Parent-child connectedness and its associations with sexual risk behavior and outcomes among young people: a systematic review and meta-analysis.

Abstract

Significant disparities in the sexual and reproductive health of young people persist globally. Although previous systematic reviews and meta-analyses have largely focused on the effects of parenting practices, such as parent-child communication and parental monitoring, on sexual behaviors among young people, the effect size of parent-child connectedness (PCC) remains underexplored. The objective of this study was to explore the associations between PCC and sexual intercourse, unprotected sex, multiple sexual partners, and unintended pregnancy among young people. We searched and screened relevant literature published between January 2000 and May 2025 from six databases: PubMed/Medline, Web of Science, Ovid Embase, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and APA PsycArticles. Eligible studies underwent quality assessment and data extraction. The meta-analysis used a multilevel mixed-effects model to calculate pooled odds ratios (OR). A total of 18 studies involving 78,284 participants were included. Meta-analysis indicated that a higher level of PCC was significantly associated with a lower risk of sexual intercourse (OR 0.72; 95% CI: 0.61-0.84), unprotected sex (OR 0.84; 95% CI: 0.74-0.96) and unintended pregnancy (OR 0.62; 95% CI: 0.43-0.91) among young people. However, its association with multiple sexual partners was not statistically significant. Higher levels of PCC are associated with lower risks of sexual-related behaviors and outcomes. However, findings should be interpreted cautiously given the high heterogeneity and limited number of included studies. Further research should explore its effects in broader populations, and incorporate prospective designs.