The Effect of Computer-Mediated Parental Health Guidance on Risky Sexual Behaviors of In-school Adolescents in Nigeria

Abstract

Keywords

Computer-mediated, communication, parental, guidance, program

Introduction
The use of computer devices for interpersonal interactions has become a common among young and old persons. This type of communication is known as computer-mediated communication. According to McQuail (2005), this type of communication communication refers to interpersonal interactions that occur through the use of networked computer applications. Bishop (2009) asserted that computer-mediated communication involves the communications through social networking platforms (e.g., Facebook, 2go, WhatsApp, BBM, Badoo, Skype, Twitter, Instagram, Pinterest, Myspace, Skyrock, Usenet, YouTube, Foursquare), e-mails, blogs, video, audio, phone, and online calls. Walther's (1996) hyperpersonal communication model posited that computer-mediated communication is valuable in providing a better communication and better first impressions. In this study, computer-mediated communication is refers to interpersonal interactions between two or more persons via computerized devices such as phone, laptop and ipad.

Overtime, computer-mediated communication has continued to influence the behaviors of people including in-school adolescents. In-school adolescents, according to Otu (2016), are in-school adolescents are considered as individuals both male and female who are currently at adolescence period of life and are also currently in school. Campbell and Park (2014) observed that computer-mediated communication has become a primary resource for in-school adolescents to expand and test boundaries and as such, the in-school adolescents may engage in computer-mediated communication for social interaction which may invariably results in risky sexual behaviors.

Risky sexual behaviors are behaviors that increase individual�s risk of contracting sexually transmitted infections or experiencing unintended pregnancies. Sexual Health Center�s (2014) publication posited that risky sexual behaviors are behaviors that puts people at risk for sexually transmitted infections (STIs), unplanned pregnancy, and being in a sexual relationship before being mature enough to know what makes a healthy relationship. Such behaviors include: unprotected sexual intercourse without male or female condom use, except in a long-term, single-partner (monogamous) relationship, unprotected mouth-to-genital contact, except in a long-term monogamous relationship, early sexual activity, especially before the age of 18 years, having multiple sex partners, having a high-risk partner (one who has multiple sex partners or other risk factors), having anal sex or a partner who does, except in a long-term, single-partner (monogamous) relationship, having sex with a partner who injects or has ever injected drugs and exchange of sex (sex work) for drugs or money.

Authors found that adolescents� engagement in risky sexual behaviors could be as a result of their engagement in computer-mediated communication (Otu, 2016; Postmes, Spears & Lea, 2013; Moren, oBrockman, Wasserheit, and Christakis, 2012; Yu, 2011; Walther, 1996). Authors also observed that parental control and guidance could regulate adolescents� use of computer-mediated communication and risky sexual behaviors (Otu, 2016; Mohammadyari, 2013; Bersamin, Michael, Fisher, Hill, Grube and Walker, 2008; Sieverding, Adler, Witt and Ellen, 2005; Huebner and Howell (2003), Longmore, Manning, and Giordano (2001) and Chewning and Koningsfeld, 1998; DicClemente, Crosby, Sionean, Cobb, Harrington, Davies, Edward, Hook & Kim, 2001). But then, studies have not been found addressing how parents can regulate their in-school adolescents� engagement in computer-mediated communication and risky behaviors unless the present study.

Computer-mediated communication parental guidance (CMCPGP) was developed by Otusum Consult, Training & Services (2015). CMCPGP is a guidance system rendered by parents at home to regulate the children�s engagement in computer-mediated communication. One of the aims of CMCPGP is to help the parents prevent their children from engaging in risk sexual behavior through the use of computerized devices such as phone, laptop and ipad.

The rationale for the development of CMCPGP was based on the fact that in several studies proven that significant relationship exist between parental guidance and risky sexual behaviors and that computer-mediated communication relate significantly with risky sexual behaviors. For instance, Otu (2016) found that computer-mediated communication significantly correlate with risky sexual behaviors and that parenting styles mediate the relationship between computer-mediated communication and risky sexual behaviors. Mohammadyari (2013) observed that when parents provide warmth/support, appropriate monitor behavior, and practice discipline in non-coercive ways, adolescents are more likely to develop interpersonal security and consider boundaries that are involved in sexual activity. Bersamin, Michael, Fisher, Hill, Grube and Walker�s (2008) asserted that parental attitudes and mediation can delay potentially risky sexual behaviors among adolescents.

Sieverding, Adler, Witt and Ellen (2005) found out that parents are the primary resource to discuss sexual matters with their adolescents to help them prevent early sexual initiation and to monitor affects on sexual activity by restricting adolescent�s opportunities to engage in risky sexual behaviors. Huebner and Howell (2003), Longmore, Manning, and Giordano (2001) and Chewning and Koningsfeld (1998) observed that parental monitoring, adult supervision and parental support or intimate relationship with their children is associated with less sexual risk-taking in the future. Also, the observation made by DicClemente, Crosby, Sionean, Cobb, Harrington, Davies, Edward, Hook and Kim (2001) that, adolescents perceiving less parental monitoring are more likely to engage in risky sexual behavior. Therefore, it is pertinent to determine the effect of computer-mediated communication parental guidance on risky sexual behaviors of in-school adolescents so as to curtail the degree to which in-school adolescents engage in risky sexual behaviors.

METHODS
Participants
The participants were from 115 households from whom the researchers received invitation to deliver the intervention program to their children (in-school adolescents) who were identified as exhibiting risky sexual behaviors. The identification was done by their school counsellors and teachers and confirmed by the parents. The researchers had an accessible household population of 465 family members from Akwa Ibom State, Nigeria. It is from these households that 125 parents and 229 in-school adolescents that met the inclusion criteria were obtained. The socio-demographic information of the participants is shown in table 1.

As observed in Table1 25% of the parent participants were male parents with mean age of 47�.34 while 75% were female parents with mean age of 34�.67; that Christians was 58% with 46�.09 mean age while Islams was 42 % with 49�.78 mean age; and that 54% with mean age of 50�.08 constituted Urban representativeness while 46% with mean age of 47�.49 constituted rural representativeness. For in-school adolescents, 63% with mean age of 17�.09 were male participants while 37% with mean age of 16�.45 were female participants; 54% with mean age of 16�.10 represented Christian religion while 46% with 18�.59 represented Islamic religion; 52% with mean age of 15�.23 showed urban area representativeness and 48% with 17�.34 showed rural area representativeness.

Figure 1: Sample size of parents determination using G*power software.

The sample size of parents (N=125) based on an a priori statistical power (1-? err prob.) of 0.922 and effect size of 0.25 was determined using G*Power 3.1 software.

Figure 2: Sample size of in-school adolescents determination using G*power software.

The sample size of in-school adolescents (N=229) was determined based on an a priori statistical power (1-? err prob.) of 0.951 and effect size of 0.197 was determined using G*Power 3.1 software.

Procedure
The intervention program was advertised at different educational settings, religious services and social gatherings within Akwa Ibom State, Nigeria for up to two months. Interested households were requested to collect Informed consent, Willingness and Participation Interest Forms at their closest Local Education Authority. The forms were designed by the researchers based on the objectives of the study and were used to mobilize participants. Within the two months of advertisement, the researchers received invitation from 465 households to carry out the intervention program with them. The study�s inclusion criteria include participants scoring within the benchmark of computer-mediated communication engagement and risky sexual behaviors engagement; the potential participant must not be receiving other intervention program; they must own at least one computer-mediated communication device such as phone, laptop or ipad; they must have at least one account with social networking sites such as Facebook, Whatsapp, 2go, BBM or Twitter.

