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

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
davidwiley@txstate.edu

2. American School Health Association
http://www.ashaweb.org
84th Annual ASHA School Health Conference
Healthy Students . . . Successful Learners
October 13 - 16, 2010
Hyatt Regency Crown Center
Kansas City, Missouri

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

5. 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

6. 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: http://www.txcampaign.org

7. 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: http://www.txcampaign.org

8. 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

9. 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

11. 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

12. 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.

13. 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?

14. 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

15. 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
http://www.justsaydontknow.org

16. 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.

17. Sexuality Education in
Texas Public Schools

18. Texas-Specific Health Education
Issues

19. 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;

20. 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

21. 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

22. Human Sexuality Instruction
• Parents’ Rights to Remove Student(s) from
Human Sexuality Instruction
• Make All Curriculum Materials Available to the
Public

23. 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.

24. 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;

25. 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

26. 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...

27. 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

28. 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.

29. 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
– http://ritter.tea.state.tx.us/taa/comm0706
09a.doc
• b. For students who entered grade 9 in 2007-08
or later
http://ritter.tea.state.tx.us/taa/comm070609b.
doc

30. 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.

31. 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 (http://www.teenpregnancy.org)

32. 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

33. 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

34. 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

35. 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
(http://www.cdc.gov/HealthyYouth/yrbs/ind
ex.htm)

36. 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

37. 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

38. 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

39. Realities of Advocacy
• Frustration is guaranteed
• Time-consuming process
• Learn to compromise
• Redefine “success”
• Best advocacy may occur at the ballot box

40. David C. Wiley, Ph.D.
• Department of Health and Human
Performance
• Texas State University
• San Marcos, TX 78666
• (512) 245-2946
• davidwiley@txstate.edu

41. Resources…
• Kaiser Family Foundation (http://www.kff.org)
• National Campaign to Prevent Teen Pregnancy
(http://www.teenpregnancy.org)
• NSBA School Health
Program(http://www.nsba.org/schoolhealth/)
• Advocates for Youth
(http://www.advocatesforyouth.org)

42. Resources…
• Alan Guttmacher Institute (http://www.agi-
usa.org)
• CDC’s Division of Adolescent & School Health
(DASH)
(http://www.cdc.gov/nccdphp/dash/index.htm
)
• Sex Education and Information Council United
States (SIECUS) (http://www.seicus.org)

43. Resources
• American Cancer Society’s Healthy Kids
Network
(http://www.cancer.org/eprise/main/docr
oot/ped/content/ped_1_5x_Healthy_Kids)
• American School Health Association
(http://www.ashaweb.org)
• ETR Associates (http://www.etr.org)