HIV / STI and Sexuality Education Curriculum Evaluation Tool
Dear Sex Education Supervisor and Advisory Board Co-Chairs:
There are a wide variety of curricula available in HIV/STI and sexuality education that can be included
as part of a coordinated school health program. How does your district know which one to choose?Many school districts have requested a user-friendly guide to evaluate curricula that takes into consider-ation the needs of students and wishes of the community. To help with this selection process, aworkgroup of the Comprehensive School Health Coordinators’ Association developed this tool that out-lines four key questions:
meeting the needs of your students? community standards? research and best state law? practices?
Districts have also asked whether they should review curricular packages or write their own curricula.
We encourage districts not to reinvent the wheel, but rather, review existing curricular packages based onthe above criteria. The bottom line is that schools do not have the time or energy to develop and imple-ment programs that are no more likely to keep young people safe and healthy. Further, research supportsthe fact that healthy children are better able to learn and succeed academically.
Your Comprehensive School Health Coordinator, typically found at the ISD or RESA office, has an
extensive number of resources, tools, and the expertise to help you in your process of choosing effectiveHIV/STI and sexuality education programs. Do not hesitate to contact them to assist your district in thedecision-making process.
Comprehensive School Health Coordinators’ Association
Developed and updated by a workgroup of the Comprehensive School Health Coordinators’ Association • Mary Ahrens, Saginaw ISD
• Arlene Richardson, Detroit Public Schools
• Laurie Bechhofer, Michigan Department of Education
For more information about HIV and sex education in Michigan schools, contact Laurie Bechhofer, Michigan Department of Education, at 517-335-7252 or email@example.com EMC Website: www.emc.cmich.edu A curriculum is unlikely to be effective if it does not meet the needs of the student population. A. Rationale for Assessing Student Needs
What do your student populations look like? What kind of risks are they taking? What kinds of specific programs are needed to reduce students’ risks and to support health and educational achievement? This data is important to help a local district meet the legal requirement of selecting
materials and methods that address student needs. §380.1507(5)(b)
As a district and community you already have some information to address these questions related to the needsof your students. For example, have you considered what proportion of your students: • Have plans and goals that reinforce a decision to be abstinent? • Have adults they can turn to for accurate information or advice? • Have a serious boyfriend or girlfriend? • Are engaging in risk behaviors? • Have had sex (ever or in the past three months)? • Use risk reduction methods to prevent pregancy and sexually transmitted infection? • Have multiple partners? • Are having sex under the legal age of consent? • Have significantly older partners? (an age difference of 3 or more years) • Have sexual relations while they or their partner are under the influence of alcohol and other drugs? • Have experienced sex against their will or without their consent? • Have ever been pregnant or gotten someone pregnant or had a sexually transmitted infection? • Have had underage sex? B. Student Needs and Curriculum Selection
The answers to some of these questions can help to:
1. Narrow the menu of curricula to review; and
2. Highlight contents or lessons that are critical to be included. Example 1: If almost half of your student population has had sex, how might this influence the types of curricula your district reviews (e.g., abstinence only or abstinence plus risk reduction)? Example 2: If a significant number of students have had older sexual partners, how might this influ- ence the content to be included in the curriculum (e.g., how power and status might affect negotiation and decision-making)? C. Gathering Student Need Data
1. Gather local and state data that is already available to begin to build the picture of student needs.
2. Collect new data to fill in the gaps to further clarify the picture. Possible sources of data:
• Safe and Drug-Free Schools surveys (SDFS)
3. Compile your information in a meaningful way and discuss implications for curricula selection (see sample form below).
Remember that what students know may not
determine what they do.
