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Essay: Bridging the Gap: Effective Sex Education for Adolescents with Decision Science Principles

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  • Published: 1 April 2019*
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  • Words: 2,610 (approx)
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The increasing prevalence of sex education across the United States does not support the disproportional rate of sexually transmitted diseases among adolescent teens compared to that of adults. The existing sex education curriculum has a significant gap of knowledge between the educator and the student, which can be filled by understanding how adolescents make sexual decisions and what implementation can successfully create change. Decision science principles such as the hot-cold empathy gap, risk tolerance, and social desirability bias can bridge the gap of disparity and put an effective sex education program in to effect. Through thorough research, online learning stimulation is the best platform to reduce sexual risk in teens.  

Significance

Sex education doesn’t carry the importance that it should, when it is a topic that all people should learn and remember for the rest of their lives. Because sex education is not consistent throughout the United States, the basic knowledge students acquire during their adolescent years is incorrectly assumed to be everything they need to know. Only 13 states in the United States of America require sexual education to be medically accurate (Guttmacher Institute). Thus, the public has to figure out a significant portion of uncovered crucial material independently. The gap of understanding that exists between the instructor and the student prevents information from being retained correctly by the student.

In light of countless buried cases of sexual violence and assault coming up to the surface, there is a reason to question if the existing sex education curriculum effectively addresses all the necessary life skills and information that adolescents can successfully retain until adulthood. The debate about whether or not sex education is effective in encouraging adolescents healthy sex choices is still ongoing. Without a clear basis of understanding on what content needs to be addressed for the adolescents receiving sex education, the education program cannot have a successful intervention to target adolescents’ misconceptions about sex and its risks. Decision science principles improve the understanding of adolescent sexual behavior, and how their normative decision-making model is not necessarily rational.

Hot-cold Empathy Gaps

The hot-cold empathy gap explains risky sexual risky behavior in adolescents. Emotionally collected individuals make more rational decisions compared to those who are emotionally heated, or “hot”. Individuals in their cold state are unable to predict their behavior in their hot state. Dan Ariely and George Lowenstein discuss “the heat of the moment” in their 2005 paper about sexual decision making in sexually aroused individuals. The same way cold state individuals are unable to picture their hot state-self, non-aroused individuals also cannot predict how they would act when aroused. This study brings up a crucial factor that goes neglected in most sex education curricula: uncertainty. Vague teachings of complex topics such as sexual intimacy can leave the adolescent unprepared in real-life situations. It is imperative to include the unpredictability of intimate situations due to uncontrollable emotions sparked from physiological change. The participants in the sexually aroused state were more likely to answer yes to controversial questions that they normally would not answer yes to (Ariely & Lowenstein, 2005). These questions ranged from “morally questionable” methods to obtain sex to bestiality, rape, and pedophilia. The extremity of questions asked and the responses from sexually aroused participants show the unexpected danger behind pleasure.

However, for questions about STDs and pregnancy prevention, responses from both non-aroused and aroused groups stayed rather consistent. While arousal did not change the individual’s knowledge on the risks of unprotected sex, it did influence one’s perceptions of weighing the advantages and disadvantages of preventing unprotected sex.

Normative Model of Adolescent Sexual Risk Behavior

The failure to capture the complexity of adolescent sexual decision-making prevented researchers in the past from understanding adolescent sexual risk behavior (Kotchick, Shaffer, Miller, and Forehand, 2001). An effective sex education curriculum should cover all variables that influence an adolescent’s sexual decision-making and risk behavior. Kotchick et al. (2001) depicts adolescent sexual risk behavior in a multisystemic perspective, including a family system, extrafamilial system, and self system. The reciprocal and interactive relationship among those systems show that an identification of common external factors that may contribute to the teen’s sexual decision and how those factors influence each other are vital steps to implement an effective education plan.

Often times, adolescents continuing to engage in sexually risky behavior despite receiving sex education is misinterpreted as adolescents not knowing the consequences of engaging in risky sexual behavior. In some instances, the adolescent is clearly aware of the existing risks, but choose to engage in risky behavior to promote other goals. For the adolescent teen, the perceived benefit of the risk outweighs the goal. In most young adolescents with sexual decision making, there are so many external factors around sex that some circumstances lead to adolescents believing that unwanted sex is the most logical option (Farris et. al, 2013). External factors such as social inclusivity and relationship damage could influence the teenager to outweigh the current negative over the future positive. Following the previous example, the perceived benefit of unwanted sex outweighs the goal of improved social status or comfort. Although adolescents are able to comprehend what is being taught about sex education, they are unable to prioritize healthy sexual behavior with the other goals in place. For adolescents that are going through a crucial period of development, these seemingly insignificant external factors influence most decisions. Instructors should educate students using a mental models approach in order to to grasp what the adolescent is considering when deciding to engage in sexual activity.

