Michael J. Rosati

Parent-Teen Communication about Sex in Urban Thai Families

This study describes sexual communication among Thai parents and their teens and identifies variables related to communication about sex in urban Thai families. Data were derived from 420 families whose teenage children ages 13–14 years were randomly selected using the probability proportional to size technique. Interviews were conducted with 1 parent and 1 teenage child in each family. In-depth interviews were also conducted in 30 parents and teens drawn from the same 420 families. Results showed that parents were most likely to talk with their teens about body changes and dating; however, less discussion about sex-related issues, birth control, and HIV/AIDS occurred. More daughters than sons reported frequent discussions with their parents about sex. Parents who believed their teens had been involved in sexual activity were more likely to talk about HIV/AIDS and the difficulty of teenagers having babies, instead of talking about sexual intercourse or when to start having sex. Multiple regression analysis indicated that gender of the child (female), parental religiosity, and parental perception of teen sexual activity were significant predictors of increased sexual communication in Thai families. The findings suggest a need for approaches designed to facilitate communication skills about sex-related issues among Thai parents.

Correlates of Precoital Behaviors, Intentions, and Sexual Initiation Among Thai Adolescents

This paper examines the risk and protective factors associated with sexual behaviors among Thai youth ages 13-14 (N=420) living in Bangkok, Thailand. Cross-sectional data were collected using a random sample of households methodology. Three outcomes were assessed: (1) intention to engage in sexual intercourse, (2) pre-coital behaviors, and (3) sexual initiation. Bivariate analysis indicated that parental disapproval of sex, exposure to pornographic media, refusal self-efficacy and having a boyfriend/girlfriend had the strongest relationships with all three outcomes. Multivariate analyses found that parental disapproval of sex and exposure to pornographic media (internet or TV) were significantly associated with all three outcomes. Having a boyfriend or girlfriend was associated with pre-coital behaviors and intentions and sexual refusal self efficacy was correlated with pre-coital behaviors only. The potential competing influences of parent disapproval and exposure to pornographic media on adolescent sexual behaviors should be considered when adapting HIV prevention interventions for Thai youth.

The Impact of Thai Family Matters on Parent–Adolescent Sexual Risk Communication Attitudes and Behaviors

This article reports on a combined family-based substance abuse and HIV-prevention intervention targeting families with 13–14-year-old children in Bangkok, Thailand. Families (n = 340) were randomly and proportionally selected from 7 districts in Bangkok with half randomly assigned to an experimental or control condition. Families in the intervention condition were exposed to 5 interactive booklets about adolescent substance use and risky sexual behavior. Trained health educators followed up by phone to encourage completion of each booklet. Primary outcomes reported in this article include whether the intervention increased the frequency of parent–child communication in general or about sexual risk taking in particular as well as whether the intervention reduced discomfort discussing sexual issues. The authors also tested to see whether booklet completion was associated with communication outcomes at the 6-month follow-up. Multivariate findings indicate that the intervention had a significant impact on the frequency of general parent–child communication on the basis of child reports. The intervention had a marginal impact on the frequency of parent–child communication about sexual issues on the basis of parent reports. Booklet completion was associated with reduced discomfort discussing sex and was marginally associated with frequency of parent–child discussion of sex on the basis of parent reports only. These findings indicate that a family-based program can influence communication patterns.

Do Thai parents really know about the sexual risk taking of their children? A qualitative study in Bangkok

This qualitative study explores the perceptions of parents and adolescents toward sexual risk-taking behaviors. In-depth interviews were conducted with 30 parents and 30 adolescents (aged 13-14 years) in Bangkok, and were analyzed by using coding and thematic analysis. The results showed that although parents generally believed that Thai teens begin to have sex at an early age and engage in sexual risk-taking behaviors, they trusted that their teens would follow parental guidance and rules and not engage in sexual activity at this age. Most of the Thai teens reported that their parents were not really aware of their sexual behaviors because of their tendency to keep their sexual stories secret for fear of being scolded, blamed, and punished. The teens also reported that they wanted their parents to listen, give them warmth and more freedom, and be more in touch with their activities. Parents expressed their need for knowledge and skills so that they could help guide their adolescent children to avoid sexual risk-taking behaviors. A family intervention specifically aimed at empowering Thai urban parents is needed.

