apt parent adolescent comm sex

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1 Parent-Adolescent Communication about Sex in Latino Families: A Guide for Practitioners By Vincent Guilamo-Ramos, Ph.D., LCSW and Alida Bouris, MSW January 2008 www.TheNationalCampaign.org www.StayTeen.org www.TeenPregnancy .org

2 The National Campaign to Prevent Teen and Unplanned Pregnancy Board of Directors Stephen W. Sanger Irving B. Harris (1910 - 2004) Chairman Chairman, The Harris Foundation Chairman and Chief Executive Officer Thomas H. Kean General Mills, Inc. Chairman Barbara Huberman The Robert Wood Johnson Foundation Victoria P. Sant Director of Training, Advocates for Youth former Governor of New Jersey President, The Summit Foundation Sheila C. Johnson, Hon. Ph.D. President Sara Seims, Ph.D. CEO, Salamander Farm Isabel V. Sawhill, Ph.D. Director, Population Program Senior Fellow, Economic Studies Judith E. Jones The William and Flora Hewlett Foundation The Brookings Institution Clinical Professor, Mailman School of Public Health Columbia University Matthew Stagner, Ph.D. CEO and Treasurer Exectutive Director Sarah S. Brown Leslie Kantor Chapin Hall Center for Children Kantor Consulting University of Chicago Nancy Kassebaum Baker Mary C. Tydings Robert Wm. Blum, M.D., Ph.D. former U.S. Senator Managing Director, Russell Reynolds Associates William H. Gates Sr., Professor and Chair Department of Population and Family Health Sciences Douglas Kirby, Ph.D. Roland C. Warren Johns Hopkins University Senior Research Scientist, ETR Associates President, National Fatherhood Initiative Linda Chavez C. Everett Koop, M.D. Stephen A. Weiswasser Chairman, Center for Equal Opportunity former U.S. Surgeon General Partner, Covington & Burling Vanessa Cullins, M.D. John D. Macomber Gail R. Wilensky, Ph.D. Vice President for Medical Affairs Principal, JDM Investment Group Senior Fellow, Project HOPE Planned Parenthood Federation of America, Inc. Sister Mary Rose McGeady Kimberlydawn Wisdom, M.D. Susanne Daniels former President and CEO, Covenant House Surgeon General, State of Michigan President, Lifetime Entertainment Services Vice President, Community Health, Judy McGrath Education, and Wellness Maria Echaveste Chairman and CEO, MTV Networks Henry Ford Health System Senior Fellow, Center for American Progress Brent C. Miller, Ph.D. Daisy Expósito-Ulla Vice President for Research TRUSTEES EMERITI Chairman and CEO, d expósito & partners Utah State University Charlotte Beers William Galston, Ph.D. Kristin Moore, Ph.D. former Under Secretary for Senior Fellow, Governance Studies Area Director, Emerging Issues Public Diplomacy and Public Affairs The Brookings Institution Child Trends, Inc. U.S. Department of State David R. Gergen former Chairman and CEO, Ogilvy & Mather John E. Pepper Editor-at-Large, U.S. News & World Report CEO Carol Mendez Cassell, Ph.D. National Underground Railroad Freedom Center Ron Haskins, Ph.D. Senior Scientist, Allied Health Center Senior Fellow, Economic Studies School of Medicine, Prevention Research Center Hugh Price Co-Director, Center for Children and Families University of New Mexico Senior Fellow, Economic Studies The Brookings Institution The Brookings Institution Annette P. Cumming Senior Consultant, The Annie E. Casey Foundation Executive Director and Vice President Warren B. Rudman Alexine Clement Jackson The Cumming Foundation Senior Counsel Community Volunteer Paul, Weiss, Rifkind, Wharton & Garrison Frankie Sue Del Papa former U.S. Senator Nancy L. Johnson former Attorney General Senior Public Policy Advisor State of Nevada Kurt L. Schmoke Federal Public Policy and Healthcare Group Dean, Howard University School of Law Whoopi Goldberg Baker, Donelson, Bearman, Caldwell & Berkowitz, PC former Mayor of Baltimore Actress Jody Greenstone Miller Isabel Stewart Stephen Goldsmith President and CEO, The Business Talent Group former Executive Director, Girls Inc. Daniel Paul Professor of Government Reverend Father Michael D. Place, STD John F. Kennedy School of Government Vincent Weber Vice President, Ministry Development former Mayor of Indianapolis Partner, Clark & Weinstock Resurrection Health Care former U.S. Congressman Katharine Graham (1917-2001) Bruce Rosenblum Chairman, The Washington Post Company Judy Woodruff President, Warner Bros. Television Group Senior Correspondent David A. Hamburg, M.D. The NewsHour with Jim Lehrer Diane Rowland President Emeritus, Carnegie Corporation of New York Executive Director Visiting Scholar, Weill Medical College Andrew Young Kaiser Commission on Medicaid and the Uninsured Cornell University Chairman, GoodWorks International former Ambassador to the U.N.

3 P T H E C A M PA I G N T O P R E V E N T T E E N A N D U N P L A N N E D AT I O N A L R E G N A N C Y N Parent-Adolescent Communication A Guide about Sex in Latino Families: for Practitioners By Vincent Guilamo-Ramos, Ph.D., LCSW and Alida Bouris, MSW January 2008 Table of Contents Introduction and purpose 2 13 Summary: Focus on the content, context, timing, and frequency 3 Parent-adolescent communication 13 Barriers to communication: About The content of communication: What 3 sex and related topics parents say matters 13 Strategies for practitioners: What Strategies for practitioners and 4 should Latino parents say? parents: How can parents feel more comfortable talking about sex? 4 Parental messages that delay the onset of adolescent sexual behavior Putting Latino parent-adolescent 18 6 Helping parents talk about the communication into context: The technical aspects of sex and Contraception importance of establishing a strong parent-adolescent relationship The context of communication: 7 Strategies for practitioners and 18 How parents communicate matters parents: How can parents improve their relationship with their teen? 8 Strategies for practitioners and parents: How should parents talk to 20 Putting Latino parent-adolescent their teens? communication into context: The 8 ¿Cómo deben hablar los padres con importance of parental monitoring sus hijos adolescentes? and supervision The timing of communication: 11 20 Strategies for practitioners and When parents communicate matters parents: How can parents improve the quality of monitoring and 11 Strategies for practitioners and parents: When should parents talk? supervision? References 22 12 The frequency of communication: How often parents talk matters 12 Strategies for practitioners and parents: How often should parents talk?

4 Introduction and purpose Social workers, guidance counselors, pediatricians, monitoring and supervision. This information nurses, and other practitioners working with Latino supplements the information presented in the National Campaign to Prevent Teen and Unplanned families are in a unique position to help parents Through specific behavior (available concerned about the risk of teen pregnancy and Consejos a los Padres Pregnancy’s pamphlet, and practices, parents can at www.teenpregnancy.org/espanol). Even effort sexually transmitted diseases (STDs). Research shows help reduce the rise of that Latino parents matter when it comes to influencing has been made to ensure that this information is teen pregnancies and STDs presented in a way that honors the cultural values and their teen’s sexual behavior—through specific parenting among Latino youth. experiences of Latino families. behavior and practices, parents can help reduce the risk of teen pregnancies and STDs among Latino youth. The The majority of research on parent-adolescent communication about sex in Latino families has purpose of this guide is to provide practitioners with practical, research-based strategies that can help Latino been conducted with mothers. This may be due, in families improve parent-adolescent communication part, to the fact that Latino mothers are more likely to talk about sex with their child than are fathers, about sexual behavior in an effort to reduce the high 4 However, this does not rate of teen pregnancy and childbearing in the Latino according to some studies. community. Although many Latino parents are mean that fathers are not influential. In general, we comfortable talking with their children about sex, love, know comparatively little about how Latino fathers communicate with their adolescent children about sex. and relationships, Latino parents themselves make clear While the strategies in this manual draw upon mother- that they want and need assistance in communicating 1,2 adolescent research, practitioners working with fathers more effectively with their children on these issues. should still find this information useful and should be In seeking to help practitioners and Latino parents aware that fathers are an understudied group. improve the quality and effectiveness of parent- Across research studies with different Latino adolescent communication about sexual behavior, we encourage Latino parents to do what is naturally subgroups living in diverse communities across the United States, we see that Latino parents can use specific and culturally important: provide the leadership, parenting practices and behavior that help reduce the guidance, and love that promotes healthy youth risk of teen pregnancies and STDs among Latino youth. development and reduces the risk of teen pregnancy and STDs. To help practitioners in their efforts to This is excellent news for advocates and practitioners whose work is focused on reducing teen pregnancy and strengthen parents’ ability to talk about sex, this STD rates in the Latino community. The evidence from guide provides advice in four areas: (1) the content of communication, (2) the context of communication, these reports must now be transferred to the field so that practitioners can work effectively with Latino parents to (3) the timing of parental discussions, and (4) the 3 ameliorate this public health challenge. As practitioners frequency of parental discussions. know, there is great diversity in Latino families with In addition, the guide reviews potential barriers to respect to acculturation, education, family structure, communication, such as religiosity and acculturation, that practitioners may encounter when working with and religiosity. Each of these factors can impact parent- Latino families. Communication is one way to help adolescent communication about sex, as well as the reduce the risk of Latino teen pregnancy and STDs. broader parent-adolescent relationship. Practitioners should be sensitive to this diversity and how it may affect However, effective communication occurs within a constellation of other parent-adolescent factors that parental communication about sex. Practitioners are practitioners can highlight for parents. Therefore, strongly encouraged to explore the relevance of these practitioners will find information on how to help topics with Latino parents and to tailor the information presented in this guide to the specific needs of the parents improve the quality of parent-adolescent relationships, as well as the quality of parental parents with whom they are working. R E V E N T 2 N A T I O N A L C A M P A I G N T O P T H E T E E N A N D U N P L A N N E D P R E G N A N C Y

5 Parent- The content of adolescent communication: What communication parents say matters Whereas much of the early research on parent- The first of our four areas of communication adolescent communication about sex tended to focuses on the content of communication. Latino parents can talk about a wide range of topics with conceptualize parent-adolescent communication their children, including puberty, dating, abstinence as the occurrence or frequency of conversations, researchers are now calling for a more complex values and expectations about sexual behavior, 5 Accordingly, we view parent-adolescent approach. marriage, pregnancy, and contraception. Research communication about sex as an ongoing process suggests that, in general, Latino parents most often 6,7,8 the negative consequences of rather than a one-time conversation, and one that talk about puberty, 9,10 and about sexual morals, attitudes sexual behavior focuses on what messages are sent, what messages 8,10 ,11,12 With respect to values and attitudes, and values. are heard, and what messages are understood. These parents often emphasize the need to abstain from sex messages can be direct or indirect, and the timing, 9,13,14 until marriage or until adolescents finish school frequency, and ways in which messages are delivered 7,9 Additionally, can all affect how Latino adolescents internalize and and establish a meaningful career. respond to parental communication about sex. Latino parents discuss how having sex would be 8,10 morally wrong, a message that teens appear to 10 Importantly, studies show that parental internalize. disapproval of sex is related to less risky sexual 15 behavior in both adolescence and adulthood. A number of studies have suggested that Latino parents have a difficult time talking about the technical aspects of sexuality, including 8,11 contraceptives and birth control. This may be because many Latino parents believe they lack the knowledge to discuss such topics or that talking about contraception may encourage adolescent 9 sexual activity. However, in longitudinal studies, parental communication about contraception is associated with less sexual risk taking on the part of 16 Latino adolescents. In cross-sectional studies where a relationship between parental communication and increased rates of adolescent sexual activity have been observed, this finding is generally attributed to the fact that family communication about sex increases when parents perceive or know that their 12,17 child has become sexually active. Latino parents tend to talk about sex with their 10 daughters more than with their sons. Adolescents are aware of this dynamic and want their parents to deliver the same message about responsible sexual 1,9 Although daughters behavior to sons and daughters. are most often on the receiving end of parents’ conversations about sex and related issues due to pregnancy concerns, Latino boys are more accepting T H E 3 A T I O N A L C A M P A I G N T O P R E V E N T T E E N A N D U N P L A N N E D P R E G N A N C Y N

