Stop Rewarding for Perfect Attendance

What messages are parents and the school sending when we are rewarding coming to school 100% of days? The message is this: We want you at school no matter what it takes. 

About a year ago, I attended a graduation for an elementary school in which students received recognition and awards for perfect attendance. Granted, the two students who won received bicycles (yah for promoting a health recognition gift versus a Pizza Hut gift card), however I want to address how this simple recognition is incredibly inequitable and potentially harmful to many students. 

Students who have perfect attendance are more likely to be engaged in school and do well academically- sure! Of course. However, many students can't achieve this for valid reasons. My biggest concern for those with perfect attendance is this... how many students strive for this recognition and refuse to be absent when truly sick? How many students come to school when they legitimately need a day off? How many come to school when contagious? What messages are parents and the school sending when we are rewarding coming to school 100% of days? The message is this: We want you at school no matter what it takes. 

I understand that it also sends the message that attendance is important, however, there are other ways of doing this without 13% of students who are chronically absent feeling marginalized as a result of a parent issue, health issue, child care issue, homeless issue, addiction issue at home. Rewarding for attendance almost punishes and stigmatizes students who in many cases don't have control over their attendance!

Based on the most recent national data, about 13 percent of students miss 15 or more school days.1 Chronic absenteeism is related to a variety of issues. Chronic absenteeism is defined differently in each state, however, research suggests that missing 10 percent or more school days can affect student outcomes.2

The McKinney-Vento Act defines homeless children and youths as individuals who lack a fixed, regular, and adequate nighttime residence. This includes: 

  • Children and youths who are sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason

  • Children and youths who may be living in motels, hotels, trailer parks, shelters, or awaiting foster care placement

  • Children and youths who have a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings

  • Children and youths who are living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings, or

  • Migratory children who qualify as homeless because they are children who are living in similar circumstances listed above.

These students are more likely to be chronically absent, as you can imagine. Other criteria that increase risk of chronic absenteeism include: Students who are hungry, living through toxic divorces or have chronic illnesses. Students with unmanaged asthma, for example, are more likely to be absent. If a student does not have health insurance or is from an undocumented family they are less likely to go to a doctor. Students who have vision, hearing and oral health problems that haven't been diagnosed are more likely to be absent as well. If a school is fortunate enough to have a school nurse who implements regular screenings on some of these issues- that does increase attendance rates since these health concerns may be caught and managed. However, nationally, our school nurse situation (ratio of a school nurse to student and even a full time nurse in each school is rare) is pretty depressing. 

My suggestion is that schools consider spending the resources, time and effort, including collecting the data to inform and determine why students are chronically absent at their school, develop a school-wide strategic plan around it and implement some evidence-based strategies to create equity around attendance and presenteeism. However, consider two things: Don't reward for 100%/Perfect attendance (lower that percent) and do it in a way creates an inclusive environment, not a disparate one. 


1 U.S. Department of Education, Office for Civil Rights, “2013-2014 Civil Rights Data Collection: A First Look,” (Washington, D.C.: U.S. Department of
Education, June 2016),

2 Robert Balfanz, Lisa Herzog, and Douglas MacIver, “Preventing Student Disengagement and Keeping Students on the Graduation Path in Urban Middle-
Grades Schools: Early Identification and Effective Interventions,” Educational Psychologist 42, no. 4 (Dec. 2007): 223–235,; and Applied Survey Research, “Attendance in Early
Elementary Grades: Associations with Student Characteristics, School Readiness, and Third Grade Outcomes,” (San Jose, Calif.: July 2011),

An Argument for Media Literacy within Middle School Sex Education

By Samantha Lowe

Media literacy refers to the ability to check if your source is creditable and ensure the information you are reading is accurate and based in science. And, it’s becoming increasingly more important. The skill of media literacy should be applied to all information you read on the internet but often people tend to believe whatever they read, credible or not. We often address “fake” news/information in adult populations, but what about adolescents? Young teens and teens are even less aware of the need to check the credibility of the information they are receiving.


