Table 3 Joint display of quantitative, qualitative, and mixed methods meta-inferences for intervention group

Confidence in teaching about sexual health topics

108–128 ↑20

FTT training session

Before I was very nervous to talk to parents…But then after, it really helped during the training breaking it down in the book and going piece by piece and writing out your script. And at first, I was like maybe that might be a little too—like as if we were reading off of the script, but it really helps when you know the key points that you want to talk about.

Adolescent sexual health education experts

Confidence is really important because even here today, a lot of people said ‘Oh, I felt uncomfortable talking to adults,’ and we all learned that we are adults and we are now these medical professionals that people come to us for advice.

Parent communication counseling experience

Initially, it was really nerve-wracking…majority of us are still on the borderline adolescent age, so we didn’t know how to communicate on like a parent to young adult level. I mean, slowly but surely, as we gained experience, we started to become comfortable in doing that.

Parent engagement

Before clinical, I wasn’t really confident in it. I didn’t think I could do it or would be comfortable doing it. But once we did it actually, it wasn’t really that bad at all. The parents really kind of wanted to know, and that surprised me the most. They were really interested in finding out more about how to talk to their kids. So, I felt a lot more comfortable once we did it.

Confirmation

FTT training, experience with parental counseling, and perceptions about parents’ engagement in adolescent sexual health education increased students’ confidence, thereby explaining the improvement seen in SECS scores.

Beliefs about parent-adolescent sexual health communication

17–23 ↑6

(4.9; 7.2)

Parents’ voices matter

Seeing the statistics that parents actually are the voice that teenagers would listen to the most, even if it appears they’re not listening…I have a teenage son, so I’m like, ‘Okay, I’m probably saying things, and it’s going in one ear and out the other,’ but after the training we received, I’m like, ‘Okay, it might appear that way, but something is sticking in there.’

Prior to this, I knew that sexual health was important to discuss…but I felt there were so many barriers… So knowing how to respond to a parent that might say, ‘Well, if I talked to them about it, they’re going to go and have sex,’ telling them that, ‘No, your voice matters…if you teach them your expectations, that actually gives them a guidance of when that time comes, if they’re in that scenario, how they could go about it and make their decision or at least know your opinion about it.’

Confirmation

FTT training provided evidence for the effectiveness of parent communication counseling for reducing sexual risk-taking in youth, thereby explaining improvement seen in scores for beliefs about parent-adolescent sexual health communication.

Perceived adolescent sexual health risk

23–24 ↑1

Early sexual debut

Seeing the statistics, that’s a really eye-opening experience because it’s like, ‘wow, these many kids are already having sex.’

STDs/STIs

I think it helped, feeling burdened by all this information we had to deliver… You want them to reach their goals, and you just want to prevent all these things and STDs.

Teen pregnancy

I knew the topic was important before this experience because a lot of people that I graduated with had their first child when they were like really young but after this and after reading actual statistics and information and stuff, you realize how big of an issue it is.

Confirmation

FTT training highlighted prevalence of early sexual debut, STD/STI risk among adolescents, and teen pregnancy, thereby explaining increase seen in scores for perceived adolescent sexual health risk.

Satisfaction with skills as parent-adolescent sexual health educator and counselor

25–47 ↑22

Competent

I feel really prepared to have these conversations in whatever practice I go into. Like, I really feel like at least the information and the approach is engrained enough and I’ve done it enough times that I feel like I could effectively communicate that information moving forward.

Confirmation

Clinical experience adequately prepared students for sexual health education/counseling, thereby explaining the improvement seen in scores for satisfaction with skills as parent-adolescent sexual health educator and counselor.

Intentions to counsel parents on sexual health

9–10 ↑1

Pressing on

It’s not just going through the training – if it’s not something you really want to do it’s going to be tough because…when you [make booster calls] and they hang up on you—if it’s not in you to know that ‘okay, this can happen,’ or ‘I really want to do this,’ or ‘even if this happens I’ll keep going’—you are really not going to do well.

Counseling readiness

It just makes me open minded to all the patients – if they want to bring up a topic or if they nudge towards a certain topic, and they’re kind of embarrassed. I would be open to talking about it now, especially with regards to sexual health and things like that. It just makes me a lot more ready to have that conversation with any patient that is willing or wants to.

Quelling fears

I think it was quite intimidating talking to some parents because I’m not a parent myself. I don’t have kids. What position am I to talk to them about their kid’s sexual health? But giving them those facts and being the informant in this situation and looking beyond that was really important.

Strategic approach

See, I never knew that you could counsel a parent…people always say, ‘You don’t tell parents how to raise a child,’ or that stuff, but after [the

Confirmation

Students discussed how the FTT training created an urgency to educate and counsel parents, and provided practical strategies for conversing about sexual health, thereby explaining the improvements seen in scores for intention to counsel parents on sexual health.

clinical] —I realized that sometimes it’s the approach, the way you say it, the way you come about it, they’ll listen—and so with that I was able to see that—okay, there are some conversations that you can have even though it seems as though you shouldn’t have this type of conversation.

Intentions to endorse HPV vaccine

9–10 ↑1

HPV vaccine advocate

So it’s kind of opened up my eyes, also with health care providers. They’re not pushing for that. And it’s like—I guess we’re going to be advocates for that. If you’re working with a doctor, they’re not pushing for that, then maybe you should have that talk with the parents.

Confirmation

Learning about lack of vaccine recommendations from HCPs motivated students to be vaccine advocates, thereby explaining the increase in scores intention to endorse HPV vaccine.

HPV vaccine endorsement skills

17–13 ↓4

Additional training needed

We need more knowledge to talk about it more…we spent so much time on the FTT script, and we all pretty much wrote ‘oh yeah, and HPV’ at the bottom.

Since we didn’t go over it as much, you’re questioning yourself, and [the parents] can probably see that so they’re like, ‘do I take her advice or do I not?’

I just think we need more knowledge about it because they do catch you off guard with questions and you’re like, ‘Shoot, I don’t know.”

Confirmation

Learning about vaccine hesitancy and lacking sufficient knowledge about the vaccine decreased students’ confidence to endorse vaccine, explaining the decrease in scores for HPV vaccine endorsement skills.