CDC COMMUNITY GUIDE: 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.

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.

To modify adolescents' risk and protective behaviors by improving their caregivers' parenting skills based on sufficient evidence of effectiveness in reducing adolescent risk behaviors.

Although the estimated effects varied substantially and were not statistically significant, risk behaviors decreased and youth participants reported increased refusal skills and self efficacy for avoiding risky behaviors in the future.

Results from the Systematic Reviews:
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