Successful Implementation of Thai Family Matters:Strategies and Implications

This article discusses the successful process used to assess the feasibility of implementing the Family Matters program in Bangkok, Thailand. This is important work since adopting and adapting evidence-based programs is a strategy currently endorsed by leading prevention funding sources, particularly in the United States. The original Family Matters consists of four booklets designed to increase parental communication with their adolescent children in order to delay onset of or decrease alcohol, tobacco, and other drug use. As part of the program, health educators contact parents by telephone to support them in the adoption of the program. Each booklet addresses a key aspect of strengthening families and protecting young people from unhealthy behaviors related to alcohol and other drug use. Adaptation of the program for Bangkok focused on cultural relevance and the addition of a unit targeting adolescent dating and sexual behavior. A total of 170 families entered the program, with the majority (85.3%) completing all five booklets. On average, the program took 16 weeks to complete, with families reporting high satisfaction with the program. This article provides greater detail about the implementation process and what was learned from this feasibility trial.

The roles of perceived neighborhood disorganization, social cohesion, and social control in urban Thai adolescents' substance use and delinquency

Substance use and delinquency in Thai adolescents are growing public health concerns. Research has linked neighborhood characteristics to these outcomes, with explanations focused on neighborhood disorganization, social cohesion, and social control. This study examines the independent associations of these neighborhood constructs with Thai adolescents’ substance use and delinquency, through peer deviance, to determine which neighborhood aspects are particularly important. Families (N = 420) with adolescents aged 13 to 14 were randomly selected from 7 districts in Bangkok, Thailand. Structural equation modeling showed that adolescents’, but not parents’, perceptions of greater disorganization were related to increased rates of both minor and serious delinquency. Surprisingly, greater neighborhood cohesion was related to greater minor delinquency. Peer deviance was unrelated to neighborhood variables. Findings can inform prevention strategies for Thai adolescents, as results suggest that neighborhoods are important for adolescent behaviors regardless of culture. Further work should help communities make use of social cohesion to benefit residents.

Effectively addressing the mid- and long-term needs of young people affected by the tsunami in Aceh: An on-site assessment

Within two months of the Asian tsunami, a team of four individuals conducted an assessment on the post-disaster needs of young people in Aceh Province. In addition to assessing current needs, the team examined the extent to which young people (aged 14–24) were involved in the planning and implementation of ongoing rebuilding and relief efforts. Finally, the team assessed the degree to which young people could be involved in such efforts as the recovery process moves forward. The team: reviewed all existing documents developed and/or compiled by the UN Office for Coordination of Humanitarian Assistance (UNOCHA) from the inception of the disaster relief response to the present; met with approximately 20 organizations including UN agencies as well as international and local programs presently working in Banda Aceh and Maulaboh; and conducted direct discussions with young people in a variety of settings.

Neighborhood Perceptions and Parent Outcomes in Family Based Prevention Programs for Thai Adolescents: The Role of Program Engagement

Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = .52) in Bangkok, Thailand in a prevention program for adolescent substance use and sexual risk. Neighborhoods were related to engagement, which was critical to outcomes. Neighborhood disorganization was related to confidence in program effects and program completion. Completion was related to increased ATOD communication. Neighborhood cohesion was related to less program enjoyment, while neighborhood social control was related to more enjoyment. Enjoyment was related to increased ATOD communication and formation and monitoring of alcohol rules. Prevention strategies should focus on neighborhood contexts and enhancing engagement.

Panel 2.10: reproductive, mental, and child health.

This is a summary of the presentations and discussion of Panel 2.10, Reproductive, Mental, and Child Health of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to reproductive, mental, and child health as pertain to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) background; (2) key issues; (3) discussion; and (4) recommendations. Key issues discussed included: (1) coordination/collaboration; (2) provision of services; and (3) raising awareness and advocacy.