This AREA proposes a randomized controlled trial (RCT) of an innovative health promotion model using student nurses as community health educators to provide a parent-based adolescent sexual health (P-ASH) intervention to parents of underserved minority youth. Adolescents experience the largest burden of sexually transmitted infections (STIs), HIV, and unplanned pregnancy in the U.S. and are at significant risk of early sexual debut with both immediate and long-term health consequences [1-3]. Parents play a pivotal role in reducing adolescent sexual risk behaviors including early sexual debut, number of sexual partners, and condom and contraceptive use [5, 9-12]. Parent-based interventions bolster parental protective factors and reduce adolescent sexual risk behaviors [17-20]. We propose to adapt and evaluate a brief P-ASH intervention, Families Talking Together (FTT), using a community-based RCT. FTT, developed for and tested in minority families, provides parent-based adolescent sexual health education and has demonstrated success in delaying sexual debut in minority youth when implemented in a clinic setting [20]. We propose to adapt FTT (herein FTT+) creating a clinic-to-community translation using community-based participatory research strategies. We will add modules to the existing FTT related to HPV and HPV vaccination. To translate this program from the clinic to community setting we will, conduct focus groups and acceptability testing of FTT+ in target communities, form a Community Action Board (CAB) to facilitate program implementation, evaluation, and dissemination of findings, and revise FTT+ based on focus group and CAB feedback. We propose to evaluate the efficacy of student nurse delivered FTT+ in a community setting. Specifically, we will conduct a RCT of expanded FTT+ in the community setting to evaluate the impact of FTT 6-months post-intervention by examining the effects of FTT+ on parent outcomes (psychosocial factors, communication, monitoring, connectedness) and adolescent outcomes (psychosocial factors, sexual behaviors, HPV vaccination status), and examining the relation between parent and adolescent outcomes. Parents of minority youth 11-14 years old will be recruited from afterschool and community programs such as the Boys and Girls Clubs (BGC). This project is significant in its capacity to reach large numbers of parents of minority youth, a high-risk group for teen pregnancy and STIs, with adolescent sexual health education and nurse-led navigation to increase awareness of and access to HPV vaccination. This study is innovative in its use of student nurses, a cost- effective model to disseminate evidence-based interventions in underserved and hard-to-reach communities while enhancing the research capacity of students and faculty at a large School of Nursing, ultimately impacting the Public Health Nursing workforce.
This AREA is significant in its capacity to develop parents of adolescents as primary sexual health educators to delay sexual debut and reduce teen pregnancy and sexually transmitted infections. It is innovative in its use of student nurses, a cost-effective model to disseminate evidence-based interventions in underserved and hard-to-reach communities while enhancing the research capacity of the Public Health Nursing workforce.