6 10 of having sex at an earlier age than Latina girls. This Parental messages that delay the onset of finding is supported by national data showing that adolescent sexual behavior Latino boys report sexual activity at earlier ages than Messages that focus on parental disapproval 18 Latina girls. of adolescent sexual behavior are one of the most In seeking to change adolescent behavior, effective ways to decrease the risk of teen pregnancy practitioners should help parents understand that and STDs for young adolescents and for youth it’s necessary to deliver messages that resonate with who have not yet become sexually active. Messages adolescents. Many Latino parents are motivated disapproving of adolescent sexual behavior can be to talk about sex out of a concern for their child’s delivered in different ways. For example, Latino 13 safety and well-being. Given this concern, it is not parents often communicate their disapproval by surprising that parents focus on questions of morals talking about the negative consequences of sexual and values as well as the negative consequences of behavior, such as pregnancy, STDs, and HIV. Many adolescent sexual activity. However, studies examining Latino parents tell their teens that they disapprove Latino adolescents’ reasons for having sex also suggest of sexual activity at young ages, because of moral or that social concerns such as reputation at school, religious reasons, because sex should not occur outside relationships with peers and romantic partners, the context of marriage or a loving relationship, or as well as their expectations of love, closeness, and simply while their teens are still in school. 10 physical pleasure are relevant. Given the difficulty These messages reflect important family, social, and complexity of these topics, it is not surprising that and cultural values. The good news is that Latino 10 Few they are not often addressed by most parents. parents are relatively comfortable talking with their programs have helped Latino parents address their teens about some of these topics and that Latino teens child’s beliefs that having sex will feel good or make are internalizing their parents’ messages. For example, them feel more attractive. These are difficult issues a recent study found that fear of getting themselves or and addressing them is challenging for all parents. a partner pregnant and religion and moral values were Practitioners can help parents to address difficult the two primary reasons that Latino virgins abstained 19 topics and develop concrete ways to talk with their from sex. Practitioners should encourage parents teen about these topics. to keep talking about morals and values that are culturally important. Helping Latino parents to keep Strategies for practitioners: What should doing what is natural and comfortable for them, such Latino parents say? as addressing moral issues and health consequences, Practitioners can help Latino parents deliver can help parents to feel comfortable in their ability to effective messages in three areas that can, in turn, help talk about sex with their teens. reduce their children’s risk of pregnancy and STDs. Research suggests that the negative consequences The first area concerns parental messages that delay associated with teen sexual activity motivate 10 the onset of adolescent sexual behavior and focus Latino parents to talk with their teens about sex. Encourage parents to keep on parental disapproval and values. The second also Consequently, practitioners should take advantage talking about morals and values that are culturally addresses issues that delay the onset of sexual activity of this by reviewing the health consequences of important. but focuses on topics that may be particularly difficult adolescent sexual behavior with Latino parents, for parents to address such as love, social influences, as this will increase the likelihood that parents positive expectations, and healthy relationships. The talk about sex and improve teen knowledge about third addresses the technical aspects of sexuality that pregnancy, STDs, and HIV/AIDS. At the same time, can reduce the risk of pregnancy and STDs, such as practitioners need to help parents address some birth control, contraceptives, STDs, and HIV. of the other factors associated with teen’s sexual E E N T 4 P T O A M P A I G N T H E R E G N A N C Y P N P L A N N E D U A N D C A T I O N A L N R E V E N T

7 5. I would be more popular with boys/girls if I behavior, such as social influences and positive expectations. Common social influences that affect had sex. 6. If I have sex, I might get a bad reputation at school. Latino adolescents’ decisions about sex include peer 7. Having sex would interfere with school. influence (being popular or getting a bad reputation 8. I think that having sex right now would be at school, for example) and partner influences (such as feeling closer to a boyfriend or girlfriend). morally wrong. Additionally, some Latino teens naturally also have 9. I would feel guilty if I had sex at this time in my life. positive expectations about sexual activity—that It’s better to wait until I am married to have sex. 10. sex will feel good or that having sex will make them feel more attractive or grown up. Practitioners can In addition, another area practitioners can help address these issues with parents so that parents can parents relate to is love and what it means to be in develop the knowledge and skills to address them in It’s equally as important for parents to talk with a way that will be relevant for teens. The challenge a healthy romantic relationship. Practitioners can their sons, not just their for practitioners is to understand that while parents help parents define a healthy adolescent romantic daughters. are motivated to talk about sex by the negative relationship in the context of their cultural values, consequences associated with adolescent sexual religious beliefs, and overall desire to keep their child behavior, the factors that are often most important to safe from harm. Let parents know that this is a good young people relate to social influences and positive opportunity to highlight their values and their wish expectations about having sex. for their child to learn about love in ways that won’t increase their risk of pregnancy. We suggest that practitioners motivate parents to talk about sex by reviewing the negative Parents need to know that it’s not just about consequences of Latino adolescent sexual behavior, raising their teen’s awareness of the possible negative such as the rates of teen pregnancy, STDs and consequences of sex, it’s about sending messages that are relevant to them. To be clear, parents shouldn’t HIV among Latino youth, as well as how teen pregnancy and STDs interfere with teens’ well- avoid talking about the negative consequences of 20 After doing adolescent sexual behavior. It’s important for parents being and future life opportunities. to communicate their disapproval of early sex, talk this, practitioners should provide parents with an about values, love, and healthy relationships, and overview of the social reasons and expectations address the risks of pregnancy, STDs, and HIV with most strongly associated with adolescent sexual decision making. By highlighting social influences their children. However, the effectiveness of parent- and expectations, practitioners will help parents to adolescent communication is likely to improve when (1) understand sex from their child’s perspective message content reflects the factors most strongly and (2) tailor the content of their communication associated with an adolescent’s decision to have sex. to address youth’s beliefs about having sex. The 10 Finally, practitioners should also help parents social reasons and expectations addressed here are understand that it’s equally important to talk with their sons, not just their daughters, about these issues. based on responses from middle-school aged Latino youth and are delivered from the teen’s point of Let parents know that social influences, relationship 10 issues, and expectations about sex affect They include: view. all teens, and 1. I think I would enjoy the way that sex feels. that pregnancy, STDs, and HIV can negatively affect 2. If I had sex, I would feel more attractive. their child’s future health and life opportunities. Given the difficulty of these topics, practitioners 3. I would feel more grown up if I had sex. 4. I would feel closer to the boy/girl with whom I should consider role-playing these conversations had sex. with parents. In addition to individual work, it may N R E V E N T P T O T H E  R E G N A N C Y P N P L A N N E D U A N D E E N A M P A I G N C A T I O N A L T

8 Many Latino parents view American culture help to bring groups of parents together to discuss this difficult topic, as group discussion, support and as sexually permissive and worry that discussing feedback may help parents feel more confident in contraception and sexuality in detail may 9 inadvertently encourage adolescent sexual behavior. their ability to tackle these tougher issues. In addition, some Latino parents are opposed to contraception for moral or religious reasons. In Helping parents talk about the technical aspects of sex and Contraception these cases, we recommend that practitioners let Many parents will want to know if they should parents know that it’s still important to talk with Take an active role their child about contraception. Let parents know talk with their teens about some of the more technical in helping parents that teens’ sexual behavior is less risky when parents aspects of sex and contraception. And if so, what understand and talk about are the major source of sexual information for should they say? Practitioners can help parents by contraception. 21 providing them with the knowledge and skills to talk In the absence of parental guidance, adolescents. effectively when they are ready to do so. Of primary teenagers may turn to other sources, such as friends or the Internet. Unfortunately, adolescents may importance is the provision of accessible and accurate information about sex, pregnancy, STDs, HIV, and receive inaccurate information about contraception and other sex-related topics. Parents can make sure contraception. Latino parents—like all parents—need factual and science-based evidence in these areas. This that their teen has accurate and developmentally- information, whether transmitted through printed appropriate information by being the person who communicates this information to them. Parents can materials, audiovisual media or person-to-person, help their teen put information about contraception should be available in Spanish and English and into the context of parental values that promote delivered in a way that is easy to understand. abstinence and healthy decision making. These It is not sufficient to simply hand parents written approaches are discussed in additional detail in the materials about contraceptives with the expectation that Strategies for Practitioners and Parents section in they will read it, understand it, and feel comfortable Barriers to Communication. enough to speak with their child knowledgeably and If opting to present this information in a group effectively. Rather, practitioners need to take an active setting, practitioners should pay particular attention in helping parents understand and talk about role to group dynamics. A lack of participation in contraception. This approach may necessitate reviewing the group context may indicate that a parent is information together, asking open- and close-ended uncomfortable with the material and needs additional questions to help ensure that parents understand, and support and assistance. If a practitioner is unable role-playing different conversations. Alternatively, to work with each parent individually, it may help practitioners can refer parents to agencies, clinics, and to have parents practice conversations with each organizations that offer programs designed to help other in ways that allow them to strengthen their parents talk about the technical aspects of sexuality communication skills and receive feedback from with their children. In these cases, practitioners should each other. Whenever possible, we recommend that a work with parents to help them identify an appropriate practitioner or other knowledgeable service provider program. Parents will need to consider if the program be available to provide parents with focused support and curricula are compatible with their personal and and feedback on these conversations. cultural values and beliefs. Practitioners can work with parents to identify appropriate programs. The focus should be on strengthening parental knowledge, comfort and ability to talk about pregnancy, STDs, HIV, and contraceptives. P N P L A N N E D U A N D 6 T R E V E N T P T O A M P A I G N T H E R E G N A N C Y C A T I O N A L N E E N

