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Rapid Responses: Rapid Responses published:
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Does this programme really reduce harmful adolescent sexual behaviour?
- Amar Latif, Jim G. Thornton (22 August 2008)
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Sexual Health-Related Parent-Adolescent Communication: A Bi-polar Event
- Mohamed I. Abdulmajed (27 August 2008)
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Re: Does this programme really reduce harmful adolescent sexual behaviour?
- Mark A. Schuster, Rosalie Corona, Marc N. Elliott, David E. Kanouse, Karen L. Eastman, Annie J. Zhou, and David J. Klein (10 September 2008)
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Amar Latif, Medical Student University of Nottingham, Jim G. Thornton
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Sir, - We were fascinated by the evaluation of Talking Parents, Healthy Teens (10 July 2008) but were a little surprised that Kirby in his editorial was so quick to advocate that such programmes be introduced generally to the workplace. We had a few methodological concerns. The authors fail to comment as to why, according to the published protocol NCT 00465010, the achieved sample size of 569 was so much smaller than the intended 1,300. In the published protocol the primary endpoint is defined as simply “parent child communication”. In the paper this is reported in multiple ways (ability to communicate, openness of communication, number of topics discussed etc.) and also at a range of time points. Was the primary outcome pre-defined more precisely in an unpublished version of the protocol? The CONSORT flow diagram in the electronic version of the paper does not separate the number of participants allocated to each treatment arm and the number who received each treatment. Nor does it show parental attendance rate divided by trial group. The 94% rate of parental and 92% adolescent completion of all four questionnaires is impressive but again is not broken down by trial allocation group. Was there any differential completion? Why were the secondary outcomes of “adolescent health behaviours” which had been planned for in the published protocol, although not defined in detail, not reported? Do the authors have any data on actual or self-reported unprotected sex, abortions or sexually transmitted diseases? Amar Latif (Medical student) Jim Thornton (Professor of Obstetrics and Gynaecology) Competing interests: None declared |
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Mohamed I. Abdulmajed, Urology Specialty Training Doctor University of Ankara / Ibni Sina Hospital / Sihhiye 06100 / Ankara -Turkey
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Adolescence is a critical era in human life, which should be accompanied by maximal parental support. Therefore, I totally agree with the idea of strengthening parent-adolescent communication, however, with developing certain criteria. Obviously, such familial intimacy has a beneficial dimension of increasing sons` and daughters` trust in their parents. As we all know, timy work and job tracing event rendered family bonds more fragile, and eventually, parents fail to be `real parents`. In addition, such campaigns help less-experienced parents to benefit from others how to be `talking` ones. Having said this, we should not forget that adolescent population are in need for `counselor parents` to decide what is `right ` and what is `wrong` in a way that false thoughts could be erased before being `pathologic`. In another word, why do not we educate our children what puberty and real sexual health mean? Doesn’t that better than leaving them to find answers for their questions from Medias, which might be with wrong components? On the other hand, rural population may still totally unaware of such programmes or intentionally refuse to share because of embarrassment or low educational level. This leaves large share of parent population out of reach. In addition, the meaningful evaluation of the development of parent -adolescent relationship and appearance of `true` healthy teen requires many years before proving its successfulness. So, why do not we leave each parent to tackle the matter on their own? `As it was for thousands of years` Not all people have the same personality, and same reaction to new events, therefore, in my opinion, `talking parents` should be individualized to get `healthy teens`. To sum up, educating parents to be `talking` is a good idea. But, information to be told and the way they are told should be individualized according to the emotional state and the emerging personality of the single teen, best known by their own parent. Competing interests: None declared |
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Mark A. Schuster, Chief of General Pediatrics & Vice-Chair for Health Policy Research; Professor of Pediatrics Children's Hospital Boston & Harvard Medical School, Boston, MA 02115, USA, Rosalie Corona, Marc N. Elliott, David E. Kanouse, Karen L. Eastman, Annie J. Zhou, and David J. Klein
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The intended sample size of 1300 that Latif and Thornton(1) mention from the ClinicalTrials.gov registry refers to the combined total of parents and adolescents; we studied 569 parents and 710 adolescents (total 1279). The parent-child communication items (discussions, condom instruction, communication ability, communication openness) were preselected. The CONSORT flow diagram shows that 288 parents were randomised to and received the intervention. The control group (n=281) did not receive the intervention, so the same number of people received the intervention as were randomised to the intervention group. The diagram does not separate the number of participants who were "allocated to each treatment arm" from "the number who received each treatment" because those numbers are the same. The paper stated that the median attendance for the intervention group was seven of eight sessions; no rate is given for the control group because they did not receive the intervention. Although the Methods section does not break down the proportion of parents who responded to all four survey waves by trial group, the diagram specifies the number in each group who did not complete all four surveys. No significant intervention-control difference exists for parents (or for adolescents—reported in the text but not the diagram). The registry did not indicate that health behaviour would be reported at this stage. We plan to examine this later when the children are older and more likely to be engaging in sex. 1. Latif A, Thornton J. Does education really alter harmful adolescent sexual behaviour? BMJ 2008;337:a1492. doi=10.1136/bmj.a1492 Competing interests: None declared |
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