Sexual health education from the perspective of school personnel: Implications for the dissemination of effective programs in middle school

Background: The delivery of effective sexual health education (SHE) programs through middle school can prevent early sexual initiation. However, school personnel may lack knowledge and self-efficacy for program implementation. Additionally, their attitudes regarding SHE and perceived support for such programs is unclear and may play a role in successful program dissemination. Methods: Staff (n=256) at 33 Southeast Texas middle schools completed baseline surveys for a SHE dissemination intervention. Measures of knowledge, self-efficacy, attitudes, and perceived support were adapted from existing surveys. Chi-square and one-way ANOVAs were conducted to examine how factors varied by gender, race/ethnicity, age, school position, and district tenure. Results: Sample was 63% female, 40% African-American, 31% White, 15% Hispanic; 36% administrators, 23% physical education (PE)/health teachers, and 25% non-PE teachers; mean age = 43.6 years (SD=10.7) and mean district tenure = 12.1 years (SD=8.9). More than 1 in 5 participants lacked knowledge of existing SHE programs and district policy. One-third reported lacking self-efficacy for teaching sex and contraception. Knowledge and self-efficacy were lowest among non-PE teachers. Almost equal percentages supported comprehensive sexual health (72%) and abstinence until marriage (64%) policies. Few staff perceived parents (14%), district (18%), and state (18%) officials to be very or extremely supportive of middle school SHE. With few exceptions, results did not vary significantly by gender, race/ethnicity, age, or district tenure. Conclusions: Although a majority of staff favor SHE in middle school, significant barriers to its implementation exist. Implications for the development of school-wide dissemination interventions to overcome barriers will be discussed.