I recently read the article “Why Can’t We Just Have Sex?”: An Analysis of Anonymous Questions About Sex Asked by Ninth Graders, this article focused on urban 9th grade students of mostly Latino and African American decent (N=645). Students were asked to write down any question about sex they would like to have answered during their sex education course. While this article shined light on what adolescent students want to learn during a comprehensive sex education course, it had some important and shocking unintentional results (Pariera and McCormack, 2017). For example,
- The number of young people who claiming to have learned about birth control has DECREASED in recent years (Pariera and McCormack, 2017);
- One third of all educators with the task of teaching sex education do not receive any special training (Pariera and McCormack, 2017);
- Less than half of the young people say they learned how to use a condom or information on where to get birth control (Pariera and McCormack, 2017); and
- 37% of all questions asked indicated some form of misinformation (Pariera and McCormack, 2017).

A 2004 report found that 11 of the 13 common used sex education curricula were inaccurate, containing falsehoods about HIV, abortion and birth control (Pariera and McCormack, 2017). Students are leaving sex education courses with no skills applicable to real life scenarios, they are often also not able to differentiate between real and false information and have no functional skills.

Youth in the United States are expected to wade through countless encounters with false information and come out with all the right information. That seems unreasonable when modern adults are not able to accomplish the same task. With recent studies showing that sex education curriculum problems are impeding student access to accurate and practical information that could be beneficial to them (Pariera and McCormack, 2017). It is time to begin equipping students with the ability to differentiate between factual and false information, it also time to begin funding specialized training for educators who will be teaching sex education courses. Equipping educators with media literacy skills and the ability to address and correct misconceptions from students.

Pariera, K. and McCormack, T. (2017). “Why Can't We Just Have Sex?”: An Analysis of Anonymous Questions About Sex Asked by Ninth Graders. American Journal of Sexuality Education, 12(3), pp.277-296.

Building Youth-Adult Partnerships

By Liz Thorne

YAC Trainings Photo 1- Group Photo.jpeg

I recently worked with the Oregon School Based Health Alliance to develop and facilitate a training to build capacity for staff that coordinate youth action councils or school health action councils (YACs or SHACs). The work is funded through the Oregon Health Authority’s School Based Health Center (SBHC) State Program Office. The funding is focused on mental health, and each YAC/SHAC works to raise awareness of their school’s school-based health center and implement a participatory action research project around mental health. Coordinators from across Oregon came together for two days to learn, share, and connect! They brought so much wisdom, energy and great strategies for working alongside young people.

What are Youth-Adult Partnerships?
Youth- adult partnerships are about sharing power with young people.  It occurs along a spectrum from zero youth involvement (they are a “vessel”) to total youth control (like youth led grass roots organizing). There’s a sweet spot in the middle where adults and youth share power. Adults may provide the connections, opportunities to build skills (like public speaking, research, writing), help keep everyone on the same page and organized, and help navigate obstacles but young people are making the decisions and leading the work. If you are interested in learning more about youth-adult partnerships, check out a webinar I co-facilitated with Haylee, the Student Health Advocate Coach for the Oregon School Based Health Alliance here .

Below are some of the best practices for building youth-adult partnerships adapted from research and practice, as well as some reflections from the training.

1) Pay attention to logistics and group dynamics. Young people have complicated lives and they need flexibility. Ensure you have many different ways young people can be involved that elevate different skills, interests and personalities. For example, you might have someone who is interested in graphic design but can’t make your meetings. Could they work on marketing materials or an infographic and keep connected through communication platforms like GroupMe, SLACK, or Google Hangout? How often does the group meet? Are there barriers that keep a diverse array of young people from being able to participate (like transportation)?

2) Creating opportunities for reflection. These can be formal or informal, and individually or as a group. Some of the benefits of youth adult partnerships come from young people creating connections with a supportive adult, their peers, and having a stronger connection to their community or school. Holding space for reflection and relationship building is critical (and particularly related to number 3).

3) Affirmatively address issues of role and power. This is a BIG one, and one that our training participants agreed could have been the whole focus of our training! Many of the “systems” (schools, local or state government, etc.) are not built to effectively partner with young people. Plus, many adults in those systems are probably not used to working with young people in a partnership capacity. As young people work together to create change in their community they will inevitably: 1) run into obstacles that will delay or derail their plans and 2) confront issues of inequality, oppression, stigma or “isms”. It’s vital that young people are supported to identify the power brokers or points of leverage in their system/community and get them on board. When obstacles do arise, the coordinator or adult ally has to hold space to be able to help facilitate the likely anger and frustration into a new path forward.  Having a strong group process, team building opportunities, and time for reflection with thoughtful facilitation can help support young people as they critically examine all the things that influence them, their families, neighborhood and community.

