Search

We compared sexual/reproductive health services and sexuality education topics provided in Texas alternative high schools (AHSs) with the prevalence of sexual risk behaviors among students in AHS. Using cross-sectional data from convenience samples of 14 principals, 14 lead health educators, and 515 students, we calculated descriptive statistics for 20 services and 15 sexuality education topics provided by AHSs and seven sexual risk behaviors among students in AHS. AHSs provided few sexual/reproductive health services and limited educational content, despite high levels of sexual risk taking among students. For example, no AHSs taught students about proper condom use, yet 84% of students have had sex. Findings provide preliminary evidence of unmet needs for school-based sexual/reproductive health services and comprehensive sexuality education in AHS settings. Future investigation with larger, representative samples is needed to assess the provision of sexual/reproductive health services and sexuality education in AHSs and monitor sexual risk behaviors in the AHS population.

Game-based learning offers an interactive and effective way to teach health content and skills. This article discusses feasibility testing of "Using the Connect" ("UTC"), an innovative, game-based sexuality education program to evaluate its acceptability among youth. Utilizing mixed methods in a single case study design, qualitative and quantitative data was collected from youth (surveys, facilitated discussions, and observations). Qualitative data triangulated quantitative findings that youth liked the program design, felt the games and content were relatable, and learned knowledge and skills around adolescent development, accessing information, communication, and making healthy decisions through playing the games. Overall, "UTC" was highly acceptable to the youth; they had fun and learned information and skills. Not only would most participants recommend the program to friends, all reported they would participate in the program again and use the information they learned in the future.

School-based sexuality education provides a means of disseminating valuable information about decision making and avoidance of risky behaviors that may result in an unplanned pregnancy or sexually transmitted infection; however, effective teacher training is required for efficacious sexuality education programs. The purpose of this paper is to describe changes in participants' perceptions and adoption of evidence-based sexuality education after attending a unique professional development opportunity for teachers of sexuality education using a Diffusion of Innovation Theory framework. Methods: A non-representative sample of 20 public school health education teachers (85% female) from across the state of Texas participated in the Sexuality Education Academy (SEA), and completed pre-, post-, and six-month follow-up Web-based surveys. Descriptive statistics and Wilcoxon signed-rank tests were used to measure change in perceptions and adoption of evidence-based sexuality education. Results: Statistically significant changes were found between pre- and post-test scores in "relative advantage," "compatibility," "complexity," and "observability." At six-month follow-up, participants indicated increased advocacy for and implementation of evidence-based sexuality education practices. Conclusions: Teacher training can improve sexuality education teachers' understanding, confidence and effectiveness in delivery of evidence-based sexuality education within school settings.

This study assessed the prevalence of verbally being put down by others and intrapersonal and normative factors associated with being put down by others among middle and high school students. Students (N = 1,027) completed the Adolescent Health Risk Behavior Survey. Over 16% of participants reported being put down at school. Students who identified with the negative words confused, unattractive, dull, and careless and identified less with the positive words popular, smart, considerate, cool, and self-confident reported being put down by others. High school students were less likely to be put down. As students scored higher on the Negative Self-Description Scale, their odds of being put down increased. As students scored higher on the Positive Self-Description Scale, their odds of being put down decreased. Students who perceived their friends drinking alcohol regularly were less likely to be put down. Strategies to enhance self-perceptions to raise self-awareness and form healthy/positive identities are needed.

In the USA, persons of Hispanic ethnicity experience higher rates of adolescent pregnancy and STIs than non-Hispanic white youth and there exists a lack of research concerning the sexuality education preferences of Hispanic adolescents. This study describes sexual health education preferences by Hispanic ethnicity among a high-risk sample of young people aged 14-20 years in Texas. Data were collected from participants in a teenage pregnancy prevention programme. Questions included preferred topics, provider of information and learning modality. Just over half of the participants was Hispanic (60%), nearly all participants were sexually experienced (96%) and more than half had been pregnant or caused a pregnancy (66%). Hispanic participants were significantly less likely to want to learn about sexual health from parents compared to non-Hispanic participants. Hispanic participants were also significantly less likely to prefer to learn about puberty and adolescent development, or to select role-playing as a preferred learning modality. Findings from the study provide evidence about the kind of sexual health topics US Hispanic adolescents are interested in as well as from who they prefer to receive sexuality education. Understanding these educational preferences can be useful to inform future policy and programming.

