿和性交流，如与祖父母、阿姨和叔叔， 年长的兄弟姐妹和堂兄弟姐妹，以及“虚构的亲属”，特别是在黑人和拉丁美洲家庭中，表明了 评估这种未被充分研究的影响。初步研究结果显示， 家庭性交流和青少年性行为，但这种风险或保护作用， 通信仍然不清楚。为了解决NICHD的目标，即确定预防 意外怀孕和性传播感染，这项混合方法的研究提出了第一个 对青少年大家庭性交流的综合评估及其与 性行为，并包括大家庭的观点，以便将定量研究结果应用于预防 干预方案。本研究采用了一个已建立的概念模型， 与大家庭的性交流，既承认直接谈论性，也承认间接（较少）谈论性。 直接）性交流，预测青少年的性信仰和行为。这项研究将 调查的目的有三：1）比较青少年与父母和大家庭的性沟通; 2） 调查大家庭性行为沟通与青少年性信仰之间的关联， 行为，以及3）探索大家庭成员如何看待与青少年的性沟通， 他们需要什么工具来支持青少年的性健康。为了实现这些目标，本研究使用了一个解释性的 序贯混合方法设计，其中包括青少年调查和大家庭访谈。十七 来自4所学校的11年级和12年级的100名男女学生将填写一份校内在线调查， 大家庭成员将接受采访。定量分析将针对目标1和2。据推测 父母和大家庭之间性交流是不同的，青少年对家庭成员的看法 青少年的性观念和性行为与性沟通和性态度有关。青少年的 与大家庭成员的亲密关系和家庭主义的价值观预计将塑造家庭的力量， 这些协会。协会的方向将因青少年是否与年长者或年轻人交谈而有所不同。 家人定性分析将指导实施目标1和2的结果，以支持学校和 以社区为基础的预防和干预工作。这项工作的意义在于它的全面性 关注家庭性交流中的所有伙伴，评估这种交流是否 对青少年的性健康有益或有害。它通过告知是否以及如何 将核心家庭以外的大家庭系统纳入预防和干预方案。

Abstract Risky sexual behaviors have high personal, social, and financial costs. Family communication about sex can reduce risky sexual behaviors, but most studies focus only on the teen-parent dyad. High levels of extended- family involvement in childrearing and sexuality communication, such as with grandparents, aunts and uncles, older siblings and cousins, and “fictive kin,” especially in Black and Latino families, suggest the importance of assessing this under-studied influence. Preliminary findings show significant associations between extended- family sexuality communication and teen sexual behavior, but the risk or protective effects of this communication remain unclear. To address NICHD's goal of identifying protective factors that prevent unintended pregnancy and sexually transmitted infections, this mixed-methods study proposes the first comprehensive assessment of teens' extended-family sexuality communication and its associations with sexual behavior, and includes extended-family perspectives in order to apply quantitative findings to prevention and intervention programs. The proposed study applies an established conceptual model of parent-teen sexuality communication to extended family, which recognizes both direct talk about sex and indirect (less straightforward) sexuality communication, which predict teens' sexual beliefs and behaviors. The study will investigate three aims: 1) Compare teens' sexuality communication with parents and with extended family, 2) Investigate associations between extended-family sexuality communication and teens' sexual beliefs and behaviors, and 3) Explore how extended-family members perceive sexuality communication with teens and what tools they need to support teens' sexual health. To address these aims, this study uses an explanatory sequential mixed-methods design, which includes teen surveys and extended-family interviews. Seventeen hundred male and female 11th and 12th graders from 4 schools will fill out an in-school online survey, and 30 extended-family members will be interviewed. Quantitative analyses will address Aims 1 & 2. It is hypothesized that parent and extended-family sexuality communication differ and that teens' perceptions of family members' sexuality communication and attitudes will be associated with teens' sexual beliefs and behaviors. Teens' closeness with the extended family member and values of familism are expected to shape the strength of these associations. The direction of associations will vary by whether teens talk with older or younger extended family. Qualitative analyses will guide implementation of findings from Aims 1 & 2 to support school and community-based prevention and intervention efforts. The significance of this work lies in its comprehensive focus on the full range of partners in family sexuality communication, assessing whether this communication is helpful or harmful to teens' sexual health. It contributes to public health by informing whether and how to include larger family systems, beyond the nuclear family, into prevention and intervention programs.