Effect of Sexual Health Education on the Rates of the Teenage Pregnancy - Research Paper Example

?Running Head: Sexual Health Education A Review of the Effect of Sexual Health Education in Secondary Schools on the Rates of Teenage Pregnancy Course Title Name of Professor Date of Submission Introduction The current discourse about the rate of teenage pregnancy in the United States has resulted in heightened concern for the possible effect of sexual health education in secondary schools on the prevalence of adolescent pregnancy. Hence, the main research question here is how does sexual education in high school students affect teen pregnancy rates? This question will be tackled in relation to existing findings on successful sex education in secondary schools, and current status of theory and practice in the United States. Sociological debates over the effectiveness of sexual health education for teenagers remain intense. A number of qualitative or descriptive studies have analyzed the results of pregnancy prevention research. Yet, descriptive studies have been hampered by their lack of breadth in study selection or by merely mentioning findings of independent programs without trying to combine the literature in a methodical manner (Muuss & Porton, 1998). They were unsuccessful in providing organized methods for synthesizing the findings of various studies and for evaluating and comparing the effect of disparities in study procedures. Another weakness of descriptive studies is that they are not endowed to evaluate the discrepancy within studies of the impact of sexual health education on various subpopulations, like certain age, ethnic, and gender groups (Somers, 2006). Furthermore, descriptive studies often face conflicting, varied, and questionable findings. Meta-analysis could bridge this gap since it enables studies to be methodically assessed and their findings summed up as a general impact (Somers, 2006). This paper reviews the findings on the effect of sexual health education in secondary schools on the rate of teenage pregnancy from a meta-analysis perspective. This paper sums up not only descriptive studies, but also experimental research, carried out in this area, and explores the capability of a meta-analysis to mitigate the weaknesses of these descriptive studies. Operational Definition of Terms The following terms are defined based on their actual meaning and relevance to the issue being studied. (1) Sexual health education- is education about forms of sexual activities, such as sexual reproduction, sexual intercourse, etc (Mast, 1986); (2) Adolescent- an intermediary phase of development between formative years and adulthood (Kirby, 1989); (3) Teenage pregnancy- pregnancy by a 13- to 19-year old female (Lickona, 1993); (4) Contraception /Contraceptive- a tool that prevents pregnancy (Somers, 2006); (5) Secondary School- midway between grade school and college that normally provides college-preparatory, vocational, or technical courses (Howard & McCabe, 1990); (6) Risky sexual behavior- engagement in sexual activities which are harmful to one’s physical, emotional, and psychological state (Kirby, 1989); (7) Premarital Sex- is a sexual contact between individuals who are unmarried (Muuss & Porton, 1998); (8) Experiential Model- a framework which is based on experience (Tingle, 2002); (9) Emulators- same as simulator; a training instrument that replicates actual environments or conditions (Somers, 2006); (10) Self-discipline curriculum- is a program that teaches the practice of refusing some or all features of sexual activity for religious, social, legal, psychological, or clinical justifications (Richard, 1989). Review of Related Literature Teenage pregnancy has become a major issue for educators and parents recently. Numerous efforts have been initiated to deal with this issue in order to curb the rate of adolescent pregnancies. This section reviews several of those attempts to determine the impact of sexual health education in secondary schools on the prevalence of teenage pregnancy. The number of adolescents taking part in premarital sex has turned into a point of concern for parents and educators for bases that involve pregnancy and health risks that go with adolescent sexual behavior. A secondary school’s integration of sexual health education in its curriculum may have an effect on lessening the numbers. Nevertheless, the discussion of the success sex education programs has been one of the contentions. Assessing the Success of Sex Education in Reducing Rates of Teenage Pregnancy Recently, investigations have been carried out to identify the extent of the effectiveness of these programs in preventing adolescent pregnancy. The safe sex model, which promotes the use of contraceptives, has compelled adolescents to think that contraceptive use makes involvement in sexual acts a safe conduct (Somers, 2006). Clinical findings show that self-discipline is the only dependable way for preventing teenage pregnancy. In a study that evaluated the success of school-based