Data Supporting a Comprehensive Approach to Reproductive and Sexual Health Education to Meet the Needs of Youth
Main Article Content
Abstract
In the United States, reproductive and sexual health education continues to be greatly debated. Although research documents a more comprehensive approach to sex education is preferred by the majority and is effective in reducing risky sexual behaviors among adolescents, current state level direction in Florida is promoting more abstinence education. This is concerning as adolescents continue to engage in risky sexual behaviors and experience high rates of sexually transmitted diseass, HIV, and unplanned pregnancy. Researchers in this study assessed support for sex education in one large district in the state of Florida to document the preferred approach and to identify specific topics perceived as being important to include. A total of 605 participants completed a 32-item survey administered through random digit dialing to include both landlines and cell phones. Data were analyzed using SAS® for Windows Version 9.4, with significance set at 5%. Pearson’s Chi-square tests were used to investigate differences in responses by participants’ characteristics, and several are noted in this study. Results document overwhelming support for a comprehensive approach to sex education, and support for a variety of topics to include in sex education for both middle school and high school students. These results confirm that the state of Florida’s push for a more restrictive curriculum is not consistent with the preference of the majority and does not meet the needs of youth. It is hoped that these results can better guide policy decisions while also supporting others in determining their local support to help promote positive change.
Keywords:
Comprehensive Sex Education, Adolescent Risk Behaviors, Sexual Health Policy, Florida Sex Education, Reproductive Health Education
Article Details
How to Cite
BARR, Elissa et al.
Data Supporting a Comprehensive Approach to Reproductive and Sexual Health Education to Meet the Needs of Youth.
Medical Research Archives, [S.l.], v. 12, n. 12, jan. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6140>. Date accessed: 20 jan. 2025.
doi: https://doi.org/10.18103/mra.v12i12.6140.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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11. Szucs LE, Harper CR, Andrzejewski J, Barrios LC, Robin L, Hunt P. Overwhelming support for sexual health education in U.S. schools: A meta-analysis of 23 surveys conducted between 2000 and 2016. J Adolescent Health. 2022;70(4):598–606. doi:10.1016/j.jadohealth.2021.05.016. Available: https://doi.org/10.1016/j.jadohealth.2021.05.016
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20. Centers for Disease Control and Prevention, (CDC). Estimated HIV incidence and prevalence in the United States, 2018–2022. HIV Surveillance Supplemental Report, 29(1). Published May 21, 2024. https://www.cdc.gov/hiv-data/nhss/estimated-hiv-incidence-and-prevalence.html
21. Florida Department of Health. 2022. State HIV slide set: State of Epidemic, 2022. [online] Available: https://www.floridahealth.gov/diseases-and-conditions/aids/surveillance/epi-slide-sets.html
22. Power to Decide (formerly The National Campaign to Prevent Teen and Unplanned Pregnancy). Fast facts: Teen pregnancy in the United States. Published April 2016. [online] Available: https://powertodecide.org/sites/default/files/resources/primary-download/fast-facts-teen-pregnancy-us.pdf
23. Centers for Disease Control and Prevention (CDC). About teen pregnancy. Published May 14, 2024. [online] Available: https://www.cdc.gov/reproductive-health/teen-pregnancy/.
24. Hendrick CE, Maslowsky J. 2019. Teen mothers' educational attainment and their children's risk for teenage childbearing. Dev Psychol. 2019;55(6):125 9–1273. doi:10.1037/dev0000705.
25. Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final data for 2021. National Vital Statistics Reports. 2023;72(1). doi: https://dx.doi.org/10.15620/cdc:122047
26. Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56(2):223 – 230. doi:10.101 6/j.jadohealth.2014.09.007. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852976/
27. Kirby D. 2007. Emerging answers 2007: Research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington DC: The National Campaign to Prevent Teen Pregnancy.
28. Goldfarb ES, Lieberman LD. Three decades of research: The case for comprehensive sex education. J Adolescent Health. 2021;68(1):13–27. doi:10.1016/j.jadohealth.2020.07.036.
