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Why it’s so important to start early, why important for it to be sustainable, how it can be sustainable
Introduction
Proper Sexuality and Reproductive Education (SRE) is vital in ensuring the health of our nation. Currently in the United States, only 24 states require any sort of sex ed, and only 21 of these states require sex ed and HIV instruction.15 In part due to these statistics, the United States has one of the highest teen pregnancy and HIV rates in the developed world. While these rates have declined substantially in recent years, many more steps must be taken to provide children with the resources and information they need to avoid becoming a participant in these statistics. One of the most important factors in the efficacy of sex ed programs is the age at which material is taught. While many SRE classes across the nation are targeted at middle and high school students, research shows that this might already be too late.12 11
According to a recent Georgetown University study, children should begin receiving sexual health instruction as early as the age of ten. Researchers designated the period between the ages of 10 and 14 as a time of rapid evolution in the child’s gender and sexual identity, and recommended that SRE begin in the very early stages of this period, when the children are still “malleable” and “relatively free of sexual and reproductive health problems and gender role biases”. Contrary to this recommendation, a majority of current American students don’t receive formal sexual education instruction until after they have become sexually active. Starting SRE at an earlier age provides students with the necessary tools to find their way during a period of immense change and development, whereas SRE programs that don’t reach a child until late in the stages of development leave students in the dark and can result in risky or harmful sexual behavior. The study also suggests that the earlier implementation of SRE would directly result in the significant decrease of unintended pregnancies, unsafe abortions, maternal deaths, and cases of sexually transmitted diseases. 12
A 2017 study in England supports this assertion that SRE should start earlier. 19 experts were brought together to identify best practice in the reproductive health education process, and the consensus of these professionals was that a “good” SRE program is “delivered from primary school onwards”.1
Sustainability of the SRE Program
As part of a study meant to determine best practice in sex and relationship education, a conference was organized that brought together 19 experts in the field of SRE. At the meeting, a list of guidelines and best practices in SRE curriculums was put together. The experts came to a consensus that to increase an SRE program’s chance of success, measures should be implemented to ensure that instruction is both sustainable and is incorporated into the “ethos” of the school (guiding principles and values); for example, building healthy relationships and challenging stereotypes are examples of core values that a school may have that tie into SRE curriculum.1 Essentially, core values in SRE education should be embedded in the values of the school and be reinforced regularly.
One of the core pitfalls in modern American sex ed courses is the idea of a “one-day class”. In a study conducted by the CDC, it was found that the average yearly class time spent on SRE related topics was only 4.2 hours in high schools and 2.7 hours in middle schools.16 The 19 experts were in consensus that SRE should be taught regularly and sustainably throughout the school year, and the equivalent of 3 or 4 class periods that the average American school currently spends is most certainly not in accordance with this recommendation. Additionally, a 2001 study by Mayer and Chandler supports the assertion that sustainable, regular learning is generally more effective than one-time instruction, where a student must process a large amount of information in a very short amount of time (17, pg 211).17 A sustainable, long-term curriculum is vital to the SRE education of students and is supported by both general learning principles and and by the recommendation of experts in the reproductive health education field.
While instituting weekly/biweekly/monthly SRE courses at a school is one intuitive way to implement these recommendations, another solution would be to embed facets of the SRE curriculum into other classes1. For example, English courses could include literature in their year-plan that promotes or includes aspects of the SRE curriculum, and Science courses could go over human anatomy while also incorporating SRE best practices (not just teaching scientific aspects of SRE as facts). However, for optimal efficiency the different parts of the SRE curriculum should be spread out throughout the year. While teachers often have the choice of when
Additionally, as part of creating a sustainable SRE curriculum, experts agreed that teachers should use the “spiral” method, coming back to previously discussed topics throughout the year and reinforcing them so that students can gain a comprehensive and complete understanding of the subject matter.