9 The context of communication: How parents communicate matters The second dimension of the communication knowledge and experience that can help their child deal with difficult issues. framework addresses the context of communication. Practitioners can work with parents to explore parents say it, is important. Studies Context, or how ways to be open to these types of conversations. have shown that the way parents deliver messages about sex influences adolescents’ receptiveness One practical way is to work with parents 22 Research on the context to identify “teachable” moments. Teachable to the message itself. of communication indicates that greater levels moments can occur while watching a TV show, , or movie, while watching news events, of perceived parental openness, responsiveness, telenovela comfort, and confidence in discussions about sex after learning about friends’ challenges, or by and related issues are associated with lower levels of attending a community event together. The goal 23,24,25,26 suggesting adolescent sexual risk behavior, is to help parents identify and take advantage of opportunities that make it easier for them to talk that adolescents’ perceptions of the quality of about sex with their child in ways that highlight communication may influence the effectiveness of values and beliefs that reduce the risk of teen parental messages about sex. pregnancy and STDs. In recent focus group discussions with Other studies examining the context of Latino families, teens said that they want their parents to remain open and calm when talking communication have found that trust between 1,9 about sex. However, even though many Latino parents and adolescents is important, as are adolescents’ perceptions of parental expertise and parents recognize the importance of an open 24,28,29 communication style, many also acknowledge accessibility. High levels of trust in the parent- Help parents identify and take advantage of that it is difficult to remain calm and open due to adolescent relationship have been associated with “teachable” moments. 9 their anxieties about their teens’ sexual behavior. higher levels of parent-adolescent communication Research suggests that one practical way that about sex and lower levels of adolescent sexual 24 In part, this may be because Latino behavior. parents can be open is to talk about their own experiences with dating and relationships as a adolescents who perceive their parents as trustworthy also seek out the advice of their parents teenager. Latino teens want to hear from their 24 parents and appear to be particularly receptive and believe that they give good and helpful advice. In turn, these perceptions of parental expertise to hearing about their parents’ adolescent experiences dealing with difficult topics, like appear to foster the type of communication that protects against youth involvement in risky sexual dating and the decision to have sex. For example, 24 behavior. In addition to trustworthiness and studies with Latino youth have found that higher rates of parental self-disclosure are predictive of expertise, Latino adolescents also indicate that parental accessibility is an important component higher levels of perceived parental openness in 12 conversations about sex. in parent-adolescent conversations about sex. Additionally, Latino youth who perceive their parents as being willing to Specifically, when youth perceive that it is easy to talk about how they dealt with tough issues during find time to talk with their parents and that their parents are not too busy to talk to them, they report adolescence report less willingness to engage in 27 higher levels of communication about sex and Practitioners should let parents sexual intercourse. 24 know that if their child is struggling with a problem lower rates of sexual behavior. or serious issue, such as the decision to have sex, it can help to talk about their own adolescent experiences with that specific issue. Openness in this area reinforces that parents have the type of P N P L A N N E D U A N D T H E T R E V E N T N 7 R E G N A N C Y P T O A M P A I G N C A T I O N A L E E N

10 ¿Cómo deben hablar los padres con sus hijos Strategies for practitioners and parents: How adolescentes? should parents talk to their teens? Los proveedores pueden ayudar a mejorar el contexto de la Practitioners can help improve the context of comunicación orientando a los padres acerca de la mejor manera communication by guiding parents on the best way de comunicarse con sus hijos sobre el sexo. Los proveedores to communicate to their child about sex. Practitioners can capitalize on the cultural value of pueden sacar provecho del valor cultural del personalismo , el cual , personalismo subraya la importancia de la sinceridad, el carácter personal y las which emphasizes honesty, personal character and inner 30,31 30,31 cualidades internas en las relaciones personales. qualities in personal relationships. Los mensajes The messages presented here are directed at parents. presentados aquí son para los padres. 1. Be Open. Adolescents want their parents to talk to 1. Sea Abierto. Los adolescentes quieren que sus padres them in an open way. Remember, teens appreciate hablen con ellos de manera abierta. Recuerde que los parental honesty and want to hear about your own jóvenes aprecian la sinceridad de sus padres y quieren experiences with dating and relationships. This saber de sus propias experiencias acerca de relaciones de type of parental openness may help your teen better noviazgo. Este tipo de sinceridad por parte de los padres puede ayudar a que sus hijos entiendan mejor sus mensajes understand your messages about acceptable sexual sobre el comportamiento sexual aceptable y su deseo que behavior and your wishes for them to stay safe. You sus hijos estén seguros. Usted tendrá que emplear buen will need to use good judgment in deciding what juicio para decidir qué tipo de información personal quiere personal information to share. But talking about your own problems and experiences and about what compartir. Aún así, el hablar de sus propios problemas, things were like for you when you were a teen can go experiencias y de cómo eran las cosas cuando usted era joven puede ser muy útil. a long way. Teens who believe that their parents 2. Be the Expert. 2. Sea el Experto. Los adolescentes que creen que sus padres know a lot are more likely to listen to them. Even if saben mucho son más propensos a escucharles. Aún si you feel like you don’t have all the answers, take the usted no piensa que tenga todas las respuestas, tome time to listen and to respond. Being an expert on your el tiempo para escuchar y responder. Ser experto en la teens’ life means talking with them and hearing their vida de sus hijos significa hablar con ellos y escuchar su point of view. If your teen asks you questions that punto de vista. Si sus hijos le hacen preguntas que no sabe contestar, está bien decir, “No sé.” Dígales que encontrará you don’t know the answer to, it’s okay to say, “I don’t know.” Let your teen know that you’ll find the answer la respuesta y luego la compartirá con ellos. Dependiendo and get back to them. Depending on the question, you de la pregunta, ustedes pueden tratar de encontrar la can try to find the answer together. When it comes respuesta juntos. Cuando se trata de la actividad sexual entre adolescentes, se puede encontrar muchas respuestas to teen sexual behavior, many answers can be found online, from your healthcare provider, at school, in the por el Internet, de su proveedor de salud, en la escuela, en la biblioteca, en la iglesia o en un centro comunitario local. library, at your church, or at a local community center. 3. Sea Accesible. Aunque los padres estén muy ocupados, es Parents have busy schedules, but it’s 3. Be Accessible. importante ser accesible para sus hijos cuando tienen que important to be available to your teen when they hablar con usted. Si no puede hablar con ellos, programe una need to speak with you. If you can’t talk, schedule hora para hablar cuanto antes. Los hijos saben que sus padres a time to talk as soon as possible. Teens know that están ocupados y están dispuestos encontrar una hora que les their parents are busy and are willing to work convenga a todos. El mensaje importante para comunicarles with you to find a time that works. The important 8 R E G N A N C Y P N P L A N N E D U A N D E E N T H E R E V E N T P T O A M P A I G N C A T I O N A L N T

11 message to communicate is that talking with your es que hablar con sus hijos sobre lo que está pasando en su vida es su primera prioridad. Mientras que los adolescentes dicen teen about what’s going on in his or her life is your que se les hace difícil cuando no pueden encontrar el tiempo number one priority. While teens say that it’s hard para hablar con sus padres, también dicen que los padres when they can’t find time to talk with their parents, todavía pueden demostrar cuánto se preocupan por sus hijos. they also say that parents can still communicate how much they care. Some practical tips teens Algunos consejos prácticos sugeridos por adolescentes incluyen: anotar una fecha y una hora en el calendario o en una hoja de suggest include writing down a date and time on a calendar or on a piece of paper, or finding time to papel, o encontrar el tiempo para hablar durante momentos de convivencia, como mientras están lavando la ropa, preparando talk when doing things together, such as laundry, cooking, going to the park, going to church, or la comida, paseando por el parque, yendo a la iglesia, o dando taking a drive. una vuelta. Sea Confiado. 4. Teens want to talk with their parents . 4. Be Trusting Los adolescentes quieren hablar con sus padres about sex but sometimes fear that their parents will sobre el sexo, pero a veces temen que supondrán que estén teniendo relaciones sexuales. Los hijos quieren que sus padres assume that they are sexually active. Teens want their les tengan confianza y que les muestren que les quieren, parents to trust them and to show that they love pase lo que pase. Esto no quiere decir que usted tenga que them no matter what. This doesn’t mean that you ser demasiado permisivo o esconder su desaprobación a las have to be overly permissive or hide your disapproval decisiones de sus hijos. Hable con ellos sobre el tema de la of your teen’s decisions. Talk with your teen about the topic of trust and what it means for each of you confianza y lo que significa para cada uno de ustedes confiar en el otro. Puede decirles a sus hijos que usted confía en que to trust each other. You can tell your teen that you trust that they will share their thoughts about the big ellos compartirán sus pensamientos acerca de los asuntos issues in their life, including the decision to have sex. importantes en su vida, incluyendo la decisión de tener In turn, your teen can trust that you will be there for sexo. A cambio, sus hijos pueden confiar en que usted estará presente para hablar sobre los asuntos grandes de la vida. them to talk about the big issues in life. 5. Manténgase Tranquilo. 5. Stay Calm . Some teens worry that their parents Algunos adolescentes se preocupan que may react badly if they learn that they are having sus padres puedan reaccionar de una forma negativa si se enteren sex or are thinking about having sex. Teens say that de que están teniendo relaciones sexuales o pensando tenerlas. Los adolescentes dicen que mantenerse tranquilo es algo que staying calm is one thing that parents can do to really improve conversations about sensitive topics los padres pueden hacer para mejorar las conversaciones sobre Aún si usted tiene opiniones like sex. Even if you feel strongly about something, asuntos delicados como el sexo. fuertes sobre algún tema, trate de mantenerse calmado cuando try to remain calm as you talk with your teen. Avoid hable con sus hijos. Evite gritar. Si las cosas se vuelven demasiado shouting. If things get too heated or emotional, acaloradas o emocionales, sugiera que tomen una pausa hasta suggest that you take a break until each of you has cooled down. que todos se hayan tranquilizado. Es común que a las personas les 6. Haga Preguntas Abiertas. 6. Ask Open-Ended Questions. People like to talk guste hablar de sí mismos y de sus propias ideas. Pregúnteles about themselves and their ideas. Ask your teen what a sus hijos lo que ellos piensan, haciendo preguntas abiertas he or she thinks, using open-ended questions (ones (las que no se pueden contestar con un mero “sí” o “no”). Sea that can’t be answered with a simple “yes” or “no”). curioso sobre las ideas y opiniones de sus hijos. ¡Usted todavía Be curious about your teen’s ideas and opinions. You tiene mucho que aprender sobre sus jóvenes adolescentes! still have a lot to learn about your teen! T T H E A T I O N A L C A M P A I G N T O P R E V E N T N E E N A N D U N P L A N N E D P R E G N A N C Y 9

