Families Talking Together
Vincent Guilamo-Ramos, Ph.D., MPH, LCSW, RN; James Jaccard, Ph.D.; and Patricia Dittus, Ph.D.
Families Talking Together is a parent-based intervention to prevent and/or reduce sexual risk behavior among Latino and African American adolescents. The main components of the intervention are parent discussions with an interventionist and a family workbook designed to teach parents effective communication skills, build parent-adolescent relationships, help parents develop successful monitoring strategies, and teach adolescents assertiveness and refusal skills. The program can be delivered to parents either individually or in small group sessions, in a range of settings.
The program was designed for and tested with African American and Latino parents of youth ages 10 to 14 years old.
The program is designed for and evaluated in various comunity-based settings, including health clinics, after school, or in the home.
For curriculum, materials, and pricing information, please contact:
Vincent Guilamo-Ramos, Ph.D., M.P.H., L.C.S.W., R.N., ANP-BC, PMHNP-BC, FAAN
Email: Vmg243@nyu.edu
Phone: 917-565-1244
For training and support, please contact:
Vincent Guilamo-Ramos, Ph.D., M.P.H., L.C.S.W., R.N., ANP-BC, PMHNP-BC, FAAN
Email: Vmg243@nyu.edu
Phone: 917-565-1244
| Category | Component | Core Component | Component present | Notes | Lesson number(s) / activities where present |
|---|---|---|---|---|---|
| Content | Graduating from high school | No | No | ||
| Content | Anatomy/physiology | No | No | ||
| Content | Other | No | No | ||
| Content | Volunteering/civic engagement | No | No | ||
| Content | Spirituality | No | No | ||
| Content | Morals/values | No | Yes (both versions) | Families Talking Together Workbook, Module 2: page 9. | |
| Content | Identity development | No | Yes (both versions) | Families Talking Together Workbook, Module 2: pages 5 - 9. Module 7: pages 1 - 7. | |
| Content | Social support/capital | No | Yes (both versions) | Families Talking Together Workbook, Module 6: pages 1 - 2. |
|
| Content | Social influence/actual vs. perceived social norms | Yes | Yes (both versions) | Families Talking Together Workbook, Module 6: pages 3 - 7. |
|
| Content | Social competence | No | No | ||
| Content | Parenting skills | Yes | Yes (both versions) | Families Talking Together Workbook, Module 1: page 3. Module 2: pages 10 - 11. Module 3: pages 2 - 12. Module 5: pages 2 - 7. Module 7: pages 5 - 7. Module 8: pages 24 - 25. The Basics, Modules 3 and 5. |
|
| Content | Normative beliefs | Yes | Yes (both versions) | Families Talking Together Workbook, Module 2: pages 6 - 7. | |
| Content | Leadership | No | No | ||
| Content | Gender roles | No | No | ||
| Content | Gender identity | No | No | ||
| Content | Cultural values | No | Yes (both versions) | Families Talking Together Workbook, Module 2, page 7. Module 3: page 9. Module 7: page 4. | |
| Content | Connections with trusted adults | Yes | Yes (both versions) | Families Talking Together Workbook, Module 5: pages 2 - 7. The Basics, Module 5 |
|
| Content | Conflict resolution/social problem solving | No | Yes (both versions) | Families Talking Together Workbook, Module 3: pages 8 - 12. Module 5: pages 2 - 7. The Basics, Module 5. |
|
| Content | Communication skills | Yes | Yes (both versions) | Families Talking Together Workbook, Module 6: pages 4 - 9. The Basics, Module 8. Teen Relationships, page 8. |
|
| Content | Child development | No | Yes (both versions) | Families Talking Together Workbook, Module 2: pages 1 - 9. | |
| Content | Boundary setting/refusal skills | Yes | Yes (both versions) | Families Talking Together Workbook, Module 3: pages 11 - 12. Module 6: pages 4 - 7. The Basics, Module 8. Teen Relationships, page 8. |
|
| Content | Substance use cessation | No | No | ||
| Content | Substance use - Other drugs | No | No | ||
| Content | Substance use - Alcohol | No | Yes (both versions) | Families Talking Together Workbook, Module 1, pages 2 -3. Module 6, page 7. Module 8, page 25. | |
| Content | Substance use - Abstinence | No | No | ||
| Content | Brain development and substance use | No | No | ||
| Content | Vocational/skills training | No | No | ||
| Content | Supplemental academic services | No | No | ||
| Content | School engagement | No | No | ||
| Content | College preparation | No | No | ||