29. Eisenberg ME, Bernat DH, Bearinger LH, Resnick MD. Condom provision and education in Minnesota public schools: A telephone survey of parents. J School Health. 2009;79(9): 416–424. doi:10.1111/j.1746-1561.2009.00429.x.
30. Ito KE, Gizlice Z, Owen-O’Dowd J, Foust E, Leone PA, Miller WC. Parent opinion of sexuality education in a state with mandated abstinence education: Does policy match parental preference? J Adolescent Health. 2006;39(5):634–641. doi:10. 1016/j.jadohealth.2006.04.022.
31. National Public Radio, Kaiser Family Foundation, Kennedy School of Government. 2004. Sex education in America general public/ parents survey. The Henry J.Kaiser Family Foundation. Published January 2004. [online] Available: https://www.kff.org/wp-content/uploads/2013/01/sex-education-in-america-general-public-parents-survey-toplines.pdf
32. Yarber WL, Milhausen RR, Crosby RA, Torabi MR. Public opinion about condoms for HIV and STD prevention: A midwestern state telephone survey. Perspect Sex Repro H. 2005;37(3):148–154. doi:10.1363/3714805.
33. Future of Sex Education Initiative. National sexuality education standards: Core content and skills, K-12. J School Health. 2012;43(1). https://healtheducationresources.unesco.org/sites/default/files/resources/ssr_tpg_1_sexualityeducationstandards.pdf
34. Kantor L, Levitz N, Holstrom A. Support for sex education and teenage pregnancy prevention programmes in the USA: Results from a national survey of likely voters. Sex Education. 2020;20(3): 239–251.https://doi.org/10.1080/14681811.2019.1652807
35. Kershner SH, Corwin S, Prince M, Robillard A, Oldendick R. Support for comprehensive sexuality education and adolescent access to condoms and contraception in South Carolina. Am J of Sexuality Education. 2017;12(3): 297-314. doi:10.1080/1554 6128.2017.1359803.
36. American Medical Association. AMA adopt new public health policies to improve health donation. Published June 15, 2018. [online] Available: https://www.ama-assn.org/press-center/press-releases/ama-adopts-new-public-health-policies-improve-health-nation-1
37. Breuner, CC, Mattson, G. American Academy of Pediatrics, Committee on Adolescence, Committee on psychosocial aspects of child in the family health. Sexuality Education for Children and Adolescents. Pediatrics. 2016;138(2):e20161348
38. World Health Organization, comprehensive sexuality education, May 18, 2023, Available: https://www.who.int/news-room/questions-and-answers/item/comprehensive-sexuality-education
39. Kaiser Family Foundation. Women’s Health Policy: abstinence education programs: definitions, funding, and impact on teen sexual behavior. Published June 1, 2018 [online] Available: https://files.kff.org/attachment/Fact-Sheet-Abstinence-Education-Programs-Definition-Funding-and-Impact-on-Teen-Sexual-Behavior
40. Future of Sex Education. 2020. National sex education standards core content and skills, K-12. 2nd ed. Available: https://advocatesforyouth.org/wp-content/uploads/2020/03/NSES-2020-web.pdf
41. Centers for Disease Control and Prevention (CDC). HIV testing and youth. [online] Available: https://www.cdc.gov/healthyyouth/youth_hiv/hiv-information-and-youth.htm. Updated 2024
42. The Trevor Project. 2023 US national survey the mental health of the LGBTQ young people. Available:https://www.thetrevorproject.org/survey-2023/
43. Chin, H, et al. Community Preventive Services Task Force. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the guide to community preventive services. Am J of Preventive Medicine. 2012;42(3):272-94
44. Santelli JS, et al. Guttmacher Institute. Abstinence-only-until-marriage: An updated review of U.S. policies and programs and their impact. J of Adolescent Health, 2017;61: 273e280. [online]Available:https://www.jahonline.org/article/S1054-139X(17)30260-4/pdf
45. Trenholm C, Devaney B, Fortson K, Quay L, Wheeler J, Clark M. Impacts of Four Title V, Section 510 Abstinence Education Programs. Mathematica Policy Research, Inc. 2007. Published April 12, 2007. [online] Available: https://aspe.hhs.gov/reports/impacts-four-title-v-section-510-abstinence-education-programs-1
46. Heritage Foundation (2010). Evidence on the Effectiveness of Abstinence Education: An Update. Available:https://www.heritage.org/education/report/evidence-the-effectiveness-abstinence-education-update
47. Stanger-Hall KF, Hall DW. Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the U.S. PLoS One, 2011;6(10): e24658 doi: 10.1371/journal. pone.0024658
48. Plastino K, Quinlan J, Todd J, Tevendale HD. Stakeholder education and community mobilization garner support for sex education. J Adolesc Health. 2017;60(3S):S24-S29. doi: 10.1016/j.jado health.2016.09.028. available: https://pubmed.ncbi.nlm.nih.gov/28235431/
49. Moore MJ, Barr E, Wilson K, Griner S. Support for offering sexual health services through school based health clinics. J of School Health. 2016;86(9): 660-668.