Present Bias

Present Bias explains two types of adolescent sexual behavior. Firstly, although sexually risk-averse behavior yields long-term benefits such as pregnancy and STD prevention, pleasure is a short-term benefit that often times leads individuals to make a decision that would provide immediate satisfaction. Present bias increases with sexually aroused individuals, who are less likely to think of long-term effects or benefits because of their emotional state that prioritizes short term pleasure. Secondly, present bias can be interpreted in a perspective that is relevant to current society. More teenage girls are starting to go on birth control at a relatively early age– either for pregnancy prevention or for hormone control– and various contraceptive methods are becoming normalized. There has been a statistically significant decline of 22% to 14% from 2007 to 2012 in the percentage of adolescents that used no methods of contraception while having sexual intercourse (Lindberg, Santelli, and Desai, 2016). In this perspective, present bias could lead teenagers who plan on engaging in sexual activity to go on birth control early—in their current state—to provide immediate satisfaction by prevent pregnancy scares in the future. Although an increased population of adolescents have been starting contraceptives, this in turn caused an increase in risk of STDs in adolescents. Sexually-active teenagers on contraceptives who assume their risk of STDs has also diminished depicts the adverse effect of the gap between the instructor and the student’s understanding. This miscommunication causes the adolescents to engage in sexually risky behavior without even realizing their actions.

Underappreciation

Ariely and Lowenstein’s 2005 study presented the topic of “under-appreciation.” People have limited knowledge on the impact of their sexual arousal on their behavior and judgment. Similar to how cold state individuals underestimate how emotionally charged they would be in a hot state; non-aroused individuals underestimate the impact of their physiological change. The concept of under-appreciation is similar to the decision science principle of underestimation. When people under-appreciate the probability of them engaging in sexual activity, they will not take the necessary precautions to engage in sex. This underestimation leaves people unprepared for sexual situations, therefore increasing the potential of sexually risky behavior. This pattern is more consistent with adolescents who are just beginning to engage in sexual activity, because they feel less likely that they would engage in sexual activity than a sexually active adult.

The current system of sex education that focuses on simplistic, easy-to-recall methods lead naïve adolescents to underestimate the possible danger and unpredictable nature of any interpersonal relations and interactions. The failure to recognize the significant impact of sexual arousal on one’s behavior could lead to inexperienced adolescents finding themselves in unexpected, uncomfortable sexual situations where phrases like “no means no” yields no behavioral change from the partner. However, failure to appreciate the impact of sexual arousal can be detrimental for adolescents going through their first sexual awakening. Teenagers taking sex education courses should learn how the “heat of the moment” could lead to self-destructive behavior by underestimating “the potential damage from their own behavioral heat of the moment” (Ariely & Lowenstien, 2005). Educators should clearly educate the students of the uncontrollable effects of sexual arousal for adolescent teens who are just beginning to become sexually active.

A study on adolescent females based in Pittsburgh tested their knowledge on STDs to test exactly when they learn about STIs (Downs, Bruin, Murray, and Fischhoff, 2006). Results show that despite receiving sex education, adolescents seem to have a good knowledge about HIV/AIDS, while only beginning to gain knowledge on STIs after the diagnosis. Although this study suffers from possible social desirability bias due to the reliance on self-reports of contracting STIs, it is important to note that by the time adolescents are actively learning on the STI, they have already contracted the disease. They underestimate the likelihood of them contracting the disease until they have actually contracted it, reaffirming Ariely and Lowenstein’s argument on limitations on self-knowledge. Adolescents are more likely to receive routine screenings without a sign of contracting the disease if they are aware of their sexually unsafe behavior. These behavioral patterns of adolescents should be presented in sex education classes to encourage introspective thinking and improve self-motivation for maintaining sexual health.

Social Desirability Bias

Gathering sufficient data for topics as discreet as adolescent sexual risk behavior can be difficult due to issues of dishonesty. The adolescent may have concern of judgment from family, doctors, friends, or faculty by disclosing information pertaining to personal sexual activity. Adolescents are more likely to disclose information about sexuality to physicians in situations of high confidentiality (Ford, Millstein, Halpern-Felsher; et al.,1997). Social desirability bias explains the disparity between self-reported sexual behavior and clinically tested sexual behavior. A human Immunodeficiency virus (HIV) prevention program held in Atlanta, Georgia asked female adolescents and young adults of their self-reported condom use through computer-assisted self-interviewing, then used a non-disease marker assessed by the Y-chromosome polymerase chain reaction (Yc-PCR) assay to detect the presence of sperm in the vaginal fluid (Rose et al., 2009). The results showed a high level of discordance between the young female participants’ self-report of condom use and the Yc-PCR assay result. This consistent pattern of dishonest behavior of young adults when discussing sexual behavior is subject to social desirability bias (Rose et al., 2009). This discordance of data could indicate either a lack of acceptance of the individual’s actual sexual behavior or incorrect condom use, both of which can be mitigated through correct sex education.

