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Abstract

Introduction: US teens are having sex early; however, the vast majority of schools do not implement evidence-based sexual health education (SHE) programs that could delay sexual behavior and/or reduce risky behavior. This study examines middle school staff’s knowledge, attitudes, barriers, self-efficacy, and perceived support (psychosocial factors known to influence SHE program adoption and implementation). Methods: Professional school staff from 33 southeast Texas middle schools completed an internet or paper-based survey. Prevalence estimates for psychosocial variables were computed for the total sample. Chi-square and t-test analyses examined variation by demographic factors. Results: Almost 70% of participants were female, 37% white, 42% black, 16% Hispanic; 20% administrators, 15% nurses/counselors, 31% non-physical education/non-health teachers, 28% physical education/health teachers; mean age = 42.78 years (SD = 10.9). Over 90% favored middle school SHE, and over 75% reported awareness of available SHE curricula or policies. More than 60% expressed confidence for discussing SHE. Staff perceived varying levels of administrator (28%-56%) support for SHE and varying levels of support for comprehensive sex education from outside stakeholders (e.g., parents, community leaders) (42%-85%). Overall, results were more favorable for physical education/health teachers, nurses/counselors, and administrators (when compared to non-physical education/non-health teachers) and individuals with experience teaching SHE. Few significant differences were observed by other demographic factors. Conclusions: Overall, study results were extremely positive, which may reflect a high level of readiness among school staff for adopting and implementing effective middle school SHE programs. Study results highlight the importance of several key action items for schools.

Key Take Away Points

  • Overall, there is broad support for middle school sex education from middle school professional staff.
  • Schools should document and effectively disseminate a clear sex education policy that specifies the need for implementation of evidence-based SHE programs, and is clear about the school’s support, or lack thereof, for education which includes discussions of condoms and contraception.
  • Schools should convey the strong support received from key stakeholders, including school staff and parents, for sex education to important decision-makers.
  • Schools should identify and train the most appropriate individuals to teach sex education.

Author Biography

Melissa Peskin, PhD, Assistant Professor of Health Promotion and Behavioral Sciences at the University of Texas School of Public Health and Associate Director of Dissemination at the University of Texas Prevention Research Center, is an expert in the development, implementation, evaluation, and dissemination of adolescent sexual health programs.

Belinda F. Hernandez, MPH, CHES, PhD candidate in Health Promotion and Behavioral Science at the University of Texas School of Public Health, has research experience with minority populations, adolescents, program dissemination, and intervention-based research.

Christine Markham, PhD, Assistant Professor of Health Promotion and Behavioral Sciences at the University of Texas School of Public Health and Deputy Director at the University of Texas Prevention Research Center, has over 20 years’ experience in child and adolescent sexual health research including family- and school-based programs.

Kim Johnson, MPH, PhD candidate in Health Promotion and Behavioral Science at the University of Texas School of Public Health, has research experience in sexual health disparities, program dissemination, and community-based participatory research, specifically involving youth as investigators.

Shellie Tyrrell, MSW, MPH, Project Coordinator, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, is co-coordinating a middle school pregnancy prevention curriculum dissemination program. She has 15 years experience in maternal, child, and women's health education, including STD/cervical cancer prevention research.

Robert Addy, PhD, Data Analyst, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, is an expert in behavioral sciences, biostatistics, and epidemiology. He is data analyst for studies on childhood & adolescent health, sexual and reproductive health, and the social determinants of health.

Ross Shegog, PhD, Assistant Professor of Behavioral Science at the University of Texas School of Public Health and Associate Director of Communication at the University of Texas Prevention Research Center, is an expert in the application of instructional technology in health promotion and disease prevention to optimally impact adolescent health behavior.

Paula Cuccaro, PhD, Associate Director of Research for the University of Texas Prevention Research Center, is Project Director for Healthy Passages, a longitudinal adolescent health study following a group of youth over a 10-year period. She is an expert in adolescent protective and risk factors, mental health, the needs of foster care youth, and the human-animal bond.

Paul E. “Eddie” deRoulet, MA, LBSW, LCDC is a Public Health Investigator Supervisor with the Bureau of HIV/STD and Viral Hepatitis Prevention at HDHHS. Eddie is a retired U. S. Marine, has taught part time at Houston Community College since 2000 and is active as a board member for the Houston Chapter of Texas Association of Addiction Professionals and the Coalition of Behavioral Health Services.

Susan Tortolero, PhD, Associate Professor of Health Promotion and Behavioral Sciences, and Epidemiology at the University of Texas School of Public Health, and Director of the Center for Health Promotion and Prevention Research and the University of Texas Prevention Research Center, has over 20 years’ experience researching risk and protective factors for adolescent physical and mental health. She is Vice Chair for the Texas Campaign to Prevent Teen Pregnancy.

Acknowledgements

This study was funded by the City of Houston Department of Health and Human Services through the Centers for Disease Control and Prevention.

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Responses to this Article:

Karin K. Coyle, Implications for Adoption and Implementation of Effective Sexual Health Education Programs (October 2011)