Starting early: Preliminary findings of effectiveness from the Especially for Daughters study of parent-mediated HIV and alcohol prevention for urban girls

Background: Especially for Daughters is an audio-CD parent education intervention that aims to provide urban parents with information and skills that will help their young adolescent daughters make healthy choices and, specifically, choose not to drink alcohol or engage in early sexual risk taking. Unlike adolescents in communities where alcohol initiation may precede sexual initiation by several years, the target population is likely to initiate sex shortly after they first use alcohol. This risk pattern, played out in communities with disproportionately high prevalences of HIV and other STIs, makes decisions about early alcohol use and sexual initiation highly consequential. Methods: A randomized field trial was conducted in four New York City public schools. During the first year of enrollment (2005-06), 268 girls and their parents were assigned to: (1) intervention, a 4-CD set, Especially for Daughters, mailed to homes, approximately one audio-CD every 6 weeks; (2) an attention-controlled condition, consisting of educational print materials covering similar topics; and (3) a control condition. Baseline 6th and follow-up 7th grade paper-pencil surveys were completed by girls at school and telephone surveys were conducted with parents. Results: Compared to controls, at follow up, girls in the intervention group were significantly more likely to report not engaging in sexual risk behaviors and, at a trend level, not drinking, controlling for baseline behaviors. Compared to attention-controls and controls, parents who received audio-CDs reported greater self-efficacy to address alcohol and sex, more communication, and greater perceived influence over their daughters' behaviors.