Importance: Parent-teen sexual health communication can support and empower teens in their sexual and reproductive health (SRH) decision-making. These conversations may differ in their associations with teen health outcomes across parent-teen dynamics and parents' knowledge about and comfort with the topic.
Objectives: To investigate parent and teen characteristics associated with the frequency of parent-teen sexual health communication, parent information adequacy, and parent communication comfort and the association between communication frequency and teens' self-efficacy to seek SRH information and services and to examine the moderating effects of parents' perceived information adequacy and communication comfort.
Design, setting, and participants: This cross-sectional survey comprised a probability sample of 522 parent-teen (aged 15-17 years) dyads representative of the US household population from the 2022 Teen and Parent Surveys of Health. Participants were recruited from AmeriSpeak and AmeriSpeak Teen panels, administered by the National Opinion Research Center (University of Chicago) from May 12 to September 30, 2022. Statistical analysis was performed from February to May 2024.
Main outcomes and measures: The frequency of parent-teen sexual health communication and teens' self-efficacy to seek SRH information and services. Moderators were parent information adequacy and communication comfort. All analyses were weighted.
Results: Of 522 parents, most were female (377 [61.3%]), 45 years of age or older (214 [53.5%]), White (309 [57.0%]), and had less than a bachelor's degree (325 [56.7%]). Of 522 teens, half were male (244 [50.3%]), and most were heterosexual (394 [79.8%]). Female parents (54.5% [95% CI, 48.6%-60.2%]; P = .001), parents aged 18 to 44 years (58.0% [95% CI, 51.3%-64.4%]; P < .001), and Black parents (74.3% [95% CI, 56.5%-86.6%]; P = .01) communicated about sexual health most frequently. Parents with a Bachelor's degree or higher (36.8% [95% CI, 30.0%-47.9%]; P = .03) and household incomes higher than $100 000 (31.1% [95% CI, 22.6%-41.1%]; P < .001) were significantly less likely to communicate about sexual health. Teens whose parents talked frequently had higher self-efficacy when parents were more informed (β = 0.11 [95% CI, 0.03-0.20]; P = .01) and more comfortable (β = 0.11 [95% CI, 0.01-0.20]; P = .03); however, if parents were not informed or comfortable, frequent communication was associated with lower teen self-efficacy.
Conclusions and relevance: In a cross-sectional, nationally representative survey of 522 parent-teen dyads, frequent parent-teen sexual health communication was associated with increased teen self-efficacy for SRH information and service seeking, but this depended on how comfortable and informed their parents felt. These findings suggest that parents must possess accurate information and comfort to discuss sexual health topics.