Faculty and staff health promotion is a cost-saving component of coordinated school health, but little is known about the comprehensiveness of these programs. Self-insured school districts require employees to contribute directly to the district's health insurance pool. The purpose of this pilot study was to identify the prevalence of self-insurance within Texas school districts and compare districts' health promotion efforts to agency-insured counterparts. Using an electronic questionnaire, human resource personnel described the characteristics of their district's insurance status, health insurance coverage, health promotion program components, and considerations when planning health-promoting activities or services for school faculty and staff. Thirteen percent of respondents reported their school districts as self-insured. No significant differences between self-insured and agency-insured districts were discovered regarding health insurance coverage, district-offered health promotion, physical activity promotion, planning considerations, or utilization of community resources. Regardless of insurance type, findings indicated an overall lack in comprehensiveness of district-offered health promotion services. This study supports the need to further investigate this school health component so that district employees can financially and physically benefit from health promotion activities or services.

Background: Violent behaviors have devastating impacts on youth and adolescents. National standards offer a framework for age and developmentally appropriate health education expectations. This study provides findings from a systematic review and analysis of teen dating violence (TDV) prevention curricula using National Sexuality Education Standards (NSES) and National Health Education Standards (NHES). Methods: Evidence-based and/or practice informed interventions for TDV prevention were compiled and analyzed. We used a standardized review instrument to analyze each curriculum (N = 11); each curriculum was reviewed independently and results met inter-rater agreement requirements. Data were analyzed to determine NSES and NHES inclusion. Results: This study provides findings from the TDV prevention curriculum analysis using the NSES. Five NSES topic areas were addressed in the TDV prevention curriculum and included personal safety, healthy relationships, identity, sexually transmitted diseases and human immunodeficieny virus, and pregnancy and reproduction. Personal safety was the most included topic and ranged from 37% to 77%. Healthy relationships were the second most included NSES and ranged from 11% to 53%. Inclusions of NHES skills, as they are embedded within the NSES, are identified. Conclusions: Curricula decision-makers gain insight by conducting reviews before recommendations are made or the adoption process is complete. The NSES and NHES support expectations for TDV prevention and can guide curricula adoption for a school or district. School professionals should work together to ensure TDV prevention curricula complements sexuality education units. While TDV curricula may cover critical topics, a singular focus on one content area cannot replace comprehensive sexuality education.

State policy and curriculum standards establish general guidelines regarding sexuality education while local school boards decide how teachers provide sexuality education. Local school districts may utilize programs and speakers from outside organizations and locally produced materials for sexuality education. Purpose: This article examines Texas curricular materials that commonly rely on scare and shaming tactics to teach students sexuality education. Methods: Materials provided by 990 Texas school districts were evaluated. The information related to the content of sexuality education was catalogued and entered into an SPSS database. Results: Problems with fear-based instruction about sexuality fell into three broad categories: 1) exaggerating negative consequences of sexual behavior; 2) demonizing sexually active youth; and 3) cultivating shame and guilt to discourage sexual activity. Conclusions: Informing students about realistic consequences of sexual activity is a vital element of sexuality education; however, in their eagerness to scare students away from a behavior (i.e. sexual activity), teachers use exaggerated, misleading, and misinterpreted facts. Recommendations: Young people need scientific, medically accurate information about sexuality to help them make healthy decisions. The use of fear, shame and guilt are not supported educational strategies in sexuality education.

At-risk adolescents may experience Social Determinants of Health (SDoH) that lead to higher rates of risky sexual behavior, including increased risk of pregnancy and sexually transmitted infections. These SDoH may include components such as unstable family structures, incomplete education, and poverty. Targeting at-risk youth for sexuality education is one way to work toward decreasing sexual health disparities. However, preferences for sexuality education approaches may differ among at-risk youth by additional factors including sex and sexual orientation. The purpose of this study was to describe sexuality education preferences among at-risk youth and how sexuality education preferences differ based on sex and sexual orientation in an at-risk sample of high school-aged youth in Texas. Results indicate sexuality education preferences differ based on sex and sexual orientation when examined by sexual health topics and methods of delivery. Implications of this study indicate including at-risk youth in sexual health programs may be a way to target those at-risk of adverse SDoH, but these groups also have specific preferences for sexuality education.