2. Centers for Disease Control and Prevention (CDC). Division of adolescent and school health, school health profiles 2022: Explore school health profiles questions – Nationwide, 2022, health education. [online] Available: https://profiles-explorer.cdc.gov/. Updated 2024.
3. Florida Department of Education. 2023. Approval of Health Materials per House Bill 1069. 2023; 1003.42(1)(b). Available: https://info.fldoe.org/docushare/dsweb/Get/Document-9960/dps-2023-167.pdf
4. Planned Parenthood, What U.S. parents think about sex education in schools, Published 2023 [online] Available: https://cdn.plannedparenthood.org/uploads/filer_public/f8/d6/f8d6439d-dbf2-4205-b447-cc9f70815f82/parent_data_fact_sheet_english.pdf?_gl=1*gxr81y*_ga*MTQ4Mjk0ODM3MC4xNzMxMjY5Njkw*_ga_ENXC8KHJL8*MTczMTI2OTY5MC4xLjEuMTczMTI2OTcwNS4wLjAuOTY5MzkzMzEy
5. Howard-Barr E, Moore MJ, Weiss JA, Jobli E. Public opinion toward sexuality education: Findings among one south Florida county. Am J Sex Educ. 2011;6(2):176–191. doi:10.1080/15546 128.2011.571955.
6. American Public Health Association Policy Statement. Sexuality education as part of a comprehensive health education program in K to 12 schools - Policy number 20143. Published November 18, 2014. [online] Available: https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2015/01/23/09/37/sexuality-education-as-part-of-a-comprehensive-health-education-program-in-k-to-12-schools
7. Moore P. Poll results: Sex ed. Published January 7, 2015 [online] Available: https://today.yougov.com/health/articles/11294-poll-results-sex-ed.
8. Power to Decide. Survey says. Published 2017. [online] Available: https://powertodecide.org/sites/default/files/resources/primary-download/survey-says-may-2017.pdf
9. Jones RP, Cox D. How race and religion shape millennial attitudes on sexuality and reproductive health. Published March 27, 2015 [online] Available: https://www.prri.org/wp-content/uploads/2015/03/PRRI-Millennials-Web-FINAL.pdf
10. Barr EM, Moore MJ, Johnson T, Forrest J, Jordan M. New evidence: Data documenting parental support for earlier sexuality education. J School Health. 2014;84(1): 10–17. doi:10.1111/josh.12112.
11. Szucs LE, Harper CR, Andrzejewski J, Barrios LC, Robin L, Hunt P. Overwhelming support for sexual health education in U.S. schools: A meta-analysis of 23 surveys conducted between 2000 and 2016. J Adolescent Health. 2022;70(4):598–606. doi:10.1016/j.jadohealth.2021.05.016. Available: https://doi.org/10.1016/j.jadohealth.2021.05.016
12. Davis CJ, Cox D, Griffin R, Jones RP. Young People Set to Impact the Debate on Women’s Health Issues. Published April, 2018. [online] Available: https://www.prri.org/research/young-people-set-to-impact-the-debate-on-womens-health-issues/.
