In 2015, TN had the 9th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives. We adapted validated measures from past sex education surveys to reflect the context of TN. The survey items were reviewed and refined by diverse groups of experts on school-based health education, teen pregnancy prevention programs, and adolescent health. The survey was created and distributed via a web-based tool. A recruitment email or letter with a weblink to the survey was sent to 3,249 potential sex education providers, from April to June 2017. Of all contacts, 509 completed the survey, yielding a response rate of 15.7%. Of those who completed the survey, 137 taught sex education in the 2015-2016 school year to any of grades 5 through 12 students. Survey responses were analyzed using descriptive tests. Abstinence (83.9%) was taught by most respondents, by grade 12, but far less respondents taught topics related to birth control (65.0%) and condoms: how to use condoms (22.6%), how to use and where to get other birth control (31.4%). Providers with more years of experience, and those who expressed that they had received enough training, were more likely to teach more number of topics, including controversial topics, such as condoms and birth control. Most providers indicated that sex education topics should be taught in earlier grades. This study identified the job titles of providers, content being taught, approach to teaching, and how providers would want to teach sex education. Identifying providers is crucial to designing sex education training programs, tracking program effectiveness, and changes in practices over time, to achieve the goal of curbing TN teen pregnancy rates through quality sex education.

Yes / Adolescent sexual and reproductive health (SRH) remains a challenge globally. High school youths without comprehensive sexuality education (CSE) are more likely to engage in high risk sexual behaviors than their peers in schools with CSE. Fiji continues to have very poor adolescents SRH indicators. This study aimed to gauge the perceptions of students towards the delivery of SRH education in schools in Fiji. A qualitative study design was used to collect data from students in year 11-13 in public secondary schools in Suva, Fiji in 2018. Schools with equal ethnic mix were selected. A semi-structured open-ended questionnaire was used to guide Focus Group Discussions (FGDs). A male research facilitator conducted FGD with males while a female research facilitator facilitated that amongst the females. Data collected was analyzed thematically. Seven FGDs were conducted. A total of 46 students (29 males) participated with the age range from 17-19 years old. Eight themes emerged: current SRH education; students' knowledge on adverse consequences of SRH; sources of SRH information; need for sex education; provision of SRH education in schools; characteristics of teachers of SRH education; age-appropriate incremental sex education; and ideal version of SRH. The study shows that Fijian students desired a lot more from sex education than what is currently offered for sexual decision-making. There is a need for mandatory and comprehensive sex education for young people.

Student voice could improve the effectiveness of sex education curricula, student input, however, is generally limited or totally absent in sex education development. This dissertation explores student content preferences in sex education curricula and how school officials can incorporate student feedback to ensure content is relevant, relatable, and reliable. Results also show that adolescents are in favor of receiving social media-delivered sex education from local health departments. To build an adolescent following and greater awareness about SNS accounts that disseminate sex education, participants suggested LHDs 1) inform intended audiences about products by building offline connections 2) use promotions to create awareness 3) emphasize price during giveaways, publicize free services and 4) use the right people to motivate others to follow accounts.