The best data on student needs will reflect, not
only knowledge, but also student intentions, Better Indicators behaviors, and/or health outcomes. Sample Worksheet Summarizing Student Need Data Information/Data About Implication(s) for Your Students Curriculum Selection
about STI risk, transmission, and preven-
35% of the district’s high school students
of students in general education) have had
A curriculum is unlikely to be implemented or II. COMMUNITY STANDARDS effective unless it is consistent with what most parents want for their children. A. Determining Community Standards The best way to find out what parents in the community want for their children is to ask them in the form of a brief, straightforward survey. The following topics include those identified in §380.1507b and include other topics that have been identified as key components of a comprehensive scope and sequence for sexuality education. Below are questions that could be asked of parents to determine when certain content might be introduced in the K-12 curriculum. At what grade level should each of the following possible sexuality education/reproductive health topics first be taught? K-3 4-5 6-8 9-12 Should not be taught 1. Puberty and Adolescence: Teaches boys and girls about the physical and social changes of puberty 2. Reproductive Anatomy: Describes male and female reproductive anatomy and function. 3. Positive Communication With Family: Encourages students to talk with their parents and other
trusted adults about feelings, relationships and setting limits. 4. Positive Friendships: Identifies characteristics of positive friends, including initiating, maintaining, 5. Child Sexual Abuse: Teaches personal safety concepts, such as good touch-bad touch, stranger
danger and identifying trusted adults who can help. 6. Healthy Dating Relationships: Recognizes healthy and unhealthy relationships. Differentiates
between emotional and physical intimacy, and limit setting. 7. Abstinence: Discusses benefits of abstaining from sex or ceasing sexual activity. Teaches
assertiveness skills for resisting pressure, such as communication and refusal. 8. Skills to Avoid Risky Behaviors: Includes developmental skills, such as decision-making,
communication, assertiveness, refusal, and negotiation, to avoid risky situations. 9. Legal Consequences of Underage Sex: Provides information about the criminal consequences of 10. Pregnancy and Childbirth: Explains how pregnancy occurs, the importance of prenatal care, and 11. Parenting Responsibilities: Explores the responsibilities of parenting (e.g., economic, physical,
emotional, social, and legal) and their impact on future goals. Provides information onresponsibilities to children born in and out of wedlock. 12. Adoption and Safe Delivery: Provides information on adoption services and the safe delivery of 13. Sexually Transmitted Infections (including HIV/AIDS): Information about the transmission,
symptoms, treatment, and prevention of sexually transmitted infections, such as chlamydia,gonorrhea, genital herpes, genital warts, and HIV/AIDS. 14. Risk Reduction: Provides information about condoms as a means to reduce risk for HIV and other 15. Contraception: Provides information about birth control methods, such as condoms, birth control
pills, and Depo-Provera and their role in preventing pregnancy. 16. Sexual Orientation/Identity: Teaches that all students deserve to be treated with respect (e.g., no
name-calling, taunting, bullying) and that some students self-identify or are perceived to be gay,lesbian, or bisexual. 17. Harassment, Sexual Assault and Rape: Provides information on the law, prevention skills, and Additional Comments: B. Quality of the Results
It is important to consider whether or not your survey results are representative of parents in your school. If results come from a convenience sample rather than a random sample, they may not represent the views of all parents in the district. Consider:
• Was this information collected using research methodology? • Are the results representative of most parents with students in the district? • Do they also represent the views of other key stakeholders in the community? • Did parents and/or other key stakeholders in the district have the chance to express their views honestly
• If the answer(s) are “no” to the above, your survey results may not be valid. The district may want to
consider collecting the data again in a more scientific fashion. III. RESEARCH AND BEST PRACTICE A curriculum is unlikely to be effec- tive unless it is consistent with the research regarding effective instruction for HIV/STI and/or pregnancy prevention.
Significant bodies of research repeatedly point to the same factors critical for successful
school-based HIV and pregnancy prevention programs.1 Effective programs, as defined by researchers, impact one or more of the following outcomes:
• Delay initiation of sexual intercourse• Maintain or encourage return to the practice of sexual abstinence• Reduce the number of sexual partners• Support the consistent use of risk reduction methods, such as condoms and birth control, for those who are sexually active• Decrease cases of sexually transmitted infection or pregnancy
As the district reviews curricula, consider the following key issues: research and best practice. A. Research
• Has the program been evaluated for behavioral intentions or outcomes?
• If yes, what was the quality of the evaluation?
a. Was it published in a peer-reviewed journal?b. Did it include a follow-up survey in addition to a pre- and post-test?c. Did it include a comparison or control group?d. Was the study population and/or setting similar to yours?
• What were the results of the evaluation? Did it demonstrate statistically significant change in key outcomes, such as sexual behavior? B. Best Practice
Not all programs have gone through a rigorous evaluation. Even programs that have not been formally evaluated should include the following characteristics of programs found to be effective. The character- istics on the next page are best practice. Best practice questions1 to ask about a curriculum:
Does the curriculum align with the national standards for health education2?
• Students will comprehend concepts related to health promotion and disease prevention. • Students will demonstrate the ability to access valid health information and health-promoting products and services. • Students will demonstrate the ability to practice health-enhancing behaviors and reduce health risks. • Students will analyze the influence of culture, media, technology, and other factors on health. • Students will demonstrate the ability to use interpersonal communication skills to enhance health. • Students will demonstrate the ability to use goal-setting and decision-making skills to enhance health. • Students will demonstrate the ability to advocate for personal, family, and community health.
Does it focus on reducing one or more sexual behaviors that lead to unintended pregnancy,
Is it based on theory of how people adopt or maintain healthy behaviors?
Does it provide a clear, consistent emphasis on abstinence and other forms of risk reduction?
