Abstract
Professional development and training efforts are essential components of effective and evidence-based approaches for educators to teach sexuality education. Public school teachers, with and without health professional preparation, are often assigned to teach sexuality units with limited training. Although sexuality-based curriculum trainings have been available to educators, they are rarely implemented for school teachers at the local, regional, or state levels. This article presents a framework for planning and implementing a professional development opportunity for public school teachers occurring outside the school setting. The authors describe a professional training, called the Sexuality Education Academy, developed to assist Texas school health professionals working with students in grades kindergarten through 12 to understand the importance of using evidence-based tools, resources, and practices in their classroom regarding sexuality education. The Sexuality Education Academy approach holds promise for professional development efforts in sexuality education, in addition to evaluating interventions to ensure accurate implementation of evidence-based sexuality education.
This article describes a professional development intervention for Texas public school teachers responsible for delivering sexuality education to students. Using a detailed description of our process, we highlight the importance of practical training strategies for professionals teaching youth in grades kindergarten through 12 about sexual health. The program, titled the Sexuality Education Academy (SEA), was one of few interventions, specifically designed for Texas school health professionals, built on evidence-based practice to focus on preventing teenage pregnancy and sexually transmitted diseases (STDs). This intervention included a qualitative and quantitative assessment of educators’ perceptions of the SEA and the program outcomes after completing the SEA.
Background/Literature Review
Schools are a recognized setting where parents and youth should be confident that healthy sexuality information can be provided in the classroom setting, and school-based sexuality educators are an essential component to ensure this education occurs (Wilson, Goodson, Pruitt, Buhi, & Davis-Gunnels, 2005). However, there are major obstacles to finding highly qualified teachers who are also comfortable teaching this subject. With the release of the National Sexuality Education Standards (Future of Sex Education Initiative, 2012), there has been a call for professional development and training for qualified teachers within sexuality education (Barr et al., 2014; Rhodes, Jozkowski, Hammig, Ogletree, & Fogarty, 2014). Teachers delivering sexuality instruction also need adequate training and understanding of their role in delivering effective and appropriate education to youth (Rhodes et al., 2014; Wilson & Wiley, 2009). Research suggests that teacher training can influence knowledge, perceptions, comfort level, intentions, and actions for implementing sexuality education (Cohen, Byers, & Sears, 2012; Eisenberg, Madsen, Oliphant, & Sieving, 2013; Eisenberg, Madsen, Oliphant, Sieving, & Resnick, 2010; Herr, Tellijohann, Price, Drake, & Stone, 2012; Levenson-Gingiss & Hamilton, 1989; Rhodes, Kirchofer, Hammig, & Ogletree, 2013).
As well, state boards of education are eliminating noncore courses, such as health education, from public high school graduation requirements (National Association of State Boards of Education, n.d.; Texas Education Agency, 2012). School health policies indicate that only 28 of the 50 states have a health education requirement for high school graduation (National Association of State Boards of Education, n.d.). The lack of commitment to ensuring students receive health education is likely discouraging to preservice professionals to become trained in disciplines encompassing sexuality, such as health education.
Educators face obstacles hindering their ability to teach quality sexuality education, despite documented public health needs and parental desire for sexuality education (Heller & Johnson, 2013). A teacher’s capacity to effectively educate about sexuality is influenced by a complex mix of internal and external factors including preservice education, self-efficacy, teaching background, values, level of professional development, practical experience, access to classroom and financial resources, adequate class time, as well as support in delivery (Duffy, Fotinatos, Smith, & Burke, 2013; Goldman, 2010; Ollis, 2010). Factors such as these may result in reduced quality or completeness of instruction if teachers are not committed to or fully competent in delivering sexuality education (Cushman, Kantor, Schroeder, Eicher, & Gambone, 2014). Teacher training, continuing education, and professional development are strategies for building an educator’s capacity to deliver effective sexuality education. According to Barr et al. (2014),
Teacher trainings can influence educators’ knowledge and perceptions about the importance of teaching health as well as their comfort level, intentions for teaching in the discipline, and actions for implementing sexuality education. In fact, teacher training is the most significant indicator in determining the comprehensiveness of the sexuality education instruction and the number of sexuality topics taught within any curriculum. (p. 397)
However, professional preparation programs are being required to cut degree requirements, and state boards of education are focused on core subjects; thus, there is little training and development of comfortable and competent sexuality educators who are expected to teach in the classroom.