| Content | Alternative schooling | No | No | ||
| Content | Self-regulation | No | Yes (both versions) | Families Talking Together Workbook, Module 6: pages 4 - 9. The Basics, Module 8. |
|
| Content | Self-esteem | No | Yes (both versions) | Families Talking Together Workbook, Module 7. | |
| Content | Self-efficacy/empowerment | Yes | Yes (both versions) | Families Talking Together Workbook, Module 8: pages 4 - 9. The Basics, Module 8. |
|
| Content | Resilience | No | No | ||
| Content | Sexual health | Yes | Yes (both versions) | Families Talking Together Workbook, Module 8, pages 12 - 24. Teen Relationships, pages 2 - 4. |
|
| Content | STIs - Treatment | No | No | ||
| Content | STIs - Screening | No | No | ||
| Content | STIs - Prevention | Yes | Yes (both versions) | Families Talking Together Workbook, Module 8: pages 2 - 28. Module 9: pages 2 - 13. The Basics, Module 8. Teen Relationship, pages 5 - 8. Birth Control and Protection, pages 1 - 8. |
|
| Content | STIs - Information | No | Yes (both versions) | Families Talking Together Workbook, Module 8: pages 2, 26 - 27. Module 9: page 6. Teen Relationships, page 5. Birth Control and Protection, page 2. National Fact Sheet. |
|
| Content | Sexual risk reduction | Yes | Yes (both versions) | Families Talking Together Workbook, Module 8: pages 2 - 27. Module 9: pages 4 - 13. The Basics, Modules 1 and 8. Teen Relationships, pages 5 - 8. Birth Control and Protection, pages 1 - 8. |
|
| Content | Sexual risk discontinuation | No | No | ||
| Content | Personal vulnerability | No | Yes (both versions) | Families Talking Together Workbook, Module 5: pages 2 - 7. The Basics, Module 5. |
|
| Content | Sexual orientation | No | No | ||
| Content | Maternal health | No | No | ||
| Content | Contraception - Condoms | No | Yes (both versions) | Families Talking Together Workbook, Module 9, pages 5, 6, 11 - 13. Birth Control and Protection, pages 1, 2, 6 - 8. |
|
| Content | Contraception - Long-acting reversible contraceptives | No | No | ||
| Content | Contraception - Other | No | No | ||
| Content | Contraception - Pills, patches, rings, and shots | No | No | ||
| Content | Reproduction | No | No |
The program seeks to prevent and/or reduce sexual risk behavior by: 1) increasing effective communication skills; 2) building parent-adolescent relationships; 3) helping parents develop successful monitoring strategies; and 4) teaching adolescents assertiveness and refusal skills.
Families Talking Together (FTT) consists of four components: (1) individual or group face-to-face sessions with FTT trained interventionist; (2) a family workbook and discussion guide entitled “The Basics;” (3) a health care provider’s endorsement of the intervention to adolescents and parents, conveying the importance of parent-adolescent communication about sexual health and the utility of the FTT program; and (4) one phone booster session one month after the face-to-face session(s) to reinforce the FTT messages and ascertain whether additional support with parent-adolescent communication is indicated.
Program Manual: Every parent receives a family workbook that includes nine parent modules about how to talk to your adolescent teen about sex, and two teen modules about teen relationships and birth control and protection from STIs. In addition, each parent receives a communication guide entitled “The Basics,” which is used during the intervention sessions(s) to guide implementation. The family workbook is intended to provide parents with specific evidence-based strategies for communicating with their teen about sexual health. Parents can decide whether to share the teen materials with their adolescent children. The first nine modules focus on topics for parents, such as adolescent development and self-esteem, parenting strategies and communication skills, and adolescent sexual behavior. The teen modules cover teen relationships and birth control and protection. The modules are intended to promote communication about adolescent development and sexual health between adolescents and their parents. The materials are available in English and Spanish. Three versions of FTT are available, with one tailored to African American parents, one tailored to Latino parents, and an alternative version that can be used with families that are not African American or Latino.
