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

• Published in: The Journal of school health Vol. 90; no. 2; pp. 88 - 98
• Main Authors: Dickson, Elizabeth, Parshall, Mark, Brindis, Claire D.
• Format: Journal Article
• Language: English
• Published: Malden, USA Wiley Periodicals, Inc 01.02.2020; Wiley-Blackwell; Blackwell Publishing Ltd
• Subjects: Administrative Personnel; Administrator Attitudes; Adolescent; adolescent health; Barriers; Curricula; Ecological studies; Education policy; Educational Objectives; Educational Policy; Female; Health Education; Health Knowledge, Attitudes, Practice; Health Policy; Health promotion; Humans; Male; New Mexico; Nurses - psychology; Policy implementation; Poverty; Pregnancy; Program Content; Program Implementation; Protective factors; Risk behavior; Risk Reduction Behavior; Rural Areas; Rural communities; Rural Population; School Nurses; School Nursing; School Teachers - psychology; secondary school; Secondary School Teachers; Secondary schools; Sex Education; Sexual behavior; Sexual health; sexual health education; Sexuality; Sexually Transmitted Diseases; Sexually Transmitted Diseases - prevention & control; social ecological model; STD; Teacher Attitudes; Teachers; Teenage pregnancy; Teenagers; Telephone Surveys; Variability; Young Adult; New Mexico; social ecological model; secondary school; policy implementation; sexual health education; adolescent health
• ISSN: 0022-4391; 1746-1561; 1746-1561
• DOI: 10.1111/josh.12853

ABSTRACT BACKGROUND Comprehensive 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. METHODS This 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. RESULTS We 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. CONCLUSIONS Given 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.