All of the above methods are strategies to improve the durability of a school’s SRE curriculum. However, the effectiveness of these strategies are fundamentally undermined if teachers do not have access to proper SRE training. Currently, only 61% of American Universities require SRE courses in order to receive health education certification18; this statistic is highly alarming and suggests that unqualified instruction of SRE is a commonplace in the United States. This incomplete training of American teachers inevitably leads to lower quality sex ed courses, and significantly decreases health education teachers’ confidence in teaching a subject that is difficult to talk about in the first place:
“You have teachers walking into a classroom who are uncomfortable or don't feel very capable. Unfortunately, that sends a message almost as strong as giving the wrong information.” 18
– Debra Hauser, the executive director for the Washington-based group Advocates for Youth
A 2014 study focused specifically on this aspect of teacher self-confidence. Researchers constructed a 4 week course for SRE uncertified instructors, concluding the study with a questionnaire that showed improved teacher attitudes toward sex education, increased perceived self-efficacy and improved sex education skills.4 This study ultimately shows how important teacher training is in improving the quality of SRE. The improved teacher attitude ties into the sustainability of a sex education program, as it may make instructors more likely to incorporate their learnings into regular lesson plans. 8 (8, pg 5)
Get real, a curriculum published by Planned Parenthood, incorporates many of the best practices discussed above.13 The Get Real organization also publishes upcoming teacher training events on its website (http://getrealeducation.org/teacher-training ), and they see instructor training as the foundation of an effective sex ed program. The curriculum begins in the 6th grade (or around the age of 11), within the period researchers recommend SRE be introduced, and goes all the way until high school. For the middle school portion of the Get Real programming, there is an estimated 7 hours of content per year, as compared to the current national average of 2.7 hours hours for middle school students. In high school, this number jumps up to 8 hours per week, nearly double the national average. By the end of the course, students would have sat through a total of 38 SRE sessions (the course is split up into ~45 minute sessions that are meant to be taught separately), a number that allows for a sustainable distribution of content throughout the 4 year program (nearly 10 sessions a year, meaning at least 1 session a month not including potential sessions to reinforce material using the spiral method).
In addition to implementing many of the scientific recommendations pertaining to the age of exposure and program sustainability, Get Real emphasizes content that is proven to delay sexual activity among teens. Some of the core values the curriculum stresses are as follows:
Abstinence is the healthiest choice, but students need a “comprehensive understanding of sexual health, sexuality and protection methods, which they will need when they become sexually active”
Relationship Skills
Parents as students’ primary sexuality educators
Get Real recognizes the parents’ important role in their child's sexuality education, and provides them with informational pamphlets that go over what is being covered in class, along with a Family Activity to help reinforce what a student has learned. Parents are also supported with strategies and tips for how they can best talk about SRE with their child.
SRE Best Practices/Goals:
Cultural level
Curriculum should be culturally sensitive, but still be medically accurate and provide needed information
Community level
Curriculum should emphasize topics important to a specific community (for example if HIV is a problem within the community, it should be emphasized)
The program should involve parents, staff members, as well as students. There should be an open line of communication between the parents and the school, and parents should be given a platform to provide their input.2 13
School/Curriculum level
SRE should be part of a “whole school ethos”, meaning that SRE should take place in a school environment that fosters a core set of “principles and values”1
SRE should “teach life skills”, ie planning and communication skills1
SRE should not be delivered in one day/all at once – professionals consider an ongoing, regular (ie weekly) program to be best practice1
However, if one-day programs “supplemented an ongoing program”, professionals agreed this was a great way to give students access to “external educators”1
SRE should reflect sexual diversity, challenge harmful gender stereotypes, and “discuss relationships and emotions”1
Young people included in the study agreed that SRE should be taught to small groups of students as opposed to larger groups that could be harder to control1
“Spiral” approach to curriculum – this means that educators should return to previously discussed topics, however professionals also agreed that educators should avoid “inappropriate repetition” if students feel like they have gotten a solid grasp on a topic
Student-teacher interpersonal level
Distancing techniques should be avoided (ie discussing fictional accounts, not allowing students to share personal stories) as they could lead to some students disengaging 1
Professionals agree that teachers should be involved in SRE education, if they have the proper training to do so (though they often don’t)1
Curriculum should stay away from teaching scientific and biological facts, and should instead focus on
Intrapersonal level (Teacher)
Help teachers become confident in their ability to teach sex education, change teacher attitude toward sex education 4
Addressing Parent Concerns 1 10
Parents are specifically concerned about their child learning to much information about sex at too young of an age, as they see SRE as a practice that effectively strips children of their “innocence”. 19 However, parents must understand that this purely anecdotal concern pales in comparison to the real, everyday threats sexually uneducated adolescents face, including the epidemics of teenage pregnancy and STIs.
Lack of Communication
Religious Beliefs/Family Values
Teacher Qualification
Desire to teach topics at home
Teacher is taking over parent responsibility
Parent wants to tailor teachings based on their own beliefs and values
Addressing Teacher Concerns 9 (9, pg 51)
Concern about Information
Concerned about whether they are using age-appropriate terminology
Feel like they don’t know enough to teach SRE
Parent reaction/support
The curriculum can’t please everybody, afraid of conflict with parents
Parent reaction to gender of teacher (eg male teacher instructing about menstruation)
Afraid that parents will blame teachers if student acts up at home (inappropriate touching, etc.)
