How to Innovate Sexual Health Education
By Karin Coyle, PhD, Chief Science Officer, ETR | Pamela M. Anderson, PhD, Senior Research Scientist, ETR | Lauren Ranalli, MPH, Director of Communications and Public Affairs, ETR | June 17, 2024
Evidence-based pregnancy and sexually transmitted infection (STI) prevention programs have been shown to have a positive effect on reducing unplanned pregnancy or associated behavioral risk factors, such as delaying sexual activity or increasing condom or contraceptive use.1
While teen birth rates reached a record low in 2023, STI rates have increased dramatically. Additionally, there are evolving issues among youth, including mental health, bullying, body image, and online safety, that should be addressed in sexual health education. As a result, the need for innovation in sexual health education is stronger than before.
Innovation in Teen Pregnancy Prevention Programs (TPP)
The experiences of young people are continuously evolving, and sexual health education needs to reflect their current realities and the experiences they are now. By developing and testing new interventions as well as evaluating (or re-evaluating) existing TPP programs to ensure they are still effective, we can create sexual health resources that are aligned with the real-time needs of young people. Here are some of the considerations we can look at as we innovate in the field of adolescent sexual health:
- Empowering Young People: Involving young people in the design of interventions that impact their health and well-being is believed to support young people’s development,2 strengthen programs and services,3 and lead to social, political, and economic benefits.4 Engagement in these processes is what young people desire.5 Historically, sexual health interventions are rarely designed in collaboration with young people, especially those from systemically marginalized communities.6 By addressing the specific needs and challenges that LGBTQ+ youth, youth of color, and unhoused youth may face when trying to access sexual health information and services, we can center lived experiences that are traditionally left out of sexual health programs. 7-10Prioritizing youth engagement during the development and delivery of sexual health education is a critical area for continued innovation and evaluation.
- Expanding Evidence for Implementation Settings: Young people engage with health information through a variety of settings—both in-person and virtually. There is a continued need to expand the evidence regarding programs in diverse settings. For example, educational, economic, and health disparities in rural areas demonstrate the need for tailored sexuality education and TPP interventions that are sensitive to the conditions impacting rural communities. Limited research on sexual health programs in rural areas leaves a gap in understanding how both the strengths and challenges of living in rural communities can inform interventions.
- Embracing Virtual Platforms: The use of technology is a key strategy to reach underserved and youth with marginalized identities who may not have access to relevant and affirming sexual health education.11, 12 Though technology is an increasingly present component of health interventions, there has been a lack of rigorous evaluation of virtual health education programs, which are more common now due to the COVID-19 pandemic. Understanding and encouraging the use of program implementation and impact via technology and virtual spaces will benefit schools and other community-based organizations as they continue to expand their use of technology for program delivery.
- Addressing Online Safety: A recent meta-analysis reported that a sizeable number of young people send or receive sexually explicit messages or images (sexts) with 1 in 7 sending sexts and 1 in 4 receiving them), with rates varying by many factors, such as age of young people, the mode of sexting, and the date of study. This study also showed that a notable percentage of young people (1 in 8) reported they have forwarded a sext without consent.13 Young people are also navigating online bullying. Data from the 2021 Youth Risk Behavior Survey shows that approximately 1 in 6 young people report ever being bullied online (e.g., via text or social media), with more females reporting online bullying experiences than males (approximately 1 in 5 females compared to approximately 1 in 9 males).14 Further, the results of a recent 2022 study suggest a notable proportion of young people (15.6%) report prior experience with online sexual abuse in a variety of forms and contexts involving peers, partners, friends, and, in some cases, adults or online strangers.15 As a result, there is a growing need for innovations in sexual health education to address online safety, including topics such as online relationships and digital communication, digital consent, online safety skill building in diverse contexts, online boundaries, and resources for seeking support when navigating online interactions.
- Integrating Health Education Topics: Sexual health is often interconnected with other health issues that young people are facing. From ETR led research centering small group discussions (focus groups) with young people, we have found that they do not segment their health in ways that it is often taught through current interventions. Innovations in sexual health call for more intersectional and integrated approaches to wellness, which would align with how young people experience and talk about their own well-being.
