Parent-Adolescent Communication Scale

Abstract

The Parent-Adolescent Communication Scale (PACS) is a brief, self-administered psychological instrument developed to quantify the frequency of sexual health discussions between adolescent girls and their parents. Developed under an NIMH-funded intervention grant, the initial measure consisted of 36 items covering key domains of sexual health, including pregnancy, STDs, HIV/AIDS, condom use, and general sex education. Through rigorous item reduction based on internal consistency and pilot testing among African American adolescent females (aged 14 to 18), the scale was refined to its final 5-item version. The PACS is designed for ease of use, requiring only a fourth-grade reading level, and is highly suitable for pre- and post-intervention evaluations in sexual health education programs, particularly those focusing on family-level dynamics.

Keywords

Parent-Adolescent Communication Scale, PACS, Sexual communication, Adolescent health, STD prevention, HIV/AIDS prevention, Condom use, Family intervention, Likert scale

Authors

Jessica McDermott Sales (Emory University), Robin R. Milhausen (University of Guelph), Ralph J. DiClemente (Emory University)

Purpose

The primary purpose of the Parent-Adolescent Communication Scale (PACS) is to provide a quantitative measure of how often adolescent individuals, specifically girls in the original validation study, engage in sexual health-related discussions with their parents or guardians. The instrument focuses on the frequency of dialogue concerning five critical domains of sexual health and risk reduction.

This scale is particularly valuable for researchers and health educators working within the context of sexual health education and intervention programs. By assessing communication frequency both before and after an intervention, the PACS serves as an effective tool for evaluating the efficacy of family-level strategies aimed at improving parent-child communication regarding sexuality and risk behaviors.

Construct

The PACS measures the construct of Frequency of Parent-Adolescent Sexual Communication. This construct is defined by the adolescent’s reported frequency of dialogue with parents over the past six months concerning specific, empirically-derived topics related to sexual health and safety. The measured domains of sexual communication include discussions about:

• General information about sex.
• Condom use.
• Protection against STDs (Sexually Transmitted Diseases).
• Protection against HIV/AIDS.
• Protection against pregnancy.

The scale assumes that more frequent and open communication between parents and adolescents regarding these topics is associated with positive health outcomes and reduced risk behaviors, reflecting the scale’s utility in preventative intervention research.

Validity

The PACS demonstrated robust validity evidence across multiple dimensions in its validation study (Sales et al., 2008).

Concurrent Validity

The PACS scores correlated significantly and in the predicted directions with several related constructs assessed at baseline. Specifically, PACS was positively associated with the frequency of sexual communication with a partner, sexual communication self-efficacy (with a new partner), family support (measured by Zimet et al., 1988), and perceived parental knowledge about the adolescent’s whereabouts. Conversely, PACS scores were negatively associated with depressive symptoms, reinforcing the idea that better family communication is linked to improved psychological well-being. Furthermore, the PACS positively correlated with recent condom use (across various timeframes) and inversely correlated with the frequency of vaginal intercourse, suggesting that communication facilitates protective behaviors. Effect sizes for these correlations were generally small to moderate (Cohen, 1988).

Predictive Validity

Baseline PACS scores successfully predicted relevant outcomes at 6-month and 12-month follow-up assessments. At both intervals, higher baseline PACS scores were significantly and positively associated with subsequent frequency of sexual communication with a partner (Milhausen et al., 2007) and sexual communication self-efficacy with a new partner. Crucially, baseline PACS scores also predicted increased condom use during the intervening periods between assessments, highlighting the scale’s ability to forecast future protective sexual behavior.

Discriminant Validity

To ensure the scale was measuring a distinct communication construct, discriminant validity was assessed by correlating PACS scores with measures unrelated to sexual health discourse, specifically measures of watching movies or television. These correlations were found to be non-significant, confirming that the PACS is measuring parental communication specifically, rather than general media exposure or non-specific communication patterns.

Reliability

The reliability of the PACS was primarily established through internal consistency during development and through test-retest stability over time.