Conflict with Personal belief
Religious
Abstinence until Marriage
Belief that parents should teach SRE
Discomfort and embarrassment teaching the topic
Teacher becomes uncomfortable because students are uncomfortable
Students will likely ask question teacher will be uncomfortable answering
Collegial Concerns
Worried about working on the curriculum with teachers that have different beliefs
Suggested Action Plan to address stated goals:
Teacher training
Should address specific curriculum to be implemented, as well as boost teacher confidence in delivering material
Gathering Feedback from students and teachers
Parent Forum/Addressing Parent Concerns
An open forum should be held for concerned parents/parents with questions
Forum could communicate specifics of the Get Real curriculum
Implement Get Real Curriculum (http://www.etr.org/get-real/ )13
Curriculum Ground Rules
An age-appropriate curriculum should be implemented and communicated with the parents
The curriculum should be sustainable – this means that topics in the SRE curriculum should be implemented throughout the year, and teachers should stay away from delivering the whole curriculum in a single day or week
The curriculum should stay away from just stating facts (scientific and otherwise) and should aim to encompass open-ended topics such as relationship building and the transition into adulthood and what that means
Examples of Effective SRE Education Across the Globe (Primary School):
Dutch Sexuality Education Curriculum
Norway Sexuality Education Curriculum
Conclusion
Bibliography:
1: What is best practice in sex and relationship education? A synthesis of evidence, including stakeholders' views.
https://www.ncbi.nlm.nih.gov/pubmed/28669970
2: Exemplary Sexual Health Education
https://www.cdc.gov/healthyyouth/fundedpartners/1308/pdf/DASH_1308_FOA_Support_Materials.pdf
3: Perceptions of Elementary School Children's’ Parents Regarding Sexuality Education
http://utdr.utoledo.edu/cgi/viewcontent.cgi?article=2632&context=theses-dissertations
4: Helping Teachers Conduct Sex Education in Secondary Schools in Thailand: Overcoming Culturally Sensitive Barriers to Sex Education (2014)
http://www.asian-nursingresearch.com/article/S1976-1317(14)00020-6/fulltext
5: Improving sexuality education: the development of teacher-preparation standards
https://www.ncbi.nlm.nih.gov/pubmed/24749922
8: Sex Education in Primary School in Tayside – an Evaluation of Sexuality and Relationships Training for Primary Teachers
http://dera.ioe.ac.uk/7028/1/0040755.pdf
9: TEACHING SEXUALITY AND SEXUAL HEALTH EDUCATION AT A RURAL GOVERNMENT PRIMARY SCHOOL IN THE NORTH EASTERN EDUCATION DISTRICT: TEACHERS’ CONCERNS
http://uwispace.sta.uwi.edu/dspace/bitstream/handle/2139/41191/Savitri%20Emmanuel.pdf?sequence=1
10: Parents and Sex Education – Parents’ attitudes to sexual health education in WA schools
http://www.healthywa.wa.gov.au/~/media/Files/HealthyWA/Original/Sexual-health/SexualhealthParentsShortReport.ashx
11: Sex Ed Classes Should Start As Early As Age 10, Researchers Recommend
https://thinkprogress.org/sex-ed-classes-should-start-as-early-as-age-10-researchers-recommend-6126894c226c
12:Investing in very young adolescents' sexual and reproductive health – Georgetown
http://irh.org/wp-content/uploads/2014/05/Investing_in_VYAs_SRH_2014.pdf
13: Get Real
http://www.etr.org/get-real/
14: CDC – Sexual Health Education: Scope and Sequence
https://www.cdc.gov/healthyyouth/hecat/pdf/developing_scope_factsheet.pdf
15: State Policies on Sex Education in Schools
http://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx
16: Results from the School Health Policies and Practices Study 2014
https://www.cdc.gov/healthyyouth/data/shpps/pdf/shpps-508-final_101315.pdf
17: E-learning and the science of instruction(2011)
http://www.nextlearning.cl/PDF/e-learning.pdf
18: New Teacher-Preparation Standards Focus on Sex Education (2014)
https://www.cdc.gov/healthyyouth/data/shpps/pdf/shpps-508-final_101315.pdf
19: “They Need to Know the Truth”: Parental Opinion on Sex Education in Schools versus Sex Education in the Home
https://www.academia.edu/4230102/_They_Need_to_Know_the_Truth_Parental_Opinion_on_Sex_Education_in_Schools_versus_Sex_Education_in_the_Home
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