Does it provide basic, accurate information about risks, ways to eliminate or reduce risk, and
Does it include activities that help students identify and respond to social pressures from
sources, such as their peers and the media?
Does the program include multiple opportunities for explanation, demonstration, and practice of skills? Essential skills include:
• Perceived risks for HIV, STI, and/or pregnancy
• Communicating with parents/guardians Y N
Does it include a variety of best practice teaching methods that encourage higher-order thinking? Such methods include: • Substantive conversation and discussion
• Cooperative learning and small groups
• Community linkages and involvement Y N
• Demonstrations and experiential learning
Does it include goals, teaching methods, and instructional materials that are
appropriate to the age, sexual experience, and culture of the students?
Does it last long enough to have a chance of impacting behavior? Research has shown that programs with 14 or more hours of instruction are more effective.
Have we selected teachers who believe in the program and will establish a climate conducive to Y N learning? Will the teachers receive curriculum-focused training?
1Adapted from Kirby, D. (2001). Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. TheNational Campaign to Prevent Teen Pregnancy: Washington, DC. These best practices are also embedded in the MichiganDepartment of Education State Board Policy to Promote Health and Prevent Disease and Pregnancy (September, 2003).
2The National Health Standards can be accessed on the American Association for Health Education website athttp://www.aahperd.org/aahe/. IV. LEGAL OBLIGATIONS The curriculum content must be consistent with state law.
In Michigan, sexuality education and HIV/STI prevention education must be in compliance with Michigan
laws (see statutes §380.1169, §380.1506, §1380.1507, §380.1507a, §380.1507b, §388.1766, and
§388.1766a). The law outlines a process for approving and implementing sexuality education programs. Italso identifies certain requirements for content:
Instruction in HIV/AIDS and sex education must stress that abstinence from sex is a responsible and effective methodof preventing unplanned or out-of-wedlock pregnancy, and that it is the only protection that is 100% effective againstunplanned pregnancy, sexually transmitted disease, and sexually transmitted HIV infection and AIDS. (§380.1169,§380.1507, §380.1507b)
Instruction in HIV/AIDS must include the principal modes by which dangerous communicable diseases are spread andthe best methods for the restriction and prevention of these diseases. (§380.1169)
Sex education material discussing sex must be age-appropriate, must not be medically inaccurate, and must do all ofthe following:
a) Discuss the benefits of abstaining from sex until marriage and the benefits of ceasing sex if a pupil is sexually
b ) Include a discussion of the possible emotional, economic, and legal consequences of sex. c) Stress that unplanned pregnancy and sexually transmitted diseases are serious possibilities of sexual intercourse
that are not fully preventable except by abstinence.
d ) Advise pupils of the laws pertaining to their responsibility as parents to children born in and out of wedlock. e) The age-appropriate sex education material also must ensure that pupils are not taught in a way that condones
the violation of laws of this state pertaining to sexuality, including, but not limited to, those relating to sodomy,indecent exposure, gross indecency, and criminal sexual conduct in the first, second, third, and fourth degrees.
f ) Teach pupils how to say “no” to sexual advances and that is wrong to take advantage of, harass, or exploit
g ) Teach refusal skills and encourage pupils to resist pressure to engage in risky behavior. h ) Teach that the pupil has the power to control personal behavior, and teach pupils to base their actions on
reasoning, self-discipline, a sense of responsibility, self-control, and ethical considerations, such as respect forself and others.
i) Provide instruction on healthy dating relationships and on how to set limits and recognize a dangerous environ-
j ) Provide information for pupils about how young parents can learn more about adoption services and about the
provisions of the Safe Delivery of Newborns Law.
k) Include information clearly informing pupils that having sex or sexual contact with an individual under the age of
16 is a crime punishable by imprisonment and that one of the other results of being convicted of this crime is tobe listed on the sex offender registry on the internet for up to 25 years.(§380.1507b)
School districts must teach about the best methods for the restriction and prevention of dangerous communicablediseases, including, but not limited to HIV/AIDS. (§380.1169)Districts are not prohibited from teaching about behavioral risk reduction strategies, including the use of condoms,within their sex education program. (§380.1507)
Clinical abortion cannot be considered a method of family planning, nor can abortion be taught as a method ofreproductive health. (§380.1507) “Reproductive health” means that state of an individual’s well-being which involvesthe reproductive system and its physiological, psychological, and endocrinological functions. (§380.1506)A person cannot dispense or otherwise distribute a family planning drug or device in a public school or on publicschool property. (§380.1507)
HIV / STI and Sexuality Education Evaluate the Curriculum To what extent is the curriculum.
.meeting the needs of your students?
.consistent with community standards?
.consistent with research and best practice? .consistent with state law? Overall Strengths: Overall Weaknesses: (educator, parent, community health professional, clergy, student, etc.)
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