Table 2.
Ecological Factors that Impact PCSC Sex Communication
| Ecological Level | Description | References |
|---|---|---|
| Microsystem | ||
| Adolescent milestones as cues | Parents use observable pubertal changes and children’s emerging sexual or romantic interests during adolescence as cues to initiate conversations about sex. Parents wait until their children are physically mature, as evidenced by breast development or menses, before initiating sex communication. For example, sex communication is triggered when daughters become more inquisitive about boys or after observing their son’s physical development or only after parents believed their children were sexually or romantically involved. Moreover, parents are less likely to talk with teens they believed are not romantically involved. Social milestones used as a reminder to discuss sex and developmental changes include times when children begin having sex education classes in school and when discussing preventive sexual health issues on general such as HPV vaccines. | Askelson et al., 2011; Cox, Scharer, Baliko, & Clark, 2010; Eisenberg, Sieving, Bearinger, Swain, and Resnick, 2006; Hannan, Happ, & Charron-Prochownik, 2009; Lehr, Demi, Dilorio, & Facteau, 2005; Marhefka, et.al., 2009; McRee et al., 2012; Miller et al., 2009; Ohalete, 2007; Swain, Ackerman, & Ackerman, 2006a |
| Closeness and comfort level | The closeness and comfort level adolescents have with parents is associated with sex communication. More sex communication is associated with greater parent-child closeness. Further, greater parent comfort with sex communication explains direct guidance, such as face-to-face discussions, and a higher number of sex topics discussed. Additionally, parental comfort in discussing general and specific topics increases over time. Approachability and responsiveness also affects sex communication. Mothers who are approachable foster trust and are able to assess daughters’ readiness to talk. Mothers with the highest responsiveness had significantly increased odds of discussions about abstinence, puberty, and reproduction. Meanwhile, paternal discomfort is interpreted as a lack of caring or being judgmental of children’s thoughts or actions, and keeps daughters away. | Boyas, Stauss, & Murphy-Erby, 2012; Corona et al., 2009; DiIorio et al., 2006; Fasula & Miller, 2006; Guzman et al., 2003; Hutchinson & Montgomery, 2007; Jerman & Constantine, 2010; Martin & Luke, 2010; McRee et al., 2012; Miller et al., 2009; E. M. Morgan, A. Thorne, & E. L. Zurbriggen, 2010; Nielsen, Latty, & Angera, 2013; Noone & Young, 2010; Pluhar, DiIorio, & McCarty, 2008; Solebello & Elliott, 2011; Woody, Randal, & D’Souza, 2005 |
| Embarrassment | For a majority of parents, discussions about sex are associated with embarrassment. Despite being cognizant of the need to address sex with their children, parents anticipate a conversation that will cause frustration and discomfort for both parties. Even among a group of urban-dwelling parents with advanced educational degrees, the embarrassing notion of someday discussing sex with their children is identified as potentially getting in the way of sex communication. Adolescents too are generally dismissive of parents’ attempts to discuss sex and are also embarrassed by the exchange. Sons joke and employ sarcasm with their parents during these talks while daughters admit that discussing sex with their parents is avoided. Overall, older adolescents tend to display higher levels of negative affect than younger children when probed by their mothers about sexuality matters. | Afifi, Joseph, & Aldeis, 2008; Ballard & Gross, 2009; Cox et al., 2010; DiIorio et al., 2006; Eastman, Corona, Ryan, Warsofsky, & Schuster, 2005; Elliott, 2010b; Fitzharris & Werner-Wilson, 2004; Guilamo-Ramos et al., 2006; Jerman & Constantine, 2010; McKee & Karasz, 2006; Meneses, Orrell-Valente, Guendelman, Oman, & Irwin, 2006; Noone & Young, 2010; Romo, Nadeem, Au, & Sigman, 2004; Rose, Friedman, Annang, Spencer, & Lindley, 2014; Wilson & Koo, 2010 |
| Extended family members | Parental silence is a roadblock that results in other family members stepping in and becoming resources for sex. Children sometimes opt to talk to aunts and grandparents. Stepmothers are seen as less judgmental, more accepting, and less inclined to worry when compared to their own mothers. Further, familismo among Latino families allow adolescents to discuss sexual issues with extended family members, including talks about romance. | Cornelius, LeGrand, & Jemmott, 2008; Crohn, 2010; Guzman et al., 2003; Pluhar & Kuriloff, 2004; Wisnieski, Sieving, & Garwick, 2015 |
