A Scoping Review of Interventions Empowering Black Fathers to Reduce Youth Sexual Risk Behaviors

Background and Purpose:

Sexual health disparities among Black youth are longstanding and well documented. Despite parental communication being a known protective factor against youth sexual risk taking, few interventions prioritize the involvement of Black fathers or father-figures, who play a unique and additive role in ensuring the wellbeing of their children. Prior studies show that Black fathers desire interventions to increase their skills around sexual health communication, yet no scoping review of the literature has explored what interventions have been developed and tested. To fill this gap, the current review has 3 specific aims: (1) Identify existing interventions on parent-child sexual health communication implemented among Black fathers/father-figures; (2) Summarize the interventions’ curriculum, delivery, and outcomes; and (3) Explore the extent to which current interventions align with the sexual health intervention needs and preferences expressed by Black fathers.

Methods:

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, four databases were systematically searched (MEDLINE, APA PsycINFO, Sociological Abstracts, and Web of Science) using search strings informed by an expert medical librarian. Our review included peer-reviewed articles published between January 1st, 1985 and April 9th, 2024 written in English related to US-based fatherhood interventions or programs with Black/African American fathers or father-figures aimed at improving youths’ sexual health outcomes. We excluded articles that were not evaluating interventions or programs, did not provide sexual health outcome data, or had a study population less than 50% Black/African American.

Results:

The search yielded 714 articles. After removing 229 duplicates and excluding 445 studies, 67 full texts were reviewed, and 2 relevant articles were included in our review. One study evaluated a 7-week intervention focused on improving fathers’ familial involvement and sexual health communication. Outcome measures included youths’ sexual risk behaviors (i.e., condom use, abstinence, and intent to delay sexual initiation), and fathers’ intention to discuss sexual health with their child. The second study evaluated a 2-month intervention designed for nonresident fathers to reduce youths’ risky behaviors by enhancing fathering skills. Outcome measures included father-child communication about sex and risky behaviors, fathers’ intention to communicate, and sons’ intention to use non-violent strategies during anger-provoking situations. Both studies reported significant positive results and can be strengthened by incorporating additional recruitment and intervention strategies desired by Black fathers.

Conclusions and Implications:

Review findings underscore the importance of involving Black fathers and father-figures in sexual health research and intervention development. When appropriately engaged, interventions among Black fathers aimed at improving father-child sexual health communication and familial involvement show positive results and have the potential to help reduce racial disparities in HIV/STIs. The dearth of literature evaluating sexual health communication interventions among Black fathers points to a clear opportunity for future research and highlights the need for culturally sensitive sexual health interventions involving the entire Black family unit.