For more information about building youth-adult partnerships or participatory action research with young people, you may contact Liz at

YAC Trainings Photo 3 - Resources.jpeg

Adolescent Health- Tobacco Prevention Ideas!

How can our tobacco prevention public health partners support youth tobacco prevention and cessation? In a couple of weeks, I have the opportunity to work with 75 Kentucky county tobacco coordinators. My hope is to work with them on some visioning and discuss evidence-based strategies when doing this work. I won't have time to focus specifically on adolescent health, as the day's focus is on all of Kentucky's population, however, wanted to suggest some ideas for anyone working on youth tobacco prevention/intervention! Here goes...

1. Work with one district that just adopted a strong comprehensive policy that is ready to go from awareness (policy is there, but only awareness of it exists) to implementation. Content support may include: Systems Thinking Systems Changing Simulation, Tobacco Policy, School/District Wellness Councils, School Health Index completion to drive action planning, review local YRBS data around tobacco, analyze inventory/Index results and prioritize, evidence-based tobacco prevention programs and practices, action planning, implementation of action plans, evaluation and sustainability work.

2. Photovoice Project- Youth ages 12-19 are asked to submit a photo that speaks to:

·      A healthier State

·      A smoke-free State

·      Tobacco prevention

·      Effects of tobacco

·      Other TBD

Photos are submitted by a certain date and state convenes a group of experts to judge photos, using a scoring rubric that has been developed and shared as contest rules/process is distributed.Use some dollars to offer prize money to 3 winners. Contest is an opportunity to partner with school related arts, school health and state and local tobacco prevention partners. It’s also an opportunity to do some advocacy for tobacco prevention. An evening event may be held where top 10 photos are displayed and invite partners, youth, etc.

3. Host and facilitate a Comprehensive Tobacco Prevention Implementation Workshop for School Board Members. Objectives:

-Review State's school tobacco prevention law;
-Learn definitions and review effective practices in tobacco prevention policies, practices and programs in schools;
-Draft school board policy that aligns with State's comprehensive tobacco prevention law;
-Develop effective media messages for their communities.

Analyze and assess all tobacco policies from all districts in State/region and score them using a rubric based in best practice. Create a statewide map with a key marking districts as gold, silver and bronze. Bring that map to training events and administrator and school board conferences and share via social media.

4. Offer Tobacco Prevention Curricula Training events to two districts that apply. Application will include a readiness checklist. Trainer facilitates a one day training on Foundations of Health Education and participants will use CDCs HECAT to select an evidence based or promising practice tobacco curriculum that best fits their district’s needs. Trainer supports district presentation to their school board for adoption of this curriculum, if applicable. Once adopted, a 2-day tobacco prevention curriculum training on the program selected will cover the following goals and objectives.

5. Host a full-day Systems Thinking Systems Changing™ simulation training with youth (middle and high school-aged) and policy makers/education leaders. Systems Thinking/Systems Changing™ is used by teams in workshop settings to experience what it takes to make effective systemic change in schools. It provides opportunities for youth, educators, school boards and councils, leadership teams, school administrators, educational consultants and reformers about the structures and strategies that schools need to be continuously improving learning organizations that are the best they can be. It supports doing systems change in schools, including policy creation, revision and implementation. 

6. Facilitate positive youth development action research project around Tobacco Prevention. Includes 3 non-consecutive full day workshops.


CVS to Stop Airbrushing Ads

Written by Antionette Meeks at Cairn Guidance in partnership with the Dove Self Esteem Project

Between numerous social media campaigns meant to unite and empower women and the latest move by CVS to stop “materially altering” (also known as photoshopping) imagery associated with beauty products in their store advertisements, website and social media, it’s clear that the narrow spaces carved out for women in society are being challenged.

This is especially true in the beauty industry. What message are we sending to our young people when the images they see convey only one type of beauty that doesn’t exist in reality without the aid of technology? 