12 7. Deje que sus hijos hablen sin Escuche a Sus Hijos. Let your teen speak without 7. Listen To Your Teen. interrupción. No termine sus oraciones. Puede ser que interruption; don’t finish sentences for them. You may feel like interrupting, but don’t. Let your teen usted quiere interrumpir, pero no lo haga. Permita que sus hijos terminen de expresar sus pensamientos. A veces ayuda finish his or her thoughts. Sometimes it helps to repetir lo que usted piensa que ha escuchado: “Bueno, lo que repeat what you think you have heard: “So what you’re estás diciendo es que...” Luego pregunte: “¿Entendí bien?” saying is...” Then ask: “Did I get that right?” If you’re not sure about something, ask about it. But above all, Si tiene dudas sobre algo, haga preguntas. Sobre todo, evite avoid turning the talk into one big lecture. Show a que la conversación se convierta en un gran sermón. Muestre willingness to listen. una buena voluntad de escuchar. 8. Póngase en el Lugar de sus Hijos. 8. Put Yourself in Your Teen’s Shoes. Teens like it if A los jóvenes adolescentes from their point of view. Make les gusta que los padres tratemos de ver las cosas desde su you try to see things and punto de vista. Haga un esfuerzo para ponerse en el lugar de an effort to put yourself in the place of your teen think about things from his or her point of view. Let sus hijos y pensar en las cosas desde su perspectiva. Déjeles saber a sus hijos que usted está tratando de hacer esto, diciendo are trying to do this by saying your teen know that you simple things like, “I get you...” or “I had some of the cosas sencillas como, “Te entiendo...” o “Tuve algunas de las mismas experiencias cuando yo tenía tu edad...” Si no sabe same experiences when I was your age...” If you’re not exactamente cómo les fue a sus hijos, pida que le cuenten más sure what it was like for your teen, ask them to tell you sobre sus experiencias. Así, les mostrará a sus hijos que usted se more about their experience. This will show your teen that you care and are interested in their life. preocupa por ellos y que está interesado en su vida. 9. Appeal to Common Goals Your teen needs to be . 9. Apele a Metas Comunes. Hay que recordarles a sus hijos que usted está a su lado. A menudo quiere las mismas cosas reminded that you are on his or her side. You often que sus hijos. Cuando quiera que sea posible, ponga énfasis want the same things your teen does. Whenever possible, emphasize common goals and tell your teen en las metas comunes y dígales a sus hijos que usted quiere you want what is best for him or her. Be supportive. todo lo mejor para ellos. Sea compasivo. Asegúrese de que sus hijos sientan Make sure your teen feels you’re Demuestre su Interés. 10. Show Your Interest. 10. giving them your full attention. Even if you have to que usted está prestándoles toda su atención. Aún si tiene que talk while doing something else, make eye contact hablar mientras hace otra cosa, mantenga contacto visual con sus adolescentes cuando habla. Asiente con la cabeza para with your teen when talking. Nod your head to indicate you understand what your teen is saying and indicar que entiende lo que sus hijos están diciendo y diga say things that indicate you are paying attention and cosas que indiquen que usted está prestando atención y que are interested. está interesado. provee a los padres consejos prácticos para For additional tips, read or download a copy of Consejos Consejos a los Padres 32 which provides parents with practical tips to ayudar a sus hijos evitar el embarazo. Disponible en español y a los Padres help their children avoid pregnancy. Available in Spanish en inglés, los padres pueden utilizar estos consejos para reforzar sus esfuerzos para reducir el riesgo del embarazo y de las EST and English, parents can use these tips to support their efforts to reduce their teen’s risk of pregnancy and STD. en sus hijos. R E V E N T P N P L A N N E D U A N D E E N T R E G N A N C Y P T O A M P A I G N C A T I O N A L N T H E 1 0

13 The timing of communication: When parents communicate matters The third part of the communication framework focuses Strategies for practitioners and parents: When on the timing of communication. Many Latino parents should parents talk? wonder when it’s appropriate to begin talking with their teen The primary message for practitioners to communicate about sex. Should they start talking when their child enters teens start dating and before is that the best time to talk is puberty? Should they wait until their teen starts dating? Or having sex. It is easier to delay the onset of sexual behavior do they wait to talk until their teen starts asking questions than it is to stop sexual behavior once it has begun. But when about sex? Research literature suggests that parents should is “before?” Practitioners can let parents know that they begin talking to their kids about sex, love, and relationships rather than later. Many parents begin these earlier should talk 33,34 before their teens start dating or become sexually active. talks with their children between the ages of 10 and 12. For Put another way, parents have an important opportunity to many Latino parents, it’s hard to believe that children this before socialize their teen about acceptable sexual behavior young have had sex. But practitioners need to let parents they find themselves in the types of situations that heighten know about the importance of talking early. the risk of sexual activity. Not surprisingly, a number Practitioners can help parents with the “When” and of studies indicate that the onset of dating is one of the “Where” aspects of talking to their teen. Ideally, parents will 35,36,37 This suggests that strongest predictors of sexual activity. want to choose a place and time: parents should begin talking to their children before they • That is quiet and free of distractions, as much as possible; begin dating. Additionally, teens who report talking with • Where they will not be interrupted; their parents about condoms before they become sexually • When there is no upcoming activity that will force them active report higher rates of condom use at first sex, which in to stop talking too soon; and 38 • When they or their teen are not caught up in thinking turn increases the likelihood of greater lifetime condom use. about or doing something else. Unfortunately, many parents wait to initiate these sorts of conversations until it’s too late. Many Latino parents As noted previously, a good time to talk might be after underestimate the extent of their child’s involvement in risky something has happened that is related to teen sex in a TV Latina magazine and sexual behavior. A study conducted by novela . This might be after parents and teens have show or a the National Campaign to Prevent Teen and Unplanned seen a news story on television about teen sex, or after a movie Pregnancy found that while 47% of Latino teens said they where the topic is part of the plot. Or, parents may simply ask were sexually experienced, only 30% of Latino parents 39 their child to sit down to talk. While the inclination for thought their teen had had sex. Practitioners are likely to encounter parents who have parents to underestimate sexual activity among teens is not 40,41 difficulty finding a time and place to talk with their teen. Other it does show a disconnect limited to Latino families, children, a busy work schedule, any number of things can between parents and teens. Many parents, in the absence of fill a family’s day. Parents shouldn’t postpone conversations clear signs of sexual activity, will assume that their teen is not indefinitely because the time and place are less than ideal. sexually active. Practitioners need to help parents understand that a significant proportion of young people are beginning Practitioners can help parents by asking questions such as: to have sex at an early age. For example, one in seven teens • Where do you feel most comfortable talking with your teen? have sex before age 15. Parents need to understand that • Is there a place in your home that is relatively free of talking about sex with their child is critical. Although some distractions? parents may believe that high school is an appropriate age to • Are there times when you and your teen are doing begin talking about sex, practitioners should let parents know something together where you could talk? that sexual behavior begins in early adolescence, before high 10 51% of school . Practitioners should let parents know that Practitioners play a particularly important role in helping 42 Waiting until Latina teens become pregnant before age 20. parents to understand that teachable moments can be found high school to begin talking about sex may be too late. in less than ideal conditions. A N D E E N T R E V E N T P T O A M P A I G N N 1 1 R E G N A N C Y P T H E U C A T I O N A L N P L A N N E D

14 The frequency of communication: How often parents talk matters The final aspect of the communication framework ongoing part of the parent-adolescent relationship that requires regular parental attention and involvement as addresses how often Latino parents should talk about . This approach children progress through adolescence sex with their children. The frequency of conversation between parents and children is a direct measure of necessitates that parents be proactive communicators their child becomes the sexual socialization that adolescents receive from before who begin discussing sex 43 parents. sexually active, and maintain open lines of Simply put, the more that parents talk about sex, the more opportunities teens have to be exposed communication throughout adolescence. Multiple to parental messages and values that reduce the risk of conversations provide parents with the opportunity to reiterate previous messages and adapt what they say pregnancy and STDs. about sex to their child’s needs. Interestingly, research with Latino parents and adolescents has shown that parents and Unfortunately, many parents, practitioners, and others mistakenly believe that parents need adolescents don’t always agree on the frequency of 2 For example, when Latino communication about sex. only address these issues with their teens once. In parents and adolescents report how often they have popular culture, this is known as “The Big Talk.” talked about sex, parents report a greater frequency of Parents and adolescents are depicted as anxious and 10 conversations than do adolescents. uncomfortable participants in these conversations, The reasons for often stumbling through these talks to comedic effect. this disconnect are not well understood. To be clear, it does not mean that parental discussions about sex Practitioners should refrain from promoting “The Big Talk” approach, and instead should emphasize that are ineffective. Rather, there are likely to be different contextual factors influencing each time parents and parents and teens need ongoing conversations. While some of these talks may be uncomfortable, ongoing teens communicate that may affect how parents and Refrain from promoting 10 communication enables parents to (1) consistently adolescents recall these conversations. “The Big Talk” approach. Practitioners need to help Latino parents discuss parental values, (2) add new information Emphasize the need for ongoing conversations. understand that talking about sex throughout as their child grows and develops, and (3) become more comfortable talking about sex. Additionally, adolescence is an important part of helping their teen practitioners should encourage parents to use humor, reduce their pregnancy and STD risk. Studies with Latino youth show that the more parents talk about as this can be a good way to minimize anxiety and specific sexuality-related topics, the more likely it is increase comfort. that adolescents will share similar views with their In promoting a long-term approach, practitioners 10 parents on that topic. This indicates that adolescents can help Latino parents understand a “Big Talk” are indeed listening to parents and that greater approach is incompatible with teens who are rapidly frequency of parental communication about sex maturing and experiencing new opportunities affects adolescents’ sexual decision-making. and pressures. With each passing year, adolescents mature physically, mentally, socially, morally, and Strategies for practitioners and parents: familismo, emotionally. The cultural value of which How often should parents talk? emphasizes strong family relationships based on 44,45 To date, there is relatively little guidance for Latino high levels of closeness, loyalty, and mutuality, parents about how often they should communicate means that being involved in their children’s with their children about sex. Is it sufficient to only life is important to Latino parents. Practitioners talk once? Should parents talk to their children a can capitalize on this by promoting ongoing specific number of times each year? Overall, we communication as a way to strengthen familial recommend that practitioners work with parents bonds and interconnectedness. Let parents know so that sexuality communication is viewed as an that the more they talk about sex with their teen, the E E N T R E V E N T 1 2 T O R E G N A N C Y P N P L A N N E D U A N D A M P A I G N C A T I O N A L N T H E P

15 Barriers to About communication: sex and related topics Although parents from all ethnic and racial more likely it is that their teen’s knowledge, values, groups find it difficult to talk to their child about and behavior will reflect their values. sex, a number of studies have suggested that Latino If parents struggle with how to do this, let them parents do not talk as often about sex as do other know that they can set up regular times—perhaps Parental discomfort 1,7,16,46,47,48 and embarrassment are once a week or once a month—to talk with their In part, this may be because parents. prominent barriers. when it comes to talking about sex, Latino parents teen about important topics. During these “talk times,” both the parent and the teen knows that don’t know what to say, how to say it, or when to 1,49 start. One of the most widely reported barriers open and respectful discussion will take place. Such a routine guarantees the “right time and place” for to sexuality communication in Latino families is 9,49,50,51 discussing not only sexual issues, but also issues parental discomfort and embarrassment. parents feel embarrassed related to other risky behavior, such as alcohol and Although the reasons why are less well understood, some have theorized drug use. Some parents plan activities with their that generational and cultural differences unique teens to take place outside the home about once a month. Parents and teens can choose activities that to Latinos in the United States may be partially responsible. For example, many Latino parents they both enjoy. When they have this chance to be were raised in families and cultures with limited alone together in a relaxed setting, both are likely to to no family communication about sex and related feel more comfortable talking about sensitive topics. 9,49 Practitioners should also let parents know that issues. Some researchers also have noted that traditional cultural norms, such as “talk times” need not focus solely on risky behavior, , marianismo may encourage women to maintain a kind of but also should address those factors that promote 8,9,52 and that Latina mothers may “sexual silence,” healthy adolescent development and reduce the risk be unable to relax when talking to their children of teen pregnancy and STDs. For example, parents 51 about sex. can also talk about the importance of success in school and having academic and career aspirations. Interestingly, studies have found that parents A balance of topics will help to ensure that teens also delay discussions about sex out of a desire to 51 not embarrass their child. For their part, many don’t feel lectured. Latino youth acknowledge feeling uncomfortable or embarrassed when talking with their parents Summary: Focus on the content, context, 7,9,13 about sex. timing and frequency Although some teens say that feeling By focusing on these four dimensions of awkward when talking about sex with a parent is communication, practitioners can help parents to be expected, others say it is rooted in a fear of strengthen their ability to talk more effectively about negative reaction from parents stemming from sex and to reduce their adolescent’s risk of pregnancy parents’ perceptions or knowledge of their child’s 9 sexual behavior. These studies do not indicate, and STD. Although the communication framework however, that teens don’t want to hear from the is a useful organizing tool for practitioners working with Latino families, practitioners also need to parents. On the contrary, research with Latino youth has found that most adolescents want and be aware that parents will need support in other 1,53,54 areas. In particular, research has identified barriers prefer to hear from their parents about sex. to communication in Latino families that warrant Another barrier to sexuality communication stems from parents’ lack of knowledge about the additional attention. 51 technical aspects of sex. Latino parents report feeling like they don’t have the necessary knowledge 7,51 or skills to talk about sex with their children. P N P L A N N E D R E G N A N C Y A N D E E N T 1 3 N U R E V E N T P T O A M P A I G N C A T I O N A L T H E

