A randomized trial of a parent-mediated intervention to reduce sexual risks among African American teens in high poverty settings

Background: African American youth living in high poverty settings have higher rates of early sexual initiation and related behavioral risks associated with negative health and social outcomes into adulthood. Healthy Futures is a brief, low demand intervention for parents of young adolescents; it provides culturally tailored audio stories that model positive parenting practices to support healthy sexual choices.

Methods: In a randomized controlled trial of Healthy Futures, 1223 sixth grade youths and parents were recruited from schools in New York City and assigned to one of three conditions: (1) Healthy Futures audio stories for an 18 month period (intervention), (2), print materials on similar topics (attention control), or (3) a control condition. Youth were surveyed at baseline and three months post-intervention about sexual behaviors.

Results: At three months post-intervention, youth in the intervention condition had lower rates of lifetime sexual activity than control youth (AOR=0.70, p=0.04), and were less likely than control or attention control youth to report having sex or touching/being touched under their clothes during the past three months (I vs. C: AOR=0.75, p=0.02; I vs. AC: AOR=0.82, p=0.04). Intervention effects were stronger for males, with intervention males having lower rates of lifetime (AOR=0.54, p=0.001) and recent sexual activity (AOR=0.55, p=.001) than control males.

Discussion: Healthy Futures demonstrated positive impacts at delaying sexual involvement. Future analyses will examine the duration of this effect. Healthy Futures represents a brief intervention disseminated directly to parents' homes that has potential to influence large populations of parents and teens.