Even with documented effectiveness, such as evidence-based teenage pregnancy prevention programs, one key hindrance is support from leadership at the local school level for the implementation of medically accurate, age-appropriate (MAAA) sexuality education (Eisenberg et al., 2013). In an attempt to teach sexual health, teachers in public education and professionals in sexual health have focused efforts on teenagers’ ability to access medically accurate and comprehensive reproductive health information (Lindberg, Santelli, & Singh, 2006). However, when incorporating sexual health lessons into one unit of a one-semester course (i.e., health education), the ability to implement best practices (e.g., providing medically accurate and comprehensive information) based on research and theory is often lacking.
There is a demand and need for local and national supporters to promote and ensure that sexuality education is a reality and is delivered with quality for all young people. As states or the federal government require medical accuracy in sexual health information provided to youth and the public, the goal is for teachers to use multifaceted resources and tools intended to decrease rates of STDs and unplanned pregnancies (Lavin & Cox, 2012; Santelli, 2008). This approach calls for additional professional development aimed at teachers in diverse disciplines to become fluent in health education principles and related literature.
Knowing the historical background about sexuality education and the context of continuing education opportunities available, a professional development training for Texas teachers was planned and implemented. It was perceived by the funding source and program planners that high-quality professional development in the area of sexual health was lacking; therefore, only Texas public school professionals were targeted for this training. The training targeted those responsible for delivering sexuality education to engage and become a champion for those who can support and also deliver sexuality education—the priority population was teachers, but other professionals within the coordinated school health framework were also eligible to apply. The purpose of this article is to inform educators and trainers about the successes and challenges of training educators in one state to promote quality sexuality education.
This article describes the initial development and implementation of SEA training for Texas public school teachers. The article covers specific activities of the SEA: (1) development of the training curriculum, (2) recruitment of teachers to participate in SEA, (3) training of the teachers, and (4) program evaluation efforts. The challenges and lessons learned during the recruitment and training phases are discussed to further inform future teacher-based sexual health initiatives. We expect that the process of developing SEA will aid other organizations in planning quality professional development for educators working within sexual health programs.
Method/Strategies/Intervention Applications
The SEA was created for a small group (N = 20) of Texas school educators (in most cases, a health teacher, but in some a cases another subject teacher) seeking professional development to improve their ability to deliver high-quality and evidence-based sexuality education in their classrooms. The planning team consisted of three university faculty members (with public school teaching experience) and one public school teacher with extensive sexuality education experience in Texas. The concept of evidence-based sexuality education was used to inform the training program, by the planning team, and focused on MAAA sexuality education methods supported by research. For the purpose of this project, MAAA was defined as
sexuality education that is aligned with the age, developmental level, and cultural background of students, and respects the diversity of values and beliefs of students represented in the community. Furthermore, medically accurate, age-appropriate sexuality education contains relevant information supported by scientific research to promote informed decision-making and does not withhold information needed to protect the health and lives of students.
This definition established a core perspective and was used throughout the program.
The goal of the planning team was to create an opportunity for teachers that would ultimately have an impact on their instruction despite the range of policies and approaches commonly faced in sexuality education and within the infrastructure of their respective school or district. A completed SEA training logic model is provided in Figure 1. Perceived by the funder and the planning team, district administrators planning professional development activities across the state of Texas often avoid opportunities based solely on sexuality; therefore, an innovative approach was needed to attract participation. The SEA format narrowed the focus of the training to develop the educator’s requisite knowledge, skills, and positive attitudes to deliver quality sexuality education. Unique to the academy design was the incorporation of online training to build or ensure the knowledge base prior to the face-to-face workshop. During the face-to-face portion of the academy, trainers were able to capitalize on the established foundation of common knowledge, from the online preparation, to provide a more comprehensive level of training.
Training logic model.
SEA Participants
School health professionals and teachers were invited to participate in the SEA program after completing an application process. The SEA coordinators collaboratively distributed applications through teachers, district administrators, and region administrators to recruit applicants (e.g., e-mail, newsletters, list serves) responsible for instruction in kindergarten through 12th grade from across the state. When applying, the school health professionals had to submit an application including information such as the school and district they worked for, a statement demonstrating their work/experience in sexual health, and an overview presenting their intention for participating in the program. Selection was also based on the participants’ direct access to youth and active teaching of sexuality education. Applications were reviewed and selected by coordinators to ensure that possible participants would philosophically embrace the aim of the SEA (to increase awareness and educational efforts that support the scientific teaching of sexuality education) and respect that the program was developed based on MAAA sexuality education.
In total, 19 public school teachers (1 teacher dropped due to family health issues) completed the online professional development requirements and fully participated in the face-to-face workshop (3 males and 16 females). The majority of teachers represented the health and physical education discipline; however, one high school biology/anatomy and physiology teacher and one elementary general education teacher also completed the SEA.
SEA Description
The SEA consisted of approximately 24 hours of training in two phases: (1) an information/knowledge phase conducted via Web-based workshops and (2) a face-to-face meeting led by experts in sexuality education. The Web-based workshops (sexuality ABC’s and STD basics [described below]) were conducted through Answer, an organization whose mission is to help youth-serving professionals create effective sexuality education for young people (Rutgers University, 2013a), to ensure that all participants were starting the program with equal knowledge of the core content. Answer workshops were a good fit as the workshops were developed by national experts in sexuality education and based on medically accurate information (Rutgers University, 2013b). Answer also provided educational and completion metrics of participants’ completion of the online courses.
Sexuality ABC’s. This 6-hour equivalent professional development course was designed to (1) help participants understand trends in teen sexual behavior, (2) provide a refresher on current contraceptive methods, (3) provide examples of effective lesson plans for middle and high school students, (4) allow participants to practice answering frequently asked questions, and (5) learn about and discover the most current resources (Rutgers University, 2013c).
STD basics. This 6-hour equivalent professional development course was designed to (1) increase participants’ knowledge and competence for teaching about STDs, (2) provide information about the transmission and prevention of STDs, (3) provide a platform for interactive discussions about common concerns and questions posed by health professionals and students, and (4) provide lessons and resources related to STDs (Rutgers University, 2013d).
Face-to-face workshop. Following the online workshop, the face-to-face workshop was conducted over a 2-day period (12 hours) and consisted of (1) skill development in evaluating sexuality curricula materials from reputable sources to ensure medical accuracy and content appropriateness for sexuality units, as well as individual lesson plans; (2) increasing skills to actively implement and advocate for MAAA sexuality education; and (3) providing an explanation of how to document the MAAA strategies and activities that teachers implement in the classroom. Session topics and descriptions are displayed in Table 1.
Sexuality Education Academy Workshop Session Descriptions.
Expected impact on sexuality education: understand the need for sexuality education. bExpected impact on sexuality education: improved sexuality instruction. cExpected impact on sexuality education: advocacy for medically accurate, age-appropriate sexuality education.
Evaluation. To understand more about SEA and the impact it had on participants and their teaching of MAAA sexuality education, an evaluation plan was designed and implemented. The SEA developers evaluated the program qualitatively through a participant town hall discussion. The town hall discussion provided participants the opportunity to talk in a group forum about what they learned and think about moving forward with advancing sexuality education in their districts. Some of the questions that guided the discussion included the following: “Discuss with us the ‘state’ of sexuality education in your school and what your role is in the school,” “What are the benefits of teaching sexuality education in your school?” “What are the barriers (and can you break those barriers) to teaching sexuality education in your school?” “What support do you or do you think you can get from your school district for implementing sexuality education?” and “How has this training affected you and your implementation of sexuality education in the future?” The team classified and prioritized participant qualitative feedback to optimize the delivery and effectiveness of the program from the teacher’s perspective. Two important themes emerged and have been prioritized for future workshops: (1) the flexibility of the SEA and (2) the quality of the program trainers.
Participants also completed a pre-, post-, and 6-month follow-up quantitative survey developed by the team focused on the perceptions and implementation of MAAA sexuality education. This portion of the evaluation included an examination of participants’ perceptions and adoption behaviors of evidence-based sexuality education using the diffusion of innovations theoretical framework. Statistically significant changes occurred between pre- and posttest scores in relative advantage, compatibility, complexity, and observability. At 6-month follow-up, participants indicated increased advocacy for and implementation of evidence-based sexuality education practices. Results from this training evaluation suggest a focus on professional resources and evidence-based practice, rather than sexual health content alone, is important to ensure the implementation of MAAA sexuality education. Moreover, findings from this study provide initial insights into the impact of training workshops designed specifically for educators charged with the task of teaching sexuality to students.
