Isolated Voices: Perspectives of Teachers, School Nurses, and Administrators Regarding Implementation of Sexual Health Education Policy

• DOI: 10.1111/josh.12853
• Publication Date: 2019-12-09T00:53:26Z
• Authors: Elizabeth Dickson; Mark Parshall; Claire D. Brindis
• Keywords: sociology and philosophy; Male; Rural Population; and promotion of well-being; Health Knowledge, Attitudes, Practice; New Mexico; Nurses; Sex Education; Education Policy; 0302 clinical medicine; Teenage Pregnancy; School Nursing; Research Articles; 360; Pediatric; Practice; Public health; Health Knowledge; Health Policy; 4. Education; adolescent health; 16. Peace & justice; policy implementation; 3. Good health; Public Health and Health Services; Female; Public Health; Adolescent Sexual Activity; Adolescent; Education policy; Sexually Transmitted Diseases; social ecological model; Basic Behavioral and Social Science; Education; Young Adult; 03 medical and health sciences; Clinical Research; Health Sciences; Behavioral and Social Science; Humans; Sociology and Philosophy; Administrative Personnel; Prevention of disease and conditions; Quality Education; Attitudes; sexual health education; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; secondary school; School Teachers; Risk Reduction Behavior; Curriculum and Pedagogy

ABSTRACTBACKGROUNDComprehensive sexual health education (SHE) reduces risky sexual behavior and increases protective behavior in adolescents. It is important to understand how professionals responsible for implementing SHE policy interpret state and local policy and what influences their commitment to formal SHE policy implementation.METHODSThis descriptive study explored content and delivery of SHE policy in a rural, southwestern state with high levels of poverty, unintended adolescent pregnancy, and sexually transmitted infections. The social ecological model (SEM) was used to better understand levels of influence on the implementation of SHE policy.RESULTSWe conducted telephone surveys with 38 teachers, 63 nurses, and 21 administrators in public secondary schools. There was substantial local variability in the scope and content of SHE curricula. Respondents identified significant barriers to the delivery of SHE content and minimal evaluation of whether educational objectives were met. Based on participant responses, community and organizational SEM levels had the greatest influence on SHE policy implementation, although examples of all SEM levels were identified.CONCLUSIONSGiven perceived challenges regarding subject matter, successful SHE implementation at the local level requires committed stakeholders working in concert at the school and community levels, backed by strong policy commitment at the state level.