The effects of dual abstinence and comprehensive sexual education programs on the pregnancy rates of rural adolescent African-American females.
Introduction
High pregnancy rates for African-American females have continued to be a problem in rural Georgia despite school taught government approved abstinence only sexual education. Study) has shown that black females either do not understand abstinence the way it is taught or they make up their own definition of abstinence. Study) shows that abstinence only programs are not as effective as once believed. It is important that other avenues be considered to teach African-American females, especially rural females, sexual education that they can understand and identify with in order to control teen pregnancy rates.
Statement of the Problem
The problem of the research was to investigate the effectiveness of a multidimensional approach to sexual education on the pregnancy rates of rural African-American adolescents.
Purpose of the Study
Adolescent African-American pregnancy rates have continued to be a problem in rural Georgia. This study is focused on the effectiveness of a multidimensional approach to sexual education in order to decrease these ever climbing pregnancy rates. There has been a lack of research on multidimensional sexual education programs on rural African-American females. It is believed that the data from this study may help influence the gaining popularity of non abstinence-only programs in the United States. If pregnancy rates can be decreased among rural black adolescent females these types of multidimensional sexual education programs may be considered by the government for implementation in other areas of the United States where high teen pregnancy rates are prevalent.
Significance of the Study
Adolescent African-American females would benefit greatly by a multidimensional sexual education program. This program of study would clearly help the girls gain knowledge about abstinence as well as sex education. According to a study by Kristin Haglund (2003) on sexually abstinent African-American females all of the girls in her study “agreed that abstinence involved refraining from having sex, particularly vaginal intercourse.” Unfortunately they did not agree on what other sexual behaviors counted as having sex therefore had to be avoided to maintain abstinence. Therefore more knowledge needs to be imparted to the girls in order for them to make more informed life choices. According to Somers and Eaves (2002), “earlier sex education does not contribute to earlier risk behavior.” Therefore, an additional comprehensive sexual education could contribute greatly to the girls knowledge of the healthy aspects of human sexuality such as intimacy and love, developmental issues, and birth control measures including abstinence. The Carrerra Model has proven that a multidimensional approach to teen pregnancy prevention can work (Carrerra,1995). This study in particular will validate Carrerra’s findings and help close the gaps that the educational community my still entertain about the effectiveness of any program other than an abstinence only curriculum.
Delimitations
1. Twenty African American Females ages 11-15 years old.
2. All participants will reside in rural Hancock County, Georgia.
3. Participants will be chosen with the help of the school system meeting at-risk indicators: female, lower-income family, lack of involvement in school, lack of performance in school, and number of previous pregnancies.
4. All of the participants will have a negative pregnancy history.
5. Multidimensional sexual education program will be utilized. See Fig. 1
6. The study will last for a period of seven years and will be ongoing throughout each year.
Limitations
1. The sample of rural African-American females may not be representative of other rural areas.
2. Program administrators may not follow the guidelines of the programs
3. Data may not be able to be generalized to other rural populations
4. Unexpected intercourse such as rape or incest.
5. Travel to areas of education.
6. Lack of interest in program by parents.
Assumptions
1. The maturational and environmental influences are unique to each child.
2. The information provided will increase the girls knowledge of abstinence.
3. Risky sexual behavior will be decreased.
4. Self-esteem and self-expression will be increased.
5. Test instruments will be reliable.
6. Pregnancy rates will be decreased.
7. The multidimensional sexual education model, as modified for the community, was
appropriate for the target population and was a valid and reliable curriculum.
8. The subjects and their parents understood the long term purpose of the study.
9. The participants were a representative sample of rural Georgia adolescent African-American females.
10. The program administrators were sufficiently trained and capable of utilizing the recommended programs and procedures.
