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Sex Education in South Carolina Still Failing 25 Years After Passage of Comprehensive Law

11:13 am in Uncategorized by RH Reality Check

Greetings from South Carolina

Greetings from South Carolina

Written by Martha Kempner for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

In 1988, the South Carolina legislature passed the Comprehensive Health Education Act (CHEA) which was designed to standardize health education instruction in the state in order to “reduce substantially the amount of money the state spends to care for teenage mothers and their often sickly babies.” We can argue about the language and motives behind the legislation but the process of standardizing how young people learn about health is an important one that many states still have not undertaken.

South Carolina was certainly ahead of the curve passing such a bill so long ago (I was still in high school in 1988), but 25 years later there are questions as to how effective the law has been since sexual health statistics show South Carolina struggling with teen birth rates and sexually transmitted disease (STD) rates higher than the national average.

A new report assesses the current status of health education with a focus on the reproductive health component. A Sterling Opportunity: 25 Years After the Comprehensive Health Education Act was conducted by Health Advocates LLC and the New Morning Foundation using a Department of Education survey of school districts in the state. The authors wanted to determine whether districts were following the parameters of the CHEA, what they were teaching, how well those teaching the subject were trained, and what materials they were using. The authors found a number of places where schools were failing to follow the law and providing inadequate — and in some cases inaccurate and outdated — information to students.

While the findings are not as outrageous as some found in other states, they shed important light on the situation in South Carolina which is struggling with a few issues: a law that has some good components and some highly restrictive ones, misunderstandings about what the law does and doesn’t require, and a complete lack of accountability.

The Law

The CHEA is very prescriptive in what is required as well as what is prohibited in health education including reproductive health education and teen pregnancy prevention. For example, it requires that each year students in grades nine through 12 receive comprehensive health education that includes at least 750 minutes of reproductive health education and pregnancy prevention education. Sixth through eighth graders are also supposed to receive reproductive health education which must include STD information. It may also include information on contraception, though this is up to the local school board.

The law does restrict sexuality education to a certain extent. It requires an emphasis on abstinence, says that contraception information must be provided in the context of future planning, and directs schools to present adoption as a “positive alternative.” In addition, schools cannot provide any information about abortions, distribute contraception of any kinds, or show films that portray actual or simulated sexual activity. Finally (and I’d argue most disturbingly), the law states that “health education classes may not include discussions of alternate sexual lifestyles from heterosexual relationships” except in the context of STDs.

Despite these conservative aspects, the sexuality education component of the law has been controversial since the law was passed. In fact, there have been a number of attempts to change that part of the law. The report notes one amendment to the law proposed in 1998 that sought to change the purpose of the CHEA from “promote responsible sexual behavior,” to “the goal of this act is to reduce the incidence of sexual activity among school aged youth.” In 2004, there was an attempt to reduce the amount of sex education instruction from a minimum of 750 minutes per year to a maximum of 200 minutes. These challenges have failed.

The law also has administrative aspects such as teacher training requirements; an “opt-out” provision that allows parents to remove their children from the reproductive health portion of the course; and a requirement that districts assemble an advisory board of parents, teachers, and clergy to review materials.

Even though the law remains in place, according to the report many school districts are not following it. In fact, the study found that 75 percent of the districts surveyed were out of compliance with some piece of the reproductive health portion of the CHEA.

The Findings

Schools were out of compliance on issues related to time spent on reproductive health, teacher training, and administration. For example:

  • 66 percent of districts that responded did not teach STD and HIV prevention in all three middle school grades.
  • 23 percent of districts that responded did not have the appropriate community members on their advisory boards.
  • 12 percent of districts that responded did not provide the required teacher training.

Interestingly, 96 percent of districts that responded reported teaching all 750 required minutes of reproductive health in high school.
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Anti-Sex Ed Curriculum Makes the List: Don’t Blame Obama, Blame the System

9:23 am in Uncategorized by RH Reality Check

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Written by Norman A. Constantine, Eva S. Goldfarb, Danny Ceballos, and Carmen Rita Nevarez for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

See all our coverage of Heritage Keepers Abstinence Education here.

A recently updated list of federally approved “evidence-based” teen pregnancy prevention programs has been causing a stir. This list specifies the programs that are eligible for federal funds and serves as the cornerstone of President Obama’s Teen Pregnancy Prevention Initiative.  Among the three programs making the list for the first time is the Abstinence-Only-Until-Marriage program Heritage Keepers Abstinence Education. Our friends and fellow advocates in the adolescent sexual health promotion field have denounced this program as medically inaccurate, biased, fear- and shame-based, and otherwise inappropriate for the classroom. Here we all agree, completely. A program like this has no place in our schools and communities, and especially not with government funding.

