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This qualitative study explores the challenges and obstacles of mother-daughter sexual communication among Thai rural communities. In-depth interviews were conducted with the selected group of 33 dyads of mothers-daughters. Focus group discussions (FGDs) were also conducted among five healthcare providers (HCPs) and school teachers. The interviews and FGDs were audiotaped and transcribed verbatim. The data were analyzed using content analysis. The results found that mothers had insufficient sexual knowledge and lack communication skills. Most mothers never talked about safe sex, birth control, and condom use in the family. They thought their daughters were too young to learn about safe sex. They were afraid that it might guide their daughters to have sexand thought that their daughters will learn about sex when they marry, and sex education is not a parental duty. Mothers' beliefs on sex issues are not to be discussed openly, even in the family. Persons who talk about sex were sensual people.
Daughters addressed the fact that the mothers were seldom present and didn’t show love by words or manner. They still blame and hit daughters for a severe argument. Besides, parents’ quarrels created a bad family climate and made daughters unhappy to talk with their parents. Daughters still never talk about safe sex, birth control, and condom use with their mothers. Furthermore, the content of sex education in the family was based on maternal experiences. Most of the teaching and learning patterns of sex education in school were lectures, and the contents were physiology development and sexual desire. The challenges and obstacles of mother-daughter sexual communication were poor maternal sexual knowledge, maternal attitudes toward sexual communication, mother-daughter relationship, and family atmosphere. These findings will be used for developing the mother-daughter dyads’ relationship model to prevent pregnancy in early adolescence.
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2. World Health Organization. Sexuality education [online] 2016 [cited 2020 July 6]. Available from: https://www.euro.who.int/__data/assets/pdf_file/0010/379045/ Sexuality_education_Policy_brief_No_2.pdf?ua=1.
3. WHO Regional Office for Europe and BZgA. Standards for sexuality education in Europe: A framework for policy makers, education and health authorities and specialists [online] 2010 [cited 2020 July 7]; [68 screens]. Available from: https://www.bzga-whocc.de/fileadmin/ user_upload/WHO_BZgA_Standards_English.pdf.
4. Alford S. Science and Success: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. Washington, DC: Advocates for Youth; 2008.
5. UNESCO. Why comprehensive sexuality education is important? [online] 2018 [cited 2020 July 7]; [3 screens]. Available from: https://en.unesco.org/news/why-comprehensive-sexuality-education-important.
6. Tef M, Nicholas A, Christie C. Working Group Report on child sexual exploitation. London: Department of Health; 2014.
7. Allen C. Situation Analysis of Adolescent Sexual and Reproductive Health and HIV in the Caribbean. Washington DC: Pan American Health Organization/ World Health Organization; 2013.
8. Hansen BT, Kjær SK, Arnheim‐Dahlström L, Liaw KL, Juul KE, Thomsen LT, et al. Age at first intercourse, number of partners and sexually transmitted infection prevalence among Danish, Norwegian and Swedish women: estimates and trends from nationally representative cross‐sectional surveys of more than 100,000 women. AOGS Acta Obstetricia et Gynecologica Scandinavisa 2020; 99(2): 175-85.
9. World Health Organization. Adolescent fertility: Situation and trend [online] 2020 [cited 2020 July 11]; [1 screens]. Available from: https://www.who.int/gho/mdg/ maternal_health/adolescent_fertility_text/en/.
10. Department of Health, Ministry of Public Health. Reproductive health situation on adolescents and youth [online] 2018 [cited 2020 July 12]; [28 screens]. Available from: http://rh.anamai.moph.go.th/download/all_file/index/%E0%B8%AA%E0% B8%96%E0%B8%B2%E0%B8%99%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B8%93%E0%B9%8CRH_2561_Website.pdf.
11. Health Data Center, Ministry of Public Health [Internet]. 2020 [cited 2020 July 10]. Available from: https://hdcservice.moph.go.th/hdc/reports/report.php?source= pformated/format1.php&cat_id=bebf866fceaef84c4078965eaf619565&id=1336d766d29c4a739ed33ff9f4e79d83.
12. Ministry of education. Review of Comprehensive Sexuality Education in Thailand. Bangkok: UNICEF Thailand Country Office; 2016
13. Facts and details. Sex in Thailand: habits, attitudes, stereotypes, monks and erotica [online] 2014 [cited 2020 June 6]; [11 screens]. Available from: http:// factsanddetails.com/ southeast-asia/Thailand/sub5_8d/ entry-3243.html.
14. Liu A, Kilmarx P, Jenkins RA, Manopaiboon C, Mock PA, Jeeyapunt S, Uthaivoravit W, Griensven F. Sexual initiation, substance use, and sexual behavior and knowledge among vocational students in Northern Thailand. Int Fam Plan Perspect 2006; 32(3): 126-35.
15. Sridawruang , Crozier K, Pfeil M. Attitudes of adolescents and parents towards premarital sex in rural Thailand: A qualitative exploration. Sexual & Reproductive Healthcare 2010; 1: 181-87.
16. Ounjit W. Social and culture dimensions of adolescent sexual relationships in Thailand. Procedia Soc Behav Sci 2015;171: 606-12.
17. Ounjit W. Pre-marital sex and pregnancy: the high price of forgiveness. International Journal of Social Science and Humanity 2011; 1(2): 111-20.
