Health education advocacy handouts wiley


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This handout correlates with the Advocacy presentation at the Texas HIV/STD Conference on Tuesday, May 25, 2010

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Health education advocacy handouts wiley

  1. 1. Health Education in Texas Schools: Creating Greater Advocacy in the Community David C. Wiley, Ph.D. Professor of Health Education Texas State University San Marcos, TX 78666
  2. 2. American School Health Association 84th Annual ASHA School Health Conference Healthy Students . . . Successful Learners October 13 - 16, 2010 Hyatt Regency Crown Center Kansas City, Missouri
  3. 3. “Schools could do more than perhaps any other single institution in society to help young people, and the adults they will become, live healthier, longer, more satisfying, and more productive lives.” — Carnegie Council on Adolescent Development
  4. 4. n 1 in 7 students has been in a physical fight on school property n Every 60 seconds a child is born to a teen mother n Obesity affects 1 in 5 children in the U.S. n Each day, 3000 children start smoking —1 every 30 seconds 1 in 3 high school students reports n having consumed 5 or more drinks in a row n Every 4 hours, a child in America commits suicide
  5. 5. Sexual Health of Texas Teens… • Every 10 minutes, a Texas teen gets pregnant. (1) • Texas has the third highest teen birth rate in the United States. (2) • Texas has the highest proportion of teen births that are repeat births. (3) • In Texas, 3 in 10 girls get pregnant at least once by the age of 18. (4) • Texas is ranked 4th among U.S. states for reported number of AIDS cases among adolescents. (5) Source:
  6. 6. Sexual Health of Texas Teens • The proportion of high school students who had sexual intercourse in the previous three months in Texas is 3.7% higher than the national average. (6) • The proportion of high school students with four or more lifetime sexual partners in Texas is 2.1% higher than the national average. (6) • The proportion of sexually active high school students who used a condom at last sex in Texas is 4.1% lower than the national average. (6) • The proportion of sexually active high school students who used birth control pills at last sex is 2.8% lower than the national average. (6) Source:
  7. 7. Healthy Schools/Healthy Communities Healthy Children School Increased Social Performance Capital Healthy Communities ―The relationship between schooling and health outcomes is one of the strongest generalizations to emerge from empirical research in the U.S.‖ Nagya R. (2000). Applied Economics, 32, 815-822
  8. 8. Health Education Family & Physical Community Education Involvement School-site School Health Health Promotion Services for Staff Healthy School Nutrition School Services Environment School Counseling & Social Services
  9. 9. What is Advocacy? • Advocacy is nothing new. People in power have always been targeted for advocacy by individuals/groups. • Advocacy takes on many forms. • It is possible to advocate for ourselves and for others. • Advocacy may/may not be time-limited. • Advocacy should be combined with: – Community mobilization – Education – Public health measures – Community support
  10. 10. Definition of Advocacy "Advocacy is an action directed at changing the policies, positions and programs of any type of institution." Reference: An Introduction to Advocacy, Training Guide, SARA Project.
  11. 11. Advocacy Checklist • What is the problem? • Who decided to advocate to address the problem? • To whom did you advocate? • What methods were used? • What difficulties did you face? • How did you overcome the difficulties? • What were the results of your advocacy?
  12. 12. Young people are at high risk of unintended pregnancy and STDs for many years MEN 28.5 33.2 16.9 26.7 14.0 AGE 10 15 20 25 30 35 26.0 17.4 12.6 30.9 25.1 WOMEN Alan Guttmacher Institute, 2003
  13. 13. Just Say Don’t Know: Sexuality Education in Texas Public Schools Drs. David Wiley and Kelly Wilson Texas State University-San Marcos Ryan Valentine Editor and Contributing Author
  14. 14. Key Findings • Finding 1: Most Texas students receive no instruction about human sexuality apart from the promotion of sexual abstinence. • Finding 2: Most school districts do not receive consistent or meaningful local input from their School Health Advisory Councils (SHACs) regarding sexuality education. • Finding 3: Sexuality Education materials used in Texas schools regularly contain factual errors and perpetuate lies and distortions about condoms and STDs. • Finding 4: Shaming and fear-based instruction are standard means of teaching students about sexuality. • Finding 5: Instruction on human sexuality in Texas often promotes stereotypes and biases based on gender and sexual orientation. • Finding 6: Some Texas classrooms mix religious instruction and Bible study into sexuality education programs.
