title: Adolescents and parental caregivers as lay health advisers in a community-based risk reduction intervention for youth: baseline data from Teach One, Reach One.
abstract: The purpose of the current study is to describe the demographic, behavioral, and psychosocial characteristics of adolescent and caregiver lay health advisers (LHAs) participating in an intervention designed to reduce risk behaviors among rural African-American adolescents. Teach One, Reach One integrates constructs from the Theory of Planned Behavior and Social Cognitive Theory. It acknowledges that changing the sexual behaviors of African-American adolescents requires changing one's knowledge, attitudes, normative beliefs about the behavior of peers, and self-efficacy regarding adolescent sexual behavior, parent-teen communication about sex, and healthy dating relations among adolescents. Study participants completed baseline questionnaires assessing demographics and psychosocial determinants (knowledge, attitudes, perceived social norms, and self-efficacy) of sexual behaviors. Sixty-two adolescent and caregiver dyads participated. Caregivers included biological parents, legal guardians, or other parental figures. Strengths and areas in need of improvement were determined using median splits. Few adolescents had initiated sex. Their strengths included high levels of open parent-teen communication; positive attitudes and normative beliefs regarding both sex communication and healthy dating relationships; and high knowledge and self-efficacy for healthy dating behaviors. Areas needing improvement included low knowledge, unfavorable attitudes, poor normative beliefs, and low self-efficacy regarding condom use. Caregiver strengths included positive attitudes, normative beliefs, and self-efficacy for sex communication; positive attitudes and self-efficacy for condom use; and low acceptance of couple violence. Areas needing improvement included low levels of actual communication about sex and low knowledge about effective communication strategies and condom use. The current study highlights the value of assessing baseline characteristics of LHAs prior to intervention implementation, as it enables a better understanding of the key characteristics necessary for planning and implementing interventions, as well as engaging in targeted training activities.
authors.affiliation: a Department of Public Health Sciences , Medical University of South Carolina , Charleston , SC , USA.|g Department of Pediatrics , Medical University of South Carolina , Charleston , SC , USA.
authors.forename: Tiarney D
authors.initials: TD
authors.lastname: Ritchwood
authors.affiliation: b NC TraCS Institute , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Dave
authors.affiliation: c School of Nursing , University of North Carolina at Greensboro , Greensboro , NC , USA.
authors.forename: Dana L
authors.initials: DL
authors.lastname: Carthron
authors.affiliation: d Office of Wellness , Wake Forest University , Winston-Salem , NC , USA.
authors.forename: Malika Roman
authors.initials: MR
authors.lastname: Isler
authors.affiliation: e Department of Social Medicine, Center for Health Equity Research (CHER) , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
authors.forename: Connie
authors.initials: C
authors.lastname: Blumenthal
authors.affiliation: f Project Momentum , Inc, Rocky Mount , NC , USA.
authors.forename: Mysha
authors.initials: M
authors.lastname: Wynn
authors.affiliation: g Department of Pediatrics , Medical University of South Carolina , Charleston , SC , USA.
authors.forename: Adebowale
authors.initials: A
authors.lastname: Odulana
authors.affiliation: h Department of Biostatistics, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.affiliation: i The Craig Dalsimer Division of Adolescent Medicine , The Children's Hospital of Philadelphia , Philadelphia , PA , USA.
authors.forename: Aletha Y
authors.initials: AY
authors.lastname: Akers
authors.affiliation: b NC TraCS Institute , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.|e Department of Social Medicine, Center for Health Equity Research (CHER) , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
authors.forename: Giselle
authors.initials: G
authors.lastname: Corbie-Smith
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D017028:Caregivers; D003142:Communication; D055812:Community-Based Participatory Research; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D015438:Health Behavior; D006801:Humans; D008297:Male; D010290:Parents; D010379:Peer Group; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012424:Rural Population; D021841:Safe Sex; D012725:Sexual Behavior / Q000208:ethnology
keywords: African-American; HIV prevention; caregivers; lay health adviser; youth