Transcript APHA 2003 poster - CRAHD Home

Motivational Aspects of Community Support for Comprehensive
School-Based Sexual Health Education for Adolescents
Norm Constantine, Ph.D., Jana Kay Slater, Ph.D., Julie Carroll, M.S.W.
Center for Research on Adolescent Health and Development, Public Health Institute
8 out of 10 American adults support comprehensive sexual health education for adolescents.
So why is it not happening more?
Abstract
Purpose. To investigate the attitudes, beliefs, and
concerns of parents, teachers, and adolescent health
professionals regarding adolescents’ sexual health
and HIV/STD prevention education needs and
strategies to meet these needs. To develop a
theoretical framework and research hypotheses for
further study about how these attitudes, beliefs, and
concerns might interact to influence stakeholders’
commitments to and actions taken in support of
adolescents’ sexual health and HIV/STD
prevention education needs.
MOTIVATIONAL SYSTEMS THEORY
=
motivation
X
Vulnerable pattern. “Teachers need consistent training. Not just initial training but mentoring and follow up. We tend to do a pretty good job of
giving a blitz of training but seldom do we really do personal analysis of what people are doing, how well they are developing skills, what their
capabilities are, and do any remediation. We give them the curriculum, train them, and expect them to go on” (community-based health
professional).
X
goals
emotions
personal agency beliefs
Fragile pattern. “I fault myself mostly for that because when I get that note home from school saying do you want your kid to participate in this I
say yes and then they’ll have a preview and I don’t go. I assume they’re getting something good but I really don’t know what they’re getting”
(parent).
Self-doubting pattern. “My husband sits down with my teenage son and is very direct with him about sexual values and expectations. Recently my
husband asked me if I had done the same thing with my 12 year-old-daughter and I said, not really, am I supposed to? Is it time yet?” (parent).
Antagonistic pattern. “I am very concerned that the chasm between what we’re able to present in schools and what the youngsters see on television
and are bombarded with all the time is so divergent, I think that creates tremendous chaos for them” (public health nurse).
Methods. A total of 21 individuals were
interviewed either individually or in one of two
focus groups. A grounded-theory approach was
used to guide the collection and analysis of indepth interview data, and the development of a
theoretical framework anchored in motivational
systems theory.
Tenacious pattern. “A community might remain stable in terms of their consensus about issues such as sex education but then in the course of a
year demographics and interests change and something that seemed so simple is no longer simple“ (superintendent).
Discouraged pattern. “Lots of teachers just don’t feel competent teaching sex education. You might have in a classroom of 30 kids – kids from low,
middle and upper income – Muslims, Christians, different sects of Christians, Jewish, Buddhist. There are boys and girls. Some may be
heterosexual, and that has a whole broad range, and some may be gay and lesbian, and that has a whole broad range. I understand why some teachers
say, give me the outline; I’m just going to give them the facts. They feel more comfortable with that level of competency. But real education comes
when the student begins to ask about who they are, is respected, and there is an educational process for addressing these issues for themselves and
seeing how their issues vary from those of their peers” (superintendent).
Results. Goals found were consistent with
promoting adolescent sexual health and HIV/STD
prevention and providing effective sexuality
education, however, some discongruence was
identified regarding views of teachers’ versus
parents’ appropriate roles. The social emotions of
embarrassment and discomfort appeared to
influence personal agency beliefs, as did the
instrumental emotion of discouragement. Goal
orientations of coping rather than thriving, and
reactive rather than active, were widely observed.
Several non-robust personal agency belief patterns
were identified, including vulnerable, fragile, selfdoubting, tenacious, antagonistic, and discouraged
patterns. Discouraged behavioral episode schemata
also were identified.
Discouraged pattern. “I just sort of feel like the curriculum is set. My frustration is that I would like to have an impact but other times when I’ve
tried to make an impact, it hasn’t really made any difference. So I don’t go look at the curriculum sometimes because I figure, why bother; it’s not
going to make any difference. It’s not going to change the curriculum right now. It’s not going to change it for my child. It won’t even have changed
a year from now. I feel frustrated” (parent).
Preliminary Theoretical Framework
Hypotheses Developed for Further Study
1. Goal conflicts regarding teachers’ versus parents’ appropriate roles reduce the potency of generally supportive goals for achieving
adolescent sexual health.
Capability Beliefs
Positive
Conclusions. A theoretical framework based in
motivational systems theory has emerged to help
explain the discongruity between consistent survey
findings of widespread support for comprehensive
school-based sexual health and HIV/STD
prevention education, and the reality of nonexistent
or suboptimal implementations in so many school
districts and communities. This framework
suggests the complexity of the factors involved, as
well as directions for further research.
Personal Agency Belief Patterns: Illustrative Quotes
Environmental
Context
Beliefs
Strong
Moderate
Weak
1. Robust
2. Modest
3. Fragile
2. Reactive and coping goal orientations among stakeholders are more evident than active and thriving orientations.
3. Embarrassment and discomfort social emotions interfere with adults’ motivation and effectiveness in communicating with
adolescents about aspects of adolescent sexuality other than physiology and disease.
4. Discouragement in various manifestations interferes with motivation and achievement in promoting adolescent sexual health.
Neutral
or
Variable
4.Tenacious
5. Vulnerable
6. SelfDoubting
Negative
7. Accepting
or
Antagonistic
8. Discouraged
9. Hopeless
Personal Agency Belief Patterns
5. Non-robust personal agency belief patterns interfere with motivation and achievement in promoting adolescent sexual health.
Poster presented at the 131st Annual Meeting of the American Public Health Association, November 18, 2003, San Francisco, CA. This study was
supported by development funding from the Public Health Institute. Thanks to Martin Ford and Wendy Constantine for consultation and review, Andrea
Agarwal for assistance with data management and coding, Nick Woolf for ATLAS.ti software support, and the parents, teachers, and adolescent health
professionals who shared their views. Reference: Ford, M.E. (1992). Motivating Humans: Goals, Emotions, and Personal Agency Beliefs. Sage.