We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior A Meta-Analysis

Laura Widman, PhD1; Sophia Choukas-Bradley, MA2; Seth M. Noar, PhD3; Jacqueline Nesi, MA2; Kyla Garrett, MA3
[+] Author Affiliations
1Department of Psychology, North Carolina State University, Raleigh
2Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
3School of Media and Journalism, University of North Carolina at Chapel Hill
JAMA Pediatr. 2016;170(1):52-61. doi:10.1001/jamapediatrics.2015.2731.
Text Size: A A A
Published online

Importance  Parent-adolescent sexual communication has received considerable attention as a factor that can positively affect safer sex behavior among youth; however, the evidence linking such communication to youth contraceptive and condom use has not been empirically synthesized.

Objectives  To examine the effect of parent-adolescent sexual communication on safer sex behavior among youth and explore potential moderators of this association.

Data Sources  A systematic search of studies published from database inception through June 30, 2014, using the MEDLINE, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles yielded 5098 studies, of which 52 studies with 25 314 adolescents met the study eligibility criteria. Analysis was conducted from July 1, 2014, to July 27, 2015.

Study Selection  Studies were included if they sampled adolescents (mean sample age ≤18 years), included an adolescent report of sexual communication with one or both parents, measured safer sex behavior, and were published in English.

Data Extraction and Synthesis  Correlation coefficients (r) and 95% CIs were computed from studies and meta-analyzed using random-effects models.

Main Outcomes and Measures  Safer sex behavior, including use of contraceptives or condoms.

Results  Fifty-two articles, including 71 independent effects representing more than 3 decades of research on 25 314 adolescents (weighted mean age, 15.2 years) were synthesized. Across studies, there was a significant weighted mean effect (r = 0.10; 95% CI, 0.08-0.13) linking parent-adolescent sexual communication with safer sex behavior, which was statistically heterogeneous (Q = 203.50, P < .001, I2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = 0.12) than boys (r = 0.04) and among youth who discussed sex with their mothers (r = 0.14) compared with their fathers (r = 0.03). Effects did not differ for contraceptive vs condom use or among longitudinal vs cross-sectional studies, indicating that parent sexual communication had a similar effect across study designs and outcomes. Several methodological issues were identified in the literature; future studies can improve on these issues by measuring parent-adolescent communication with robust, multi-item measures, clearly specifying the target parent, and applying multimethod longitudinal designs.

Conclusions and Relevance  Sexual communication with parents, particularly mothers, plays a small protective role in safer sex behavior among adolescents; this protective effect is more pronounced for girls than boys. We discuss the implications for practice and make suggestions for future research on parent-adolescent sexual communication.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?


Place holder to copy figure label and caption
Figure 1.
Study Flow Diagram

Screening and inclusion and exclusion criteria for studies in the meta-analysis.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Forest Plot Displaying 71 Independent Effect Sizes

Each study is followed by 2 letters: the first represents the sex of the sample (B, all boys; G, all girls; and M, mixed), and the second represents the race/ethnicity of the sample (B, black; L, Latino; M, mixed; and W, white). The diamond indicates the overall weighted mean effect across all studies (r = 0.10; P < .001).

aSample from Uganda.

bSample from Malawi.

cSample from Ghana.

dSample from Burkina Faso.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles