Reid, Kaydian S’s concept paper



“Black Male Mentors as the Necessary Bridge”: Communication about sex and relationships among Black single mothers, their sons, and male mentors in high HIV-seroprevalence neighborhoods

Kaydian S. Reid, MA, Principal Investigator

Specific Aims

Big Brothers Big Sisters of Brooklyn and Queens (BBBSBQ) provides community-based mentoring to 75 youth (boys and girls, ages 9-15) annually, primarily of single parent households, (i.e., anyone with primary responsibility for raising the youth, e.g., foster-, grand-, stepparents as well as biological parents). Youth served are also largely from socially and economically disadvantaged neighborhoods in Brooklyn and Queens, with high rates of crime and health concerns, specifically HIV (New York City Department of Health and Mental Hygiene [NYCDoHMH]). For example, East New York and New Lotts, Brooklyn have a higher percentage (34%) of its residents living below the poverty line than in all of Brooklyn and New York City, the highest number of cases of STIs (i.e. gonorrhea), and 1,760 people per 100,000 are living with HIV/AIDS (NYCDoHMH).

To date, no unit or module in BBBSBQ prepares mentors for discussing sex and relationships. Yet approximately 90% of single mothers in BBBSBQ have given consent for male mentors to speak with their child about sex and relationships, and a substantial number of mentor reports that such conversations occur. Conversations with adults have been shown to be protective for HIV (Krauss & Miller, In Press). Within the last three years, over 225 mentors have been trained using a standard curriculum. Quite often, during the intake process, mothers of male youth indicate that, “I cannot relate to my son from that male perspective about sex and relationships and this is one of the reasons why I need my son to have a male mentor”. The current project focuses on 1) the extent to which conversations about sex and relationships already occur within the youth-single mother-male mentor triad; 2) the content and style of these discussions; and 3) the perceived needs by all members of the triad for communication and knowledge skills to prevent HIV and other related conditions (e.g. STIs, pregnancy among partners) and promote healthy relationships.

Black male mentors who are largely professionals and advanced in their education, but sharing similar backgrounds as their mentees, might well be “the necessary bridge” for these single mothers to communicate effectively with their pre-and early-adolescent sons about sex, relationships, HIV, and STIs in high HIV-seroprevalence neighborhoods.

During this two-year pilot study, we will:

• describe sex, relationship, HIV, and STI discussions, and communication methods (i.e., via phone, electronic mail, text messaging, face-to-face, etc.) through one-on-one semi-structured interviews with each member of 10 mother-mentor-mentee triads (e.g., 30 individuals) enrolled in mentoring organizations;

• explore the rationale for giving or not giving permission for allowing discussions between mentor and youth, during one-on-one interviews with mothers;

• use structured measures adapted from the Parent/Preadolescent Training for HIV prevention (PATH, Krauss, 2000) to assess HIV and STI knowledge of each member of the triad immediately post-interview;

• assess the perceived ability of mothers and male mentor to communicate prevention knowledge and skills accurately to youth; and

• initial thematic results from one-on-one interviews will be presented for discussion to four focus groups composed of the original triads: pre-adolescent youth (9-11); early adolescent youth (12-15); and two mixed groups of mothers and mentors to reflect on, confirm or expand the findings.

The proposed pilot study is a first step in a long-range program to design, evaluate, and disseminate a culturally appropriate training program for male mentors and intake for mothers to address HIV-related issues. This larger program will draw on the published literature on parent-child communication and HIV prevention (O’Connell, Boat & Warner, 2009; Pequenat & Szapocznik, 2000).

Background and Significance

Most literature focuses on the mother-daughter relationship when addressing sex, relationship or HIV-knowledge communication (Krauss & Miller, In Press; DiIorio, Pluhar, & Belcher, 2003). Due to the growing rate of absentee Black fathers, Black single mothers are often left to educate their sons alone (Jemmott et al., 2000). Single mothers from socially and economically disadvantaged backgrounds care deeply for the welfare of their sons. In order to make up for the absence of fathers, they often seek out formal mentoring organization (i.e., Big Brothers Big Sisters) for male mentors who will “serve as crucial educators and support figures, promot[e] learning and competence, provid[e] exposure to positive social norms, increas[e] a sense of efficacy and mattering, and help youth realize their full potential” (DuBois & Silverthorn, 2005, p. 518). Mentoring organizations are currently serving more than two million youth in the U.S., the majority from disadvantaged social and economic backgrounds (Cavell, DuBois, Karcher, Keller, & Rhodes, 2009).

Research done on early debut of sexual intercourse of youth, specifically pre- and early- adolescents, indicates that guardians and parents may need extra support to effectively convey values, expectations, and effectively communicate about sexual behaviors that will reinforce HIV and STI prevention (Dittus, et. al., 2004). Communication between mothers and sons about sex may be especially problematic (McKee, Forehand, Miller, Whitaker, Long, & Armistead, 2007). Dlorio, Pulchar, & Belcher’s ( 2003) research reports that mothers direct more communication with their children than fathers and when mothers do, daughters are the recipient of more communication about sex than sons. Furthermore, sex conversations appear to be different: daughters receive more messages on responsibility for setting limits and on the aftermath or stigmatized consequences of sex (Dilorio, Pluchar, & Belcher, 2003). Hence, information and messages that are, or are not communicated, between mothers and sons have the potential to shape sexual decision-making during adolescence, specifically related to HIV/AIDS risky behaviors (Dilorio, Pluchar, & Belcher, 2003). In fact, a significant percent of mothers request that male mentors deal with these issues, but there is little evidence to suggest mentors feel prepared for this role. Supervisory meetings with Black male mentors suggest a significant number of them feel uncomfortable about discussing sex and relationships with their male mentees. To date, no training module within the BBBSBQ prepares Black male mentors for this role.

Mentored youth are more likely to report favorable overall health than non-mentored youth (Ahrens, DuBois, Richardson, Fan, & Lozano, 2008) as well as to report positive differences in multiple domains of youth behavior and development (Cavell et. al., 2009). There has been no research done, however, to look at sex, relationship, STI, and HIV knowledge communications, specifically, among the triad. Likewise, the primary preventive role male mentors may play has not been assessed for sex and relationship outcomes such as getting a girl pregnant, forming healthy relationships and avoiding STIs including HIV. Supportive mentoring relationships with nonparent adults (i.e. Big Brothers) have the “potential to make a key contribution to promoting outcomes important to public health goals and objectives” (DuBois & Silverthorn, 2005, p. 518); it is important to measure such potential outcomes.

Preliminary Studies

Kaydian S. Reid, M.A., Certified Mentor Supervisor, Principal Investigator, has studied Criminal Justice and Sociology at the B.S. and M.A. levels. She received a JP Morgan Fellowship to support her Mentoring Supervisor certification. Ms. Reid is currently Program Director of BBBSBQ. For two years, she has conducted recruitment, orientations, interviews, supervisory meetings, and training workshops for parents, children, and mentors. Ms. Reid has access to the triads for this pilot study, and knows from the program census that there are 30 triads fitting the pilot study profile from which to draws a sample. Ms. Reid is well aware of issues in Black families, having taught Sociology of the Family and Introduction to Sociology as well as social theory of race and class for two years at the Rosa Parks Campus of College of New Rochelle. Her students, the majority of whom are single parents in New York City, have further educated her about family issues. Discussing sex and relationship with Black male youth has emerged as a topic of concern for both students and mentors.

Ms. Reid will receive continuous guidance from Dr. Christine Thorpe, New York City College of Technology, whose research area is health disparities among people of color, and Dr. Beatrice Krauss, Hunter College, whose research area of interest has been the family’s role in HIV prevention. Dr. Krauss has successfully developed PATH, first implemented in housing projects in NYC, which has been successfully replicated in Miami, Fl, Mexico, and Mumbai, India, will be replicated by the Ontario Ministry of Health, by the American Psychological Association in a distance-learning platform, at Memorial Sloan-Kettering Cancer Center, and, is under consideration, for dissemination to Swaziland under sponsorship of the foreign ministry of Swaziland and the United Nation Non-governmental Organizations on AIDS.