health programs that taught birth control methods and schools that have sexual health education curriculum, findings demonstrated that sex education infused with self-discipline programs were the most successful strategy for deterring adolescent sexual behavior and pregnancies (Resnick et al., 1997). Khouzem (1995) mentioned in one article, particularly, that was carried out by the Institute for Research and Evaluation and financially supported by the U.S. Department of Health and Human Services. The research involved 7,000 teenagers in Utah in grade schools who were educated with a values-oriented program. Three Title XX curricula were placed in three schools and eventually assessed (Khouzem, 1995). The three programs, Values and Choices, Sex Respect, and Teen-Aid, were launched to conform to the legislative directives of self-discipline as the preventative actions for adolescent pregnancy (Khouzem, 1995). Pre- and posttest information were gathered. Respondents in each of the curriculum were given two instruments: the Rejection of Permissiveness scales and the Affirmation of Abstinence. On the latter instrument for high school students, each of these curricula generated a variation that was significant statistically for the three curricula (Somers, 2006). Researchers discovered substantial disparities for the Values and Choices program and for the Teen Aid and Sex Respect programs in positively influencing the choices of students concerning self-discipline (Vessey, 1996). The Teen-Aid self-discipline education program has been implemented in Edinburg, Washington for several years. A yearly report is made public regarding the success of this program in curbing ‘unsafe behavior’ (Vessey, 1996). This curriculum had a statistically significant effect on the probability that respondents would discontinue their sexual activities (Somers, 2006). In addition, there was a statistically significant modification in the perceptions of adolescents that refusing to engage in premarital sex was the most effective means to prevent unintended pregnancies. School administrators in San Marcos, California adopted a self-discipline curriculum as well, Sexuality, Commitment, and Family for their high school pupils (Lickona, 1993). This district had been recorded as having one of the highest rates of adolescent pregnancy in the United States (Somers, 2006). According to Richard (1989), during the school year 1983-1984, one in five adolescent girls were pregnant. San Marcos Junior High, during the school year 1984-1985, the period before the implementation of the program, stated 147 pregnancies (Richard, 1989). Still according to Richard (1989), the numbers were reduced to 20 pregnancies two years after. Similarly, in Lamar, Missouri, teenage pregnancy rate was substantially curtailed (Richard, 1989). According to Mast (1986), five hundred pupils accomplished the curriculum Sex Respect: The Option of True Sexual Freedom. None of the pupils who took the curriculum became pregnant in two years. None of the pupils had become pregnant two years after the end of the curriculum (Mast, 1986). As reported by Kirby (1989), Project Research carried out field experiments on the Sex Respect program for a few years. At least 1,800 pupils took part in the Sex Respect trial course, which was carried out in six states. Prior to taking part in the course, 36 percent of the participants ignored the practice of adolescents having sexual encounter on the condition that the act did not lead to pregnancy (Kirby, 1989). Only 18 percent conformed to that principle after the program. In addition, subsequent to the program, 58 percent of the participants conformed to the premise that there were numerous advantages in refusing to engage in premarital sex (Kirby, 1989). Only 35 percent conformed to the premise prior to the completion of the program (Kirby, 1989). Identical outcomes were attained in a curriculum that employed Me, My World, My Fortune, according to Kirby (1989), another self-discipline program for secondary school pupils. The outcomes of these findings of the effect of this program and the Sex Respect program on the attitudes and behavior of students were significant statistically. According to Howard & McCabe (1990), an assessment of Postponing Sexual Involvement (PSI), a self-discipline program that was created at the Emory University School of Medicine, reported that respondents in the curriculum were several times more probable to refuse engagement in sexual activities than pupils who did not take the course. The PSI program employed skill-building practices on saying ‘no’ to educate pupils about self-discipline (Howard & McCabe, 1990). As the central element in the curriculum area, PSI is a component of the curriculum Education Now and Babies Later that has been a remarkably successful educational initiative. The students who took part in the study were enrolled in the Florida school district and were placed in control and experimental groups (Howard & McCabe, 1990). After the respondents in