18. Rhucharoenpornpanich O, Chamratrithirong A, Fongkaew W, Miller BA, Cupp PK, Roseti MJ, Byrnes HF, Atwood K, Chookhare W. Parent-Teen Communication about Sex in Urban Thai Families. J Health Commun 2012;17(4):380-96.
19. Sridawruang C, Pfeil M, Crozier K. Why Thai parents do not discuss sex with their children: a qualitative study. Nurs Health Sci 2010; 12: 437-43.
20. Fongkaew W, Cupp PK, Miller BA, Atwood KA, Chamratrithirong A, Rhucharoenpornpanich O. Do Thai parents really know about the sexual risk taking of their children? A qualitative study in Bangkok. Nurs Health Sci 2012; 14 (3): 391–97.
21. Kay NS, Jones MR, Jantaraweragul S. Teaching sex education in Thailand. Journal of Research 2010; 5: 11-6.
22. Boonmongkon P,,Shrestha M, Samoh N, Kanchawee K, Peerawarunun P, Promnart P, et al. Comprehensive sexuality education in Thailand? A nationwide assessment of sexuality education implementation in Thai public secondary schools. Sexual Health 2019; 16(3): 263-73.
23. Lin W-H, Liu C-H, Yi C-C. Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood. PLoS ONE 2020; 15(4): 1-26.
24. Rusec JE. Socialization processes in the family: social and emotional development. Annu Rev Psychol 2011; 62: 243-69.
25. Jaccard J, Dodge T, Dittus P. Maternal discussions about pregnancy and adolescents, attitudes toward pregnancy. J Adolesc Health 2003; 33: 84–7.
26. Hutchinson MK, Jemmott JB, Jemmott LS, Braverman P, Fong GT. The role of mother–daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. J adolesc health 2003; 33: 98-107.
27. Lehr ST, Dilorio C, Dudly WN, Lipana JA. The relationship between parent-adolescent communication and safer sex behaviors in college students. J Fam Nurs 2000; 6: 180-96.
28. Dutra R, Miller KS, Forehand R. The process and content of sexual communication with adolescents in two-parent families: Associations with sexual risk-taking behavior. AIDS Behav 1999; 3: 59-66.
29. Berlo DK. The process of communication: An introduction to theory and practice. New York: Holt, Rinehart and Winston; 1960.
30. Shin H, Lee JM, Min JY. Sexual knowledge, sexual attitudes, and perceptions and actualities of sex education among elementary school parents. Child Health Nurs res 2019; 25(3): 312-23.
31. Lukolo LN, Dyk A. Parents’ Participation in the sexuality education of their children in rural Namibia: a situational analysis. Glob J Health Sci 2014; 7(1): 35-45.
32. Thinh T, Steckler A, Ngo A, Ratliff E. Parent communication about sexual issues with adolescents in Vietnam: content, contexts, and barriers. Sex Educ 2009; 9: 317-80.
33. Rasamimari A, Dancy B, Talashek M, Park CG. Predictors of sexual behaviors among Thai young adults. JANAC 2007; 18(6): 13-21.
34. Shahhosseini Z, Simbar M, Ramezankhani A, Majd HA. Supportive family relationships and adolescent health in the socio-cultural context of Iran: a qualitative study. Ment Health Fam Med 2012; 9: 251-6.
35. Blondal KS, Adalbjarnardottir S. Parenting practices and school dropout: a longitudinal study. Adolescence 2009; 44: 729-49.
36. Resnick M, Ireland M, Borowsky I. Youth violence perpetration: What protects? What predicts? Findings from the National Longitudinal Study of Adolescent Health. J of Adolescent Health 2004; 35(5): 424e1-e10.
37. Guilamo-Ramos V, Jaccard J, Turrisi R, Johansson M. Parental and school correlates of binge drinking among middle school students. Am J Public Health 2005; 95(5): 894-99.
38. Markham CM, Lormand D, Gloppen KM, Peskin MF, Flores B, et al. Connectedness as a predictor of sexual and reproductive health outcomes for youth. J Adolesc Health 2010; 46: S23–S41.
39. Catalano RF, Berglund ML, Ryan JA, Lonczak HS, Hawkins JD. Positive youth development in the United States: Research findings on evaluations of positive youth development programs. The ANNALS of the American Academy of Political and Social Science 2004; 591(1): 98-124.
40. Davies SL, Crosby RA, Diclemente RJ. Family influences on adolescent health. In: Diclemente RJ, Santelli JS, Crosby RA, editors. Adolescent health: Understanding and preventing risk behaviors. 1st ed. USA: PB Printing; 2009.
41. Aufseeser D, Jekielek S, Brown B. The Family environment and adolescent well-being: exposure to positive and negative Family Influences. Child trends and the National Health Information Center [online] 2006 [cited 2020 Jan 6]; [12 screens]. Available from: URL: http://nahic.ucsf.edu/downloads/FamEnvironBrief.pdf.
42. Baek H, Roberts AM, Higgins GE, Losavio MM. The impact of negative family environment and depression on running away from home among Korean adolescents. International Criminal Justice Review 2017; 27(3): 188-202.
43. Jaccard J, Dittus PJ, Gordon VV. Maternal correlates of adolescent sexual behavior. Fam Plann Persp 1996; 28: 159-65,185.
44. McNeely C, Shew ML, Beuhring T, Sieving R, Miller BC, Blumet RW. Mothers’ influence on the timing of first sex among 14- and 15-year-olds. J Adolesc Health 2002; 31(3): 256–65.