Improving sexuality education: the development of teacher-preparation standards

Development of a School Health Policy Implementation Survey: A Delphi Study

Data on school health policy implementation are limited due to the absence of a validated measurement tool. The purpose of this study was to create and pilot a school health policy implementation survey. A modified, four-round Delphi process was used to achieve consensus on content and format of the survey. The final 76-item survey was piloted in 655 schools with a return rate of 57.1% (n  =  378). Seven schools participated in environmental audits. Based on the audits, survey responses represented an accurate description of school practices for 84.2% (n  =  64) of questions. The remaining 15.8% (n  =  12) of survey items were eliminated or revised. This measurement tool begins to fill the research gap between the evaluation of written school health policy and implementation. Further, this tool may be used by school nurses in alignment with the Framework for 21st Century School Nursing Practice.

The Health Education Teacher Instructional Competency Framework: A Conceptual Guide for Quality Instruction in School Health

BACKGROUND

Teacher instructional competency, the set of essential knowledge and skills needed to guide teaching practice, is critical to the successful implementation of school health education. The purpose of this paper is to introduce the Health Education Teacher Instructional Competency (HETIC) framework, a new conceptualization describing teacher characteristics, essential knowledge, and essential skills, which can influence instructional practice and improve student learning outcomes in health education.

METHODS

Data from 17 publicly available guidance documents, professional standards, published reports, and empirical studies relevant to the fields of public education, school health education, and sexual health education were abstracted and analyzed using qualitative thematic content analysis.

RESULTS

The framework describes 3 domains: personal characteristics, essential knowledge, and essential skills, which are believed to contribute to teachers' instructional competencies in delivering health education. The knowledge domain asserts 5 key categories, while the essential skills domain includes 3 categories (learning environments, content and delivery, and collaboration and learning) and contains 11 unique skills. Collectively, these domains are influenced by the learner, school/community, and policy-level factors that shape health education curriculum and instruction.

CONCLUSIONS

The HETIC framework presents a conceptual roadmap to guide quality health education preparation, job-embedded training, and delivery. Improving teachers' instructional competencies strengthens learning and prosocial environments that are inclusive, responsive, and affirming of students' health and learning needs. Teacher who demonstrate instructional competency can help students to achieve desired education and health outcomes, specifically acquiring the knowledge and skills needed to adapt, practice, and maintain healthy behaviors throughout their lifetime.

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

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.

Developing gender-specific evidence-based standards to improve the health and wellbeing of women in prison in England: a literature review and modified eDelphi survey

PURPOSE

There are significant health inequalities experienced by women in prison. They face distinct challenges and have particular and complex needs, specifically with regard to their physical and mental health. The purpose of this paper is to describe the approach taken to develop a set of health and wellbeing standards for the women's prison estate in England, which can be applied elsewhere.

DESIGN/METHODOLOGY/APPROACH

A structured literature review of standard healthcare databases and grey literature was used to inform development of suggested standards. A multidisciplinary expert panel provided consensus on the standards through an online survey and women with a history of contact with the criminal justice system were consulted through consensus groups.

FINDINGS

A total of 549 papers were included in the final review. From this, 127 standards were identified for inclusion in the Delphi process. Consensus was achieved on all standards; this, combined with the analysis of qualitative feedback provided by both the survey and the consensus groups, resulted in the development of 6 overarching principles and 122 standards, across ten topic areas.

ORIGINALITY/VALUE

These standards are the most extensive that are known to exist for health and wellbeing of women in prison and the first to be developed in England. The process used ensures the standards have high validity, acceptability and feasibility and can be used to support those developing similar methodologies. There are few papers which document the development of standards to improve health and to the authors knowledge, only one other paper has been published detailing the development of health standards in prison settings specifically.

The Effect of Sexual and Reproductive Health Education on Knowledge and Self-Efficacy of School Counselors

PURPOSE

Enrichment of school counselors' knowledge would be an effective way to promote sexual and reproductive health (SRH) among adolescents. The present study aims to assess the effect of educational intervention on knowledge and self-efficacy of high school counselors on teenage SRH.

METHODS

A randomized controlled trial was conducted between June 2016 and March 2017. One hundred and twelve high school counselors from Tehran were recruited and randomized into two groups. The intervention was comprised of training courses on adolescent SRH as per two educational approaches: the team-based learning (TBL) and lecturing, which consisted of four sessions of 2hours in 2 weeks. The knowledge and feeling of self-efficacy in both groups were assessed at the beginning of the study and 8 weeks after the intervention by researcher-made questionnaires.

RESULTS

After intervention, the mean and standard deviation of the knowledge and self-efficacy scores increased significantly in both TBL and lecture groups (p < .001). However, the final mean (standard deviation) of counselors' knowledge and self-efficacy scores in the TBL group were significantly higher than that of those in the lecture group [20.06 (2.74) vs. 18.90 (2.95); p = .03 for knowledge and 43.01 (4.08) versus 41.15 (4.99); p = .03 for self-efficacy] with an almost moderate effect size d = .55 for both outcomes.

