Leora Tuchman
Public Health
Professor Persaud
January 17, 2018
Title: Public Health Program Development and Evaluation: Sex Education in NYC
1.Scope of the Problem –
The CDC 2016 Sexually Transmitted Disease Surveillance recorded a rise in Chlamydia trachomatis, gonorrhea and syphilis. Blacks accounted for the highest proportion of the infected for all recorded STDs. Rates of chlamydia were highest among Blacks in 2016, however rates decreased by 3.5% since 2012. Gonorrhea rates in Blacks was 481.2 cases per 100,000 population compared to 145.8 cases per 100,000 population in the general population. Rates of congenital syphilis were also highest among Blacks, 43.1 cases per 100,000 live births in 2016. STIs, especially when not treated properly can pose serious health risks such as infertility, ectopic pregnancy, chronic pelvic pain, newborn disease, increased risk of HIV infection as well as social consequences and an economic burden on the healthcare system. New York reported above average rates in all three previously stated sexually transmitted infections, with the highest concentration of new cases in the Bronx. As STIs continue to rise in the general population and disparities continue to exist in the Black populations, preventative efforts must be evaluated.
The Bronx is home to clinics offering screening and treatment for STIs at reduced rates for individuals over the age of 12. The High School Condom Availability Program requires all New York City high schools to provide free condoms, health information and health referrals for students upon request. Despite these resources, the Bronx ranked the borough with the first highest rate of chlamydia and second in gonorrhea and syphilis. The prevalence of STIs can be attributed to the poor sex education. According to New York City Comptroller Scott Stringer’s report released in September 2017, over 40 percent of NYC’s middle and high school students are not receiving the sex education required by the state. Only 7.6% of the health instructors had received formal training in sexual education, while 53% of high schools have no teacher licensed by the city for health education.
- Planning –
The changes this health program is looking to make is improving sex education in NYC public schools, specifically the Bronx in areas with higher Black population and STI prevalence. This program is aiming to lessen health disparities of STIs among minority groups, mainly Blacks and improve STI prevention education in NYC. The key stakeholders would be the Department of Education. It is important to underscore the need for reform in STI and health education in NYC. The comptroller’s report indicating that only 7.6% of health educators have received formal training would be a key point to bring up. In addition, I would discuss how New York is ranked 12 worst in the country for chlamydia, the Bronx being the county with the third worst rate in the country. Most importantly, the CDC reported that 15 to 24 year olds accounted for two-thirds of chlamydia diagnoses. These statistics indicate a need for greater education.
The use of focus groups using high school students would be helpful in gathering information regarding their knowledge as well as perceived awareness about STI prevention. This qualitative research will provide a better understanding of the gaps in knowledge as well what aspects of sex education were not properly addressed. This program will be funded by the Department of Education. It should continue running until every public school has a properly trained sex education teacher. This program will be feasible in that it will allow educators to receive
- Development & Dissemination of the Intervention –
The goal of this program is to ensure high school and middle school students are receiving proper sex education in NYC, focusing on areas where STI disparities exist the most such as the Bronx. The framework of this program is addressing the lack of proper educators in NYC public school systems. In order for any clinics or materials to be properly utilized, young adults need good educators to empower them to make safe sex decisions. In return for promising five years of work in the NYC public school system, health educators will receive appropriate training sex education. The Department of Education will fund a 3-month long sex education training seminar for educators interested in teaching health classes in public schools. These seminars will be given in public schools over the course of summer vacation. These classes will meet five times a week over the duration of the course. They will ensure that each school is properly equipped with well-trained educators. These educators will be responsible not only for providing an in-depth sexual health education but for disseminating and helpful materials and providing students with the appropriate resources necessary to maintain their sexual health.
- Evaluation & Maintenance –
Evaluation will be performed yearly to evaluate the effectiveness of the program. The effect will be evaluating by measuring STI rates in students with formally trained sex educators, as well as measuring the utilization of The High School Condom Availability Program. In addition, there will be a survey given to the middle and high school students to evaluate if their knowledge regarding sexual health improved. Before the implementation of the program, knowledge of sexual health of high school seniors will be evaluated. The same survey will be conducted in the years following the implementation of the program. Results will then be compared to evaluate the effectiveness of the program.
If the plan does not yield the expected results, there will be a closer analysis of the of the actual sex education curriculum being taught to evaluate. After which there will be an effort made to standardize the education being given in each institution. The next 5-10 years will be focused on ensuring each school has a well-trained sex educator teaching sex education, after which the program will shift to a maintenance period. This will comprise of holding continuing education for sex educators, informing them of current issues, new developments and resources for preventing STIs in young adults. In addition, public schools will be monitored to ensure there is a teacher with proper training in sexual health education to teach health classes on staff.
Sources
https://patch.com/new-york/new-york-city/manhattan-bronx-most-std-filled-boroughs-new-york-cdc
http://schools.nyc.gov/Academics/Wellness/WhatWeTeach/HealthEducation/default.htm
https://www.cdc.gov/std/stats16/natoverview.htm
http://newyork.cbslocal.com/2017/09/14/nyc-schools-sex-education/
https://www.plannedparenthood.org/planned-parenthood-new-york-city/local-education-training/sex-education-schools
https://www1.nyc.gov/site/doh/services/sexual-health-clinics.page
https://www.health.ny.gov/diseases/communicable/std/clinics/clinics.htm#westchester
https://www.cdc.gov/nchhstp/healthdisparities/africanamericans.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754735/
https://www.ncbi.nlm.nih.gov/pubmed/18971796
http://www.sexualityeducation.com/sexeducator.php
https://www.aasect.org/certification/aasect-requirements-sexuality-educator-certification