13. Barr E, Moore MJ, Wilson K, Parisi T, McCann H. Documenting support for ongoing and improved efforts in sexuality education. Florida Public Health Review. 2017;14: 45–55. https://scholars.unf.edu/ws/portalfiles/portal/40651347/Documenting%20Support%20for%20Ongoing%20and%20Improved%20Efforts%20in%20Sexuality.pdf
14. Kantor L, Levitz N. Parents' views on sex education in schools: How much do Democrats and Republicans agree? PloS One. 2017;12(7): e0180250. doi:10.1371/journal.pone.0180250.
15. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Healthy People 2030. Reduce pregnancies in adolescents - FP‑03. Published 2020. [online] Available: https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/family-planning/reduce-pregnancies-adolescents-fp-03
16. World Association for Sexual Health (WAS). WAS statement on comprehensive sexuality education. Published July 26, 2023. [online] Available: https://www.worldsexualhealth.net/statement-on-comprehensive-sexuality-education
17. Centers for Disease Control and Prevention (CDC). 1991-2021 High school youth risk behavior survey data. [online] Available: http://nccd.cdc.gov/youthonline/. Accessed October 11, 2024.
18. Centers for Disease Control and Prevention (CDC). Sexually transmitted disease surveillance. Published 2021. [online] Available: https://www.cdc.gov/std/statistics/2022/2021-STD-Surveillance-Report-PDF_ARCHIVED-2-16-24.pdf
19. Centers for Disease Control and Prevention, (CDC). Sexually Transmitted Infections Surveillance 2022. [online] Available: https://www.cdc.gov/std/statistics/2022/default.htm. Updated 2024.
20. Centers for Disease Control and Prevention, (CDC). Estimated HIV incidence and prevalence in the United States, 2018–2022. HIV Surveillance Supplemental Report, 29(1). Published May 21, 2024. https://www.cdc.gov/hiv-data/nhss/estimated-hiv-incidence-and-prevalence.html
21. Florida Department of Health. 2022. State HIV slide set: State of Epidemic, 2022. [online] Available: https://www.floridahealth.gov/diseases-and-conditions/aids/surveillance/epi-slide-sets.html
22. Power to Decide (formerly The National Campaign to Prevent Teen and Unplanned Pregnancy). Fast facts: Teen pregnancy in the United States. Published April 2016. [online] Available: https://powertodecide.org/sites/default/files/resources/primary-download/fast-facts-teen-pregnancy-us.pdf
23. Centers for Disease Control and Prevention (CDC). About teen pregnancy. Published May 14, 2024. [online] Available: https://www.cdc.gov/reproductive-health/teen-pregnancy/.
24. Hendrick CE, Maslowsky J. 2019. Teen mothers' educational attainment and their children's risk for teenage childbearing. Dev Psychol. 2019;55(6):125 9–1273. doi:10.1037/dev0000705.
25. Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final data for 2021. National Vital Statistics Reports. 2023;72(1). doi: https://dx.doi.org/10.15620/cdc:122047
26. Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56(2):223 – 230. doi:10.101 6/j.jadohealth.2014.09.007. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852976/
27. Kirby D. 2007. Emerging answers 2007: Research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington DC: The National Campaign to Prevent Teen Pregnancy.
28. Goldfarb ES, Lieberman LD. Three decades of research: The case for comprehensive sex education. J Adolescent Health. 2021;68(1):13–27. doi:10.1016/j.jadohealth.2020.07.036.
29. Eisenberg ME, Bernat DH, Bearinger LH, Resnick MD. Condom provision and education in Minnesota public schools: A telephone survey of parents. J School Health. 2009;79(9): 416–424. doi:10.1111/j.1746-1561.2009.00429.x.
30. Ito KE, Gizlice Z, Owen-O’Dowd J, Foust E, Leone PA, Miller WC. Parent opinion of sexuality education in a state with mandated abstinence education: Does policy match parental preference? J Adolescent Health. 2006;39(5):634–641. doi:10. 1016/j.jadohealth.2006.04.022.
31. National Public Radio, Kaiser Family Foundation, Kennedy School of Government. 2004. Sex education in America general public/ parents survey. The Henry J.Kaiser Family Foundation. Published January 2004. [online] Available: https://www.kff.org/wp-content/uploads/2013/01/sex-education-in-america-general-public-parents-survey-toplines.pdf
32. Yarber WL, Milhausen RR, Crosby RA, Torabi MR. Public opinion about condoms for HIV and STD prevention: A midwestern state telephone survey. Perspect Sex Repro H. 2005;37(3):148–154. doi:10.1363/3714805.