the experimental group accomplished the curriculum, the two groups were compared through covariance analysis; the covariate was the pretest (Howard & McCabe, 1990). The results showed that there was a significant disparity between the control group respondents’ and experimental group respondents’ posttest scores (Howard & McCabe, 1990). Vessey (1996) reviewed results from a longitudinal study of self-discipline curricula in public schools in Illinois. A pretest was given to 7,100 pupils who took part in the curricula Choosing the Best and Facing Reality (Vessey, 1996). A subsequent assessment was carried out one year after with pupils who had accomplished pretest of the earlier year. The findings illustrated that 54 percent of the adolescents who had engaged actively in sexual activities prior to the implementation of the course were not sexually active anymore one year after (Vessey, 1996). Furthermore, the forecasted rate of new sexually vigorous adolescents was lessened by roughly 20 percent after they took part in the curriculum (Vessey, 1996). Teen Sexuality Teaching, another self-discipline curriculum, in the perspective of Adult Responsibility, is being implemented in the United States (Somers, 2006). Lickona (1993) made public that Teen Adult Responsibility was implemented in 1993 by roughly 5,000 adolescents. Hardly any of these adolescents became sexually vigorous and roughly half of the adolescents who were sexually vigorous ceased being sexually active after taking part in the course. In an assessment of another self-discipline curriculum that is empirically based, the program Loving Well, Lickona (1993) explained that adolescents who were not sexually vigorous at the onset of this course sustained a 92 percent abstinence rate. This figure was 20 percent greater than the control group’s abstinence rate (Lickona, 1993). According to Charen (1998), Best Friends is self-discipline, youth development course that concentrates on character development for teenage girls. It was created by Elayne Bennett in 1987, a teacher in Georgetown University Development Center, and adopted in the District of Columbia’s public schools during the initial period of its development (Charen, 1998). High school girls took part in Best Friends and continue the program until they finish high school. An independent assessment study in 1995 was carried out where in students in the Best Friends curriculum were evaluated against their classmates who did not take part in the course (Charen, 1998). Findings demonstrated that 1 percent of the members of Best Friends were pregnant prior to their graduation in high school in comparison to 26 percent of their classmates (Charen, 1998). Of the members who took part in sexual activities, 5 percent were members of Best Friends, in comparison to 63 percent of their female peers (Charen, 1998). Finally, as reported by Resnick and colleagues (1997), the Journal of the American Medical Association made public results of two investigations regarding self-discipline education. The first investigation was carried out in South Carolina district where there was a substantial rate of teenage pregnancy. Findings of the study revealed that pupils who received sexual health education displayed a reduction in pregnancy rates in a populace characterized as high risk of adolescent pregnancy (Resnick et al., 1997). Resnick and colleagues (1997) revealed that the results from a large-scale study backed up the national Title V self-discipline course. The research, named Add Health, was derived from a written review of roughly 90,000 teenagers; among this group, 12,118 were monitored and updated in home discussions (Resnick et al., 1997). Add Health, according to Resnick and colleagues (1997), discovered that “adolescents who reported having taken a pledge to remain a virgin were at significantly lower risk of early age of sexual debut” (ibid, p. 830). The research also substantiated that the family and parent relationship was a major preventive force against unsafe adolescent sexual attitudes and behavior. In general, the study verified that adolescents have rediscovered self-discipline. The pattern of an increase in risky sexual behavior has stopped. According to the Centers for Disease Control (1998), the proportion of adolescents who have ever taken part in sexual activities is decreasing, from 54 percents from 1990 to 48 percent in 1997. The results of these investigations constantly showed that self-discipline-oriented sexual health education courses were successful in reforming adolescents’ beliefs, awareness, attitudes, and potential motives concerning their engagement in sexual activities (Centers for Disease Control, 1998). Family relationship also affected the beginning and extent of sexual behavior. The programs influenced pupils of all family backgrounds and socioeconomic classes (Somers, 2006). To sum it up, the descriptive and experimental studies reviewed showed that self-discipline-oriented sexual health education curricula are successful in curbing