Hypothesis
1. African-American teen pregnancy rates will decrease
2. Participants knowledge of sexual education will increase
3. Participants knowledge of birth control will increase
4. Participants will be able to utilize decision making techniques
5. Participants will know all the methods of birth control
Literature Review
For the past 20 years, the U.S. government has been funding abstinence-only programs to be taught in the public school systems. Abstinence only curriculums usually promote communication, decision-making, assertiveness, goal setting, and abstinence as a way of preventing pregnancy and STD’s. According to SIECUS, the Sexuality Information and Education Council of the United States, these programs leave out valuable information on reproductive health, sexuality issues, and other forms of pregnancy and STD prevention. The government mandates that any school that receives federal money for abstinence only programs must also include teachings that emphasize that, “sexual activity outside of marriage is likely to have harmful psychological and physical effects.” Nothing is to be mentioned about the positive effects of love and intimacy between two people.
Abstinence only programs are good programs because they do teach knowledge and valuable life skills. In a study of the Sex Can Wait abstinence program the results showed an increase in knowledge for elementary, middle, and high school, although not as much as expected (Denny, Young, Rausch, Spear, 2002). However, when it comes to pregnancy prevention abstinence only programs are not always effective. In a study on abstinence education for rural youth by Barnett & Hurst (2003), they found that the Life’s Walk abstinence program that they were studying was not entirely effective. Attitudes toward teen sexual activity did not change as a result of the program. Nor did attitudes change as a result of the Sex Can Wait program. Denny et al states, “the finding that the curriculum did not produce more positive attitudes at the elementary school and middle school level is puzzling”. Barnett & Hurst (2003) also reported that sexual behavior of the participants actually increased. To substantiate these findings the British Medical Journal reported a meta-analyses of 26 trials of pregnancy prevention programs that showed pregnancies actually increased in partners of male participants (DiCenso, Guyatt, Griffith, 2002) .
Part of the problem with abstinence only programs may be the lack of a clear definition for abstinence. There is not even a clear common definition between nationally recognized abstinence programs. Haglund (2003) reports in her study “Sexually Abstinent African American Adolescent Females’ Descriptions of Abstinence” that
Each state that gets Federal money for abstinence programs are allowed to define abstinence themselves. Some states included the federal description that abstinence meant refraining from sexual activity but sexual activity was not defined. Others defined abstinence as refraining from vaginal heterosexual intercourse, from all types of sexual activity with a significant risk for transmission of a sexually transmitted infection (STI), or from any expression of sexual feeling (as cited in Sonfield and Gold, 2001).
So, not only are the proponents for abstinence unsure about the definition so are the students.
Haglund also reports that the girls in her study was widely confused as to the definition of abstinence. When participants were asked how a variety of sexual behaviors fit into their definition of abstinence, kissing and holding hands were unanimously considered abstinent. But touching a partner on the genitals including breasts, clothed or partially unclothed, was also considered abstinent because no intercourse had occurred. Oral-genital contact was considered a sex act by participants but most girls believed that if genital to genital intercourse was avoided then they were still abstinent. If anal intercourse occurred the person was no longer considered abstinent but one could still be considered “technically” abstinent. Participants in Haglund’s study believed that vaginal penetration was the only “real way” that people had sex. “Thus, incomplete descriptions of abstinence might cause some young people to unknowingly put themselves at risk by engaging in other forms of genital sexual activities” (Haglund, 2003).
Parents are the last ones that want their children to engage in potentially risky sexual behavior. Parents would much rather their children be educated than be ignorant or misinformed about all of the topics that sexual education would cover. A survey by SIECUS and Advocates for Youth suggest that most Americans support sex education in schools that includes information on abstinence and contraception. In a SIECUS and Advocates for Youth 1999 nationwide poll of adults on their attitudes about sex education in the U.S., 93% of those polled supported comprehensive sex education and believed young people, “should be given information to protect themselves from unplanned pregnancies and STDs”(as cited in Starkman and Rajani, 2002). Reported in the same survey, most Americans believed abstinence should be a topic, even though they rejected abstinence-only education. Eighty-six percent of respondents believed that “young people need information about sexuality so they will have healthy and happy intimate relationships as adults”. A Kaiser Family Foundation report, released in September 2000,
found that most parents want their children to receive information on a variety of subjects, including contraception and condom use, sexually transmitted disease, sexual orientation, safer-sex practices, abortion, communications and coping skills, and the emotional aspects of relationships (as cited in Starkman and Rajani, 2002).
