When it comes to the developed nations, the United States does not rank number one in many things. Until you look at the rates of unplanned teenage pregnancy and sexually transmitted diseases (STDs). The United States currently holds the number one spot for both unplanned teenage pregnancy and STDs (Stanger-Hall & Hall, 2011). There appears to be a correlation between the United States’ policies on abstinence only sex education and the higher prevalence of pregnancy and STDs (Stanger-Hall & Hall, 2011).
Overview of the Problem
The federal government funded several “abstinence only” education programs for public schools up until early 2009 when that funding ran out (Stanger-Hall & Hall, 2011). Initially there was nothing allocated in the 2010 fiscal year budget to continue the abstinence only education, but late in 2009 the funding was renewed (Stanger-Hall & Hall, 2011). While the abstinence only programs were being funded between 2002 and 2005 there were 72.2 reported pregnancies in every 1000 females aged 15-19 (Stanger-Hall & Hall, 2011). In 2009 a federally funded evidence based comprehensive sex education program was approved for use in schools as well (Stanger-Hall & Hall, 2011). With the advent of this new program, and the refunding of the old one, there is the option to either pursue an abstinence only, or a comprehensive education program. The currently approved sex education guidelines do not allow room for information on contraception or safe sex practices and therefore teens who are engaging in sexual behaviors are unprepared for the consequences of their lack of information (Stanger-Hall & Hall 2011).
This problemIt is important to include a comprehensive approach to sex education in the curriculum for young adults as the lack of information teenagers receive on engaging in safe sex practices does not in fact stop them from engaging in those activities it simply means an increase in the undesirable results of unwanted pregnancy and STDs which in turn the field of social work because it influences the dignity and worth of the individual. In areas where This is seen when there are high rates of unplanned teenage pregnancy. In areas where the teenage and the birth rate is higher there is a strain on already limited social service resources. Many people who have children in their teenage years are limited to their ability to seek adequate employment and education opportunities and will often end up utilizing social welfare programs such as EBT, TANF, and other funding sources (Blackman & Garcia, 2020).
Overview of The Intervention
Comprehensive sex education provided to students beginning in sixth or seventh grade through classes such as health education and science classes should provide encompasses programs that provide information on practicing safe sex, as well as alternatives to engaging in sexual activity. These Many of these programs also provide information on sexually transmitted diseases and their prevention as well as thoroughly covering birth control options. Some even tout abstinence as the desired outcome while providing an in depth look at the things that can happen if one chooses to engage in sexual behavior. Comprehensive sex education programs can also provide information on the range of genders and sexual identities that many would not learn about through other means. Several studies have found that Stanger-Hall and Hall (2011) found that a comprehensive sex education approach that informs of safe practices while encouraging abstinence as the only fail-safe way to prevent pregnancy and STDs, has the highest level of success (Stanger-Hall & Hall, 2011).
The evidence-based practice question I am posing is how effective is a comprehensive sex education program in reducing the undesired outcome of teenage pregnancy? To answer this question, I utilized information from the Cochrane-Woods library database and the search terms “comprehensive sex education” and “abstinence only”. I narrowed the search to peer reviewed journals and those written within the last five to ten years. I was able to locate several studies in support of the idea that a comprehensive sex education program would be beneficial in reducing unwanted and unplanned teenage pregnancy.
Critical Appraisal
Purpose
In a study, titled “Can Sex Education Delay Early Sexual Debut” which was published in June 2012 researchers Sumru Erkut, Jennifer M Grossman, Alice A. Frye, Ineke Ceder, Linda Charmaraman and Allison J Tracy looked at a comprehensive sex education program introduced in sixth grade, and whether that program would reduce the prevalence of early sexual emergence. There is a correlation between how early a teen engages in sexual behaviors and a reduction in overall health and wellness for the teen. Some of the risk factors include a higher instance of sexually transmitted diseases, substance abuse, and unintended pregnancy, which leads to higher rates of poverty, and abortions (Erkut et al. 2012).