Individual or Group Sessions: The family workbook is distributed to parents in face-to-face individual or small group sessions facilitated by trained FTT interventionists. The sessions primarily focus on teaching parents how to use the program manual and how to structure conversations with their adolescent children. In addition, parents and FTT interventionists discuss the topics covered in the program manual, such as communication strategies and parental monitoring.
Families Talking Together is based on two theoretical frameworks, a Theory of Adolescent Sexual Risk Behavior and a Theory of Parent-Adolescent Influence. The program specifically links the theories on adolescent sexual behavior with parental influence. A program logic model is available from the developer.
The program is delivered through the interventionist targeting parents through individual or small group discussions. Parents implement the program through the use of the family workbook and individual discussions with their teen.
The number and length of sessions may vary according to the delivery setting. Typically, parents receive one or two sessions, each lasting around 30-45 minutes. The program has been delivered to individuals by trained interventionists (e.g. community health workers, health professionals) in clinics and community-based settings such as schools. Additional booster sessions may be delivered to parents after the end of the program.
The program should be delivered by trained facilitators.
Core intervention materials include a family workbook (parent and teen modules) and supplementary videos. All program materials can be accessed by contacting the developers at clafh@nyu.edu. Formal use of Families Talking Together requires training by the program developers.
None specified
The program has a logic model, and fidelity checklist (available in English and Spanish) for practitioners or researchers to monitor fidelity. The fidelity checklist outlines the key components that should be covered with the parent to ensure program fidelity. Evaluation tools are also available from the developer for assessing program outcomes.
Staff delivering the Families Talking Together intervention are required to complete, at minimum, a 40 hour approved training from the program developers that covers the essential components of the intervention. Upon successful completion of the Families Talking Together training, interventionists will receive a certificate stating that they can effectively use the program within their own setting or organization. Those interested in training can contact clafh@nyu.edu for details.
Programs requiring technical assistance resources or guidance on implementing Families Talking Together can contact clafh@nyu.edu with specific questions.
The Families Talking Together intervention allows adaptations provided they obtain the developers’ approval. Families Talking Together is designed to work in both individual and small group contexts. Specifically, the program can be delivered one-on-one with the interventionist and the parent (or primary adult care-giver) or in small group contexts. The developer should be contacted for formal approval of potential adaptations of the program.
| Citation | High-Quality Randomized Trial | Moderate-Quality Randomized Trial | Moderate-Quality Quasi-experiment | Low Study Rating | Did Not Meet Eligibility Criteria |
|---|---|---|---|---|---|
| Guilamo-Ramos et al. 2020 |
✓ | ||||
| Guilamo-Ramos, Bouris, et al. 2011 |
✓ | ||||
| Guilamo-Ramos, Jaccard, et al. 2011 |
✓ | ||||
| Santa Maria et al. 2021 |
✓ |
| Citation | Setting | Majority Age Group | Majority Racial/Ethnic Group | Gender | Sample Size |
|---|---|---|---|---|---|
Guilamo-Ramos et al. 2020 |
Health clinic or medical facility | 13 or younger | Hispanic or Latinx of any race | Youth of any gender | 900 |
Guilamo-Ramos, Bouris, et al. 2011 |
Health clinic or medical facility | 13 or younger | Hispanic or Latinx of any race | Youth of any gender | 264 |
Guilamo-Ramos, Jaccard, et al. 2011 |
After school | 13 or younger | Hispanic or Latinx of any race | Youth of any gender | 2016 |
Santa Maria et al. 2021 |
After school, In school: Middle school | 13 or younger | Hispanic or Latinx of any race | Youth of any gender | 508 |
Evidence by Outcome Domain and Study
| Citation | Sexual Activity | Number of Sexual Partners | Contraceptive Use | STIs or HIV | Pregnancy |
|---|---|---|---|---|---|
Guilamo-Ramos et al. 2020 |
|
n.a. | n.a. | n.a. | n.a. |
Guilamo-Ramos, Bouris, et al. 2011 |
|
n.a. | n.a. | n.a. | n.a. |
Guilamo-Ramos, Jaccard, et al. 2011 |
|
n.a. | n.a. | n.a. | n.a. |
Santa Maria et al. 2021 |
|
n.a. | n.a. | n.a. | n.a. |
| Citation | Details |
|---|---|
Guilamo-Ramos et al. 2020 |