As part of the study parents given the choice to remove their children from a comprehensive sex education program, only 1% to 5% of parents would remove their child.
Teachers in the United States play an important role in teens sexual education. Today’s teachers are not completely in favor of leaving sex education to parents (Bowden, Lanning, Pippin, Tanner, 2003). Teachers generally feel that they can have a positive influence over the direction of their student’s lives and most teachers feel empowered to teach the material, hold conversation, respond to individual student questions and engage in other influential methods of teaching and learning (Bowden et al, 2003). The main problem that teachers are faced with is that much of their influence is diminished by student’s peers. In several studies peer “education” has had a negative effect on teens (Haglund, 2003, Forrest, Strange, and Oakley, 2002, Weekes, 2002). Haglund reports that the African-American teens, in her study, main source for sexual information was peers. Their “beliefs about sex and abstinence were based on what they had heard others say.”
This bit of information is particularly valuable for the purposes of this study because African-American adolescent females are not only being influenced by their peers but by Black popular culture portraying stereotypes in film and music (Weeks 2002). In Weeks study she found that black females were being oversexualized by popular media and by young black boys. Stephens and Phillips writes, “The eroticizing of African American women as wild, sexually promiscuous, and amoral continues to be normalized by descriptors that are widely circulated, accepted, and used to frame ideas about this population” ( as cited in Hooks, 1992). There are very few black female role models on television, print, and music outlets. Especially role models that present the pure and chaste image above an overtly sexual image (Stephens and Phillips). The black females in Weeks study were having a hard time presenting themselves as respectable but also living up to the oversexualized ideal that they felt that should portray externally. All of this confusion over who their sexual selves should be, pure and chaste or the Diva, Gold Digger, Freak that is being portrayed in popular Hip Hop culture, has left African-Americans questioning their own body image and how they fit into society. In a study titled, “Body Image and African American Females’ Sexual Health”, the authors report that one of the most significant finding of their study was that women with
negative body image evaluations, through their associations with unhealthy sexual attitudes, beliefs, ad behaviors, could enhance the risk of unintended pregnancy, STI, and HIV infection. Moreover, women having greater dissatisfaction with their body image were significantly less likely to negotiate condom, as they feared that this practice would result in abandonment by their partners. [This] fear of abandonment and adolescents’ perceived limited control in the relationship may reduce the likelihood of negotiating safer sex or using condoms , and the consequence, they may feel more concerned about acquiring HIV.
We may already be seeing today the consequences of the negative effects of body image on young African-American females. Studies suggest that some 12 million new cases of sexually transmitted diseases are reported each year, with about 25% of new cases found among teens (Carter, Franklin, Heath, 2000). In Georgia alone, the 1999 Georgia County Guide gives staggering numbers for STI’s reported. Reports were: 1,054 cases of AIDS, 2,008 cases of Syphilis, 22,041 cases of Gonorrhea, and 31,516 cases of Chlamydia. There were 14,208 live births to unwed teen mothers. Thirty percent of all unwed teen births were by African-American females.
The facts clearly show that abstinence only programs are not working for African-American females. It is believed that this comprehensive sexual education program will show measurable meaningful data to reduce teen pregnancy. Mainly because this program will include components that other research has concluded could be most beneficial. It could be most promising by learning from the studies already performed and implementing as part of the curriculum such areas as: clear and concise definitions of abstinence, emphasis on the benefits of abstinence while teaching contraception and disease prevention methods, comprising differential racialised experiences and definitions of sexuality that embrace how young black females experience their sexual selves, and body image screening to determine levels of dissatisfaction. It is the hope of this study that these components along with the other components of a comprehensive sexual education curricula that we can be a successful model for future educators and African-American teenage pregnancy prevention
Ideas and Deletions
Mix signals = pregnancy ( quote below) ( haglund – abstinence is the best was to prevent infections and pregnancy ( Landry et al)
Teachers and parents want sex ed---- teachers probs with sex ed– the study
Black Females and body issues
Earlier sex education
Barnett & Hurst These same students when asked the best way to prevent pregnancy reported: abstinence (37%), birth control pills (30%, and condoms (27%).
