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Parent-Adolescent Communication About Sex in Filipino American Families: A Demonstration of Community-Based Participatory Research

  • Paul J. Chung
    Correspondence
    Address correspondence to Paul J. Chung, MD, MS, Department of Pediatrics, David Geffen School of Medicine at UCLA, MDCC 12-325, 10833 LeConte Ave, Los Angeles, CA 90095
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Hena Borneo
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Shelley D. Kilpatrick
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Donna M. Lopez
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Raphael Travis Jr
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Camillia Lui
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Shefali Khandwala
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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  • Mark A. Schuster
    Affiliations
    From the Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif (Drs Chung and Schuster); UCLA/RAND Center for Adolescent Health Promotion, Los Angeles, Calif (Dr Chung, Ms Borneo, Dr Kilpatrick, Ms Lopez, Mr Travis Jr, Ms Khandwala, and Dr Schuster); Asian American Drug Abuse Program Inc, Los Angeles, Calif (Dr Lui); RAND Health, Santa Monica, Calif (Dr Schuster); and the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Schuster)
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      Objectives.—Pregnancy rates among Filipino American adolescents exceed those of other Asian and Pacific Islander adolescents. Strong parent-adolescent communication may promote healthy sexual development and protect against adolescent sexual risk behaviors. We explored communication barriers between Filipino American parents and adolescents.
      Methods.—Using community-based participatory research (CBPR), we collaborated with Filipino American community leaders, parents, and adolescents to design a focus-group study. Trained bilingual moderators conducted focus groups with 85 Filipino Americans (41 parents and grandparents and 44 adolescents aged 14–18 years) from various neighborhoods in Los Angeles. Sessions were recorded, transcribed, coded, and analyzed for themes.
      Results.—Focus-group participants appeared to divide sex information into 3 categories, which we termed facts, feelings, and values. Adolescents emphasized facts and feelings. Parents and grandparents emphasized facts and values. In general, facts were obtained through school, feelings through friends, and values through parents. The focus groups identified large barriers to value transmission, stemming from adolescent acculturation to the United States. Parents and grandparents felt that values were transmitted best through traditional Filipino respect for parents who often eschewed open discussion. Adolescents believed that open discussion was necessary for value transmission to occur. The result was bilateral withdrawal from family communication about sex.
      Conclusions.—Our focus groups found that parent-child communication about sex, especially regarding values, was limited. Potential causes included conflicts between Filipino and US beliefs regarding respect for parents and open discussion. Our results raise important questions about the effect of acculturation on sex education for Filipino American adolescents and demonstrate potential advantages of CBPR.

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