CONCLUSIONS

The better SRH knowledge and self-efficacy in TBL group can be indicative of the group's effect on making challenges, especially in subjects that are socio-religious by nature. It seems that applying learner-centered educational approaches such as TBL can facilitate achieving pre-assigned SRH goals.

Equipping early childhood educators to support the development of sexuality in childhood: Identification of pre- and post-service training needs

Pre- and post-service sexuality training for Early Childhood Educators (ECEs) is lacking in Canadian and international contexts. The objective of this study was to assess pre- and post-service sexuality education instruction and training needs among an ECE population in Ontario, Canada. Sixty-four participants completed an online survey, which included both closed- and open-ended questions. The survey assessed ECEs': a) perceptions of the quality of addressing sexuality and gender in early learning centres; b) current level of preparation in addressing the development of sexuality; and, c) sexuality training needs. Collectively, participants identified a variety of approaches to sexuality, spoke to themes of inadequate climates to address sexuality education, and the relational characteristics ECEs felt were beneficial for addressing sexuality and gender. Participants (65.6%) recognized the everyday opportunities in which they could engage in discourses of sexuality. Nevertheless, a lack of training to address these domains was notable, with 53.2% reporting inadequate preparation in their current role as an ECE. Findings are discussed in response to a paucity of curriculum documents, which hinders professionals' ability to adopt an emergent approach to address sexuality and gender.

Achieving Consensus on Principles of Good Practice for School Health in Independent Schools: A Delphi Study

BACKGROUND

Although the 8 components of the coordinated school health (CSH) framework have been implemented to various degrees in the nation's public schools, principles of good practice (PGPs) to guide health promotion efforts in independent schools do not exist. The purpose of this study was to generate PGPs and rate their feasibility of implementation.

METHODS

A modified Delphi process was used to generate PGPs for school health in independent schools and develop consensus regarding their feasibility of implementation. A working group of 6 independent school health professionals (ISHPs) was convened to propose draft PGPs based on the CSH framework. The proposed PGPs were then reviewed by a national and geographically diverse expert panel of 10 school health researchers and 23 ISHPs that completed 3 Delphi rounds to achieve consensus on the PGPs. Of 33 participants originally invited to participate, 27 completed the Delphi process.

RESULTS

A total of 27 panelists rated 67 PGPs, provided 399 comments, and achieved consensus using interquartile range on 56 (84%) of the proposed PGPs, 41 of which were rated feasible and 15 somewhat feasible.

CONCLUSION

This study has generated empirical support for the feasibility of PGPs for school health in independent schools.

Health Promotion Intervention to Improve Diet Quality in Children

OBJECTIVE

This study aims to evaluate the impact of an intervention program, taught by trained teachers, on foods and nutrients components of the Diet Quality Index-International among children in Grades 1 to 4.

METHOD

A total of 464 children (239 female, 6-12 years) from seven elementary Portuguese schools participated in this randomized trial. Three schools were allocated to the intervention, and four to the control group. The intervention program was based on the health promotion model and social cognitive theory. Teachers previously trained by researchers in nutrition, healthy eating, and healthy cooking implemented the intervention in the classroom from November 2008 to March 2009. Sociodemographic, anthropometric, physical activity, and dietary assessments were performed before (2007/2008) and at the end of the intervention (2009). Dietary intake was gathered by a 24-hour dietary recall and the components of Diet Quality Index-International were defined.

RESULTS

Children from the intervention schools reported a significantly higher adequacy in vegetable consumption (p = .018) and a significantly higher moderation in sodium consumption (p = .032) compared with the controllers.

CONCLUSION

Our study provides further support for the success of intervention programs that aim to enhance children's dietary intake. Implementing similar interventions can be promising to support vegetable consumption and moderate sodium intake.

Assessing Teacher Confidence and Proficiency With Sexuality Education Standards

The timely emergence of the National Teacher Preparation Standards for Sexuality Education in the United States will transform preparation of future educators and provide guidance for professional development training of current sexuality educators. This article focuses on identifying factors that affect sexuality education by examining perceptions and experiences held by certified Rhode Island public school health educators. Study participants were asked to respond to questions addressing their confidence in teaching sexuality education topics, ability to plan and implement sexuality lessons with the National Health Education Standards, and ability/proficiency in the National Teacher Preparation Standards for Sexuality Education. The topic of identity (36%), which addresses people’s understanding of who they are, was the only topic identified by the National Sexuality Education Standards that teachers were uncomfortable teaching. The majority of the educators felt very confident in their abilities to teach lessons integrated with four of the six National Health Education Standards. Less than half of the educators felt very confident with integrating communication and advocacy skills. The educators surveyed also believed to be very confident in meeting all seven National Teacher Preparation Standards for Sexuality Education. This article concludes that gauging current teacher’s confidence and proficiency with these standards can isolate factors that either impede or enhance quality sexuality education for youth. Expanding the understanding of these factors can influence professional development and provide meaning as to what confident and proficient sexuality educators look like in practice.