Following the model described by Creswell et al. Qualitative date was collected on both the mothers and sons and the quantitative survey with conducted with the sons only. We conducted separate analysis of the qualitative and quantitative data and mixed them at the level of inference.
Data collection One-on-one interviews averaging 20 minutes were conducted with sons and mothers, separately, in private areas in community centers and afterschool program locations. Following Seidman , we used a loosely structured, comfortable, and conversational style to conduct our interviews. Questions and probes were used to elicit information about and description of their experience of sexual health communication.
Questions proposed during the interview were modified using an iterative process by which participant responses informed interview questions. Prior to interviews, mothers provided demographic data. Sons took a brief survey about sexual behaviors and parent-child communication because of the sensitive nature of asking young adolescents sexual questions in a face-to-face interview format.
The 17 question survey took about 10 minutes to complete Table 1 and was developed after exploring several instruments used in parent- based sexual health interventions . The survey was meant to serve as a simplified way of gathering sensitive information from adolescent boys and was not meant for rigorous quantitative analysis. Two experienced qualitative researchers conducted interviews and coded transcripts.
Questions were asked about relationship quality, general communication, and sexual health communication Table 2. Little new information arose from mothers or sons after 40 interviews were conducted, and data collection was stopped shortly thereafter. University of Texas Institutional Review Board approval was obtained for this study. Data analysis We analyzed the data using a four step process. First, we used methods outlined in Bernard et al.
Second, we conducted a concordance analysis between mother and son qualitative data. Third, we used mixed methods to analyze the results of the subgroup survey given to sons and results of the qualitative data at the level of inference. Finally, we developed a conceptual framework to describe the findings of the study Figure 1. Audio files were transcribed, cross-validated with transcriptions, and cleaned. Mother-son qualitative data were linked to allow a dyadic analysis of themes between mothers and their sons.
Data were coded and analyzed by the first author and a second coder trained in qualitative analysis to determine thematic consensus and to mitigate bias. We used consensus building to merge differing interpretations of text. Confirmability of data was verified among the authors using peer debriefing of coding, thematic analysis, exemplars, and supportive quotes to assess the cohesiveness of descriptive interpretations. We recruited a community-based voluntary sample of single African American mothers and sons from after-school programs, health fairs, and community organizations in low income areas of a large urban city in south-central Texas.
Eligible participants were African American adolescent males ages who were English- speaking and resided primarily with their single mother. Fam Med Med Sci Res 3: The mother consented and then the adolescent assented for interviews. The sample included 23 African American mothers and 25 sons ages years.
Only two adolescents reported sexual behaviors and all sons indicated talking with their parent about most sexual health topics once or twice. Sons reported higher communication about waiting to have sex than about condoms in the survey. There are three subthemes related to sexual health messaging; disapproval of adolescent sexual activity, use of a two-prong abstinence and risk reduction message, and discussion of consequences of sex.
Mother-son sexual health communication We asked both mothers and sons about what they think about think about adolescent sexual health and parent-child sexual health communication. Participants described both comforts and discomforts, how they timed conversations, the desire for child disclosure, and the strategies used. Comfort While many mothers and sons felt comfortable discussing sexual health topics together related to their sense of connectedness, others described apprehensions.
Most mothers described themselves as comfortable with communication about their beliefs regarding adolescent sexual activity. Other mothers attributed comfort to open communication with their mothers. Discomfort Some mothers described discomfort with communication related to not knowing what to say and negative communication outcome expectations. While most mothers expressed positive outcome expectations for communicating with their sons, three mothers expressed concern for negative outcomes.
Kids going to do what they going to do despite what your parents said. Communication timing preferences Mothers described how they determine when to communicate with their sons when they; 1 exhibit signs of readiness by asking questions, 2 have sexual health-based homework, or 3 show interest in dating.
Mothers unanimously expressed a desire to have sons talk to them before having sex in order to provide a just-in-time message about risk reduction strategies.
Mothers wanted to help with decision making, talk about consequences of sex, and take sons to get condoms. Mothers encouraged sons to tell an adult before having sex. Somebody can give you something. Sons discussed their openness to disclosing information to their mothers. They described their comfort in talking with their mothers about anything including their sexual activity.
Nine mothers discussed how they encourage disclosure and communication. Mothers and sons described the ways they communicate. Mothers described how they find teachable moments such as TV shows and school work to start the conversation.
Mothers also responded to adolescent behaviors in order to engage in sexual health conversations. We also asked sons what message they want to get from your mom about sex and how that compared to what she told them. Mothers and sons talked about messages of disapproval, used a two-prong message, and discussed consequences of sex.
However, seven mothers described beliefs that adolescent sexual activity is normal and expected. Mothers expressed conflicting feelings, a desire for sons to wait until marriage for sex and the belief that their sons would have sex prior to marriage. Two-prong message Mothers discussed the importance of getting a good education and establishing healthy relationships.
Mothers most often promoted delayed sexual debut and condom use by discussing the consequences of sexual activity. Additionally, sons discussed how becoming a teen parent can negatively impact future plans. Mothers also stressed the impact of sexual activity on the formation of healthy relationships.
They noted that youth should focus on their education rather than sex. Finally, mothers described how they clearly expressed their expectation for sons to delay sexual debut. Concordance In step two, we conducted a concordance analysis between mother and son qualitative data.
While most mother-son dyads felt comfortable communicating, two sons who expressed discomfort communicating had mothers who also reported feeling uncomfortable.
Six mothers believed their sons would tell them when they were going to have sex. Survey results In step three, we used mixed methods to analyze the results of the subgroup survey Table 1 given to sons and results of the qualitative data at the level of inference.
Five mother and son dyads indicated during the interview that they had not started talking about sexual health. However, in the survey, all 25 sons indicated some level of conversation with their parents regarding sexual health topics. While all sons reported during interviews that their mothers had talked to them about waiting, 10 sons reported on their survey that they had never talked with their parent about waiting to have sex until they were older or married.
Seven mothers reported not discussing a risk reduction message. While 18 sons indicated during the interview that they had received a message to use condoms, 12 sons indicated on the survey that they had never talked about condoms. Only five sons reported on both the survey and in the interview that they had never talked about condoms with their parents. Topics Adolescents N General sexual health How many times has your parent ever talked to you about dating or going out with a boy or a girl?