16 This may be why many parents do not feel effective Strategies for practitioners and parents: 9 or confident in their communication skills. Yet How can parents feel more comfortable another barrier to communication deals with talking about sex? parental expectations. A lot of Latino parents worry Although the barriers reviewed previously do not that talking about sex could encourage their child represent all of the potential reasons that parents 1,9 to become sexually active. In contrast, other have for not talking with their teen about sex, they Latino parents have indicated that their decision to suggest that Latino parents need assistance feeling talk about sex with their teen is rooted in the belief more comfortable talking about sex. The good that it will help their children to avoid pregnancy news for practitioners is that Latino parents freely and STDs by encouraging them to adopt more admit that they want help with talking to their 51 2 Many Latino parents freely mature thinking and decision-making. The child about love, values, sex, and relationships. admit that they want help Another challenge relates to parent’s confidence communication framework discussed previously with talking to their child in their ability to influence their child’s sexual can help practitioners by providing four specific about love, values, sex and relationships. behavior. Some Latino parents believe that talking points of intervention: content, context, timing to their kids about sex will have little or impact and frequency. For example, many Latino parents 9 on their child’s decisions about sex. This may believe that they lack the knowledge to talk fatalismo, or the idea reflect the cultural value of effectively with their children about the technical 55 2 that people can do very little to alter fate. In this aspects of sexuality. Practitioners working with context, a “master plan” guides teens and nothing parents struggling with this barrier can utilize parents say can interrupt those forces. When asked the strategies presented in the section addressing to identify other reasons for not talking about sex, the content of communication. Similarly, parents parents have said that they expect their children struggling with how to talk to their teen can draw 9,13 or will will get sexuality instruction at school upon the strategies discussed in the context of talk with other adults or family members, such as communication. 56 sisters, cousins, and aunts. However, beyond the dimensions addressed in Finally, theorists have noted that communication the framework, there are some additional barriers in Latino families may be influenced by other that practitioners can help parents to overcome. 57 important factors, such as parents’ religiosity We present below some practical techniques 58,59 Religious beliefs and and acculturation. practitioners can utilize to help Latino parents acculturation differences between parents overcome barriers to communication. and adolescents may serve as a barrier to communication. For example, religious parents may Support Parent’s Confidence in their Ability to 1. perceive that their faith community discourages Communicate. open discussions about sexual behavior, especially • Improve parental knowledge about sexuality, explicit discussions about contraception. pregnancy, STDs, HIV, and contraception. Additionally, parents who immigrated to the United • Work with parents to generate two lists: List 1 States may have a difficult time being open about should identify the reasons parents think that 9 sexuality communication. Practitioners need to talking about sex will not make a difference. help parents negotiate both of these barriers, as List 2 should identify how parents have made they may heighten the risk of parent-adolescent a difference in their teen’s life. The goal is to 60 miscommunication and conflict. identify parents’ strengths that can be capitalized upon and to identify those areas that require assistance and intervention. P N P L A N N E D U A N D E E N 1 4 R E V E N T P T O A M P A I G N R E G N A N C Y C A T I O N A L N T H E T

17 and a little embarrassment shouldn’t prevent you • Place parent-adolescent communication about from giving your child the best chance for a safe sex in a framework of responsible parenting that and successful life. Remember, teens appreciate 1) shows that parents care, 2) helps adolescents honesty. You can let your teen know that talking focus on school, 3) helps teens think in a more about sex is hard for you because your own parents mature way, and 4) helps teens to do better in life. rarely or never discussed the topic with you, if that is the case. Tell your teen that you’re going to Emphasize the Message: Talking with your teen work through the difficulty because you care about about waiting to have sex is important for many reasons besides preventing pregnancy and STDs. them. With practice, we can work together to make It shows that you are a responsible parent and you feel more comfortable. Embarrassment doesn’t that you take being a parent very seriously. It have to be a permanent feeling. shows that you care about your child and what happens to him or her. It may also be the case 3. Address Perceived Religious Disapproval. that if your child does not become wrapped up • Identify and explore if parents perceive that in a sexual relationship with another teen, then their religion or faith community disapproves of parent-adolescent communication about sex. he or she can focus more on school. As you talk with your child about these things, you will help • Let Latino parents know that the majority of Latino teens think that religious leaders should be your child think in a more mature way. You will 1 more involved in the fight against teen pregnancy. be teaching your child how to be more mature. Teens appreciate honesty • If parents perceive that their religion discourages These things will help your child do better in life. Remember, your child wants to hear from parent-adolescent communication about sex, let you and you can make a difference! them know that Latino religious leaders through out the United States are working to prevent teen pregnancy in the Latino community. A good Identify and Manage Parental Embarrassment. 2. Faith, Hope guide for parents and practitioners is • Again, work with parents to generate two lists: List & Love: How Latino Faith Communities Can Help 1 should focus on why parents feel embarrassed Prevent Teen Pregnancy about talking about sex. This list provides parents by the National Campaign to Prevent Teen and Unplanned Pregnancy and practitioners with clear points of intervention. List 2 should identify for parents and practitioners (available at www.teenpregnancy.org). those areas where parents feel comfortable, which It’s important to Emphasize the Message: can be used to support parents’ strengths. remember that the guidance and wisdom that • Work with parents to develop an outline of what you they will say to their child. The outline should help the church and your faith provide can to advise your teen. Discussions about sex, love, organize the key messages that parents want relationships, and family that are focused on your to communicate. Use the outline to practice conversations with parents so that they feel religious beliefs and values may help your teen comfortable talking about the topics that cause understand how these morals are important in them to feel embarrassed. Let parents know that their decision not to have sex. they shouldn’t actually use the physical outline 4. when talking to their teen. Address Generational Differences. • Talk to parents about the potential presence of Emphasize the Message: As embarrassing as it acculturation-related or generational differences. feels, remember that your teen’s future is at stake Do parents believe that such differences interfere P N P L A N N E D U A N D T H E T R E V E N T P T O A M P A I G N C A T I O N A L N 1  R E G N A N C Y E E N

18 Emphasize the Message: with their ability to talk with their teen about If you can’t talk to your child about sex, is there another adult in your life sex? Help parents to understand their teen’s who could? Some parents ask aunts, uncles, other perspective and to identify common ground that close adults, or a religious leader to talk with their can bridge generational differences. child about sex. No matter who you choose, make • Let Latino parents know that the majority of Talking about sex does not sure that your teen respects this person and that Latino youth don’t think that being a virgin is hasten the onset of sex. 1 embarrassing. this person shares your values about your teen’s sexual behavior. As a parent, you need to make • Work with parents to identify family and sure your teen knows the facts, and other family cultural values that can be transmitted to adolescents. How can values such as familismo, members and friends who share your values can respeto, simpatía, personalismo, marianismo, support you in this role. and machismo be utilized to support parent- adolescent communication about sex? Minimizing Parents’ Fears and Anxieties. 6. • Many parents fear that talking about sex or contraception with their child will encourage Emphasize the Message: Many Latino teens live 1 Help ease their teen to become sexually active. in two worlds. One is the world of non-Latino people and the other is the world of Latinos. Your their concerns by pointing out that research about sex does not hasten talking makes clear that teen needs to learn how to deal with the differences in these “worlds.” This is part of growing up. Your the onset of sex among teens nor do teens tend teen may learn things outside the home that are to identify such conversations as tacit approval to different from basic Latino values. This is not a have sex. • Focus on the fact that research has shown bad thing. All Latino teens must learn to balance the values of Latinos with the values of non-Latino that when parents are the major source of information about sex, teens are less likely to groups. Talk with your teen about your family’s 21 values. Explain the positive aspects of being Latino. engage in it. Let parents know that Latino adolescents are receptive to hearing messages Recognize that your teen will need to adjust to about abstinence, contraceptives, and delaying two worlds. Try to help your teen understand the 1 sex until after high school. demands of the “two worlds.” Identify a Support Network. 5. Research shows that Emphasize the Message: • Work with parents to identify a list of trusted teens are less likely to have sex when parents adults who can support their efforts to prevent are their major source of sexuality information. their teen from becoming pregnant. The list Parents should be comfortable talking about should include adults who share parents’ contraception even if they are opposed to teens cultural values, are knowledgeable about teen having sex. If you talk about contraception and sexual behavior, and are respected by their want your teen to not have sex, you need to be teen. Supportive adults can include friends, very clear about your wishes. Leave no ambiguity. family members, extended family members, and This will make a difference! One strategy is to tell religious leaders. your child that you are going to talk with him • Have parents reach out to the individuals on the or her about contraception and how to use it, list: Who can help you practice conversations with but that this information is for later—when they your teen? If you’re unable to do so, is there anyone are older and ready to have sex. You will explain on the list who could talk to your teen about sex? things now so that they will be fully informed. A N D E E N T R E V E N T 1 6 T O A M P A I G N C A T I O N A L N R E G N A N C Y P N P L A N N E D U T H E P

19 Answering Challenging Questions: Did You Have you feel about it in retrospect. Perhaps you had a 7. Sex as a Teen? negative experience? If not, parents can say that just because they were lucky enough to escape • Work with parents to manage the worry that their teen will ask them if they had sex as a too-early pregnancy doesn’t mean that your teen will have the same luck. Take this opportunity teen. This is a particularly challenging question to talk to your teen about how you dealt with that requires practitioner support. If parents had sex as a teen but answer “no,” they are not this difficult decision in adolescence, and what you think about sex, love, relationships and being honest. If they answer “yes,” they may family values. Help your teen understand your look hypocritical to their teen. Practitioners can values and your strong desire for them to avoid prepare parents for this question so that when becoming pregnant or causing a pregnancy. adolescents ask, parents have an appropriate response that reflects their values. With the above strategies, practitioners can utilize • Let parents know that it is natural for teens to be curious. Highlight that some research shows that individual or group approaches. Programs like Plain 61 Latino teens are less likely to have sex when their and Linking Lives/Uniendo Talk/Hablando Claro 20 have brought together groups of parents in mothers talk about how they negotiated difficult Vidas decisions in adolescence, such as the decision to homes and community settings in order to provide 27 Be prepared for the date or have sex. factual information about adolescent reproductive question: Did you have • Talk with parents about how they want to answer health and pregnancy and STD prevention. Focus sex as a teen? this question and how they think their adolescent groups with Latino parents indicate that these 2,13 Practitioners groups are welcome and appreciated. will respond. Two sample responses are presented. can organize community seminars that give parents the opportunity to improve their knowledge and Keep the Focus on Your Emphasize The Message: Teen. communication skills, connect with other parents, If your teen asks if you had sex as a teen, you can tell them that the focus of the discussion is and feel supported in their ability to talk effectively not on you. If you believe that your sexual history with their child about sex. Practitioners using should not be part of the discussion, tell your teen this approach should make sure that locations that this is not relevant. Let your adolescent know are accessible and appropriate for Latino families. decisions and not your that the focus is on Community seminars and groups should be their own. Highlight that the overwhelming majority of scheduled at times that are convenient for working sexually active Latino youth regret having sex too families, with attention paid to the fact that parents 1 may work multiple or non-traditional jobs. and that you don’t want your teen to have soon these same regrets. You can also explain that the risks today are more severe than they have been in the past. Help your teen understand your values and wishes for them to avoid becoming pregnant or causing a pregnancy. . Alternatively, if you decide to tell Be Honest your child that you had sex as a teen, consider in advance what to say. For example, you can use this opportunity to talk about your reasons for having sex at an early age and to discuss how N 1 7 T H E P N P L A N N E D U A N D E E N T R E V E N T P T O A M P A I G N C A T I O N A L R E G N A N C Y

