Cost of talking parents, healthy teens: a worksite-based intervention to promote parent-adolescent sexual health communication.

PURPOSE To examine the cost and cost-effectiveness of implementing Talking Parents, Healthy Teens, a worksite-based parenting program designed to help parents address sexual health with their adolescent children. METHODS We enrolled 535 parents with adolescent children at 13 worksites in southern California in a randomized trial. We used time and wage data from employees involved in implementing the program to estimate fixed and variable costs. We determined cost-effectiveness with nonparametric bootstrap analysis. For the intervention, parents participated in eight weekly 1-hour teaching sessions at lunchtime. The program included games, discussions, role plays, and videotaped role plays to help parents learn to communicate with their children about sex-related topics, teach their children assertiveness and decision-making skills, and supervise and interact with their children more effectively. RESULTS Implementing the program cost $543.03 (standard deviation, $289.98) per worksite in fixed costs, and $28.05 per parent (standard deviation, $4.08) in variable costs. At 9 months, this $28.05 investment per parent yielded improvements in number of sexual health topics discussed, condom teaching, and communication quality and openness. The cost-effectiveness was $7.42 per new topic discussed using parental responses and $9.18 using adolescent responses. Other efficacy outcomes also yielded favorable cost-effectiveness ratios. CONCLUSIONS Talking Parents, Healthy Teens demonstrated the feasibility and cost-effectiveness of a worksite-based parenting program to promote parent-adolescent communication about sexual health. Its cost is reasonable and is unlikely to be a significant barrier to adoption and diffusion for most worksites considering its implementation.

[1]  D. Kaplan,et al.  Sexuality Education for Children and Adolescents , 2001, Pediatric Clinical Practice Guidelines & Policies.

[2]  Susan D. Voyer,et al.  An Adolescent Perspective on Sexual Health Education at School and at Home: I. High School Students , 2003 .

[3]  J Shepherd,et al.  The effectiveness and cost-effectiveness of behavioural interventions for the prevention of sexually transmitted infections in young people aged 13-19: a systematic review and economic evaluation. , 2010, Health technology assessment.

[4]  P. W. Bowman,et al.  PHS Public Health Service , 1963 .

[5]  D. Kanouse,et al.  Promoting adolescent health: worksite-based interventions with parents of adolescents. , 2001, Journal of public health management and practice : JPHMP.

[6]  J. Gard,et al.  Perspectives on Sexual and Reproductive Health Parents ’ Perspectives on Talking to Preteenage Children About Sex , 2010 .

[7]  K. Bogenschneider,et al.  Parent-Teen Communication About Sexual Topics , 1998, Journal of family issues.

[8]  Doreen Rosenthal,et al.  The Effect of Communication Characteristics on Family Members' Perceptions of Parents as Sex Educators , 2000 .

[9]  R. Ingham,et al.  Doctors should advise adolescents to abstain from sex , 2000, BMJ : British Medical Journal.

[10]  B. Miller,et al.  Family Relationships and Adolescent Pregnancy Risk: A Research Synthesis , 2001 .

[11]  B. Miller,et al.  Interventions designed to promote parent-teen communication about sexuality. , 2002, New directions for child and adolescent development.

[12]  L. Wang,et al.  Economic evaluation of Safer Choices: a school-based human immunodeficiency virus, other sexually transmitted diseases, and pregnancy prevention program. , 2000, Archives of pediatrics & adolescent medicine.

[13]  E. Byers,et al.  Sexual Health Education at School and at Home: Attitudes and Experiences of New Brunswick Parents , 2002 .

[14]  G. Stave,et al.  Quantifiable Impact of the Contract for Health and Wellness: Health Behaviors, Health Care Costs, Disability, and Workers’ Compensation , 2003, Journal of occupational and environmental medicine.

[15]  B. Cobb,et al.  Parent-adolescent communication and sexual risk behaviors among African American adolescent females. , 2001, The Journal of pediatrics.

[16]  M. Drummond,et al.  Health Care Technology: Effectiveness, Efficiency and Public Policy@@@Methods for the Economic Evaluation of Health Care Programmes , 1988 .

[17]  James Jaccard,et al.  Parent-Teen Communication about Premarital Sex , 2000 .

[18]  B. Stanton,et al.  Parental underestimates of adolescent risk behavior: a randomized, controlled trial of a parental monitoring intervention. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[19]  L. Belcher,et al.  Parent-child communication about sexuality: A review of the literature from 1980-2002 , 2003 .

[20]  Lisa Williamson,et al.  Parental influences on young people's sexual behaviour: a longitudinal analysis. , 2006, Journal of adolescence.

[21]  Rüdiger Kabst,et al.  Effects of work-family human resource practices: a longitudinal perspective , 2008 .

[22]  R. Ingham,et al.  Factors affecting British teenagers' contraceptive use at first intercourse: the importance of partner communication. , 2002, Perspectives on sexual and reproductive health.

[23]  Adolescent sexuality and parent-adolescent processes: promoting healthy teen choices. , 2002 .

[24]  T. Farley,et al.  Comparing the Cost-Effectiveness of HIV Prevention Interventions , 2004, Journal of acquired immune deficiency syndromes.

[25]  M. Elliott,et al.  Evaluation of Talking Parents, Healthy Teens, a new worksite based parenting programme to promote parent-adolescent communication about sexual health: randomised controlled trial , 2008, BMJ : British Medical Journal.

[26]  A H Briggs,et al.  Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation. , 1997, Health economics.

[27]  G. Parcel,et al.  The "Safer Choices" intervention: its impact on the sexual behaviors of different subgroups of high school students. , 2004, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[28]  M. Lohan,et al.  The silent treatment: parents' narratives of sexuality education with young people , 2010, Culture, health & sexuality.

[29]  J. Szapocznik,et al.  Patterns of Retention in a Preventive Intervention with Ethnic Minority Families , 2006, Journal of Primary Prevention.

[30]  B. Efron Better Bootstrap Confidence Intervals , 1987 .

[31]  L. Wang,et al.  An Economic Evaluation of a School-Based Sexually Transmitted Disease Screening Program , 2002, Sexually transmitted diseases.

[32]  S. Aldana Financial Impact of Health Promotion Programs: A Comprehensive Review of the Literature , 2001, American journal of health promotion : AJHP.

[33]  M. Hutchinson,et al.  The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. , 2003, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[34]  R. Forehand,et al.  Why Parents Matter!: The Conceptual Basis for a Community-Based HIV Prevention Program for the Parents of African American Youth , 2004 .

[35]  G. Ryan,et al.  Worksite-based parenting programs to promote healthy adolescent sexual development: a qualitative study of feasibility and potential content. , 2005, Perspectives on sexual and reproductive health.

[36]  Kaye Wellings,et al.  Teenage Pregnancy Strategy Evaluation - Final Report , 2005 .

[37]  M. Gold,et al.  Panel on cost-effectiveness in health and medicine. , 1996, Medical care.