For adolescents who are encouraged to promote abstinence, and sexually risk-averse behavior, social desirability bias has a slightly different effect. Formal school-based or church-based sex education aim to reduce sexual risk behavior by promoting abstinence, while emphasizing the ineffectiveness of birth control methods (Kohler, Manhart, and Lafferty, 2008). These prevention-based lesson plans have proven to have little to no effect in promoting abstinence. Adolescents who are under this restrictive, stubborn education system face an even greater pressure to act appropriately under the eyes of the educator. Because these sex education programs fail to prevent sexual intercourse, the young adolescents who have been taught that engaging in sexual activity is ‘wrong’ and that contraceptives ‘don’t work’ are unable to receive proper medical check-ups after breaking their virginity promise due to shame and guilt.

Sex education curricula constructed to fit the adult educator’s mind are ineffective in shaping young adolescents’ minds. Simplistic teaching methods such as “just say no” may just minimize its significance in the adolescents’ minds and lead them to underestimate its importance. Downs et al. (2004) compared the normative and descriptive accounts of adolescent sexual behavior and filled gaps between the expert’s view and the adolescent’s own view of self to create an interactive learning initiative on sexual risk and health for female adolescent teenagers.

Sex Education through Online Intervention

Seventeen Days, an interactive online-intervention tool for adolescent girls from ages 14 to 19 created by Julie Downs showed a significant decrease in condom failures and STD contraction compared to the control in a six-month period (Downs et al., 2004). This study shows a successful implementation of the understanding of adolescent sexual risk behavior and decision making. The video intervention allowed teenage girls to engage in hypothetical situations that offered options to reduce risk and encouraged them to actively engage in a cognitive rehearsal of safe sex. Using the mental models approach, the online program allows the participant to visualize the hypothetical situations. This lesson plan also reduces social desirability bias because the adolescent teens have no pressure to fit into a certain social standard. A one-on-one lesson would remove stigmas and judgments that teenagers normally expect to receive from their health care provider or educator.

Discussion

With the increase in behavioral and neural studies of adolescent teens, the improved criteria should reflect the progress of knowledge. Sex education should serve as a preparation, not a requirement. Sabia reviews Doug Kirby’s article on the review of literature on sex education and notes that the program with the most notable behavioral effect in reducing sexual risky behavior focused on “developing teens’ social skills, such as sex resistance skills or negotiation and communication skills” (Sabia, 2006). Realistic curricula that focus on the adolescent’s ability and knowledge to act safely are more likely to yield actual beneficial behavioral change.

Online interventions that require the participant to actively engage in the provided material have proven to reduce sexual risk behavior, as seen in Seventeen Days. There are other online learning programs for young adults that educate healthy sexual behavior. For example, Sexual Assault Prevention for Undergraduates, or SAPU, is a sex education course required by Carnegie Mellon for all undergraduate students coming to the university.

A possible plan for improving sex education would be to allow a greater audience of developing adolescents to participate in an online interactive intervention similar to Seventeen Days and SAPU.  An online interactive study plan for adolescents in addition to their existing sex education curriculum offered in their place of education (school, church, and home-schooling) will allow students to learn the material in a mental models perspective, engaging in hypothetical situations and recognizing the unpredictable nature of these situations. This online interactive study plan would educate adolescents on how their minds work and how they make decisions in regard to sex and sexual risk. By allowing adolescents to understand why they engage in sexual risky behaviors rather than telling them that it is downright wrong, the indirect online learning program will allow the students to think of the material in relation to themselves. This in turn can possibly reduce under-appreciation bias and allow them to gain a better understanding of one’s sexual judgment and behavior. Relevant teaching materials are necessary to have the students actually understand the importance of sex education. With Julie Downs’ video learning tool proving successful with a moderate sample size, online learning tools in addition to school materials that allow the student to have a personal, private learning experience will bridge the gap between the instructor and the student to allow for actual behavioral change. With the increase in technological development and more online tools becoming incorporated in school systems, sexual education through interactive tasks online is not unrealistic in our future.

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