But we take issue with criticisms of the Obama administration for “backroom deals and secrecy,” “political expediency,” and “blatant hypocrisy,” among other barbs and arrows recently launched by understandably frustrated advocates. Rather than blaming Obama for this unfortunate development, we’d all do better to recognize that it was the result of a fundamentally flawed system operating according to explicit agreed-upon rules—a system sorely in need of review and repair.

What’s wrong with this system? Simply put, it is based on a fundamental misunderstanding of the nature of scientific evidence and its appropriate use. To earn a place on the list, a program needs only to produce one statistically significant outcome in one evaluation study–no matter how many outcomes were tested across how many studies. Yet it is a well-known principle of research statistics that the likelihood of a false finding increases as the number of outcomes tested increases. In fact, if a program has no effect, for every twenty outcomes tested one outcome can be expected to be incorrectly identified as a statistically significant effect merely due to chance alone. Even testing just two outcomes raises the probability of a false finding of effectiveness beyond the traditionally tolerated level of less than five percent. The technical name for taking advantage of this principle to obtain a statistically significant finding is “fishing for significance.”

And this is just one of the more blatant of the numerous problems with the evidence review system currently in place. These problems and their implications are described elsewhere in more detail. Suffice it to say that under current “evidence-based” standards of effectiveness, a Mickey Mouse cartoon could be listed as an effective teen pregnancy prevention program with just a moderate amount of evaluation creativity and persistence. Perhaps it is then no surprise that upon release of the original version of this evidence-based teen pregnancy prevention program list in 2010, the independent non-partisan research-use watchdog Coalition for Evidence-Based Policy commented that “HHS’s evidence-based teen pregnancy prevention program is an excellent first step, but only 2 of 28 approved models have strong evidence of effectiveness.”

The biggest challenge in research and research use in this area is that we as a field need to move away from asking these simplistic out-of-context yes/no questions about effectiveness of individual name-brand curricula. These types of questions inevitably lead to the picking and choosing of isolated favorable findings. Instead, we can do a better job of critically weighing and integrating the entire body of relevant program evaluation evidence —together with the broader body of scientific research evidence on adolescent health and development —as they inform a set of general principles of effective and responsible comprehensive sexuality education.

To complement this more encompassing view of evidence, while at the same time recognizing the understandable demand among funders and program providers for simple and straightforward guidance about program development and selection, we propose a move to standards-based lists. There are now many excellent sets of standards and guidelines for comprehensive sexuality education, from groups such as SIECUS, UNESCO, and IPPF, as well as the newly developed National Sexuality Education Standards.  These standards represent an enormous improvement over what is currently passing for comprehensive sexuality education, and enjoy widespread support from mainstream health and education organizations.  Any of these could be used as the basis of an objective and systematic process for rating curricula and other programs on the most important content and process criteria.

California has already provided a model of such a system, based on its Sexual Health Education Accountability Act and related California Education Code. These basic standards for comprehensive sexuality education provide 45 explicit criteria that serve as the foundation for an objective and systematic process used to rate curricula in California.  The successful experience in California with this system could help inform the adaption of such as system in other states, and for federal program review as well. It could be applied to any of the existing standards.

Advocates for Youth has promised to challenge the existing evidence-based paradigm and to “advocate for a recalibration of the current balance towards a vision of sex education that is evidence-informed and rights based.” We enthusiastically support this new focus, and will help however we can.

Family Makes Millions Taking in Federal Funds for Failed Abstinence-Only-Until-Marriage Programs

8:14 am in Uncategorized by RH Reality Check

Written by Martha Kempner for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

See all our coverage of Heritage Keepers Abstinence Education here.

Photo by Mandarin Strawberries.

This week RH Reality Check has been reporting on the Obama administration’s decision to add Heritage Keepers, an abstinence-only-until-marriage curriculum, to its list of evidence-based programs.  As a number of my colleagues pointed out in an earlier article this decision seems to be based solely on unpublished research that has already been declared flawed.  And, as I pointed out in an article detailing the content of Heritage Keepers the program is more marriage promotion than sexuality education and was definitely one of the curricula that sexuality educators were eager to see disappear as the funding for abstinence-only-until-marriage programs dried up. Truth be told, though, many of us were also eager to see the creator of the programs, Heritage Community Services—an organization that went from tiny to wealthy almost exclusively on taxpayer’s money—disappear as well.

Heritage Community Services was founded in 1995 by Anne Badgley as an adjunct organization to the Lowcountry Crisis Pregnancy Center which she had founded in 1986. Today, the two groups are separate non-profits but they continue to share the same office and some staff members. Like most crisis pregnancy centers,  Lowcountry exists to convince women facing an unplanned pregnancy not to choose abortion. The organization’s website explains:

Because LPC does not profit from your decisions, we do not provide or refer for abortion, and we do not sell or refer for birth control.”

The organization also discusses the “emotionalproblems that women can expect after an abortion:

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