BACKGROUND: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth‐centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school‐based clinics. METHODS: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web‐based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: School‐based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health‐related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe college-aged females' human papillomavirus (HPV) knowledge and beliefs, perceptions and perceived benefits of the HPV vaccine, and identify characteristics associated with vaccination status and support for HPV vaccine mandates. Data were collected from 1,105 females by an Internet-delivered questionnaire during February to March 2011. This descriptive study utilizes ?[superscript 2] tests and t-tests to compare participant responses. HPV-related knowledge scores were 8.08 out of 11 points. Those who initiated HPV vaccination were significantly younger, single, engaged in sex, were sexually active, and had a Pap test. Participants who had more friends receiving the vaccine were significantly more likely to support mandates for 9-11 and 12-17 years and were more likely to complete the HPV vaccination cycle. Findings suggest the importance of educational programs adopted and delivered by school nurses, which aim to improve student knowledge and reduce misconceptions related to the HPV vaccine and vaccination mandates.

Background: We examine personal characteristics, alcohol consumption, normative beliefs, household factors, and extracurricular engagement associated with intentions to have intercourse before marriage among abstinent students. Methods: Data were analyzed from 245 freshmen enrolled in a school-based abstinence-only-until-marriage program. Two binary logistic regression analyses identified factors associated with intentions to engage in intercourse before marriage and within the next year. Results: Approximately 21% and 14% of participants reported intentions to have intercourse. Respondents participated in 2.2 (standard deviation [SD] = 1.2) extracurricular activities. Freshmen who were male, perceived their friends to approve of premarital sex, and consumed alcohol were more likely to report intentions to have intercourse. For every additional extracurricular activity in which freshmen participated, they were less likely to report intentions to have intercourse within the next year (odds ratio [OR] = 0.56). Conclusions: Factors such as extracurricular activities provide youth with opportunities to build supportive relationships, connect with peers and role models, and positively engage in schools and communities. Extracurricular activities typically already exist, have funding, and are generally well-supported. School-based strategies can increase teenagers' autonomy by providing a variety of activities to participate in and reduce unsupervised time. This, in turn, has the potential to decrease sexual risk taking behaviors.

Background: Many programs emphasize subsequent pregnancy prevention and high school graduation among teenage mothers; however, less is known about their ability to increase financial earnings from employment opportunities while concurrently enrolled in school. This study evaluates factors influencing employment status among teenage mothers after enrolling in a community-based randomized intervention. Methods: Project Mothers and Schools (PMAS) initiative participants were surveyed at baseline and 12 months after enrollment. The 56 control group participants received homebound education and family case management, whereas the 59 intervention group participants received these basic-level services as well as group parenting time, life skills, and leadership training. A generalized estimating equation was used to identify statistically significant changes associated with the intervention. Results: Participants were significantly more likely to receive money from their jobs at postintervention relative to baseline (OR = 4.75, p = 0.023); however, this change was not statistically significant when comparing the control group to the intervention group. At postintervention, those who received money from parents were significantly less likely to receive money from their job (OR = 0.12, p = 0.002). Conclusions: While PMAS benefited participants in terms of employment, the role of parental support requires additional investigation to determine its influence on teenage mothers' ability to achieve financial independence.

Background: The ways in which adolescents define and view sex, abstinence, and virginity impact the efforts of sexuality educators and sexual health professionals. This study examined terminology used by nonsexually active high school students to define abstinence and virginity and identified words students associate with these terms. Purposes included (1) describing words/phrases associated with abstinence; (2) describing phrases for "being abstinent until marriage" and "being a virgin;" (3) assessing concordance between word dyads associated with abstinence; and (4) assessing concordance between phrases defining "abstinent until marriage" and "a virgin." Methods: In this study, 216 freshmen provided information about beliefs, behaviors, and perceptions. Pearson chi-square tests and Wilcoxon sign-rank tests assessed sex-based differences, definitions, and levels of concordance were conducted. Results: Girls' friends took an abstinence pledge (p?=?0.004) and their parents (p?=?0.025) and best friends (p < 0.001) think they should abstain. Male counterparts reported being dissatisfied with current sex status (p?=?0.002) and high acceptance of sex before marriage (p?=?0.011). Boys were more likely to endorse "negative" words than girls. Conclusions: Professionals need to use relevant materials incorporating terminology that resonates with adolescents and programs that engage coherent participant discussions.