  15. 15. Sexuality Education in Texas Public Schools
  16. 16. Texas-Specific Health Education Issues
  17. 17. Sexuality Education Curriculum Standards (Texas Education Code (TEC 28.004) • Any course materials and instruction relating to human sexuality, sexually transmitted diseases, or human immunodeficiency virus or acquired immune deficiency syndrome shall be selected by the board of trustees with the advice of the local school health advisory council and must: • (1) present abstinence from sexual activity as the preferred (emphasis added) choice of behavior in relationship to all sexual activity for unmarried persons of school age; • (2) devote more attention to abstinence from sexual activity than to any other behavior; • (3) emphasize that abstinence from sexual activity, if used consistently and correctly, is the only method that is 100 percent effective in preventing pregnancy, sexually transmitted diseases, infection with human immunodeficiency virus or acquired immune deficiency syndrome, and the emotional trauma associated with adolescent sexual activity; • (4) direct adolescents to a standard of behavior in which abstinence from sexual activity before marriage is the most effective way to prevent pregnancy, sexually transmitted diseases, and infection with human immunodeficiency virus or acquired immune deficiency syndrome;
  18. 18. Human Sexuality Instruction… • Devote More Attention to Abstinence Than Any Other Behavior • Emphasize Abstinence as the Only 100% Effective Technique • Teach Contraception & Condom Use in Human Use Reality Rates Instead of Theoretical Rates
  19. 19. Human Sexuality Instruction… • Schools May Not Distribute Condoms as a Part of Instruction • Schools May Separate Students by Gender • District Shall Notify Parents of Basic Content of Human Sexuality Instruction
  20. 20. Human Sexuality Instruction • Parents’ Rights to Remove Student(s) from Human Sexuality Instruction • Make All Curriculum Materials Available to the Public
  21. 21. Health Education – SB 283 (2009) • Written notice must be sent home before each school year indicating whether or not the district will provide human sexuality instruction to students. • If human sexuality instruction is provided, a summary of its content, the requirements established under state law, a statement of the parent’s right to review the materials, the option to remove the student without penalty, and information describing opportunities for parental involvement in the development of the curriculum (SHAC) must be included in the written notice.
  22. 22. Role of SHACs (TEC 28.004) • LOCAL SCHOOL HEALTH ADVISORY COUNCIL AND HEALTH EDUCATION INSTRUCTION. (a) The board of trustees of each school district shall establish a local school health advisory council to assist the district in ensuring that local community values are reflected in the district's health education instruction. • (b) A school district must consider the recommendations of the local school health advisory council before changing the district's health education curriculum or instruction. • (c) The local school health advisory council's duties include recommending: (1) the number of hours of instruction to be provided in health education; (2) curriculum appropriate for specific grade levels designed to prevent obesity, cardiovascular disease, and Type 2 diabetes through coordination of: (A) health education; (B) physical education and physical activity; (C) nutrition services; (D) parental involvement; and (E) instruction to prevent the use of tobacco; • (3) appropriate grade levels and methods of instruction for human sexuality instruction;
  23. 23. Local School Health Advisory Councils (SHACs) • To Ensure That “Local Community Values & Health Issues Are Reflected in District’s Human Sexuality Instruction” • Recommend Appropriate Grade Levels for Instruction • Recommend Methods of Instruction • Recommend Hours of Instruction
  24. 24. Membership of SHACs • MUST Include Persons Who Represent Diverse Views • MUST Include Parents of Students Enrolled in District as a Majority • MAY Include Teachers, School Administrators, Students, Health Care Professionals, etc...