The United States has the highest teen pregnancy rate in the Western, industrialized world. Approximately 9% of females ages 15 to 19 years become pregnant each year. According to the 2003 Kids Count data book 37% of Georgia female adolescents between the ages of 15 and 17 had a baby in the year 2000. According to the Georgia County Guide on vital statistics 30.8% of live births to unwed teenage mothers were to African-American females. Although all of these statistics are alarming Kids Counts shows that there is a 27% decrease in teen birth rates in Georgia from 1990 to 2000. The facts still remain that even though these numbers are decreasing they are still alarmingly high and something needs to be done to prevent teen pregnancy.
A lot of the responsibility for pregnancy prevention has fallen on the heads of school educators. But a majority of the teachers are limited by what they can teach youth inside of the school setting. This is because for the past 20 years, the U.S. government has ben funding abstinence-only programs to be taught in the public school systems. Programs funded by the government must teach, among other things, that “sexual activity outside of marriage is likely to have harmful psychological and physical effects.” It is almost like the government wants to use scare tactics like beware of the boogie man to prevent minors from engaging in sexual activity.
Chapter 3
Methods And Procedure
This chapter will discuss the method of research to be used, the respondents of the study, the sampling technique, the instrument to be used, the validation of the instrument, the administration of the of the instrument and the statistical treatment of the data that will be gathered.
Method of Research to be UsedThis study will use the descriptive approach. This descriptive type of research will utilize interview, observation and questionnaires in the study. To illustrate the descriptive type of research, the researcher will be guided by Cresqell (1993) when he stated: “Descriptive method of research is to gather information about the present existing condition. The purpose of employing this method is to describe the nature of a situation as it exists at the time of the study and to explore the cause/s of a particular phenomena.
Although early researchers conceptualized body image as being unidimensional, it is now considered to be, and is measured as, a multidimensional construct. Examples of dimensions are: perception, attitude, cognition, behavior, affect, fear of fatness, body distortion, body dissatisfaction, cognitive-behavioral investment, evaluation, preference for thinness, and restrictive eating (Cash, 1994; Cash & Henry, 1995; Gleaves, Williamson, Eberenz, Sebastian, & Barker, 1995). The way in which body image is conceptualized is not just of theoretical interest, but has implications for the way in which disturbances in body image are treated.
Empirical investigation is needed to determine the extent to which these models of body image accurately reflect the grouping of items. The aim of this research is to define body image more clearly and obtain data on the nature of the dimensions of body image. In doing so, it will be possible to develop a clearer idea of the actual dimensions of body image among African-American teenagers. Moreover, positive attitude towards body image may significantly reduce pregnancy rates among African-American teenagers. This construct is aimed to examine and propose to incorporate a multi-dimensional sex education and dual abstinence in African-American schools in rural Georgia. Past conceptualizations of body image have generally incorporated at least one of the following four dimensions: perception, cognition, affect, and behavior. These four dimensions have the appealing features of being simple, functional, and clearly testable, and are the starting point for this paper.
The present study is an examination of a multi-dimensional approach to sex education by exploring a model of body image that incorporated perceptual, affective, cognitive, and behavioral dimensions. Thus, the aim of the study was not to construct a measure of body image, but to determine the validity of conceptualizing body image as comprising four dimensions: perception, affect, cognition, and behavior.
The primary source of data will come from a researcher-made survey questionnaire which will be given to the respondents. The respondents of this study will be randomly selected African-American teenagers in Georgia.
The secondary sources of data will come from published articles from social science, sex education and health journals, theses and related studies on sex education.