We also adapted a CMCPGP manual from Otusum Consult, Training & Services to guide the treatment process and it consisted of six months of full intervention and 2 months of follow-up meetings that marked the end of intervention. The 125 households who participated in the study were grouped into 10 and each group had one meeting point (usually, primary/secondary schools central to all the households in the group). The training run concurrently in all the groups with the help of trained research assistants.

The first batch of the intervention program which lasted for 4 weeks was participated by only parents and it was aimed at teaching parents how to carry out CMCPGP with their in-school adolescents. The next two weeks were used for revision and practical demonstration and thereafter the parent participants were allowed to start the intervention with their in-school adolescents who met the study�s inclusion criteria. The parents were basically taught how to monitor and control their in-school adolescents� engagement in computer-mediated and risky sexual behaviors.

Among other things, we insisted that parents must obey these four major rules: (1) the parents must establish a law that their in-school adolescents must submit their computer-mediated communication device for them to check the call log and chat details, (2) parents should get to know all the social network sites their in-school adolescents had account and should ensure that they follow them in those account, (3) parents must have access to the call chat account of their children in order to monitor the chats, calls and Messages (4) parents must reinforce whenever they comply with the rules of the intervention program.

The second batch of the intervention program was carried out by the parent participants for the period of four months and two weeks. The parents monitored and controlled their in-school adolescents� engagement in computer-mediated communication and risky sexual behaviors. We met with each parents once per week to get feedbacks and encourage them to keep running the program. At the end of the 6 months of the program, we had four weeks follow-up sessions which provided the participants opportunity of sharing with us how they were able to cope with the intervention process.

The in-school adolescent participants completed selreport questionnaires schedules at three time points (Time 1, Time 2 and Time 3). At Time 1, in-school adolescent participants in both groups were pretested before the administration of the intervention package (an CMCPGP program) to the treatment group. At Time 2, approximately four months and two weeks apart, the researchers conducted assessment at the end of the intervention with all the participants at their different households. After Time 2, approximately 6 months apart, the researchers conducted follow-up meetings with all the participants at their different homes that enabled them to partake in a third assessment (i.e. Time 3), which also involved completing the selreport questionnaires. Parent participants in the control group received generalized guidance (i.e. one not anchored on computer-mediated communication) to enable them mobilize their in-school adolescents throughout the intervention period. The researchers employed the services of 20 research assistants in the course of this study (i.e. two per training group). The CMCPGP sessions for parent participants lasted for ? 45minutes and twice per week for each group. The CMCPGP sessions were delivered in the participants� native language (Ibibio language). The Ibibio Language is one of the Nigerian languages spoken by a vast majority of people in Akwa Ibom State, Nigeria.

Measures
Adolescents� Risky Sexual Behaviors Questionnaire (RSBQ) was used in the study. RSBQ has 26 items that focused on the extent of in-school adolescents� engagement in risky sexual behaviors, in terms of making romantic calls, sending romantic text Messages, texting, communicating with opposite sex partner to arrange for a meeting, exchanging pictures with opposite friends, viewing pornographic sites etc. the response format of the instrument was 4-point Scale of Very High Extent (VHE), High Extent (HE), Low Extent (LE) and Very Low Extent (VLE).

Design
The design of this study is a pretest-posttest randomized control group design while Repeated measures ANOVA was used to measure at time 1 (before intervention), at time 2 (end of the intervention) and at time 3 (follow-up meetings), the in-school adolescents� levels engagement in computer-mediated communication and risky sexual behaviors, as well as their improvements over time across the control and treatment groups. The researchers further reported partial eta squared ( ) for this design. Prior to analyses, the researchers ensured that there were no missing values and screened for assumption violation with SPSS 22 software (SPSS Inc., Chicago, IL).

Results
Figure 3: Estimated marginal means of measures in the treatment and control

Figure 3 shows the changes that took place among the depressed adolescents who participated in CMCPGP. It is observed that the treatment group had time 1 score of 72.77�1.25, time 2 score of 10.91�1.06 and time 3 score of 3.46�2.10. The control group had time 1 score of 72.05�1.95, time 2 score of 68.50�1.62 and time 3 score of 67.36�2.04. The decline in their risky sexual behaviors is indication that CMCPGP was beneficial to the study participants in the treatment group.