33. Future of Sex Education Initiative. National sexuality education standards: Core content and skills, K-12. J School Health. 2012;43(1). https://healtheducationresources.unesco.org/sites/default/files/resources/ssr_tpg_1_sexualityeducationstandards.pdf
34. Kantor L, Levitz N, Holstrom A. Support for sex education and teenage pregnancy prevention programmes in the USA: Results from a national survey of likely voters. Sex Education. 2020;20(3): 239–251.https://doi.org/10.1080/14681811.2019.1652807
35. Kershner SH, Corwin S, Prince M, Robillard A, Oldendick R. Support for comprehensive sexuality education and adolescent access to condoms and contraception in South Carolina. Am J of Sexuality Education. 2017;12(3): 297-314. doi:10.1080/1554 6128.2017.1359803.
36. American Medical Association. AMA adopt new public health policies to improve health donation. Published June 15, 2018. [online] Available: https://www.ama-assn.org/press-center/press-releases/ama-adopts-new-public-health-policies-improve-health-nation-1
37. Breuner, CC, Mattson, G. American Academy of Pediatrics, Committee on Adolescence, Committee on psychosocial aspects of child in the family health. Sexuality Education for Children and Adolescents. Pediatrics. 2016;138(2):e20161348
38. World Health Organization, comprehensive sexuality education, May 18, 2023, Available: https://www.who.int/news-room/questions-and-answers/item/comprehensive-sexuality-education
39. Kaiser Family Foundation. Women’s Health Policy: abstinence education programs: definitions, funding, and impact on teen sexual behavior. Published June 1, 2018 [online] Available: https://files.kff.org/attachment/Fact-Sheet-Abstinence-Education-Programs-Definition-Funding-and-Impact-on-Teen-Sexual-Behavior
40. Future of Sex Education. 2020. National sex education standards core content and skills, K-12. 2nd ed. Available: https://advocatesforyouth.org/wp-content/uploads/2020/03/NSES-2020-web.pdf
41. Centers for Disease Control and Prevention (CDC). HIV testing and youth. [online] Available: https://www.cdc.gov/healthyyouth/youth_hiv/hiv-information-and-youth.htm. Updated 2024
42. The Trevor Project. 2023 US national survey the mental health of the LGBTQ young people. Available:https://www.thetrevorproject.org/survey-2023/
43. Chin, H, et al. Community Preventive Services Task Force. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the guide to community preventive services. Am J of Preventive Medicine. 2012;42(3):272-94
44. Santelli JS, et al. Guttmacher Institute. Abstinence-only-until-marriage: An updated review of U.S. policies and programs and their impact. J of Adolescent Health, 2017;61: 273e280. [online]Available:https://www.jahonline.org/article/S1054-139X(17)30260-4/pdf
45. Trenholm C, Devaney B, Fortson K, Quay L, Wheeler J, Clark M. Impacts of Four Title V, Section 510 Abstinence Education Programs. Mathematica Policy Research, Inc. 2007. Published April 12, 2007. [online] Available: https://aspe.hhs.gov/reports/impacts-four-title-v-section-510-abstinence-education-programs-1
46. Heritage Foundation (2010). Evidence on the Effectiveness of Abstinence Education: An Update. Available:https://www.heritage.org/education/report/evidence-the-effectiveness-abstinence-education-update
47. Stanger-Hall KF, Hall DW. Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the U.S. PLoS One, 2011;6(10): e24658 doi: 10.1371/journal. pone.0024658
48. Plastino K, Quinlan J, Todd J, Tevendale HD. Stakeholder education and community mobilization garner support for sex education. J Adolesc Health. 2017;60(3S):S24-S29. doi: 10.1016/j.jado health.2016.09.028. available: https://pubmed.ncbi.nlm.nih.gov/28235431/
49. Moore MJ, Barr E, Wilson K, Griner S. Support for offering sexual health services through school based health clinics. J of School Health. 2016;86(9): 660-668.