Search

Despite national guidelines advocating a comprehensive, age-appropriate, and sequential approach to sexual health education in schools, many young people in the USA do not receive sexual health information until high school. To date, there has been little research on the need for a supplemental round of sexual health education -- a 'booster' -- later in adolescence to reinforce and expand upon information and skills previously provided. In rural California, we conducted six focus groups with young people (N = 22, ages 14-20) and key informant interviews with youth-serving professionals (N = 10) to examine the sexual health education needs of youth as they complete high school. Five themes were identified, indicating a need for booster education that 1) reinforces existing sexual health knowledge; 2) expands beyond traditional areas of sexual health education; 3) addresses community stigma about adolescent health; and 4) prepares young people for the transition to adulthood. In addition, booster education should 5) be established within the school system to promote an environment that addresses and normalises health issues throughout the school year. Providing booster sexual health education may meet critical gaps in efforts to support the healthy sexual development of young people, especially those living in rural communities.

Background: Adolescents often lack access to accurate and appropriate sexual health information and services. Providing information about local clinical services during sexual health education classes is one strategy to increase awareness, yet many programs miss this opportunity. This study aims to learn about adolescents' experiences with sexual health education and their perceptions of barriers and facilitators to clinical care. Methods: Nine focus groups were conducted between April to July 2018 with 69 adolescents who had recently attended a comprehensive sexual health education program in California. Topics included information received about local clinics during class and barriers and facilitators to access care. Qualitative data were coded and analyzed for key themes and compared by sex and geographic location. Results: The majority of participants (89%) were Latino and most reported receiving relevant information about clinical services and had positive impressions of local services. Several mentioned that this information increased the likelihood that they would access services if needed. Common barriers to clinic services included parental disapproval, stigma, embarrassment, and confidentiality concerns. Facilitators included peer and family support, confidentiality of services, awareness and education, and accessibility. Conclusions: Sexual health education programs can provide an important bridge to local clinic services and address adolescents' concerns.

This article examines neighborhood-level factors to help explain why adolescent birth rate trajectories differ in certain communities in California, with rates in some areas remaining elevated or increasing while rates in other areas with similar demographic characteristics declined. Researchers conducted in-depth interviews with 94 community stakeholders and 22 focus groups with 186 adolescents from five "promising" communities (with declining adolescent birth rates) and five "struggling" communities (persistently elevated or increasing rates). Promising communities had more employment prospects, better neighbor interactions, and greater educational opportunities for youth. Parent-child communication around sex and youth knowledge of clinics were also more common. In contrast, struggling communities tended to have higher perceived levels of crime and poverty and more negative attitudes toward youth. These findings illustrate the complexity of factors that influence adolescents' lives and decision-making. Synergistic community-based approaches to adolescent health and development are critical to promote positive health outcomes.