As shown in Table 2, the repeated measures ANOVA test conducted show that risky sexual behaviors remain high at end of the intervention for the control group (68.50�1.62) but has become reduced for participants in the treatment group (10.91�1.06). At the follow up, risky sexual behavior still remain high for control group (67.36�2.04) but much reduced for treatment group (3.46�2.10). Thus, the within subject test indicates that there was a significant time effect, F (1, 227) = 110.3, p = 0.000. = 0.830.

The results from the Table 2 further demonstrates how individual participant in each groups� risky sexual behaviors changed over time. Whereas the control group�s risky sexual behaviors remained substantively high over time, the treatment group�s risky sexual behaviors are seen reducing due to exposure to computer-mediated communication parental guidance program (CMCPGP). Based on decision rule, we reject the hypothesis since the exact probability value of 0.000 is less than the �a priori� probability value of 0.05. Also, the value of is indication that through computer-mediated communication parental guidance program (CMCPGP) risky sexual behavior was significantly reduced in the treatment group when compared to the control group.

Discussion
This study revealed that Computer-Mediated Communication Parental Guidance Program had significant effect on risky sexual behaviors among in-school adolescents as it reduced the risky sexual behaviors among in-school adolescents. This finding support Otu�s (2016) assertion parental guidance can mediate the relationship between in-school adolescents� engagement in computer-mediated communication and risky sexual behaviors. The finding also support Bersamin, Michael, Fisher, Hill, Grube and Walker�s (2008) finding that parental mediation can delay potentially risky sexual behaviors among adolescents.

In addition, the study lend credence to the findings of Huebner and Howell (2003), Longmore, Manning, and Giordano (2001) and Chewning and Koningsfeld (1998) that parental monitoring, supervision and support for children is associated with less sexual risk-taking in the future. Finally, the study support DicClemente, Crosby, Sionean, Cobb, Harrington, Davies, Edward, Hook and Kim�s (2001) assertion that adolescents perceiving less parental monitoring are more likely to engage in risky sexual behavior.

When once in-school adolescents perceive parental control and guidance they are likely to redress their steps and live with the consciousness of their behaviors. Thus, the reason why in-school adolescents could use computer-mediated communication wrongly in such a way that they are predisposed to risky sexual behaviors is when parents are not guiding them on the computer-mediated communication issues.

Therefore, we concluded that parent should engage in computer-mediated communication guidance so as to help their in-school adolescents abstain from risky sexual behaviors. Thus, we recommended that every parent should be exposed to computer-mediated communication parental guidance program to equip themselves with knowledge, wisdom and ability to control regulate their in-school adolescents� use of computer-mediated communication and engagement in risky sexual behaviors.

Limitation
Though Computer-Mediated Communication Parental Guidance Program was considered effective in reducing risky sexual behaviors among in-school adolescents, one could assumed that there could be the tendency for the in-school adolescents to be deleting some romantic Messages from their chat inbox, outbox, spam, and trash of their computer-mediated device so that their parents would not know that they are engaged in risky sexual behaviors. Even at that, the consciousness and awareness of the parental guidance must have gone a long way reducing the in-school adolescents� risky sexual behaviors.

Also, it is observed that the study took a relatively long period and measures that look stressful. We intentionally allowed the program to run for up to six months and two additional months for follow-up. This was particularly because the researchers wanted to ensure whether the intervention program could be effective for a long period.

Conclusion
Computer-Mediated Communication Parental Guidance Program is effective in reducing risky sexual behaviors among in-school adolescents. Therefore, we recommend that the program should be adopted by counsellors as a means of minimizing risky sexual behaviors among adolescents in Nigeria.

Acknowledgement
The researcher appreciates the participants of the study and all the agencies that approved the study.

Conflict of Interest
The author declares no conflict of interest.

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