1

Getting Parents Involved

Getting Parents Involved

Reducing Teen Pregnancy Rates
Laura L. Thomas
Jackson College
Evidence Based Nursing Project
December 1, 2015

Getting Parents Involved

1 Write a PICOT statement based on patient care or unit practices you have experienced during
your clinical days in the Jackson College Nursing Program.
Population: All adolescents, whether sexually active or not, in middle and high school and
their parents.
Intervention: Will parental involvement with sexual education at home, help reduce teen
pregnancy rates?
Comparison: No parental involvement at home with sexual health education (school based
education only).
Outcome: By giving parents tools to use at home, we can achieve better sexual health
outcomes for todays youth and reduce the number of unplanned teenage pregnancies.
Time: Parents should start talking to their kids about sexual health as early as elementary
school.
What type of PICOT statement is this?
Prevention
What is the best type of evidence to answer this question?
Controlled Trials, Cohort Studies and Systematic Reviews Meta-Analysis
Search for the best evidence reflecting the highest level of evidence available.
Name the database you
used.

#1

List search terms you tried first How many hits did you
& your final revisions:
get from your final search
on this database?
First terms:

CINAHL

Sexual Education in Schools

1,641

47
Preventing Teen Pregnancy

Getting Parents Involved

Final terms:

52

Parental Involvement in Sexual

Education

Look at your top 10 most relevant & pertinent findings from your best search. Using the full text
or abstract, indicate how many of each you found in each category?

Systematic Review from RCT __________

Meta-Analysis from RCT __________

EB Clinical Practice Guideline based on Systematic Reviews of RCT
__________
RCT (well designed) ____1______
Controlled Trial Non-Randomization (well designed) __________
Case Control or Cohort Studies (well designed) ____3______
Systematic Reviews of Descriptive or Qualitative Studies ____2______
Single Descriptive or Qualitative Study ____3______
Opinion of Authorities &/or Reports of Expert Committees ____1_____
Other: __________ (Describe)

Based on your analysis in question #5, rate the evidence that you found using the PICOT level
of evidence.
HIGH

MEDIUM

LOW

Select at least 3 full text sources that you found for your PICOT. Either attach copies of them or
list the complete citation or URL so that your classroom faculty can easily find the documents
and go to them directly.
Barr, E. M., Moore, M. J., Johnson, T., Forrest, J., & Jordan, M. (2014). New Evidence: Data
Documenting Parental Support for Earlier Sexuality Education. Journal Of School
Health, 84(1), 10-17 8p. doi:10.1111/josh.12112

Getting Parents Involved

Grossman, J. M., Frye, A., Charmaraman, L., & Erkut, S. (2013). Family Homework and
School-Based Sex Education: Delaying Early Adolescents' Sexual Behavior. Journal Of
School Health, 83(11), 810-817 8p. doi:10.1111/josh.12098
Grossman, J. M., Tracy, A. J., Charmaraman, L., Ceder, I., & Erkut, S. (2014). Protective
Effects of Middle School Comprehensive Sex Education With Family Involvement.
Journal Of School Health, 84(11), 739-747 9p. doi:10.1111/josh.12199
Wang, B., Stanton, B., Deveaux, L., Li, X., Koci, V., & Lunn, S. (2014). The Impact of
Parent Involvement in an Effective Adolescent Risk Reduction Intervention on Sexual
Risk Communication and Adolescent Outcomes. AIDS Education & Prevention, 26(6),
500-520 21p. doi:10.1521/aeap.2014.26.6.500
https://uwjackson.microform.com/pdfs/2012TPPIStrategicPlan.pdf
http://thenationalcampaign.org/
http://www.parentactionforhealthykids.org/
http://www.cdc.gov/teenpregnancy/prevent-teen-pregnancy/index.htm/

Summarize the findings from your search and whether or not it is applicable to your PICOT.
How does the information you found answer (or not answer) the question that you had?
I did find while doing my research that parental involvement at home in conjunction with
school-based sexual health education helped reduce teen pregnancy rates and produced better
sexual health outcomes for adolescents. One study I read performed a cohort study of 980
Massachusetts middle school students who were taught using the Get Real: Comprehensive
Sex Education That Works program. This program provides family homework assignments
as part of the curriculum that focus on relationship skills and communication between the
parent and their student. The study did find a meaningful difference in the number of students
initiating sex who participated in the family homework versus those who did not. While the
study has its limitations it does add to the literature that family communication about sexual
health is vital to achieving better outcomes for our teens and reducing teen pregnancy rates
(Grossman 2013).