This study used a randomized controlled trial involving Hispanic or African American youth ages 11–14. Mothers and their children were recruited as dyads from a pediatric clinic in the New York City area. Dyads were randomly assigned to either a treatment group that received the Families Talking Together program or to a control group that did not receive any program. During the 45–60-minute single-session program, health care providers discussed sexual risks for teenagers and the importance of good parent-adolescent communication on these topics. In addition, parents were given program materials and encouraged to use them to talk to their children about the program's content. This was followed by one phone call at one-month post-program to check in with the parents and encourage them once more to talk to their children. Data from parents and children were collected immediately before the program (baseline), and three months and 12 months after study enrollment. The study found that 12 months after enrolling in the study, teenagers who participated in the program were significantly less likely to report having had vaginal sex (effect size = -0.84) and having had their sexual debut in the past 12 months (effect size = -0.76). The study also examined program impacts on the children's knowledge about healthy relationships and dating; their self-esteem; attitudes and knowledge about leadership; healthy life skills; knowledge about the process of career and decision making; knowledge about career readiness, college readiness, sexual risk, and condom use; confidence in |
Guilamo-Ramos, Bouris, et al. 2011 |
The program's evidence of effectiveness was first established in a randomized controlled trial involving African American and Latino adolescents recruited in the waiting room of a community-based pediatric health clinic in the Bronx borough of New York City. The adolescents and their mothers were randomly assigned to either a treatment group that was offered the program or to a control group offered the current standard of care. Surveys were administered immediately before random assignment (baseline) and again nine months later. The study found that nine months after the program ended, adolescents in the treatment group were statistically significantly less likely to report ever having engaged in vaginal intercourse and a significantly lower frequency of sexual intercourse in the past 30 days. The study found no statistically significant program impacts on rates of oral sex. |
Guilamo-Ramos, Jaccard, et al. 2011 |
A separate study by the same group of researchers evaluated the effectiveness of Families Talking Together (FTT) relative to another teen pregnancy prevention program, Making a Difference (MAD). The study used a randomized controlled trial involving Latino and African American adolescents from five New York City middle schools. The adolescents and their mothers were randomly assigned to one of three research groups: (1) a group receiving FTT alone, (2) a group receiving MAD alone, or (3) a group receiving both FTT and MAD together. The programs were offered after school and on weekends, outside of regular school hours. Surveys were administered immediately before random assignment (baseline) and 12 months later. The study found that at the time of the 12-month follow-up survey, there was no statistically significant difference in rates of sexual intercourse between students in the group that received FTT and those in the group that received MAD. The study also examined program impacts on frequency of intercourse. Findings for this outcome were not considered for the review because they did not meet the review evidence standards. Specifically, findings were reported only for subgroups of youth defined by sexual activity at follow-up. Program impacts were also examined on measures of mother-adolescent communication, maternal monitoring and supervision, perceived maternal expertise and trustworthiness, satisfaction with mother-adolescent relationship, and social desirability tendencies. Findings for these outcomes were not considered for the review because they fell outside the scope of the review. |
Santa Maria et al. 2021 |
This study used a randomized controlled trial involving medically underserved youth ages 11–14. Parents and their children were recruited as dyads from 22 after-school programs and 19 charter schools in the Houston, Texas, area. Dyads were randomly assigned to either an intervention group that received Families Talk Together and HPV vaccination education program (FTT + HPV) or a control group that received a program on strategies to prevent obesity. Parents of youth in both groups received an approximately 45-minute program from student nurses, took the materials home, and were encouraged to use them to talk to their children. This initial treatment was followed by two phone calls at one month and three months post-program to monitor parents' progress and support them with any communication problems. Data from parents and children were collected immediately before the program (baseline), and at one month and six months after study enrollment. The study found at both one month and six |