Online instruction might serve sex ed best

Online instruction might serve sex ed best

(Chicago, Ill.) Not surprisingly, for teenagers with questions about sex, birth control and sexually transmitted diseases or related issues there are digital resources they can access on their own for answers.

Sex education is also taught in many schools across the country, most often as part of a district’s or state’s comprehensive health education curriculum.

But as educators move to further blend digital learning into classrooms, they should also consider using online programs to deliver sexual health information to students, according to an opinion published this month in the Journal of the American Medical Association.

“In the age of smartphones, texting, Twitter, Instagram and Facebook, sex education should evolve to fit the 21st century and the media-saturated lives of young people today,” wrote authors Victor Strasburger, a doctor at the University of New Mexico School of Medicine, and Sarah Brown, a public health expert who founded the National Campaign to Prevent Teen and Unplanned Pregnancy. “Online material and social media could help to fill the gaps in sex education and support for many young people.”

Though the teen birth rate has declined to its lowest levels since data collection began, the United States still has the highest teen birth rate in the industrialized world, according to the national Centers for Disease Control. Three in 10 girls will be pregnant at least once before their 20th birthday; one in four teens who become pregnant is between the ages of 15 and 17.

In addition, adolescents are disproportionately affected by sexually transmitted infections (STIs) – young people ages 15 to 24 represent 25 percent of the sexually active population, but acquire half of all new STIs, which amounts to 9.8 million new cases a year, says the CDC. About 3.2 million adolescent females are infected with at least one of the most common STIs.

The cost to taxpayers of unplanned teen pregnancies and STI contraction is roughly $14 billion annually in medical, social and legal expenses, according to the National Campaign to Prevent Teen and Unplanned Pregnancy.

Despite the data, sex education remains controversial in many places. Less than half of all states – 22, plus the District of Columbia – actually require schools to teach sex education. Slightly more – 33 – mandate HIV/AIDS education, according to the National Conference of State Legislatures.

It should be noted, however, that in some of the states where sex ed isn’t a requirement – such as California – HIV/AIDS education is required, and includes information on how the disease is or isn’t transmitted as well as instruction on sexual abstinence, monogamy, avoidance of multiple sexual partners, and abstinence from intravenous drug use. California law also provides for schools to voluntarily offer comprehensive sexual health education – guidelines for which are included in the state’s standards for health education, also not a required high school course.

While debate over what – or even whether – schools should teach students about sexual health serves as one barrier to reaching kids, another is sheer scale. At a time when many districts lack resources to provide core curriculum, JAMA’s Brown and Strasburger argue that online programs could be used to reach larger numbers of students with perhaps better results than a few brief classroom lessons.

Online programs dealing with sensitive subjects like sex education and drug use might also appeal more often to adolescent students embarrassed, afraid to ask questions or discuss personal situations in a group setting.

Research on whether, in fact, teens engage better and learn more effectively through online courses of any kind is limited but growing.

When it comes to online sex education, however, several reviews of computer-based interventions – conducted in the early and middle part of the decade – suggest that student behavior was positively altered by completion of the courses.

An oft-cited 2006 randomized control trial to evaluate an online sexual health education course designed for Colombian public schools found that the program had “significant impacts on knowledge and attitudes and, for those already sexually active, fewer STIs.”

To go beyond self-reported measures, the researchers – from Ottawa, Toronto and Yale universities – provided condom vouchers six months after the course, and found a 10 percentage point increase in redemption.

“We find no evidence of spillovers to untreated classrooms, but we do observe a social reinforcement effect: The impact intensifies when a larger fraction of a student’s friends is also treated,” they wrote.

Strasburger points out in his Journal of the American Medical Association blog that the U.S. Department of Health and Human Services’ Office of Adolescent Health lists 31 classroom-based programs “that have evidence of effect” in schools across the country.

Despite that, says Strasburger, many sexually experienced teens (46 percent of males and 33 percent of females) report that they had not received any instruction about contraception before they began having sex.

“Sex education materials and conversations provided through digital and social media could be useful adjuncts to classes and programs that may be offered in a community or school system; in areas where no such programs exist, they may help to fill serious gaps,” he wrote.

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