Discussion
Lessons learned from the planning and implementation of SEA can assist future professional development opportunities related to sexuality education in the school setting. This training can help health education coordinators and other school professionals focus on the improvement of sexuality education in a scientific, engaging, and organized manner. Additionally, teachers who went through this training felt a stronger efficacy in supporting the teaching of MAAA sexuality education in their respective classroom and districts. This sense of a stronger voice may be needed to advance the implementation of effective sexuality programs and curricula delivery in schools.
Recruitment of Teachers
Several important issues emerged related to delivery of sexuality education that were foundational and associated with content comfort and classroom effectiveness. These included school and district recruitment of the “right” teacher to deliver classroom instruction in sexuality education and the delivery of the “right” instruction in the classroom for youth. Literature confirms that sexual health educators need to be adequately trained to understand their role in delivering effective sexuality education but also realizes that the instruction they deliver can and will influence youth sexual behaviors (Kirby, 2007).
Teachers who are responsible for providing sexuality education come from a wide range of professional training backgrounds. Despite their primary content background, a majority of the teachers accepted into SEA were the supporters of sexuality education in their respective school and/or district. However, the reality is that many teachers, regardless of their professional preparation experiences and primary content area, have been mandated to teach sexuality but do not have the background, skills, competence, or comfort level to effectively implement the sexuality unit. This teacher training experience provided the opportunity to gain and hone the skills needed to deliver sexuality education to youth.
While sexuality education training programs, such as SEA, continue to recruit teachers, it is different from the usual recruitment strategies for other teacher professional development opportunities. The program needed to use a broad scope of methods to attract skilled teaching professionals who may have never made the connection between their vocation as teachers and the potential impact SEA may have on sexuality education. The program was promoted primarily through key district personnel, a statewide school health association, and regional school health specialists. Teachers wanting to participate had to submit an application that included a statement demonstrating their work/experience in sexual health. Each applicant also included an overview statement presenting why he or she was interested in this professional development activity, and a vision of his or her participation in the program. This application approach is far beyond what most districts require for participation in professional development opportunities, but it reflects a training experience where interest in the program exceeded the number of participant slots available due to funding restrictions. The SEA team strategically looked for participants who were highly motivated, recognized teaching as important, would embrace the objectives of the SEA, and had a strong sense concerning the importance of sexuality education for youth and adolescents.
Knowledge and Skilled Delivery of Sexuality Education
This group of multidisciplinary teachers brought a wealth of information and experiences to the program in- and outside the sexuality education arena. The program researchers had to expect a wide range of understanding about various topics related to sexuality. Some participants had strong professional backgrounds in this topic area, while others had less. The training team was prepared for this reality and required all participants to successfully complete the online professional development, which provided baseline information for all participants (and served as a welcomed refresher for those already knowledgeable in the content area). Although not custom-designed, the online portion of the program met individual learning needs and built on individual strengths.
The SEA program was collaboratively developed by experts in sexual health and education, each with an extensive knowledge and understanding of the subject and variation in policies regarding sexuality education in Texas public school districts. This knowledge influenced the program delivery and provided a positive learning experience for the participants. The SEA provided some flexibility via online professional development and ample time for the participants to complete the online courses within the 1-month time frame. The face-to-face workshop was held over a 2-day period during the summer. This format allowed for teachers to not miss classroom instruction and eliminated substitute teacher arrangements.
In terms of program outcome goals, it is important to recognize the final objective was not to achieve a uniform knowledge change but rather for each teacher to gain necessary and valuable requisite skills and comfort level to teach and advocate for sexuality education. Teachers were evaluated following their SEA participation. Additionally, participants were asked to anecdotally share their local stories as they advanced the acceptance of sexuality education in their local school districts. The feedback about local changes as well as SEA content, delivery, and program structure was taken into account for future planning and programming.
Facilitating Networks and Leadership Among Teachers
The teachers benefitted significantly from the networking opportunities gained through this multidisciplinary, statewide program. Many teachers who are teaching a debated subject, such as sexuality, often feel like they are operating in a vacuum. They struggled with some of the challenges they face, and this program offered the opportunity for them to realize they are not alone in their efforts.
As educators and skilled facilitators, we could not assume that the teachers would “network” just because they were participating in SEA or because they were physically in the same facilities. Opportunities for teacher participants to interact included organized meal functions and activities. For 12 months following the face-to-face training, the SEA also offered and used an online network site to generate regular (e.g., monthly) announcements and to inform participants of new educational resources/materials, activities, and opportunities in the field of sexuality education.