Methods
This study used a randomized control experimental design. The design limited the ability for participants to self-select into the different groups studied (Erkut et al. 2012). The study used surveys to create a baseline and a follow-up to gather data that shows whether the intervention appears to be effective. Regarding the surveys that were used for both the baseline and the follow-up survey they students were asked about past and current sexual behaviors, age, race, familial status, and an abbreviated social desirability assessment (Erkut et al. 2012). The study operated on five individual models utilizing baseline sexual activity, social desirability, age, gender, and whether the participant was involved in the intervention or not (Erkut et al. 2012). In subsequent models the researchers either added or subtracted the remaining criterion of familial status and race, this was done to demonstrate the presence of overlapping risk and the effect of the intervention on each overlapping criterion (Erkut et al. 2012).
Sample
The participants for this study were selected from sixth, seventh, and eighth grade classes at middle schools in the Boston area (Erkut et al. 2012). There were a total of 1223 participants selected, of these students 55% identified as female (Erkut et al. 2012). Through random assignment 57.6% was included in the intervention group (Erkut et al. 2012). The study excluded schools and classrooms whom already participated in a comprehensive sex education curriculum or had already adopted the intervention the study was investigating (Erkut et al. 2012). The participants came from 24 schools including public, private and charter schools (Erkut et al. 2012). The schools that participated in the study were primarily comprised of minority populations and were in urban areas of the city (Erkut et al. 2012). Additionally, informed consent was gained from the parents of the participants (Erkut et al. 2012). Effort was taken to ensure that the control and intervention groups encompassed an equal distribution of participants across demographic qualities (Erkut et al. 2012).
Results
The researchers found that the implementation of the specific comprehensive sex education program “Get Real” showed a strong correlation with a reduced number of participants engaging in early sexual behaviors (Erkut et al. 2012). It can be deduced through the information received from this study that the likelihood of a participant who experienced this intervention, would go on to experience an unwanted pregnancy in their teenage years would be small. Early sexual debut is associated with an increased risk of unwanted pregnancy (Erkut et al. 2012). Reducing this risk factor through the comprehensive sex education curriculum can additionally reduce the likelihood of additional undesired consequences of sexual behavior.
Appraisal
The study performed by the researchers in the article “Can Sex Education Delay Early Sexual Debut” met with some limitations in the design of the study. The researchers acknowledge that the correlation noted between Latino and non-Latino groups and the presence of early sexual debut could be related to the variable that culturally Latino people are less likely to have engaged in sexual experiences prior to seventh grade with, or without the intervention (Erkut et al. 2012). Another limitation that was noted was that the information was self-reported by the participants and thus could be biased by the potential that the participants would have a desired social desirability from their peers (Erkut et al. 2012). Another limitation that the study had was the focus on vaginal intercourse only, this left out other sexual experiences influencing the results that showed that the intervention worked to reduce early sexual debut (Erkut et al. 2012).
The study primarily looked at minorities within both the control and intervention groups and encompassed a variety of races and backgrounds into both groups (Erkut et al. 2012). The demographic of the area appeared to be primarily of minority groups, so both the control and intervention groups were a good representation of the population.
The intervention was administered to the participants by educators that had been trained exclusively in the specific curriculum of the intervention and thus may have provided some advantage or bias to the results of the study (Erkut et al. 2012). The researchers state that they may need to repeat the study to validate the findings with the curriculum being administered by educators from the schools (Erkut et al. 2012). The results of the study give a strong correlation to the idea that the earlier an age appropriate theory-based sex education curriculum can be introduced the better the outcomes for reducing teenage pregnancy and STDs.
References
- Blackman, K., & Garcia, A. (2020). Teen Pregnancy Prevention. Retrieved February 4, 2020, from https://www.ncsl.org/research/health/teen-pregnancy-prevention.aspx#1
- Erkut, S., Grossman, J. M., Frye, A. A., Ceder, I., Charmaraman, L., & Tracy, A. J. (2012). Can Sex Education Delay Early Sexual Debut? The Journal of Early Adolescence, 33(4), 482–497. doi: 10.1177/0272431612449386
- Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-only education and teen pregnancy rates: why we need comprehensive sex education in the U.S. PloS one, 6(10), e24658. doi:10.1371/journal.pone.0024658