adolescent sexual activity. A large number of school districts are interested in decreasing rates of adolescent pregnancy, and school staff may have some doubt about implementing a suitable sex education program for teenagers. There is at present no agreement within the education institution concerning such programs. Studies on the issue of self-discipline-oriented curricula contribute in fostering agreement among educators, hence contributing to the assurance that needed curricula are applied in schools. The Experiential Model of Sexual Health Education In theory, there is justification to assume that an experiential model of sex education as an adolescent pregnancy prevention program would be productive. For instance, as claimed by the Optimistic Bias model, when an individual prefers to take part in an activity known to involve uncertainties or risks, s/he has a tendency to defend taking part in the activity by ignoring the likelihood of gaining detrimental impacts (Somers, 2006). An experiential model appears likely to have an impact since it offers a personal perception of reality that will encourage adolescents to ignore that reality. The common belief of a teenager, particularly secondary school students that unfavorable consequences are not likely to occur to him/her could be significantly curtailed by experiential models (Somers, 2006). According to Miller (1993), cognitive development is a major theoretical perspective pertinent to this experiential model. In spite of the weaknesses of several features of the theory of Piaget, his bases in the order of progression in the acquisition of knowledge dominate. Piaget, adopting a biological approach, suggested that cognition and knowledge also grow in equally general ways. Even though a number of teenagers begin to try theoretical and abstract reasoning abilities, majority of skills has a tendency to be more tangible than intangible, particularly during adolescence (Miller, 1993). Large numbers of teenagers do not yet methodically develop assumptions and experiment these in actual. Hence, they may not methodically develop and verify assumptions against reality with notions such as child rearing, pregnancy, parenting, which are quite intangible and conceptual. Teenagers are less probable to relate to them if shown in conventional lecture layouts where in perspective adoption, visualization, and others, is essential (Miller, 1993). Cognitive constraints momentarily encountered by teenagers, specifically adolescent self-centeredness, are likely as well to influence their imperfect reasoning. This is usually typified by views of immunity, an inclination to overdo difficulties, and a feeling that their personality and behavior is the target of other people’s attention (Somers, 2006). As teenagers gain experiences that they can relate to, their reasoning likely expands such that they can cognitively explain the forms of intangible notions aforementioned (Somers, 2006). Nevertheless, Muuss (1998) claims that “fully operational formal-stage reasoning ability… is far from being normal or typical among adolescents” (ibid, p. 199); likewise, Dulit (1972) states that “it is more ideal than typical, more potential than actual” (ibid, p. 298). Hence, a concrete experience with an idea which is more tangible may have a more powerful effect on behavior and attitudes than if a teacher were to only instruct teenagers to assume, justify, and examine theoretically. Research on Experiential Model of Sexual Health Education as a Prevention of Teenage Pregnancy It appears obvious that there is strong empirical and theoretical justification for assuming efficiency of this experiential model. Nevertheless, until lately, unexpectedly few studies have been carried out, even though school districts have been giving substantial financial support and academic effort to this project. Empirical findings of the initial form of this experiential model have been varied (Somers, 20060. According to Kralewski and Stevens-Simon (2000), educators and parents admitted that they agreed to employing emulator. The course has had negligible research target generally, and the initial few investigations showed varied outcomes concerning the effect that the course had on teenagers (Kralewski & Stevens-Simon, 2000). There are a small number of further studies on experiential approach, all putting emphasis on evolving attitudes toward early parenting and adolescent pregnancy. Rosenbaum and Parietti (1997) discovered favorable impacts of the course in a descriptive research employing a sample of 13 high school pupils. Clark (1998 as cited in Somers, 2006) carried out an equally structured research and also discovered sign of favorable impacts. Space and Wood (1998 as cited in Somers, 2006) in a research reported to the American Association of Administrators’ National Conference on Education, talked to 11 high school students after their exposures with the emulators. Instantly after the course and a follow up, they declared that 10 of the 11 pupils had concrete ideas