| Mesosystem | ||
| Parental Education | Parental education is positively associated with sex communication; discussions are more likely to occur with mothers who have a college degree or parents with more formal schooling. More educated Latina mothers probe more about children’s sexuality-related activities and questions, while paternal education predicted sex communication with both Latino sons and daughters. Nevertheless, fathers with less education have also been reported to engage in more sex communication. | Kim & Ward, 2007; Lefkowitz, Boone, Au, & Sigman, 2003; Lehr et al., 2005; McRee et al., 2012; Raffaelli & Green, 2003; Romo et al., 2004; Stidham-Hall, Moreau, & Trussell, 2012 |
| Religiosity | There are mixed results about the role religion plays in how conversations about sex are framed. Several reports support the idea that religion impacts sex communication. In rural South Carolina, mothers used faith-based messages with their children where “biblical instruction should be sufficient to prevent the adolescent from engaging in sexual activity,” p. 189, (Cox et al., 2010). Less religious mothers initiate sex communication earlier compared to their religious counterparts and parents in the southern U.S. are receptive to faith-based and church-led sex discussions with their children. Regnerus (2005) found that higher parental religiosity was linked to fewer discussions and greater unease in talking about sex. Further, religious affiliation and church attendance contributed to less frequent conversations about birth control and were associated with more discussions about the moral implications of adolescent sexual activity. Adolescents who discussed safer sex with their parents reported less church attendance compared to their peers who did not discuss safer sex, but attended church more frequently. However, there are a handful of studies that do not link religiosity and parent-child sex communication where reports of religiosity did not determine the amount of time Latina mothers talked both implicitly and explicitly about abstinence and contraceptive use, despite being Catholic. | Afifi et al., 2008; Baier & Wampler, 2008; Cornelius, Cornelius, & White, 2013; Cox et al, 2010; El-Shaieb & Wurtele, 2009; Hertzog, 2008; Lefkowitz et al., 2003; Nadeem, Romo, & Sigman, 2006; Ohalete, Georges, & Doswell, 2010; Pluhar et al., 2008; Regnerus, 2005; Romo, Bravo, Cruz, Rios, & Kouyoumdjian, 2010; Swain et al., 2006; Williams, Pichon, & Campbell, 2015 |
| Exosystem | ||
| Mass Media | Mass media emerged as the most influential factor in the exosystem and its impact occurs in two distinct ways. First, the perceived negative effects of highly sexualized media content on impressionable minds compel parents to discuss sex-related issues with their children. Even among parents who found it challenging to verbalize their concerns about sex, a form of indirect sex communication included restricting media use by Asian American children to convey disapproval of Western sexuality. Second, many parents used examples from TV as opportunities to broach sex-related issues. For example, in a study about how mothers discuss sexuality with daughters born with Type 1 Diabetes, mothers recalled addressing reproductive health when sexually explicit content appeared on TV. Similarly, the internet has been used by parents to assist their children to find sexuality-related resources to complement discussions they had about sex. | Aronowitz, Todd, Agbeshie, & Rennells, 2007; DiIorio et al., 2006; Eastman et al., 2005; Edwards & Reis, 2014; Hannan et al., 2009; Kim, 2009; McRee et al., 2012; Noone & Young, 2010; Pluhar & Kuriloff, 2004 |
| Macrosystem | ||
