Sexual Health Promotion in U.S. Schools – Highlights from the CDC’s SHPPS 2012

Source:
Laura Kann, et al., “Health Education: Results from the School Health Policies and Practices Study 2012,” Results from the School Health Policies and Practices Study 2012 (August 2013).

Description:
The School Health Policies and Practices Study (SHPPS) is a national survey to assess school policies and practices related to general health promotion (including but not limited to sexual health) at the state, district, school, and classroom levels. The U.S. Centers for Disease Control and Prevention (CDC) conducted this survey at all levels in 1994, 2000, and 2006. In 2012 SHPPS collected data at the state and district levels only.

SHPPS assesses the characteristics of eight components of school health: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. SHPPS gathers national data on a small number of topics in sexuality education – specifically, sexual health topics such as HIV and unintended pregnancy prevention.

In 2012, SHPPS collected state-level data via web-based questionnaires completed by designated personnel working in state Departments of Education in all 50 states and the District of Columbia. All 51 Departments of Education responded, resulting in a 100% response rate. District-level data were also collected via web-based questionnaires completed by designated personnel working in a nationally-representative sample of public school districts. Of 1,048 school districts eligible for the study, 804 responded, resulting in a 77% response rate. For additional details on the study design, see http://www.cdc.gov/HealthyYouth/shpps/index.htm.

Key Findings:

• In 2012, at least two out of three U.S. school districts had a policy stating that middle and high schools would teach about human sexuality, HIV/other STD prevention, and pregnancy prevention.
   
• Between the years 2000 and 2012, there was an increase in the percentage of school districts with a policy stating that high schools will allow parents or guardians to exclude their children from receiving instruction on those topics (from 62% to 78%).
   
• Between 2000 and 2012, there was a decline in the percentage of school districts with a policy stating that elementary schools will teach about HIV prevention (from 59% to 40%).
   
• Between 2000 and 2012, there was a decline in the percentage of school districts with a policy stating that elementary schools will teach about other STD prevention (from 39% to 29%).

Analysis:
“Despite evidence of supportive policies and practices, these data indicate that there is room to increase the percentage of states and districts that implement policies and practices that support effective health education…”[1] This statement best captures the promise and problems that characterize sexuality education when housed within health classes in U.S. K-12 schools. While it is encouraging that at least two thirds of the nation’s school districts had a policy stating that middle and high schools would teach about human sexuality, HIV/other STD prevention, and pregnancy prevention, it is no guarantee that those districts are teaching comprehensive, medically-accurate, sexuality education that is inclusive of all learners. Adopting such a policy is a necessary step toward ensuring that a school district will cover topics in sexual health, but it is hardly sufficient for ensuring that quality instruction will result. To use a term coined by the CDC’s Division of Adolescent and School Health, ‘exemplary sexual health education’ (ESHE)

“is delivered by well-qualified and trained teachers, uses strategies that are relevant and engaging, and consists of elements that are medically accurate, developmentally and culturally appropriate, and consistent with the scientific research on effective sexual health education.”[2]

Perhaps more troubling than the fact that more than thirty years into the HIV/AIDS epidemic one third of U.S. school districts still lack such any sexual health policy, SHPPS has found a steep decline since 2000 in the percentage of school districts with policies for teaching about HIV and other STDs at the elementary school level. The decline in school districts’ commitment to teaching about these basic sexual health topics does not bode well for ESHE (or any other more comprehensive approach) at the middle and high school levels. The fact that more school districts now allow parents to exclude their children from instruction even in high school further complicates efforts to provide U.S. youth with quality instruction in human sexuality.

Although SHPPS 2012 reveals a number of troubling trends that sexuality educators and policy advocates will work hard to reverse in the coming years, the results of this periodic study are invaluable for helping stakeholders in the field understand where U.S. schools are now, and what must be done to improve their sexuality education programs in the future.