Recent Innovations from ETR
Since our founding in 1981, ETR has been committed to promoting the sexual and reproductive health of young people and communities in the United States and internationally. ETR is honored to have received an award from The Office of Population Affairs (OPA)- Teen Pregnancy Prevention Programming to support the RYSE (Reimaging Young People’s Sexual Health Equity) Innovation Hub, Yes and Know virtual curriculum evaluation, and the evaluation of Teen Talk High School, a booster program. These projects employ the strategies highlighted above in our efforts to lead the charge in amplifying innovation within sexual health education. To learn more about RYSE, click here for our recent press release.
Additional Resources from ETR
ETR is here to support your work providing education and working towards innovation in adolescent health. Check out more of our offerings below!
Sexual Health Curriculum – View and purchase our evidence-based and evidence-informed sexual health programs offered through ETR.
Educator Training – Check out available trainings for educators and other youth-serving professionals on implementing sexual health programs. We have plenty scheduled throughout 2024!
Check out the ETR Store for health promotion materials on topics such as birth control and pregnancy prevention, LGBTQ+ health, and STI/HIV prevention.
3-In-30 Events: Take a deeper dive into our free on-demand video resources that feature discussions on topics to further adolescent health in 30 minutes or less!
Karin Coyle, PhD (she/her), is the Chief Science Officer at ETR. She specializes in the development and evaluation of health promotion programs, particularly HIV, other STI, and pregnancy prevention programs.
Pamela M. Anderson, PhD (she/her), is a Senior Research Scientist at ETR and an applied developmental psychologist specializing in adolescent development.
Lauren Ranalli, MPH (she/her), is the Director of Communications and Public Affairs at ETR. She is a public health professional specializing in adolescent health, health education, and communication strategies.
References
1. https://youth.gov/evidence-innovation/tpper
2. Zeldin S, Petrokubi J, Collura J, Camino L, Skolaski J. Strengthening Communities through Youth Participation: Lessons Learned from the ACT for Youth Initiative. ACT for Youth Center of Excellence; 2009:24.
3. Patton G, Sawyer S, Santelli JS. Our Future: a Lancet commission on adolescent health and wellbeing. The Lancet. 2016;387(10036):2423-2478.
4. UNICEF. Adolescent and Youth Engagement Strategic Framework. Published online 2017.
5. Gowen L, Winges-Yanez N. Lesbian, gay, bisexual. transgender, queer, and questioning youths’ perspectives of inclusive school-based sexuality education. Journal of Sex Research. 2014;51(7):788-800.
6. Peterson A, Drake P, Tat S, Silver G, Bell H, Guinosso S. Youth Engagement in Sexual Health Programs and Services: An Environmental Scan. Published online 2020.
7. Tyler K, Whitbeck L, Chen X, Johnson K. Sexual health of homeless youth: prevalence and correlates of sexually transmissible infections. Sexual Health. 2007;4(1):57-61.
8. Khalili J, Leung L, Diamant A. Finding the Perfect Doctor: Identifying Lesbian, Gay, Bisexual and Transgender-Competent Physicians. 2015. 2015;105(6):1114-1119.
9. Decker M, Berglas NF, Brindis C. A Call to Action: Developing and Strengthening New Strategies to Promote Adolescent Sexual Health. Societies. 2015;5(4):686-712.
10. Peterson A, Drake P, Tat S, Silver G, Bell H, Guinosso S. Youth Engagement in Sexual Health Programs and Services: An Environmental Scan. Published online 2020.
11. Brayboy LM, McCoy K, Thamotharan S, Zhu E, Gil G, Houck C. The use of technology in the sexual health education especially among minority adolescent girls in the United States. Current opinion in obstetrics & gynecology. 2018;30(5):305.
12. Sheoran B, Silva CL, Lykens JE, et al. YTH StreetConnect: Development and usability of a mobile app for homeless and unstably housed youth. JMIR mHealth and uHealth. 2016;4(3):e5168.
13. Madigan S, Ly A, Rash CL, Van Ouytsel J, Temple JR. Prevalence of Multiple Forms of Sexting Behavior Among Youth: A Systematic Review and Meta-analysis. JAMA Pediatr. 2018;172(4):327–335. doi:10.1001/jamapediatrics.2017.5314
14. Centers for Disease Control and Prevention (CDC). 1991-2021 High School Youth Risk Behavior Survey Data. Available at http://nccd.cdc.gov/youthonline/
15. Finkelhor, D., Turner, H., & Colburn, D. (2022). Prevalence of Online Sexual Offenses Against Children in the US. JAMA network open, 5(10), e2234471. https://doi.org/10.1001/jamanetworkopen.2022.34471
