1. PARENTS’ BEHAVIOR INFLUENCES ADOLESCENTS’ HEALTH – PROMOTING BEHAVIORS Lynn Rew, EdD, RN, AHN-BC, FAAN Kristopher L. Arheart, EdD Micajah Spoden, BS

2. ACKNOWLDGEMENT  Funded by National Institute of Nursing Research/National Institutes of Health [R01 NR0039856], Lynn Rew, Principal Investigator.

3. HEALTH-RISK BEHAVIORS IN ADOLESCENCE  Smoking  Drinking  Illicit drug use  Unsafe sexual practices  Use of tobacco products and marijuana

4. HEALTH-PROMOTING BEHAVIORS IN ADOLESCENCE  Safety: use of seat belts and helmets  Nutritional diet  Sufficient sleep  Physical activity  Managing stress

5. SOCIALIZATION: NEW ROLES  Elementary to middle school  Middle school to high school  Religious institutions/organizations

6. KNOWLEDGE GAP  Known: influence of peers on adolescent’s behavior, especially on health- risk behaviors  Unknown: influence of parents’ behavior on adolescent’s health- promoting behaviors

7. SPECIFIC AIM  Determine the influence of parental monitoring, parenting style, and parental self-care behaviors on adolescents’ health-promoting behaviors.

8. CONCEPTUAL FRAMEWORK  Primary Socialization (Oetting & Donnermeyer, 1998)  Social Learning Theory  Primary socialization from parents, peers, schools, religious organizations  Parents promote prosocial behaviors  Adolescence: critical time, potential for learning deviant norms is highest

9. METHOD  Longitudinal study  IRB approval annually 5 years  Written consent from parents and assent from adolescents < 18 years.  Consent and assent obtained annually

10. SAMPLE  N = 1,081  Mean age = 17 (SD 0.6) years  43% Male  44% Hispanic  28% Non-Hispanic White12% Non-Hispanic Black6% other/unk

11. VALID MEASURES  Translated: English >> Spanish >> English  Self-report from parents when adolescent enrolled in study as freshman in high school.  Self-report from adolescents when they were juniors and seniors in high school.

12. PARENT’S DATA  Religious commitment: 10 items, 5-point Likert scale  I often read books and magazines about my faith.  Parent’s Self-Care Inventory  40 items  4-point Likert response Eat a nutritious breakfast? Practice good oral hygiene care (e.g., brushed and flossed your teeth)?

13. ADOLESCENT’S DATA  Parental Monitoring 8 items, 5-point Likert scale  My parents know where I am after school.  Parenting Style 16 items, 4-point Likert scale  She (he) listens to what I have to say.  Religious Commitment 10 items 5-point Likert scale  Same measure as parents’ religious commmitment

14.  Social Connectedness 10 items 4-point Likert scale  How much do you feel that adults care about you?  Peer Influence 15 items, 5-point Likert scale  How many of your friends drink alcohol. How often have friends asked you to drink alcohol?

15. ADOLESCENT LIFESTYLE QUESTIONNAIRE  43 items, 6-point Likert Scale  7 Domains of health-promoting behaviors:  Nutrition: I usually follow a healthy diet.  Physical activity: I participate in a regular program of sports/exercise at school.  Safety: When riding in an automobile, I wear a seatbelt.  Identity awareness: I like who I am.  Social support: If I had a problem, I have people I could turn to.  Health practices awareness: I read pamphlets, teen magazines about health topics.  Stress management: I exercise to control my stress.

16. DATA ANALYSIS  General Linear Models (GLM)  Adjusted for age, gender, race/ethnicity, and grade level  Significance: </= 0.05

17. RESULTS  Regression coefficients 10-40  Parent’s religious commitment (RC) and adolescent’s RC [ r = 0.50]  Most variance explained in domain of safety behaviors (40%)  Peer influence b = 0.27 SE = 0.02 p = < 0.001  Parental monitoring b = 0.25 SE = 0.03 p = < 0.001  Religious commitment b = 0. 06 SE = 0.02 p = < 0.001  Parenting style (resp) b = 0.11 SE = 0.03 p = < 0.001

18.  Least variance explained in nutrition (0.10)  Parental Monitoring significant in all behavioral domains  Parenting Style significant only for identity awareness, nutrition, and physical activity  Social Connectedness significant predictor for all domains except safety

19. DISCUSSION  Support for conceptual framework: Primary Socialization Theory  Parenting factors influenced adolescents’ health-promoting behaviors.  Surprising: peer influence positively related to safety—may motivate adolescents NOT to adopt health-risk behaviors (e.g., smoking)  Surprising: parents’ self-care behaviors contributed little—may be related to measure of adolescents’ HP behaviors, focuses on self- directed behavior and communication with friends and teachers.

20. LIMITATIONS  All variables, self-report  Single geographic area

21. CONCLUSIONS  Parenting behaviors such as monitoring an adolescent’s activities contribute to adolescent’s development of health-promoting behaviors.  Socializing agents of religious institutions and peers also influence an adolescent’s development of health-promoting behaviors.  Social connectedness is strong protective factor in adolescence.

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