For this research design, the researcher will gather data, collate published studies from different local and foreign universities and articles from social science journals, distribute sampling questionnaires; arrange interviews; and make a content analysis of the collected documentary and verbal material. Afterwards, the researcher will summarize all the information, make a conclusion based on the null hypotheses posited and provide insightful recommendations on the dealing with sex education and dual abstinence among African-American in Georgia.
Instrument to be UsedA questionnaire consisting of 28 questions ranging from perception, affect, cognition, and behavior and statements concerning body image was administered to the respondents. These dimensions were clearly defined at the beginning of the questionnaire and on each of the subsequent pages. The definitions used to classify items were: Perceptual items: The way individuals view their body in relation to its actual form; Affective items: Feelings individuals have about their body; Cognitive items: Thoughts individuals have about their body; Behavioral items: Behaviors that are aimed at changing the body shape of individuals.
The items contained in the questionnaire was derived from Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) with some revisions from Banfield and Mccabe (2002) consisting of 28 statements. The scales and subscales chosen were selected because of their good reported psychometric properties, claimed relevance to the four body image dimensions, and best representation of the instruments available. An attempt was made to obtain a range of different measures for each construct. Since these measures contain different numbers of items, a different number of items were included in the final measure for each construct. However, this would not be expected to influence the final factor structure. These items will be randomly ordered in the questionnaire by assigning randomly generated numbers.
Ben-Tovim Walker Body Attitudes Questionnaire (BAQ). The BAQ (Ben-Tovim & Walker, 1991) was developed to assess a broad range of attitudes which women have about their bodies. This study used the Feeling Fat Subscale which consists of 12 items, with an example being, "I have a slim waist." Items are rated on a five-point Likert scale from (1) strongly agree, to (5) strongly disagree.
ProcedureAfter receiving ethics approval, questionnaires will be distributed to participants. The questionnaire shall take approximately thirty minutes to complete and the participants can complete it on their own time. All items will be categorized (perception, affect, cognition or behavior) according to the dimension the respondent believed the item was evaluating. Responses will be anonymous and confidential. Participants were instructed to return the questionnaire in a stamped self-addressed envelope. All respondents who will agree to participate in the study shall return the questionnaires.
Respondents of the Study The general population for this study will be composed of African-American teenagers aged 13-18 residing in Georgia numbering to sixty (60).Validation of the Instrument
The Ben-Tovim Walker Body Attitudes Questionnaire has been validated several time in the literature. Thus, it has already established itself to be a reliable questionnaire. However, in order to prove that it applies to the African-American adolescents in Georgia, the researcher will initially submit a survey questionnaire and after approval, the survey will be given to ten African-American teenagers. After the survey questionnaire will be answered, the researcher will ask the respondents for any suggestions or any necessary corrections to ensure further improvement and validity of the instrument. The researcher will again examine the content of the survey questionnaire to find out the reliability of the instrument. The researchers will exclude irrelevant questions and will change words that would be deemed difficult by the respondents, to much simpler terms.
Administration of the Instrument
The revised instrument will then be administered to the respondents of the study which will be chosen through a combination of cluster and random sampling. The researcher will exclude the ten respondents who will be initially used for the validation of the instrument. The researcher will also tally, score and tabulate all the relevant data in the survey questionnaire.
References
Banfield, S. and Mccabe, M. (2002) An evaluation of the construct of body image. Adolescence, Vol. 37.
Ben-Tovim, D. I., & Walker, K. M. (1991). The development of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ), a new measure of women's attitudes towards their own bodies. Psychological Medicine, 21, 775-784.
Cash, T. F. (1994). Body image attitudes: Evaluation, investment and affect. Perceptual and Motor Skills, 78, 1168-1170.
Cash, T. E., & Henry, P. E. (1995). Women's body images: The results of a national survey in the U.S.A. Sex Roles, 33, 19-28.
Gleaves, D. H., Williamson, D. A., Eberenz, K. P., Sebastian, S. B., & Barker, S. E. (1995). Clarifying body-image disturbance: Analysis of a multidimensional model using structural modeling. Journal of Personality Assessment, 64, 478-493.
(Temporary, more to be added) Reference List
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