A master’s level research assistant, to be hired, will conduct interviews with male youth. We envision hiring a male college student in the social or health sciences, with prior experience interviewing youth; gender matching and closeness in age may make youth feel more comfortable in discussing sex and relationships.

Research Design and Methods 

Proposed is a convenience sample of ten triads (30 individuals) enrolled in BBBSBQ, who have agreed and have given consent to participate in this research. In year one, ten mothers and ten mentors will each participate in 1 hour one-on-one semi-structured interviews, separately. Ten youth will participate in a 30 minute one-on-one semi-structured interview separately, conducted by a male interviewer. Participants will inform interviewers of their preference of location to be interviewed—private room at BBBSBQ, at their nearby home, or in an interview room at a local university.

The focus of the interviews is to:

• describe sex, relationship, HIV, and STI discussions, and communication methods (i.e., via phone, electronic mails, text messaging, face-to-face, etc.) with each member of the triad separately;

• explore the rationale for giving or not giving permission for allowing discussions between mentor and youth, during one-on-one interviews with mothers;

• use structured measures adapted from PATH (Krauss, 2003) to assess HIV and STI knowledge of each member of the triad; and

• assess the perceived ability of mothers and Big Brothers to communicate prevention knowledge and skills accurately to youth.

Consent forms will indicate that the research is voluntary, triads can opt out of the study at anytime or refuse to answer any question, and triads will be assigned pseudonyms for confidentiality. The Research Assistant (RA) will be trained to be cognizant of any signs of emotional distress, and if that is the case, the RA will inform the PI who will make appropriate referrals. Audiotaped qualitative data, with consent from mothers, youth, and mentors will be transcribed verbatim and will be imported, sorted, and analyzed by a computer-assisted qualitative data analysis, NVIVO 8. NVIVO 8 provides a systematic approach to managing qualitative data. Major thematic results from the semi-structured interviews, which we anticipate will include the precedents and context for conversations, perceived skills, knowledge, and needs, will be used to inform the topic guides for the focus groups. The structured HIV knowledge questionnaire (Krauss, 2003) will be given immediately post-interview. This 54-item checklist has been adapted from Krauss (2003), used successfully with adults and youth Incentives, and measures knowledge domains of transmission, treatment, and common myths and facts about HIV. Incentives, i.e., $30.00 gift card for mentor, $15.00 gift card for mother, and $15.00 gift card for son, will be awarded at the end of each interview session.

In the last month of year one, initial thematic results from one-on-one interviews will be presented for discussion to four focus groups composed of the original triads: 1) pre-adolescent boy (9-11); 2) early adolescent boy (12-15); and, 3) and 4), two mixed group of mothers and mentors. It is important to separate the focus groups based upon pre-and early adolescence in order to describe, assess, and explore these communications among the youth at different socio-developmental stages. Furthermore, the mixed group of mothers and mentors is designed to assess the collaborative support of mothers and mentors as well as to ascertain what each individual wants to ensure that they are collaborative on behalf of the youth. The focus group of youth is designed to assess what are their needs as well as to assess what method of delivery on the topics of sex and relationship are ideal for them. Thus, the long-range plan is to design, evaluate, and disseminate a culturally and age appropriate training program for male mentors and intake for mothers to address HIV-related issues. The adolescent boys’ focus group will be facilitated by the same male RA who had interviewed the youth; all members of the research team will receive training around facilitating focus groups. It is anticipated that the one-session focus groups will inform design of a culturally appropriate training program for male mentors and intake for mothers to address sex and relationships issues; these activities will be pursued under additional funding.

Dissemination Plan:

The dissemination plan is to publish at least two articles in peer reviewed journals, attend, and present at mental health, mentoring, and HIV conferences. Findings and articles will be disseminated to Big Brothers Big Sisters organizations, other youth mentoring organizations, and to local social services throughout New York State. Findings will be used to seek future funding in order to develop a training program for mentors acceptable to the mother-youth-mentor triad.

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