that the infants affected their choice to postpone pregnancy until after graduating from secondary school (Somers, 2006). Tingle (2002), more lately, carried out a no comparison, non-randomized investigation all over ten regions in North Carolina and declared enhanced assumptions about and attitudes toward parenting. In two current investigations of the effect of the initial experiential model of sex education employing quasi-experimental procedure, the course was more thoroughly assessed for its effect on the attitudes and behavior of teenagers toward childrearing abilities, adolescent pregnancy, and activities engaged in preventing early pregnancy (Tingle, 2002). Somers and colleagues’ (2001 as cited in Somers, 2006) pilot research and a later research by Somers and Fahlman (2001, as cited in Somers, 2006), employing multivariate analysis and two distinct samples, were unsuccessful in exposing statistically significant transformations in teenagers’ views of their childrearing ability, their outlooks toward adolescent pregnancy, and their concrete sexual activities related to prevention of pregnancy. Currently, the makers of experiential model of sexual health education updated their initial frameworks with what are named ‘Real Care Babies’ (Somers, 2006, 4). This paradigm is a reformed version of the program Baby Think It Over. The reformed programs necessitate that the teenagers actually identify the cause of the infant’s agony by carrying out such exercises as simulated infant feeding, changing of infant diapers, burping the baby, and so on (Somers, 2006). An internal computer unit records and documents the responses of the infant to the teenager, information that can afterwards be copied into a portable device and used by educators. The essence of these new programs is that they are more lifelike and hence will put more physical and cognitive pressures on the teenagers who care for them (Somers, 2006). Employing this enhanced experiential model, a final objective is to produce the maximum idea on the teenagers concerning the obligations, hardships, and challenges (Somers, 2006) related to childrearing. Discussions and Conclusions The outcomes of the assessments of the sex education programs reviewed in this paper can be summed up by examining their impacts on important factors, such as pregnancy, contraceptive behavior, sexual attitudes, and so on. Even though the findings from the federal probability studies have been unsuccessful in confirming a strong correlation between sexual health education and sexual behavior, assessments of concrete major intervention procedures show some stable trends in their findings (Rosenbaum & Parietti, 1997). Adolescents who took part in sex education programs discontinued their engagement in sexual activities when evaluated against control groups (Rosenbaum & Parietti, 1997). This outcome was similar to teenagers in the multidimensional study of Zabin and colleagues (1986). Furthermore, assessments of a single program demonstrated a boost in any form of sexual behavior, the pure self-discipline course of Christopher and Roosa (1990). Even this outcome entailed precoital action and did not surface as a major result in the reproduction of the initial study (Christopher & Roosa, 1990). This outcome is important because one of the issues that frequently emerged about sexual health education courses is that sexual awareness will provoke teenagers into coital behavior. None of the assessments thus far have proven this consequence (Somers, 2006). The impact of sexual health education programs appears to be more confined to a particular subgroup. Even though the findings of federal studies show that those adolescents who have took part in some kind of sexual health education are more prone to make use of contraception, assessments of concrete programs substantiate this result (Somers, 2006). Eisen and colleagues (1990) discovered that chaste male respondents were more prone to make use of birth control methods in comparison to controls. Howard and McCabe (1990) and Kirby and colleagues (1991) reveal this impact for female and male teenagers who were not yet engaged in sexual activities at the time their courses started. None of these courses had an impact on contraceptive use of adolescents who had been sexually active before the onset of the course. The single intervention among this group that appears to have had an impact was school-based sexual health clinics (Somers, 2006). The actual measurement for any of these sexual health education programs is whether they have an impact on rates of adolescent pregnancy in their sample population. Researchers, such as Kirby and colleagues (1993), have demonstrated how hard this is to quantify. It necessitates post-intervention information and multiyear baseline; hardly any program assessors have the wherewithal to gather this kind of information (Khouzem, 1995). The two multidimensional processes have proven to be the most capable thus far. 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