Internal Consistency

During the development phase, items were rigorously analyzed to ensure they contributed meaningfully to the overall construct. Items that decreased the overall scale reliability were deleted, resulting in the final 5-item scale structure. The resulting scale demonstrated high internal consistency, retaining only items that maintained the scale’s Cronbach’s alpha coefficient above .90.

Test-Retest Reliability (Stability)

Measurement stability was assessed using the Pearson correlation coefficient over two long-term intervals, mirroring the typical duration of intervention studies (Gliner, Morgan, & Harmon, 2001). The stability of the PACS scores was significant and robust:

• The intercorrelation between baseline scores and 6-month follow-up scores was significant (r = .58, p < .001).
• The intercorrelation between baseline scores and 12-month follow-up scores was also significant (r = .53, p < .001).

These results confirm the stability of the PACS measure over time, making it suitable for longitudinal intervention research.

Factor Analysis

While a formal Exploratory or Confirmatory Factor Analysis (EFA/CFA) was not explicitly detailed in the source material, the scale development process utilized statistical methods to ensure unidimensionality. The authors achieved a streamlined 5-item scale by deleting items that were highly correlated with others or which reduced the scale’s overall internal consistency (i.e., decreased the Cronbach’s alpha below the strong threshold of .90). This item reduction process strongly supports the conceptualization of the PACS as a single-factor, highly cohesive measure of parent-adolescent sexual communication frequency.

Instrument

Test Type: Behavioral self-report scale

Format: 5-item, self-administered questionnaire using a 4-point Likert-type scale.

Language Available: English (Original validation)

Population Group: Adolescents (primarily focused on females in validation study, but items are widely applicable to both genders and various ethnic backgrounds).

Age Group: 14 to 18 years old (validated sample). Applicable to broader adolescent age groups.

Population Details: The measure was validated using a sample of African American adolescent females. The scale is designed to be accessible to low-literate samples, requiring only a fourth-grade reading level.

Test Methodology: Respondents answer based on the frequency of communication with their parent(s) over the past six months. The response options are: 1 (Never), 2 (Rarely), 3 (Sometimes), and 4 (Often). The administration typically requires less than 5 minutes.

Scoring

All five items are scored such that higher values indicate more frequent sexual communication with parents. The final scale score is calculated by summing the responses to the individual items. Scores on the PACS range from 5 to 20. In the original validation sample (Sales et al., 2008), the mean score was 14.20 (SD = 4.79).

Keywords

Psychometric scale, Health education, Family support, Depressive symptoms, Test-retest reliability, Concurrent validity, Predictive validity, Sexual risk reduction

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: Not provided in source content.

Correspondence Address: Not provided in source content. Correspondence should generally be directed to the primary author, Jessica McDermott Sales, at Emory University.

Permissions & Fee and Test Year

The scale was developed and validated in 2008 (Sales et al., 2008). The authors requested that researchers utilizing the PACS inform them of the results obtained with the measure, suggesting a collaborative approach to its dissemination and application. Information regarding commercial fees or explicit licensing permissions is not detailed in the source material, but typically, scales published in academic journals require permission from the copyright holder or primary author for use.

Reference’s

Primary Validation and Development

Sales, J. M., Milhausen, R. R., Wingood, G. M., DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2008). Validation of a parent-adolescent communication scale for use in STD/HIV prevention interventions. Health Education and Behavior, 35, 332–345.

Supporting Methodological and Related Measures

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.

Gliner, J. A., Morgan, G. A., & Harmon, J. J. (2001). Measurement reliability. Journal of the American Academy of Child and Adolescent Psychiatry, 4, 486–488.

Milhausen, R. R., Sales, J. M., Wingood, G. M., DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2007). Validation of a partner communication scale for use in HIV/AIDS prevention interventions. Journal of HIV/AIDS Prevention in Children and Youth, 8, 11–33.

Zimet, G., Dahlem, N. V., Zimet, S. G., & Farley, G. K. (1988). The multi-dimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41.

Items of the Parent-Adolescent Communication Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.