  25. 25. SHAC Legislation (SB 283, TEC §28.004) • Meet 4 times per year, minimally • Contain a minimum of 5 members • Report directly to the school board at least once annually with detailed account of SHAC activities and recommendations • Appoint parent as chair or co-chair • Recommend indicators for evaluating effectiveness of Coordinated School Health Programs
  26. 26. SHAC Facts 65% of Texas school districts reported that their SHACs had not discussed the topic of sexuality in the previous three years 81% of school districts could not produce any formal SHAC recommendations on sexuality education instruction regardless of date 25% of districts have no formal policy at all governing sexuality education.
  27. 27. High School Graduation Requirements – HB 3 (2009) • Chart of revised high school graduation requirements may be found on the following TEA websites: • a. For students who entered grade 9 before 2007-08 – 09a.doc • b. For students who entered grade 9 in 2007-08 or later doc
  28. 28. Coordinated School Health (CSH) – SB 892 (2009) • Develop goals and objectives based on fitness assessment data, academic performance, attendance rates, academic disadvantages, the use of success of any method to ensure students are reaching required moderate or vigorous physical activity (MVPA), and any other indicator recommended by SHAC. • Include in all Campus Improvement Plans (CIPS) for elementary middle and junior high school campuses.
  29. 29. Easy Advocacy Steps • Volunteer for your local SHAC • Serve in leadership roles in SHAC • Ask to review sex education policy • Ask to review sex education materials • Evaluate curriculum used evidenced-based practices (
  30. 30. Sexuality Education Advocacy Recommendations… • Members of SHACs should be trained in best practices in sexuality education instruction • Utilize only curricular materials from reputable sources that ensure medical accuracy and appropriate content
  31. 31. Sexuality Education Advocacy Recommendations • Utilize qualified classroom teachers to teach sexuality education and ensure they receive necessary training • Carefully vet all guest speakers and monitor all sexuality education presentations provided by outside individuals or group • Instruction must extend beyond the approved health education textbooks
  32. 32. Common Misperceptions about Sexuality Education in Texas Schools • Texas is an “abstinence-only” state • Texas law requires abstinence-only sex education • Parents must give permission (i.e. opt-in) for sexuality education • Contraception cannot be discussed
  33. 33. General Health Education Advocacy Points… • Health education requirement is a local issue • More than sexuality education • Focus on risk behaviors of youth • Conduct Youth Risk Behavior Survey (YRBS) locally ( ex.htm)
  34. 34. General Health Education Advocacy Points • Ensure a delivery mechanism for health education instruction • Insist upon evidence-based practices and tools • Adopt an evidence-based, K-12 curriculum • Make the link between student health and academic achievement • Make student health a “public” issue
  35. 35. Don’t… • Overload a visit with too many issues • Confront, threaten, pressure, or beg • Be argumentative • Overstate the case • Expect decision-makers to be specialists • Be put off by smokescreens or long-winded answers
  36. 36. Don’t • Be afraid to take a stand on the issues • Shy away from meetings with decision- makers with known view opposite your own • Be offended if a decision-maker is unable to meet and requests that you meet with his/her staff
  37. 37. Realities of Advocacy • Frustration is guaranteed • Time-consuming process • Learn to compromise • Redefine “success” • Best advocacy may occur at the ballot box
  38. 38. David C. Wiley, Ph.D. • Department of Health and Human Performance • Texas State University • San Marcos, TX 78666 • (512) 245-2946 •
  39. 39. Resources… • Kaiser Family Foundation ( • National Campaign to Prevent Teen Pregnancy ( • NSBA School Health Program( • Advocates for Youth (
  40. 40. Resources… • Alan Guttmacher Institute (http://www.agi- • CDC’s Division of Adolescent & School Health (DASH) ( ) • Sex Education and Information Council United States (SIECUS) (
  41. 41. Resources • American Cancer Society’s Healthy Kids Network ( oot/ped/content/ped_1_5x_Healthy_Kids) • American School Health Association ( • ETR Associates (