Dove is on a mission to challenge this notion through the Dove Self Esteem Project (DSEP).  The DSEP Confident Me! curriculum represents five lessons and a single lesson stand-alone or booster activity focused on helping youth develop or improve body confidence and increase self esteem.  Included in these lessons are opportunities for students to learn about external influences and manipulations by media and social media.  They learn about where appearance ideals come from and how these ideals affect their own self-image.  These are young people who are at an age where they are searching for their identity and searching for their place while being constantly bombarded with images telling them how they should look.

The lessons also include internal influences.  What is the “speak” a student says to themselves?  How do they internalize the external influences, interpret and act on them?  Often they reach for an unattainable look and begin to doubt themselves or think less of their looks because they are not the same as the perfection they see in an image.

Educators and young people from across the United States have said the most impactful part of the DSEP Confident Me! materials is analyzing influences and media manipulations. Students state they they didn’t realize how much images are manipulated and echoed the call to have a logo or warning for manipulated images.

Find out more about the DSEP Confident Me! Lessons at

Another Reactive Legislative Bill Isn't Going to Help

With so little time to teach health education and so many content areas being added annually, health education instruction is not as not as effective as it could be. Meth bills, opioid bills, bullying prevention bills... is that really the answer? Putting more pressure on health teachers to teach more content?

 From  School Health Profiles , page 11

Let me be honest... students are getting severely minimal health education to begin with. Like, embarrassingly small amounts of time focusing on one of the most important areas of one's life- health & well-being. According to Centers for Disease Control and Prevention School Health Profiles Survey, there is a large discrepancy of secondary schools that taught a required health education course 6th-12th grades. Some states do not require a credit in health education for graduation and many middle school students receive less than 9 weeks of health education throughout their middle school tenure.

As more and more state bills are introduced to intervene on public health crises, more content is added to the health teachers' plate. A plate that is typically full to begin with since there isn't enough time allotted to the content area.

To add to the lack of time for health education, many health teachers are not highly qualified/certified and in some cases, the science or PE teacher is asked to teach health, whether or not they have a degree or certification in the area. Non-qualified teachers teaching health are less likely to teach certain subjects (lack of comfort or knowledge on finding strong materials & resources) and many have not had training in answering difficult questions, skills-based health education pedagogy and the evidence-based practices in the field.

 A health teachers plate- over 10 content areas and 7 skills (in pink).

A health teachers plate- over 10 content areas and 7 skills (in pink).

Teaching a 2 day unit on promotion of healthy eating to expect that students gain the functional information and skills they need to eat breakfast everyday, select nutrient-rich snack and meals, drink water, eat fruits and veggies is not realistic. A math teacher doesn't spend two days on the addition unit and move on. There is a logical progression and application over time that is integrated in through hours of study. Health education should consist of units that are taught specifically to address concerning data points of student health behavior and to help support the maintenance of health promoting behaviors. Meaning, 2-day units aren't going to cut it. But, if you haven't had strong professional development in the content area and you aren't even a certified health teacher, you might not know that isn't effective. Units should be a couple weeks in length and I believe they should be more focused on skill-building than content anyway. Most legislative bills focus on content without any specific skill-building aspects aligned to health education. 

I'm not saying passing legislative bills isn't the way to go. It really is a great opportunity. But, I'd like legislators and even public health content specialists passionate about addressing a public health crisis to understand health education pedagogy and the National Health Standards of which ONE is content specific, and SEVEN are skills-based (analyzing influences, accessing information, interpersonal communication, decision making, goal setting, self-management and advocacy).

Bills that legislators might introduce that will help health education, and therefore prevent drug use and other public health crisis might have language that includes something like...

  • Comprehensive health education K-12 is taught sequentially through a locally develop scope and sequence aligned to the state content standards and informed by local data driven decisions on adolescent health behaviors. The minimum minute requirements are: 
    • Elementary School: 45 minutes/week
    • Middle School: 90 minutes/week
    • High School: 90 minutes/week
  • Health education should be skills-focused in which students are spending 75% of instructional time within a course on practicing and demonstrating the seven National Health Education Skill Standards.
  • Health teachers should be highly qualified to teach health education.
  • Health teachers should have access to content-specific professional development opportunities at least twice a year.
  • Health teachers should use research-based curriculum with specific behavioral outcomes to teach health education.
  • Health teachers should have access to professional development on creating a trauma-informed classroom while teaching sensitive topics.
  • And, then finally- include the functional information that students need to know in order to prevent the public health crisis.