| Race/Ethnicity | Race and ethnicity affects how sex communication occurs in various ways. In a diverse sample of adolescents from the Midwest, Caucasian children reported more sex communication when compared to African American and Latino/Hispanic children. African American adolescents received significantly more paternal communication than Caucasians did, and Caucasians received more sex communication from fathers than Hispanic adolescents did. Data from a national study found that Asian and Latina mothers reported the most infrequent amounts of sex communication. Among Asian families, mothers, more than fathers, are the sources of sexual information, but there is also a “don’t ask, don’t tell” policy in which both parties avoid communication about sex to avoid tension. Parents of Latino children tend to use direct rather than indirect communication about sexuality. Discussing sex as improper was associated with less perceived openness in general communication by both Latina mothers and daughters. On the contrary, tener confianza (“instilling confidence”) observed among Latino parent-child dyads underscores confiding in parents and seeking their advice, keeping information confidential and having non-punitive responses to children’s disclosures. Among Asian American children, indirect sex communication included gossiping to convey sexual values along with imposing rules that constrained how daughters dress and socialize. Cultural differences between immigrant parents and their U.S.-born children that impede sex communication are consistently noted, with more adolescent acculturation predicting less frequent discussions about sex. For example, the varying ability of parents to speak to their children in English or the conservative upbringing of Latina mothers clash with children’s sexual mores. In Asian American families, a cultural divide caused both groups to withdraw from family communication about sex to avoid conflict and preserve harmony. Nonetheless, migrating to the U.S. has also been pointed out by fathers as causing a transformation in traditional views about children’s sexuality. |
Chung et al., 2005; Chung et al., 2007; González-López, 2004; Kim & Ward, 2007; McKee & Karasz, 2006; Meneses et al., 2006; Meschke & Dettmer, 2012; Murphy-Erby, Stauss, Boyas, & Bivens, 2011; Orgocka, 2004; Raffaelli & Green, 2003; Romo, Bravo, Cruz, Rios, & Kouyoumdjian, 2010; Sneed, 2008; Somers & Vollmar, 2006; Tobey, Hillman, Anagurthi, & Somers, 2011 |
| Gendered Content | There are differences in what parents tell males compared to what they tell females during sex discussions. Females are held to a stricter moral standard compared to males. Daughters recalled discussing delaying sex until marriage while more males discussed condom use. Similarly, college-aged women remembered receiving restrictive sex messages, including warnings about the opposite sex, while young men received positive sex messages, including the inevitability of sex before marriage. According to parents, daughters have to value themselves in order to avoid being taken advantage of, while sex communication with sons are more about taking responsibility for behaviors and treating women with dignity and respect. Fathers wanted to teach their sons to grow up heterosexual by modelling masculine behavior and giving tacit permission when sons are caught watching pornography. Among Asian and Latino families, parents are explicit about their expectations for their daughters’ dignified behaviors out of concern for family reputation while sons do not receive the same messages. | Akers, Schwarz, Borrero, & Corbie-Smith, 2010; Akers, Yonas, Burke, & Chang, 2011; Aronowitz et al., 2007; Averett, Benson, & Vaillancourt, 2008; Brown, Rosnick, Webb-Bradley, & Kirner, 2014; Dennis & Wood, 2012; Elliott, 2010a; Gilliam, 2007; González-López, 2004; Guilamo-Ramos et al., 2006; Heisler, 2014; Kapungu et al., 2010; Kim & Ward, 2007; Martin & Luke, 2010; Morgan, Thorne, & Zurbriggen, 2010; Murphy-Erby et al., 2011; Sneed, Somoza, Jones, & Alfaro, 2013; Solebello & Elliott, 2011; Stauss, Murphy-Erby, Boyas, & Bivens, 2011; Wilson & Koo, 2010 |
| Socioeconomic Status | A family’s socioeconomic status influences the content of sexual communication. Low income minority parents reported more discussion about the negative consequences of sex and where to obtain birth control, compared to higher income Caucasian parents. Scripts explicitly about postponing sexual intercourse or involvement in a relationship are recalled mostly by low income girls, while girls from higher income households have fewer explicit discussions about sexual risks, but more conversations about good decision-making and life opportunities. Similarly, Latina mothers from a lower socioeconomic background talked more to their daughters about avoiding risky situations and engaging in self-protective practices, while those with a higher socioeconomic status had longer discussions about positive sexuality, and contraceptive use. | Romo et al., 2010; Swain, Ackerman, & Ackerman, 2006b; Teitelman & Loveland-Cherry, 2004 |