Methods: Data come from 585 parents of AI children (ages 10-17) in a randomized controlled trial of P2W in three Arizona cities. Parents were recruited by urban Indian centers in their city, and were randomly assigned to P2W or to an informational family health curriculum, Healthy Families in 2 Worlds (HF2W) that was not culturally tailored. Both P2W and HF2W consisted of 10 workshops delivered weekly by AI community facilitators. Parents received incentives for attendance and survey data collection: 98% consented to complete self-administered questionnaires, with pretests at the first workshop and post-tests at the last workshop. We tested the efficacy of P2W versus HF2W through baseline adjusted regression models, employing random effects for city/site and facilitator and FIML missing data estimation, controlled for dosage (# workshops attended), and investigated whether intervention effects differed depending on the gender of the parent or of the adolescent.
Results: Most participants (77%) were female and had annual incomes under $10,000 (56%). On average parents were 38 years old, had lived for 14 years on a reservation, and resided in the city for 18 years. They were affiliated with 31 different AI tribes. P2W parents reported significantly larger pretest to post-test increases than HF2W parents on measures of communication with their adolescents about sexuality, safe sex, and pubertal physical changes. These desired program effects for P2W participants achieved medium size and did not differ significantly for male and female parents, but effects were stronger for parents of adolescent sons than of daughters.
Conclusions: Culturally grounded parenting interventions like P2W effectively strengthen parenting practices among urban AI families that can reduce adolescent risky sexual behaviors.