20 Putting Latino parent-adolescent communication The importance of establishing a into context: strong parent-adolescent relationship Parent-adolescent communication occurs in the Emphasize that a good relationship is always a two-way street. While this may seem intuitive broader context of parent-adolescent relationships. to some parents, other parents struggle with In general, good parent-adolescent relationships are likely to strengthen the effectiveness of parental understanding what makes a good relationship. Practitioners may want to give parents a copy of the communication. Parent-adolescent relationships Consejos a los Padres, National Campaign’s which that are based on mutual warmth, closeness, trust, . provides additional tips for parents and connectedness are one of the strongest factors Practitioners also can give parents effective protecting youth from early sexual activity and 62,63 strategies to improve parent-adolescent pregnancy. Latino adolescents who report feeling close to their parents are less likely to initiate sex at an relationships. The following messages reflect the 64 early age and are more likely to use contraception important cultural values that characterize many 29 Latino families and are directed at parents to help consistently and carefully. A number of studies have them think about and enact ways to improve their noted the high levels of warmth and connectedness 65 These between Latino parents and adolescents. relationship with their teen. 44,45 and familismo reflect cultural values of simpatía, Respeto 1. Talk About the Importance of Respect. which speaks to the value of keeping relationships 66 is important for both parents and adolescents. between people in the family smooth and flowing. Let your teen know why you believe respect is Practitioners working with Latino parents should support these dynamics when present and work with important. Think of examples where showing parents and adolescents to help strengthen these disrespect creates problems and where showing emotional bonds if absent. respect helps. Try to use examples of family members or of people who are important Strategies for practitioners and parents: to your teen—this can help improve their How can parents improve their relationship understanding. with their teen? The single best way to get respect 2. Give Respect. Latino values such as it. Some parents believe that because give familismo, personalismo, is to and they have authority over their teen, they don’t simpatía respeto all emphasize the importance of family relationships characterized by closeness, need to listen to their teen’s opinions or show interdependence, respect and harmony, especially respect. But teens say they have a hard time Respect is important 44,45,66,67,68 between parents and adolescents. giving respect when they don’t get it. Think Yet, for both parents and adolescents. practitioners are likely to encounter parents who about people you know who don’t respect your want to know what they can do to build a better opinions. Do you respect them? One way to relationship with their teen. First, practitioners can show respect is by listening to your teen and help parents understand the qualities that characterize taking his or her opinions seriously. a good parent-adolescent relationship. The most 3. Emphasize Support for Each Other. important qualities are: Communication with your teen becomes easier 1. Respect when your teen understands the importance of for one another. each other’s feelings. unity and support within the family. Even when 2. Understanding trust 3. Being able to each other. you may not agree on something, keep in mind for each other’s well-being. 4. Having concern that many Latino families believe in familismo . each other (what each other is like, Although you and your teen may disagree, 5. Knowing what each other wants, and what each other likes the importance of maintaining close ties is a and dislikes). common goal. C A T I O N A L R E G N A N C Y P N P L A N N E D U A N D E E N T 1 8 P T O A M P A I G N N T H E R E V E N T

21 4. Be Willing to Admit When You Are Wrong. when you must talk directly, even if conflict People do not respect others who believe they occurs. If your teen breaks rules and agreements, you need to talk about it. You do not want it to are always right. If you make a mistake, be happen again. Your teen needs to understand willing to admit it to your teen. When you do why rules are important. He or she cannot this, you show your teen that you value honesty, understand this if you never say anything. personal character and inner qualities, also Latinos value the importance of known as the Latino value of personalismo . 8. Explain Rules. Grab onto whatever time you respeto . And, of course, Practicing what you preach can have a powerful obeying authority, or can to be with your teen. impact on your teen. When you admit that it is important for teens to respect you and you’ve made a mistake, you increase the respect your rules. But it also is important for teens to your teen has for you and the set of values you understand why you have the rules you do. For example, when you set a time for your teen to are trying to teach. 5. Spend Time Together. Families are very busy come home at night (called a “curfew”), why are you setting the curfew? What is the purpose these days. Between jobs and chores and other of it? Why is it necessary? Teens will be more things, there often is little time leftover for accepting of curfews if they are given reasons. enjoying each other’s company. You need to grab onto whatever time you can to be with your 9. Keep Your Word . If you make a promise to your teen. It will help you keep your teen’s free time teen, keep it. If you are unable to keep your occupied and you will get to know your teen promise because of something you can’t help, better. You will build a good relationship, and let talk to your teen about it. Say you are sorry. Your teen needs to know he or she can count your teen know you care. One mother we spoke to talked about playing basketball with her teen on you to keep your word. This is an important part of gaining trust and respect. If you keep even though she was terrible at it! Whatever it your word, he or she is more likely to keep his takes — even if it’s just once a week. Even if it’s just going to the store together. Your teen will or hers. 10. notice if you make time. Some of the above . Be Real with Your Teen Touch base with your teen 6. Keep in Touch . ideas may seem to go against what many Latino regularly, even when everything is going families view as “good parenting.” But please consider them. They can be useful tools that smoothly. Let your teen know what’s going on in your life and find out what he or she is up to. build trust between you and your teen. Your Keeping in regular touch with your teen is one teen will be able to see you as a real person— someone who is truly concerned about the of the most important things you can do as a parent. Teens feel their parents care about them teen’s well-being. when they take an interest in what’s happening in their lives. Teens, like anyone else, don’t want to feel ignored. Getting along and 7. Don’t Avoid Conflict. avoiding conflicts is important in many Latino families. Some Latino parents prefer to avoid conflict and not raise the issue if their teen breaks an agreement. This is demonstrated in . Reducing conflict simpatía the Latino value of with your teen is a good idea, but there are times N 1 9 T H E P N P L A N N E D U A N D E E N T R E V E N T P T O A M P A I G N C A T I O N A L R E G N A N C Y

22 Putting Latino parent-adolescent The importance communication into context: of parental monitoring and supervision 1. It’s important for teens to respect you and In addition to having a strong parent-adolescent your rules. relationship, parental monitoring and supervision also 2. It’s also important for teens to understand why are factors that can reduce the risk of teen pregnancy Parental monitoring traditionally has been you have the rules you do. For example, when and STDs. you set a time for your teen to come home at defined as knowing about the activities, whereabouts, 69 Whereas some night (called a “curfew”), why are you setting and companions of ones’ child. emphasize the behavior of parents that lead them the curfew? What is the purpose of it? Why is to acquire information about their child, others it necessary? Teens will be more accepting of emphasize simply knowing about the activities, curfews if they are given reasons. 70 As whereabouts and companions of their children. with parent-adolescent communication, parental As parents seek to elicit information from their active and child, practitioners can help them understand that monitoring should be conceptualized as an in which both parents and adolescents ongoing process their child may choose not to disclose information. send and receive information. This reluctance may be particularly high when teens A number of studies have found that higher think that their answers may cause their parents to levels of parental monitoring are associated with respond in a negative way. Practitioners can help 29 higher rates of abstinence and lower levels of risky parents find ways to elicit information about their 71,72 While sexual behavior in Latino adolescents. adolescents’ friends, whereabouts and activities in ways that foster open communication. The parental monitoring protects against teen pregnancy and STDs, how parents acquire this knowledge is strategies listed in the Context of Communication may be especially helpful. In addition, let parents important. Studies have found that adolescents may know that having a good relationship with their perceive parental questions about their friends and personal experiences as intrusive and may respond teen also helps, as teens may be more receptive to 73 Practitioners can work with in a hostile manner. parental questions in the context of a relationship parents to help them ask questions that minimize based on mutual love, trust, warmth, and openness. negative teen responses and promote adolescent A lot of parents tend to supervise and monitor sharing of information. their teen less and less as he or she grows older. Parental monitoring Practitioners should emphasize that the risk of and supervision are adolescent sexual behavior increases as teens Strategies for practitioners and parents: important. How can parents improve the quality of get older. While parents should not be overly controlling, they also should stay knowledgeable monitoring and supervision? Practitioners can let parents know that when it about where their teen is, who their teen hangs comes to supervising and monitoring their teen, the out with, and what their teen is doing when parents aren’t home. Parental knowledge in these best approach is one that monitors their teen while slowly giving him or her the necessary knowledge, areas can reduce the risk of teen pregnancy and STDs. Strategies to increase the quality of parental power and skills to make good choices in life. In this regard, parental rules are important. They provide monitoring include: teens with firm guidelines on acceptable behavior 1. If your teen is not coming home after school, find and help parents maintain a healthy amount of out where he or she will be and who he or she control over their teen. Many Latinos value the is hanging out with. Find out if there will be an 68,74 importance of obeying authority or respeto adult around. . , practitioners should In the context of 2. If you can’t be home after school, try to make sure respeto highlight two primary messages with parents: your teen is involved in activities where an adult R E G N A N C Y P N P L A N N E D U 2 0 E E N T R E V E N T P T O A M P A I G N C A T I O N A L N T H E A N D

23 10. will be around. Something like being in a club or Ask your teen about his or her life. When you ask your teen about this, try not to sound suspicious. playing sports. Let your teen know that you care. You just want to 3. If your teen is going out on a weekend or at night, keep in touch. Supervision is easier if you show an find out where he or she is going and who he or she will be with. Try to make sure it is a place interest in your teen’s life in general, and not just where adults will be around. when your teen is going out. 4. As much as you can, try to have an adult at home Conclusion when your teen is there. This might be a neighbor or other family member. Teens are more likely to Practitioners working with Latino families have good reason to believe that they can help parents reduce get in trouble when they have friends over with the risk of teen pregnancy and STDs. Overall, the no adult around. existing research on Latino families clearly shows 5. Discourage your teen from going out on school that parents matter. Latino parents are concerned nights. You want to keep your teen focused on about teen pregnancy, STDs, and HIV, and they school. You want your teen to do his or her homework and get plenty of sleep on school want to keep their children safe from harm. The nights. Partying or hanging out on school strategies presented in this guide are designed to help nights is not the way to do this. practitioners work with Latino parents to do just this. 6. When your teen goes to parties, make sure there Latino parents want and need assistance in talking more effectively with their teens about sex, love, will be an adult there. Call the parents of the teen relationships, and family. Practitioners can work with who is having the party. Double check the time parents to reduce the barriers to communication and of the party and ask if an adult will be there. You to improve parents’ communication skills with respect might even offer to help. to the content, context, timing, and frequency of 7. If you let your teen have a party, chaperone, communication. Additionally, helping Latino parents keep alcohol and smoking out of the party. Ask guests to leave jackets and bags with you when to maintain strong parent-adolescent relationships entering the party. Allow only invited guests based on love, warmth, and appropriate levels of into the party. parental monitoring all can help parents keep their teens safe. Whether working with parents individually 8. Discourage your teen from hanging out with or in group settings, a focus on the evidence-based older teens. This usually leads to trouble. Older communication and parenting strategies presented in teens are more likely to take risks. this guide will help practitioners and parents to work 9. Discourage your teen from early dating. A together to reduce teen pregnancy and STDs among romantic partner can have a big influence on your teen. This influence may not always be Latino adolescents. good. Teens that date early are more likely to get into trouble. This is even more likely if your teen dates someone older. This does not mean you should forbid dating. Nor should you stop your teen from interacting with the opposite sex. Just do not encourage serious dating. Your teen will do fine without being involved in a serious romantic relationship with someone. Be extra careful if your teen wants to date someone who is older. N 2 1 R E G N A N C Y T H E N P L A N N E D U A N D E E N T R E V E N T P T O A M P A I G N C A T I O N A L P