The worldwide burden of diseases, environmental threats, and injuries help establish the global context and need for credentialing in health education and promotion. To ensure effective practice by certified or credentialed individuals, it is critical that the global health education and promotion workforce identify, agree on, and establish core competencies grounded in knowledge, skills, and abilities to strengthen the global capacity to improve the practice of health education at the entry and advanced levels. Dialog regarding the development of Domains of Core Competency for global capacity in health promotion has occurred. One unique process for granting certification was how a U.S. certifying organization used an Experience Documentation Opportunity to validate advanced-level professional competency. In this article, a one-time, 6-month opportunity in certifying advanced-level health education specialists is documented, and the implications of these results on the Domains of Core Competency are discussed. The authors provide valuable insight for health education professionals worldwide on establishing a process for quality assurance and accountability and alignment with the current global competency discussion. The Experience Documentation Opportunity process also may be useful in international efforts to establish certification based on core competencies. (Contains 4 tables.)

Background: Given the growing scientific evidence against abstinence-only-until-marriage education, health educators are supporting an evidence-based approach to teaching sexuality education. However, there is still an abundance of federal support and funding streams allocated to sustain abstinence-only programs. This study assessed indicators that influence the adoption of abstinence-only-until-marriage education as well as school teachers' likelihood of adopting such programs. Methods: Predictors included relative advantage, compatibility, complexity, and observability and were assessed with a self-administered, validated questionnaire. Additional questions were asked related to demographics, professional history, and abstinence-only-until-marriage education policies and funding. The relationships were tested with multiple regression analysis. Results: A trend became apparent in which most teachers would allow a state- or federally funded program to be offered and presented in their schools, but most did not know if their school received funding to support abstinence-only-until-marriage education. Attendance at religious services, complexity of abstinence-only-until-marriage programs, and abstinence-only-until-marriage curriculum emerged as important predictors of the likelihood to adopt abstinence education. Conclusions: Trends in political agendas, policy development, and state and federal funding have supported abstinence-only-until-marriage education programs. In order to ensure an understanding about the inclusion of sexuality education in the classroom, insight into the teacher's role in the integration of sexuality education in the classroom is important. (Contains 5 tables.)

The authors reviewed the content, methods, and overall quality of 21 curricula used in abstinence-only-until-marriage programs. Only materials designed for use in middle school grades (fifth to eighth) or with middle school-aged audiences (9-13 years of age), which presented the abstinence message in at least 40% of their content, were included. A rating instrument adapted from 2 sets of education guidelines structured the assessment of each curriculum. Four experienced teachers rated each curriculum. Curricula exhibited considerable variability, in overall quality ratings. While on average, materials scored a 3.33 on a 1-to-5 scale (1 = Unacceptable; 5 = Excellent), 12 curricula received summative scores above the average, with 4 scoring 4.0 or higher. Eight curricula, however, received a below-average rating. While abstinence materials vary considerably in terms of overall quality; the values and world views underlying this sample of curricula were clear and consistent: those who develop abstinence education curricula value nonsexual antecedents of sexual behavior such as skills (goal setting, decision making, and assertiveness), deals (fidelity, friendships), and psychological factors such as self-esteem. (J Sch Health. 2005;75(3):90-98)

Historically, traditional school health programs involved a three-component model (health education, health services, and healthful school living). Though the eight-component model, later received widespread attention, the health education profession was resistant. Over time, a preference for the coordinated school health model arose. Confusion persists about when to use the terms "coordinated" and "comprehensive." An analysis of the impact of terminology on school health program implementation is included. (SM)

This study examined the association of demographic and other factors with acceptance of sex before marriage among 262 male and female freshmen attending Missouri high schools who reported they had [...]

We compared sexual/reproductive health services and sexuality education topics provided in Texas alternative high schools (AHSs) with the prevalence of sexual risk behaviors among students in AHS. Using cross-sectional data from convenience samples of 14 principals, 14 lead health educators, and 515 students, we calculated descriptive statistics for 20 services and 15 sexuality education topics provided by AHSs and seven sexual risk behaviors among students in AHS. AHSs provided few sexual/reproductive health services and limited educational content, despite high levels of sexual risk taking among students. For example, no AHSs taught students about proper condom use, yet 84% of students have had sex. Findings provide preliminary evidence of unmet needs for school-based sexual/reproductive health services and comprehensive sexuality education in AHS settings. Future investigation with larger, representative samples is needed to assess the provision of sexual/reproductive health services and sexuality education in AHSs and monitor sexual risk behaviors in the AHS population. [ABSTRACT FROM AUTHOR]