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BackgroundExisting research has shown that the parent-adolescent relationship and its associated communication and interaction styles are important for adolescent development and outcomes. Measuring parent-adolescent communication and interaction using self-report methods has substantial research limitations. Video observational methodologies offer a novel and more objective approach to measuring parent-adolescent communication and interaction from the point of view of participants. This study aims to explore the feasibility and acceptability of this methodology, and analysis using automated coding software in an urbanized context.MethodsThis study recruited parent-adolescent pairs in Soweto, South Africa which included 11–15-year-old adolescents and their biological parents. Parent-adolescent communication and interactions were measured using novel video observational portable head cameras called “Teencams”. Feasibility was evaluated by testing three observational game tasks (Matching pairs card game, Jenga and Charades) to stimulate communication and interaction between 16 parent-adolescent pairs, and the Teencam's ability to record video and audio content. Acceptability was explored using one-on-one interviews with the parents (n = 14), on whether they found the Teencam comfortable to wear, whether the parents believed their adolescents acted naturally, and which observational game tasks were feasible during their interactions. The videos were analysed using automated coding software called FaceReader which detects and codes basic facial expressions.ResultsThe Teencam methodology was found to be feasible and acceptable amongst parent-adolescent pairs in Soweto, South Africa. The Matching pairs card game stimulated excellent interaction and communication with good video and audio quality. Some feasibility limitations were identified in the operations (switching on/off and starting recording), the ability of the device to cope with the movement of the participants, and the lighting conditions of the room, all of which resulted in poor coding and analytic output from FaceReader. Refinements and adjustments were made to the methodological protocol by improving the head cameras and lighting conditions and refining the Matching pairs card game, which resulted in improved analytic output from FaceReader.ConclusionBased on these findings, a methodological protocol was developed to measure parent-adolescent interaction and communication in an urban setting. The unique contribution of this research lies in its potential to lead to improved methodologies for measuring parent-adolescent communication and interactions.

Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalisation, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counsellors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement and custody planning. An uncontrolled pre-post evaluation study with 281 families showed the intervention was feasible, acceptable and effective in increasing maternal disclosure. The aim of this manuscript is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms and activities; and to present a summary of results from the large scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for the child. The intervention model demonstrates the potential for disclosure interventions to include pre-adolescent HIV education and prevention for primary school-aged children.