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Parental communication and youth sexual behavior. Journal In S. Feldman, & D. A. Rosenthal (Eds.), Talking Sexuality: Parent- of Adolescence, 30 (3) , 449-466. adolescent communication (pp. 9-41). San Francisco: Jossey-Bass. 18 Centers for Disease Control and Prevention. (2006). Youth Risk 4 Hutchinson, M. K. (2002). The influence of sexual risk communication Behavior Survey. Youth Online: Comprehensive Results. Retrieved July Family between parents and daughters on sexual risk behaviors. 21, 2007 from: http://apps.nccd.cdc.gov/yrbss/ 51 (3), 238-247. Relations, Abma, J. C., Martinez, G. M., Mosher, W. D., & Dawson, B. S. (2004). 19 5 Lefkowitz, E. S. (2002). Beyond the yes-no question: Measuring Teenagers in the United States: Sexual activity, contraceptive use, and parent-child communication about sexual topics. In S. Feldman, & D. childbearing, 2002. Hyattsville, MD: National Center for Health Statistics. Talking sexuality: Parent-adolescent communication A. Rosenthal (Eds.), 20 Guilamo-Ramos, V., Jaccard, J., & Dittus, P. (2003). The Linking Lives/ (pp. 43-56). San Francisco: Jossey-Bass. Uniendo Vidas Health Education Program: Families Talking Together. 6 Ancheta, R., Hynes, C., & Shrier, L. A. (2005). Reproductive health 21 Whitaker, D. J., & Miller, K. S. (2000). Parent-adolescent discussions education and sexual risk taking among high risk female adolescents about sex and condoms: Impact on peer influences of sexual risk Journal of Pediatric and Adolescent Gynecology and young adults. , (2), 251-273. behavior. Journal of Adolescent Research, 15 (2), 105-111. 18 22 Kotchick, B.A., Dorsey, S., Miller, K.S., and Forehand, R. (1999). 7 O’Sullivan, L. F., Meyer-Bahlburg, H. F. L., & Watkins, B. X. (2001). Adolescent sexual risk-taking behavior in single-parent ethnic minority Mother-daughter communication about sex among urban African families. Journal of Family Psychology, 13 (1), 93-102. American and Latino families. Journal of Adolescent Research, 16 (3), Dutra, R., Miller, K. S., & Forehand, R. (1999). The process and 23 269-292. content of sexual communication with adolescents in two-parent 8 Raffaelli, M., & Ontai, L. L. (2001). ‘She’s 16 years old and there’s boys AIDS and families: Associations with sexual risk-taking behavior. calling over to the house’: An exploratory study of sexual socialization (1), 59-66. Behavior, 3 (3), 295-310. in Latino families. Culture, Health & Sexuality, 3 24 Guilamo-Ramos, V., Jaccard, J., Dittus, P., & Bouris, A. (2006). Parental 9 Guilamo-Ramos, V., Dittus, P., Jaccard, J., Goldberg, V., Casillas, E., expertise, trustworthiness, and accessibility: Parent-adolescent & Bouris, A. (2006). The content and process of mother-adolescent Journal of Marriage and communication and adolescent risk behavior. Social Work Research, communication about sex in Latino families. 1229-1246. (5) Family, 68 , 30 (3), 169-181 . 25 Halpern-Felsher, B. L., Kropp, R. Y., Boyer, C. B., Tschann, J. M., & Ellen, J. 10 Guilamo-Ramos, V., Jaccard, J., Dittus, P., Bouris, A., & Holloway, I. M. (2004). Adolescents’ self-efficacy to communicate about sex: Its role in (2007). Adolescent expectancies, parent-adolescent communication, (155), 443-456 Adolescence, 39 condom attitudes, commitment, and use. and intentions to have sexual intercourse among inner city, middle 26 Whitaker, D.J., Miller, K.S., May, D.C., and Levin, M.L. (1999). school youth. Annals of Behavioral Medicine, 34 (1), 56-66 Teenage partners’ communication about sexual risk and condom 11 Raffaelli, M., & Green, S. (2003). Parent-adolescent communication Family Planning use: The importance of parent-teenager discussions. about sex: Retrospective reports by Latino college students. Journal of (3), 117-121. Perspectives, 31 (2), 474-481. Marriage and the Family, 65 27 Guilamo-Ramos, V. (under review). Mother-Adolescent 12 Romo, L. F., Lefkowitz, E. S., Sigman, M., & Au, T. K. (2002). A communication about risk behaviors in Latino families: The role of longitudinal study of maternal messages about dating and sexuality maternal self-disclosure. Journal of Adolescent Health, and their influence on Latino adolescents. 28 Miller, K. S., Forehand, R., & Kotchick, B. A. (1999). Adolescent sexual (1) 31 , 59-69. behavior in two ethnic minority samples: The role of family variables. 13 Villarruel, A. M. (1998). Cultural influences on the sexual attitudes, Journal of Marriage and the Family, 61 (1), 85-98. Journal of the Society of beliefs, and norms of young Latina adolescents. 29 Vélez-Pastrana, M. C., González-Rodríguez, R. A., & Borges- (2), 69-79. Pediatric Nurses, 3 Hernández, A. (2005). Family functioning and early onset of sexual 14 Guzmán, B. L., Arruda, E., & Feria, A. L. (2006). Los papas, la familia y (160), 777-791. Adolescence, 40 intercourse in Latino adolescents. la sexualidad. In J. Denner, & B. L. Guzmán (Eds.), Latina girls: Voices of 30 Marín, G. (1989). AIDS prevention among Hispanics: Needs, risk adolescent strength in the United States. (pp. 17-28). New York, NY, US: Public Health Reports, 104 behaviors, and cultural values. (5), 411-415. New York University Press. 31 Flores, E., Eyre, S. L., & Millstein, S. G. (1998). Sociocultural beliefs 15 Ford, C.A., Pence, B. W., Miller, W. C., Resnick, M. D., Bearinger, L. H., related to sex among Mexican American adolescents. Hispanic Journal Pettingell, S., et al. (2005). Predicting adolescents’ longitudinal risk for of Behavioral Sciences, 20 (1), 60-82. sexually transmitted infection: results from the National Longitudinal 2 2 R E G N A N C Y P N P L A N N E D U A N D E E N T P T O A M P A I G N C A T I O N A L N T H E R E V E N T

25 47 Hovell, M., Sipan, C., Blumberg, E., Atkins, C., Hofstetter, C. R., & 32 National Campaign to Prevent Teen and Unplanned Pregnancy. Consejos a los padres. Available for free in Spanish at: https://www. Kreitner, S. (1994). Family influences on Latino and Anglo adolescents’ sexual behavior. teenpregnancy.org/product/pdf/hisptip.pdf and available for free Journal of Marriage and the Family, 56 (4) , 973-986. 48 Hutchinson, M. K. (2002). The influence of sexual risk communication in English at https://www.teenpregnancy.org/resources/reading/ between parents and daughters on sexual risk behaviors. Family Relations: hispanic/engtips.asp. 33 Guzmán, B. L., Schlehoffer-Sutton, M. M., Villanueva, C. M., Dello Interdisciplinary Journal of Applied Family Studies, 51 (3), 238-247. 49 National Campaign to Prevent Teen and Unplanned Pregnancy. (2001). Stritto, M. E., Casad, B. J., & Feria, A. (2003). Let’s talk about sex: How It all starts at home: Hispanic parents speak out on preventing teen comfortable discussions about sex impact teen sexual behavior. Journal of Health Communication, 8 (6) 583-598. Washington, DC: Author. pregnancy. A focus group report. , 34 O’Donnell, L., Stueve, A., Wilson-Simmons, R., Dash, K., Agronick, G., 50 Meneses, L. M., Orrell-Valente, J. K., Guendelman, S. R., Oman, D., & & JeanBaptiste, V. (2006). Heterosexual risk behaviors among urban Irwin, C. E., Jr. (2006). Racial/Ethnic differences in mother-daughter communication about sex. Journal of Adolescent Health, 39 (1), 87-109. Journal of Early Adolescence, 26 (1), 128-131. young adolescents. 51 Guilamo-Ramos, V., Jaccard, J., Dittus, P., & Collins, S. (under review). 35 Cavanagh, S.E. (2004). The sexual debut of girls in early adolescence: The intersection of race, pubertal timing, and friendship group Parent-adolescent communication about sexual intercourse: An Journal of Research on Adolescence, 14 (3), 285-312. characteristics. analysis of maternal reluctance to communicate. 36 Van Oss Marín, B., Coyle, K.K., Gómez, C.A., Carvajal, S.C. & Kirby, D.B. 52 Van Oss Marín, B. (2003). HIV prevention in the Hispanic community: (2000). Older boyfriends and girlfriends increase risk of sexual initiation Sex, culture, and empowerment. Journal of Transcultural Nursing, Journal of Adolescent Health, 27 (3), 186-192. (6), 409-418. 14 in young adolescents. 37 Zimmer-Gembeck, M.J., Seibenbruner, J. & Collins, W.A. (2004). A 53 McKee, M. D., & Karasz, A. (2006). “You have to give her that prospective study of intraindividual and peer influences on adolescents’ confidence”: Conversations about sex in Hispanic mother-daughter heterosexual romantic and sexual behavior. dyads. Journal of Adolescent Research, 21 Archives of Sexual Behavior, (2), 158-184. 54 Somers, C. L., & Surmann, A. T. (2004). Adolescents’ preferences for (4), 381-394. 33 38 Miller, K.S., Levin, M.L., Whitaker, D.J., & Xu, X. (1998). Patterns of (1), 47-59. source of sex education. Child Study Journal, 34 55 Antshel, K. M. (2002). Integrating culture as a means of improving condom use among adolescents: The impact of mother-adolescent Psychology, Health & communication. American Journal of Public Health, 88 (10), 1542-1544. treatment adherence in the Latino population. 39 National Campaign to Prevent Teen and Unplanned Pregnancy. (2006). Medicine, 7 (4), 435-449. 56 Guzmán, B. L., Arruda, E., & Feria, A. L. (2006). Los papas, la familia y New survey highlights disconnect between Latino parents and teens in la sexualidad. In J. Denner, & B. L. Guzmán (Eds.), Latina girls: Voices of talking about sex. Retrieved from: http://www.teenpregnancy.org/press/ (pp. 17-28). New York, NY, US: pdf/ Latina_Release_04_06.pdf adolescent strength in the United States. 40 Jaccard, J., Dittus, P. J., Gordon, V.V. (1998). Parent-adolescent congruency New York University Press. 57 Jenkins, K. W. (1991) Religion and families. In S. J. Bahr (Ed.), in reports of adolescent sexual behavior and in communications about Family sexual behavior. , Volume 1 (pp.235–288). New Child Development, 69, 247– 261. Research: A Sixty-Year Review, 1930–1990 41 Albert, B., Brown, S., & Flanigan, C. (Eds.) (2003). York: Lexington Books/Macmillan, Inc. 14 and Younger: 58 Mattson, M. (1999). Toward a reconceptualization of communication The sexual behavior of young adolescents. Washington, DC: National cues to action in the Health Belief Model HIV test counseling. Campaign to Prevent Teen and Unplanned Pregnancy 42 National Campaign analysis of Martin, J.A., Hamilton, B.E., Ventura, S.J.., 240–265. Communication Monographs, 66 , (3) 59 Nadeem, E., Romo, L. F., & Sigman, M. Knowledge about condoms National Menacker, F., &Park, M.M. (2002). Births: Final data for 2000. (5) Ventura, S.J., Abma, J.C., Mosher, W.D., & among low-income pregnant Latina aolescents in relation to explicit Vital Statistics Reports, 50 Henshaw, S. (2003). Revised pregnancy rates, 1990-97, and new rates for maternal discussion of contraceptives. Journal of Adolescent Health, (1), 119.e9-119.e15 1998-99: United States. 39 (7). National Vital Statistics Reports, 52 43 Lefkowitz, E. S., Boone, T. L., Sigman, M., & Au, T. K. (2002). He said, 60 Biggs, M. A., Brindis, C. D., & Yankah, E. (2001). Adolescent Latino Hispanic Journal of reproductive health: A review of the literature. she said: Gender differences in mother-adolescent conversations about sexuality. (3), 255-326. Journal of Research on Adolescence, 12 (2), 217-242. Behavioral Sciences, 23 61 Walker, K. E., & Kotloff, L. J. (1999). Plain Talk: Addressing adolescent 44 Sue, D.W., & Sue, D. (2003). Counseling the culturally diverse: Theory sexuality through a community initiative: A final evaluation report prepared and practice (4th ed.). Hoboken, NJ: John Wiley. 45 Cauce, A. M., & Domenech-Rodriguez, M. (2002). Latino families: for the Annie E. Casey Foundation. Philadelphia: Public/Private Ventures. 62 Henrich, C. C., Brookmeyer, K. A., & Shrier, L. A. (2006). Supportive Myths and realities. In J. M. Contreras, K.A. Kerns, & A. M. Neal- (pp. Latino children and families in the United States Barnett (Eds.), relationships and sexual risk behavior in adolescence: An ecological- 5-25). Westport, CT: Praeger Press. transactional approach. Journal of Pediatric Psychology, 31 (3), 286-296. 46 Dutra, R., Miller, K. S., & Forehand, R. (1999). The process and 63 Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. content of sexual communication with adolescents in two-parent M., Jones, J., et al. (1997). Protecting adolescents from harm: Findings AIDS and families: Associations with sexual risk-taking behavior. from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278 Behavior, 3 (1), 59-66. (10), 823-832. T N R E G N A N C Y P N P L A N N E D U A N D E E N 2 3 R E V E N T P T O A M P A I G N C A T I O N A L T H E