Shortly after teachers participated in SEA, they started a new fall semester of the academic year. Thus, in planning for the upcoming school year, they were asked to participate in community-based advocacy outreach events supporting sexuality education. They were also asked to ensure the lessons they were using in the classrooms were based on MAAA sexuality education as they carried out their sexual health units. This experiential learning provided participants with a unique and effective experience that facilitates a problem-based learning approach to overcoming local barriers to sexuality education. In Texas, due to local control of schools, teachers are essential voices for development and sustainability of sound sexuality education in local school districts and across the state. There is also stress on teachers contributing to the process of reviewing and ensuring the best sexual health units are offered to their students.
Flexibility of SEA
Because of the flexible, modular structure, the online professional development allowed participants to work and study at their own pace. The amount of online time spent at any given period was personally managed, so classroom responsibilities of the teacher were not interrupted. Advanced notification of the dates for the face-to-face meeting was provided, with ample time to make travel arrangements. Participants were required to complete the online professional development 1 week prior to the face-to-face meeting. Important resources for the participants’ future teaching of sexuality education and use were provided at the face-to-face meeting and via the online network site. The face-to-face meeting provided participants the ability to interact with the trainers and the other participants, which was identified as important by the teachers.
Diverse Trainers
The SEA was successful in recruiting diverse trainers with various areas of expertise within the sexual health arena. One important factor was that all the trainers had obtained public school experience at some point in their careers. This proved invaluable in that a trainer could consider not only the academic perspective of sexual health education but the application challenges as well. Gleaning knowledge and experience from the trainers allowed teachers to have a broader understanding of sexuality education and the challenges of delivering sexuality education in the diverse communities across the state. The trainers also benefited from working with teachers who were not necessarily trained in health education but rather came from a broad base of experience and perspectives (two of the trainers came from traditional health education backgrounds and two trainers became involved in sexuality education via science training/certification). The trainers’ ongoing involvement in the program and regular attendance at professional development opportunities demonstrates the professional and personal commitment they made to influence the leadership development and advocacy efforts for sexual health within the public school arena.
Conclusions
Training is a critical element in preparing health educators, as is keeping them abreast of current information, especially as they deliver sexuality education programs to young people who may not obtain this information elsewhere (Telljohann, Everett, Durgin, & Price, 1996). Organizations such as the Sexuality Information and Education Council of the United States, The National Campaign to Prevent Teen and Unplanned Pregnancy, and Advocates for Youth have made a call for professionally trained individuals who are responsible for teaching sexuality education (Barr et al., 2014). However, in many states, the question can be asked, “How much, if any, professional training are teachers receiving in sexuality education?” In an era when professional preparation programs are continually cutting degree requirements and state boards of education are focused on core subjects, there is little systematic nurturing and grooming of professionally trained sexuality educators who are comfortable and competent to teach sexuality education in the classroom.
Therefore, the training of local educators in sexuality education requires professional development and trainings sensitive to the learning needs, time constraints, and other realities teachers face on a continuous basis. Training programs are best if they offer hands-on, experientially based workshops that are relevant to teachers’ everyday lives and work situations. Empowerment and training of teachers is further supported as teachers enhance their self-efficacy in their ability to teach and implement MAAA information in the classroom on a regular basis (Rasberry et al., 2007; Smith, Flaherty, Webb, & Mumford, 1984). The SEA was successful in recruiting vested participants, ensuring that the program was developed and planned to meet teachers’ needs, and providing networking and leadership development for participants in the program. In this case, diverse and qualified trainers ensured the content and delivery of SEA met a high standard of education, and the training could be maintained and delivered again as a future professional development opportunity.
The implementation of sustained, professional development and training for sexuality educators can lead to enhanced, quality sexuality education in the schools. It is recommended that local and state agencies embrace strategically planned professional development for sexuality educators of other content areas expected to deliver sexual health instruction. Furthermore, schools and districts should consider professional development opportunities to ensure that all educators, regardless of their primary content area, are capable of providing youth with MAAA sexuality information, even though they may not be responsible for direct instruction.
Given the intensive nature of the SEA, professional development trainings should ensure that stakeholders involved in the training activity have a basic knowledge about sexuality content and invested in evidence-based sexuality education practice. Building and maintaining support at the school and/or district level from the community and school administration may also enhance teacher willingness to participate in such professional development opportunities, thus influencing the delivery of sound sexuality education.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported, in part, by the Texas Pediatric Society Foundation.