Getting Parents Involved

In the follow-up to the above referenced study, they again found that early support for
family communication was critical for adolescent sexual health, especially with boys. Not
only is it essential that parental involvement begin early but is frequent (Grossman 2014).
The issue of teen pregnancy doesnt just stop with educating our girls, boys sexual health
education is just as important.
A third study I found wanted to make a parental component to school-based sexual health
education that was less-time consuming and less-labor intensive than other parent-adolescent
programs currently available. They created a short 20 minute video, simple communication
pointer handout and brief condom demonstration and then facilitated a short discussion and
role-play between parents and mid/late-adolescents. They found that this intervention used
along with the comprehensive evidence-based sexual education course was more effective at
reducing risky sexual behaviors than that education course alone or the parent/adolescent
intervention alone. Their findings are consistent with the current evidence that highlights the
importance of a parental component in the sexual health education of adolescents (Bo Wang
2014).
The final study I examined looked at wasnt focused on parental intervention but on
parental support for initiating sexual health education to elementary children. I felt this was
an important component because all of the research I found support better sexual health
outcomes when parents talked early and often to their children about sex. This telephone
study of Florida parents, showed that 80% supported starting sexual health education for their
children in elementary school. Evidence-based sexual education needs to begin before risky
behaviors do to maximize effectiveness (Elissa 2014).

Getting Parents Involved

If you were a staff nurse who had completed this search, fully describe what next steps you
would consider after completing the search. Describe what practice changes might be indicated.
How might patient/family preferences influence implementation? How would you go about
recommending or implementing a change in practice?
If I was a public health nurse or school nurse I could use this information to help change
or develop sexual health education courses to include homework and information to send
home to parents to help them talk about sex with their children. I may also want to hold
informational and educational sessions specifically for parents prior to teaching a sexual
health education course to students, so that parents can be fully prepared to talk and answer
questions their children might have. I found some wonderful national and local resources that
would help facilitate these changes. The CDC sponsors The Presidents Teen Pregnancy
Prevention Initiative http://www.cdc.gov/teenpregnancy/prevent-teen-pregnancy/index.htm/
which promotes communitywide prevention initiatives to reduce to number of teenage
pregnancies among the populations with the highest rates. The National Campaign
http://thenationalcampaign.org/ is a private, non-profit organization dedicated to preventing
teen and unplanned pregnancies. They offer programs and resources on the national, state,
local and individual levels. Parent Action for Health Kids
http://www.parentactionforhealthykids.org/ is a website dedicated to providing parents
resources they need to help keep their children safe and healthy and include sexual health as
a key component. They sponsor Talk Early & Talk Often, a 2 hour parent workshop designed
to teach parents how to talk to their kids about sex. Locally I found Jackson County has the
Teen Pregnancy Prevention Initiative founded by the Jackson County Health Department and
United Way of Jackson. Every 5 years they release a strategic action plan
https://uwjackson.microform.com/pdfs/2012TPPIStrategicPlan.pdf and have just recently

Getting Parents Involved

updated and refilmed their I Wish video which highlights stories ofteen parents and their
struggles. The initiative runs several programs throughout all the Jackson county schools.
I can see this plan having a few issues though. Parental follow-through is essential.
Sometimes getting parents to participate at home is difficult even when it is in their childrens
best interest. Having the support of the parents would be vital. Also some parents value
systems may conflict with sexual health education all together. It can be a heated topic for
some, so resistance may be met. But as my research found those numbers are small compared
to the percentage of parents wanting their children taught comprehensive evidence-based
effective sexual health education.
To implement these changes, I would either write a proposal for the school board or
possibly local health department outlining what parental teaching methods and materials I
want to use. I would need to figure out how they were being paid for and who was going to
put the changes into practice. Depending on what sort of sexual health education program
was in use, it may be a relatively easy and inexpensive change. Utilizing the resources
already available would be vital.