Impact of a Parent-Child Sexual Communication Campaign: Results from a Controlled Efficacy Trial of Parents

This article describes a study evaluating the Parents Speak Up National Campaign (PSUNC), a multimedia campaign that reaches out to parents of 10- to 14-year-old children in the United States (US) to encourage parent-child communication about waiting to have sex. The campaign is grounded in social cognitive theory, which predicts a chain of cognitive events that lead to behavioural outcomes and choices. The research described in this paper examines the cognitive factors that precede parent-child communication specifically.

As detailed here, the US Department of Health and Human Services launched the campaign nationally in June 2007, having observed that a number of studies show that parent-child communication about sex is related to delayed onset of sexual intercourse, increased contraceptive use in daughters, and increased sexually transmitted infection (STI) prevention behaviours, including condom use and fewer sexual partners. The campaign primarily uses televised public service announcements (PSAs), supplemented by radio, print, and outdoor advertising. PSUNC television advertisements feature age-appropriate youth letting their parents know that they want to talk to them about sex and that they should talk "early and often." The campaign PSAs are also designed for multiple racial/ethnic audiences, including ads designed for a general audience and ads for African American, Hispanic, and Native American parents. The advertisements also promote the PSUNC website, which provides age-appropriate information and guidance to parents about talking to their children about sex.

The study consisted of a randomised efficacy trial of PSUNC messages under controlled conditions. A sample of 1,969 parents was randomly assigned to treatment (PSUNC exposure) and control (no exposure) conditions. Parents were surveyed at baseline, 4 weeks, 6 months, 12 months, and 18 months post-baseline. Linear regression procedures were used in the analyses. Reflective of the campaign's theoretical basis (social cognitive theory), outcome variables included self-efficacy to communicate with child, long-term outcome expectations that communication would be successful, and norms on appropriate age for sexual initiation. The researchers first estimated multivariable models to test whether these cognitive variables predict parent-child communication longitudinally. Longitudinal change in each cognitive variable was then estimated as a function of treatment condition, controlling for baseline individual characteristics.

Results are shared. In short, mothers who were exposed to PSUNC in this experiment exhibited a larger change than control mothers in their norms toward the belief that teens should wait until they are older to have sex. Mothers who were exposed to PSUNC messages also exhibited larger increases than control mothers in their beliefs that parent-child communication about sex would have a positive impact on their child's future success. There is limited evidence of short-run effects among mothers on parent efficacy to communicate with their child. Results from the longitudinal model of parent-child communication confirm that the two cognitive factors most impacted by PSUNC messages (i.e., the "wait until older norm" and "long-term outcome expectations") are also strongly predictive of actual parent-child communication. This study also provides insights into potential gender differences in message processing for parent-child communication campaigns. Specifically, no exposure effects on cognitive precursors were shown for fathers; in the discussion section of the paper, the authors explore possible reasons for this and suggest that gender-specific message tailoring may be appropriate for parent-child communication campaigns.

According to the authors, these findings also have implications for the development of parent-child communication messages more generally. This study highlights the importance of developing a theoretical framework that identifies appropriate cognitive precursors that are both predictive of a campaign's behavioural outcome and sensitive to campaign messages. "This type of framework provides a roadmap of specific cognitions and other precursors to behavior that should be emphasized directly in campaign messages."