26 64 Miller, B. C., Norton, M. C., Fan, X., Christopherson, C. R. (1998). Dr. Vincent Guilamo-Ramos is a licensed Pubertal development, parental communication, and sexual values in clinical social worker and an Associate relation to adolescent sexual behaviors. Journal of Early Adolescence , Professor at the Columbia University , 27-52. (1) 18 School of Social Work. His principal focus 65 Guilamo-Ramos, V., Dittus, P., Jaccard, J., Johansson, M., Bouris, A. & of investigation is the role of parents in the Acosta, N. (2007). Parenting practices among Dominican and Puerto prevention of adolescent sexual risk behavior, Social Work, 52 (1), 17-30. Rican mothers. 66 Triandis, H. C., Marin, G., Lisansky, J., & Betancourt, H. (1984). with a special focus on the role of parent- Simpatía as a cultural script of Hispanics. Journal of Personality and adolescent communication. His research primarily focuses on Social Psychology, 47 1363-1375. (6) , Latino youth and their families. Additional research interests include 67 Arcia, E., Reyes-Blanes, M. E., & Vazquez-Montilla, E. (2000). intervention research and methodological considerations for applied Constructions and reconstructions: Latino parents’ values for children. family-based research. Dr. Guilamo-Ramos has conducted research 9 (3), 333-350. Journal of Child and Family Studies, 68 Zayas, L. H., & Solari, F. (1994). Early childhood socialization in primarily in urban, resource-poor settings, most recently in the South Hispanic families: Context, culture, and practice implications. Bronx, Harlem and Lower East Side communities of New York City. Professional Psychology: Research and Practice, 25 (3) , 200-206. Currently, Dr. Guilamo-Ramos is developing a Latino Family 69 Brown, B. B., Mounts, N., Lamborn, D., & Steinberg, L. (1993). Institute at the Columbia University School of Social Work. The Child Parenting practices and peer group affiliation in adolescence. Latino Family Institute will conduct applied family-based research Development, 64 (2), 467-482. with Latino families in the United States and abroad. Dr. Guilamo- 70 Dishion, T. J., & McMahon, R. (1998). Parental monitoring and the prevention of child and adolescent problem behavior: A conceptual Ramos has published a number of scholarly articles on parent- and empirical formulation. Clinical Child and Family Psychology adolescent communication about sex and on the role of parents Review, 1 , (1) 61-75. in the preventing adolescent sexual risk behavior. In addition, he 71 Borawski, E. A., Ievers-Landis, C. E., Lovegreen, L. D., & Trapl, E. has published methodological articles related to adolescent risk S. (2003). Parental monitoring, negotiated unsupervised time, and Annals of behavior. His scholarly work has been published in the parental trust: The role of perceived parenting practices in adolescent Journal of Adolescent Health, 33 health risk behaviors. (2), 60-70. the Behavioral Medicine, the American Journal of Public Health, 72 Kerr, M. H., Beck, K., Shattuck, T. D., Kattar, C., & Uriburu, D. (2003). Psychology of and Journal of Adolescent Health, Health Psychology, Family involvement, problem and prosocial behavior outcomes of Addictive Behaviors. He also is finishing an edited volume entitled American Journal of Health Behavior, 27 Latino youth. (Sl1), 55-65. “Parental Monitoring of Adolescents,” to be published by the 73 Romo, L. F., Nadeem E., Au, T. K., & Sigman, M. (2004). Mexican- Columbia University Press. American adolescents’ responsiveness to their mothers’ questions about Journal of Applied Developmental Psychology, dating and sexuality. 501-522. 25 (5) , is a doctoral candidate and Alida Bouris 74 Lefkowitz, E. S., Romo, L. F., Corona, R., Au, T. K., & Sigman, M. (2000). Project Coordinator at the Columbia How Latino American and European American adolescents discuss University School of Social Work. Ms. Bouris is Developmental conflicts, sexuality, and AIDS with their mothers. a Master’s level social worker with practice and Psychology, 36 (3) , 315-325. research experience with Latino parents and Many of the strategies in the manual are based on the Note: adolescents residing in urban communities. Linking Lives/Uniendo Vidas Health Education program. Linking Her primary research interest is in the Lives is an applied parent-based intervention program designed to development and design of family-based interventions to prevent foster parent-adolescent communication about sexual risk behavior adolescent risk behavior, with an emphasis on preventing secondary in Latino families. The developers of Linking Lives Program Drs. and higher-order pregnancies among pregnant and parenting Vincent Guilamo-Ramos, James Jaccard and Patricia Dittus. The teens. She has published several scholarly articles on adolescent Linking Lives/Uniendo Vidas Program was supported by funding from the Centers for Disease Control and Prevention, Cooperative risk behavior, including youth involvement in alcohol, tobacco and Agreement #U87/CCU220155-3-0. The findings and conclusions sexual risk behaviors. Her scholarly work has been published in the in this manual are those of the authors and do not necessarily Journal of Clinical Child and Journal of Marriage and Family, the represent the views of the CDC. Annals of Behavioral Medicine and the Psychology, Adolescent . R E V E N T P N P L A N N E D U A N D E E N T R E G N A N C Y P T O A M P A I G N C A T I O N A L N T H E 2 4

27 Latino Initiative Advisory Group Chair Octavio A. Hinojosa Mier Executive Director Daisy Expósito-Ulla Congressional Hispanic Leadership Institute Chairman and CEO d expósito & partners; Carmen T. Joge Chief Operating Officer Board Member The National Campaign to Prevent Teen and The Congressional Hispanic Caucus Institute Unplanned Pregnancy Michelle Minguez Moore Senior Associate Members Mickey Ibarra and Associates; Executive Director Elena Alvarado Latino Leaders Network President National Latina Health Network Alma Morales Riojas President and CEO Liany Elba Arroyo, MPH MANA, A National Latina Organization Director Institute for Hispanic Health Elena V. Rios, MD, MSPH National Council of La Raza President and CEO National Hispanic Medical Association Claire Brindis, Dr.P.H. Executive Director Gloria Rodriguez, PhD Center for Reproductive Health Research and Policy President Nuestros Niños National Adolescent Health Information Center, UCSF Pablo Rodriguez, MD Elizabeth Burgos Associate Chief of OBGYN Executive Director Women and Infants Hospital; National Hispanic Caucus of State Legislators Chair Association of Reproductive Health Professionals Betty Cortina Former Editorial Director Héctor Sánchez-Flores Latina Magazine Senior Research Associate Center for Reproductive Health Policy Research, Rev. Father Alberto R. Cutié National Adolescent Health Information Center, UCSF President and General Director Pax Catholic Communications Alvaro Simmons, M.ED, MSW, LCSW Chief Operating Officer Lisa Trevino Cummins Mary’s Center for Maternal and Child Care Founder Urban Strategies, L.L.C. Helen Iris Torres Executive Director Angela Díaz, MD, MPH Hispanas Organized for Political Professor Equality (HOPE) Mt. Sinai School of Medicine; Director Mt. Sinai Adolescent Center Carlos Ugarte, MSPH Senior Public Health Consultant María Echaveste UGARCAMP Consultants, LLC Senior Fellow Center for American Progress; Antonia Villarruel, PhD, RN, FAAN Lecturer Professor and Nola J. Pender Collegiate Chair University of California Berkeley School of Law University of Michigan, School of Nursing Vincent Guilamo-Ramos, PhD, LCSW Associate Professor of Social Work Columbia University TheNationalCampaign.org TeenPregnancy.org StayTeen.org 1776 Massachusetts Ave, NW, Suite 200 Washington, DC 20036 Phone: 202.478.8500 Fax: 202.478.8588 Email: [email protected]

28 The goal of the National Campaign to Prevent Teen and Unplanned For more information, contact the Campaign at: Pregnancy is to improve the lives and future prospects of children and 1776 Massachusetts Avenue, NW Suite 200 families and, in particular, to help ensure that children are born into stable, Washington,DC 20036 Telephone (202) 478-800 two-parent families who are committed to and ready for the demanding Fax (202) 478-888 task of raising the next generation. Our specific strategy is to prevent teen pregnancy and unplanned pregnancy among single, young adults. We www.TheNationalCampaign.org support a combination of responsible values and behavior by both men www.StayTeen.org and women and responsible policies in both the public and private sectors. www.TeenPregnancy.org If we are successful, child and family well-being will improve. There will be less poverty, more opportunities for young men and women to complete their education or achieve other life goals, fewer abortions, and a stronger nation.

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