In conclusion, I end with a question... How do we as a field, educate our passionate lawmakers to write bills that are effective and appropriate instead of knee-jerk reactions to an epidemic or event? 


Health Education Blog Post Series Part 1: Health Education Needs a New Identity

The entire K-12 content area or discipline of health education needs a new identity. My generation and older remembers health ed as the class where you learned to Just Say No, or that having sex means you'll have blisters on your genitalia. We remember reading Chapter 11 on smoking cigarettes and answering 5 questions at the end of the chapter to assess our knowledge that smoking is bad.

Unfortunately, health education has continued to be branded in peoples' minds as drug ed and sex ed. Those embarrassing activities or conversations that felt uncomfortable and forced. And sadly, due to a lack of professional development and support to people teaching health, how health was taught 30 years ago is still happening today. 

If the goal of K-12 school health education is health literacy, the ability for students to use, analyze, interpret, access, advocate for resources, information and products that are health-enhancing, we still have a long way to go. Many of the textbooks, activities and instructional methods used are about teaching content and it's time we leave those practices behind.

Fortunately, over the years, we have more adolescent brain research to understand how the tween/teen brain makes decisions (or fails to). Teenagers behave in irrational and sometimes harmful ways and we question why. Science proves that many times, it's because making decisions and solving problems isn't thought out like the fully mature adult brain. Brains continue to mature through young adulthood, in fact, the frontal cortex, the area of the brain that controls reasoning and helps us think before we act, develops later.

An article on the Teen Brain: Behavior, Problem Solving, and Decision Making by the American Academy of Child and Adolescent Psychiatry shares that based on the stage of their brain development, adolescents are more likely to:
-act on impulse
-misread or misinterpret social cues and emotions
-get into accidents of all kinds
-get involved in fights
-engage in dangerous or risky behavior

Adolescents are less likely to:
-think before they act
-pause to consider the consequences of their actions
-change their dangerous or inappropriate behaviors

Some health teachers aren't aware of the research, nor are organizations, content specialists and non-profits that are writing content for health education. This is not to point blame, but rather, due to the lack of knowledge and professional development support. Much of the curriculum out there is still based on assuming youth can make great decisions every time if they just read about the risks and dangers.

Health education has gone through quite a paradigm shift. Teachers are just catching up.

Health education has gone through quite a paradigm shift. Teachers are just catching up. Understanding the adolescent brain is one piece of research that has been helpful, but another shift is skills-based instruction, learning, demonstrating and assessment. We've started to ask better questions...

  • Does answering 5 questions correctly at the end of a tobacco unit mean that the student will have excellent refusal skills when offered a cigarette?
  • Do students need to know the names of the germs in order to effectively wash their hands?
  • Do students need to memorize the 206 bones of the body in order to fit a helmet properly, wear elbow/knee pads and wear a seatbelt consistently and correctly 100% of the time while riding in a vehicle?

Having the skill to memorize and recite Martin Luther King's exact words doesn't mean you understand the Civil Rights Movement. The answer is NO! to all of these questions above. If our goal is health literacy, every lesson, activity, demonstration, video, assessment should lead to healthy behavior outcomes (HBOs). And, if it doesn't- let it go! (You can find a list of HBOs in the HECAT, in the boxes on the front page of each module.

So, as we started to focus on skills in the classroom, we have also started to question what content is important? Benes and Alperin define functional information as information that is useable, applicable, and relevant. It is not arbitrary, traditional, or extensive. Functional information is the context in which the skills will be taught and the base for students’ developing functional knowledge. (Benes & Alperin, 2016)

I know, many of you are saying, I do skills-based. But, then I hear... it's important for a middle school student to know the body systems. To an extent, yes. But students aren't all going into pre-med in high school. In order to keep your heart healthy, you don't need to be able to diagram it, but rather, what behaviors help keep it healthy? And, how do you set some goals around those behaviors? What do students really need to know and demonstrate in order to lead to a healthy behavior outcome? Not much, actually. They need to practice skills, and be able to master those skills. 

RMC Health's Health Skills Models define what mastery looks like for each of the skill standards by grade level band. For example, for Advocacy, high school students should: 
• Students are able to identify a health-enhancing behavior using peer and societal norms.
• Students are able to demonstrate how they can influence and support others into making positive health choices.
• Students are able to work cooperatively with a group, analyze and solve various barriers they may encounter
• Students are able to adapt the health message to a specific audience.
• Students are able to reflect on the process and make adjustments as needed.

