Improving Adolescent Health: Person-to-Person Interventions to Improve Caregivers' Parenting Skills
Parenting interventions have the potential to affect a variety of adolescent risk behaviors and associated health outcomes. The interventions addressed in this review are designed to modify adolescents’ risk/protective behaviors and health outcomes by improving their caregivers’ parenting skills. To be included in this review, an intervention had to use information or behavioral strategies to improve parenting skills, and to do so through direct personal contact between the intervention provider and the caregiver.
Summary of Task Force Recommendations and Findings
The Community Preventive Services Task Force recommends person-to-person interventions intended to modify adolescents’ risk and protective behaviors by improving their caregivers’ parenting skills based on sufficient evidence of effectiveness in reducing adolescent risk behaviors. These interventions are conducted either face-to-face or by telephone and occur outside of clinical settings.
About the Interventions
- Interventions may be targeted at:
- Caregivers only
- Caregivers and adolescents together
- The focus is usually on the caregiver/child relationship dynamic
- Caregivers and adolescents separately, with the:
- Caregiver portion focused on parenting behaviors
- Adolescent portion focused on risk behaviors
- Interventions may be delivered via:
- Group sessions
- One-on-one training to the caregiver, in person or over the telephone
- These person-to-person interactions may be supplemented by provision of written materials or online resources.
- Content of these interventions may include:
- Behavioral and social strategies that target thoughts (e.g., awareness, self-efficacy) and social factors (e.g., skill-building activities, rewards or reinforcement)
- Information about strategies to improve communication
- Recommendations for parental monitoring of adolescent behavior
- Information on more specific topics, such as teen sexual behaviors, along with guidance on how to approach an adolescent with these topics
Results from the Systematic Review
Twelve studies qualified for the review.
- Outcomes assessed include:
- Sexual behaviors (7 studies)
- Violence, delinquency, hyperactivity, suicide, and self-harm (5 studies)
- Alcohol, tobacco, and other drug use (7 studies)
- Behaviors related to motor vehicle safety (1 study)
- Teen pregnancy (2 studies)
- Estimated effects for individual studies and outcomes varied substantially; most estimates of effect favored the intervention, but were not statistically significant.
- A meta-analysis indicated that this intervention results in an approximately 20% reduction in the overall set of risk behaviors evaluated (p<.05).
- For sexual behavior and violence, the effect estimates were RR=0.69 (95% CI 0.50, 0.94) and 0.68 (95% CI 0.49, 0.94), respectively, meaning that these risk behaviors decreased by approximately 30%.
- The effect estimate for substance use was much smaller and was not statistically significant (RR=0.87, 95% CI 0.73, 1.04), suggesting the potential for a weaker effect or no effect on these outcomes.
- Youth participating in these interventions also reported they had increased refusal skills and self efficacy for avoiding risky behaviors in the future.
- The majority of studies were conducted in the United States.
- Findings are applicable to diverse populations in a variety of settings, including communities, homes, and schools.
- Three elements were common to all of the interventions in the qualifying studies:
- An education component
- A discussion component, and
- An opportunity for the caregiver to practice new skills
These results are based on a systematic review of all available studies. The review was led by scientists from Research Triangle Institute, Intl., through a contract mechanism and with input from a team of specialists in systematic review methods and experts in research, practice and policy related to adolescent health.
- Analytic Framework – see Figure 1 on page 319 [PDF - 424 kB]
- Evidence Gaps
- Included Studies
- Search Strategy
- Summary Evidence Table* [PDF - 103.71 kB]
Burrus B, Leeks KD, Sipe TA, Dolina S, Soler RE, Elder RW, Barrios L, Greenspan A, Fishbein D, Lindegren ML, Achrekar A, Dittus P, Community Preventive Services Task Force. Person-to-person interventions targeted to parents and other caregivers to improve adolescent health: a Community Guide systematic review [PDF - 434 kB]. Am J Prev Med 2012;42(3):316-26.
Community Preventive Services Task Force. Improving adolescent health through interventions targeted to parents and other caregivers: a recommendation [PDF - 53 kB]. Am J Prev Med 2012;42(3):327-8.
Community Guide News
- Helping caregivers reduce their teen's health risk behaviors
Developed by The Community Guide
*PDF includes all of the information available and will not be updated.
The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Improving adolescent health: person-to-person interventions to improve caregivers' parenting skills. www.thecommunityguide.org/adolescenthealth/PersonToPerson.html. Last updated: MM/DD/YYYY.
Review completed: October 2007