Testing the usability of a web-based parent-adolescent communication program

Background: Parent-adolescent communication about sex improves sexual health outcomes among adolescents. No web-based programs that teach parents communication skills exist. Objective: To evaluate the usability of and satisfaction with a web-based program to improve parents' skills for communicating with their adolescents about sexual health issues. Methods: We recruited urban African American mothers of adolescent females, aged 11 to 18, from Allegheny County, Pennsylvania and adolescent health experts nationally. Between April-September 2009, a Think Aloud protocol (TAP) was used by mothers and experts to critique a 30-minute web-based program to improve mothers' communication skills. With TAP, participants' vocalized their thoughts as they navigated the program. Their non-verbal responses and answers to questions imbedded in the program were documented using a standardized observation guide. Participants also completed a semi-structured interview and completed a 9 item satisfaction scale. Interviews were analyzed using grounded theory and the constant comparison method. Results: Five mothers and four adolescent health experts participated. All experts and 4 mothers thought the program was easy to use. Both felt the literacy level was too high; wanted more detailed navigation instructions and a shorter program length; and expressed concern about the unbalanced number of negative versus positive images of minority and non-minority families. Experts suggested more detailed comments such as specific wording revisions. Conclusions: Web-based interventions are an acceptable format for delivering parental skills training. Web interventions targeting racial minorities must be attuned to cultural issues and how their visual presentation of minorities could be perceived.