A Multipronged, Community-Partnered Intervention (The TALK) to Improve Parent-Adolescent Communication About Sexual Health and Racial Discrimination Among Black Male Adolescents and Young Adults and Their Caregivers: Protocol for a Feasibility and Acceptability Study.

backgroundUnsafe sexual behaviors among Black male adolescents and young adults increase their susceptibility to negative health outcomes that widen persistent health disparities. Parent-adolescent relationships and communication can impact Black male adolescents and young adults' sexual health behaviors, but parents and adolescents often lack knowledge and effective tools to improve health outcomes. Culturally tailored sexual health interventions that integrate the intersectionality of race, gender, family, and social influences on sexual health are limited yet needed to reverse these trends.

objectiveThis project aims to develop a nurse-led multipronged intervention, The TALK, which is a parent-centered, adolescent-involved health promotion intervention for Black male adolescents and young adults.

methodsThis mixed methods study uses a community-engagement approach to develop and pilot a parent-centered eHealth intervention. There are 3 research phases: development, usability for community of interest, and testing for real world usability. First, The TALK development is tested with parents and caregivers by using the dscout platform, a digital platform for virtual ethnographic research used to explore early-stage user experience. Second, we will recruit parent-adolescent dyads for a pretest-posttest survey data collection to examine the usability, acceptability, and preliminary intervention outcomes. This phase focuses on the frequency and quality of parent-adolescent sexual health and racial discrimination communication, improvements in knowledge of HIV testing, improvements in parent-adolescent conversations around racial discrimination, and its impacts on sexual health and improved perceived racial identity among Black adolescents. Third, we will examine the usability of the intervention's web-based modules through promotion in real-world settings of barbershops and beauty salons across North Carolina through signage (with a QR code to scan and access the website). We will measure the usability through website metrics, including page views, average time on page, average session duration, pages per session, bounce rate, and traffic sources.

resultsThis project was funded by the Gordon and Betty Moore Foundation and approved by the Duke University School of Nursing institutional review board in September 2022 (Pro00105116) for development with the community. Intervention components were developed in partnership with community partners in the first year. Data collection for phase 1 began in October 2022. Data collection for phase 2 began in July 2023 and ended in January 2024. Data analysis is scheduled for completion by July 2025. The primary and secondary results are expected to be published by January 2026.

conclusionsCulturally tailored interventions that include content on the intersectionality of race, gender, and family and social relationships combined with strategies to improve parent-adolescent communication have promise for promoting sexual health and racial identity among Black male adolescents and young adults. Our findings have the potential to influence intervention design and research for other populations and contribute to broader efforts to reduce health disparities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67403.