Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake

Abstract

Background Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement. Methods Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11–14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level. Results Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period. Conclusion A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates. Trial registration ClinicalTrials.gov Identifier: NCT02600884. Prospectively registered September 1, 2015.

Relationship between religiosity and HPV vaccine initiation and intention in urban black and hispanic parents

“…The current study is a secondary analysis of baseline data collected for a randomized controlled trial (RCT) designed to test the effects of a parent-based, adolescent sexual health intervention [ 24 ]. In the broader study, a convenience sampling strategy was used to recruit 11–14 year old youth and their caregivers from 21 after-school programs (e.g., Boys and Girls Club) and 19 charter schools in medically underserved communities.…”

Impact of preparing nursing students to deliver a parent-based sexual health intervention on attitudes and intentions for sexual health education and parent communication counseling: a mixed methods study

“…Methods used included lecture, group discussion, script development, student presentations, and role playing. After completing the FTT + HPV training, nursing students delivered the intervention to parents in a community-based setting [ 17 ].…”

“…This holds important implications for future nursing practice and the effects of the students’ practice on the communities they will serve. Nursing students can bring about positive changes in communities [ 17 ], and while doing so, increase their confidence and intentions to continue using these proven sexual health education interventions in the future.…”

“…Families Talking Together (FTT), an evidence-based intervention, outlines the delivery strategies and content of sexual health topics that should be covered with parents to promote effective P-ASH communication [ 14 – 17 ]. A pilot study in which nursing students completed training on delivering FTT to parents revealed statistically significant improvements in nursing students’ sexual and reproductive health counseling self-efficacy, ability to address barriers to sexual and reproductive health communication, and skills in engaging both adolescents and their parents [ 18 ].…”

Maternal perceptions of vaccinating boys against human papillomavirus (HPV) in Seoul, South Korea: A descriptive exploratory qualitative study

“…Asian parents tend to approach these issues indirectly or implicitly, avoiding words in their language for sexual health topics, such as HPV [51]. Evidence from the United States suggests that parent-child sexual health communication can curb negative sexual health outcomes [52] and improve HPV vaccination rates [53]. The consistent discomfort mothers felt to initiate conversations with their sons about sexual health may have contributed to their lack of confidence or refusal to talk about HPV vaccination.…”