State Departments of Education are shifting to creating State Content Standards that are more focused on the skills and what mastery looks like for the skills and less on content, leaving that to local decision making. And, I agree with that. I think districts should spend the time reviewing any local data they can get their hands on and using student behavior data to drive/inform their local scope and sequences. Write down the concerning data points and determine which HECAT HBOs will address the concerning points. Which skill and knowledge expectations from the HECAT modules will address those student risk behaviors? Limit the number of units you teach. In fact, I suggest calling units the skills, not the content areas. 

I believe instead of teaching mental/emotional health promotion in September, you teach accessing information with 2-3 content areas as context to the skill. And, you move on to another skill... maybe goal setting and you teach 2-3 content areas for context. The district scope and sequence process is guided by those initial concerning data points.

If we go this way, truly, it means we need to re-brand our discipline. Our education leaders still think of drug ed and sex ed. Many do not understand that the skills in health education are life skills (analyzing influences, accessing information, interpersonal communication, goal setting, decision making, self management and advocacy). At multiple events, I have heard from businesses and employers that they expect the people they hire to have communication skills, decision making skills, negotiation skills... that is HEALTH EDUCATION! But, nobody recognizes it, because we still have health educators that aren't here yet. They aren't teaching skills-based, so our field continues to be stereotyped that it's the same it was 30 years ago. 

I want to re-brand our field. This is the first of many health education posts in this series. Upcoming topics include:

  • What does a skills-based unit really look like?
  • How do we re-brand our field?
  • How does the ACES research support health education?
  • How our legislators creating bills to teach content isn't helping the field.
  • How to begin shifting our schools to CSHEIs-  Comprehensive School Health Education Initiatives

Supporting K-12 Schools to #TeachThem in a Time of #MeToo

By Liz Thorne

The #MeToo movement has shown the extent to which acts of rape, sexual violence and sexual misconduct permeate the lives of countless women, as well the people and institutions that allow it to perpetuate like an “open secret”. Last month, the news of allegations of sexual misconduct against Asis Ansari added a new dimension to the #MeToo discourse. There was a debate about whether the actions of Asis belonged in the same conversation as the actions of Harvey Weinstein or Larry Nassar. But folks working in the field of sexuality education knew that it did.

While I was consuming all of this in my news feed, I just kept thinking to myself, “This is why we need more comprehensive sexuality education in every school in every town starting from preschool through higher education!” According to the Guttmacher Institute, fewer than half the states require schools to include the topic of “avoiding coercion” as part of a sexuality education program and similarly, a majority don’t require discussion of healthy relationships. But teaching young people about healthy relationships is the primary prevention for sexual violence because it’s centered on breaking down gender stereotypes, setting healthy boundaries, communication, and that consent is more than just “not hearing no”.

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There are states and school districts that are using this as an opportunity to strengthen laws and policies around sexuality education. The Sexuality Information and Education Council of the United States (SIECUS) has developed a toolkit to support educators to advocate for policies that support comprehensive sexuality education. They also created the partner #TeachThem movement to build on the awareness that #MeToo has brought to the need for stronger comprehensive sexuality education. But even states with strong policies struggle with implementation due to a lack of funding for professional development for teachers and administrators.

This is why I’m so proud to be supporting a school district with funding from Advocates for Youth to develop a sexuality education plan of instruction K-12 inclusive of policy, scope and sequence and training/professional development. Earlier this month we held a meeting with folks representing: education, public health and child welfare at the state level; school administrators; district staff; county public health; community based organizations that provide culturally specific sexuality education; university; LGTBQ rights; and sexual assault/violence prevention.  The group came together to critique the first draft of a district sexuality education policy. We envisioned a policy that codifies instruction that is not just developmentally appropriate and science-based, but inclusive and trauma-informed. A policy where school level data are used to guide instruction, and teachers are enthusiastic and equipped to teach sexuality education through strong professional development and support from an incredible network of community partners. There is so much more work to do, but I left this meeting filled with energy and hope.   

I salute these and other professionals, sexuality educators, young people, teachers, administrators and advocates across the country working to strengthen sexuality education. Our work has never been more important or needed.


An Article Review: "We Talked About Sex." "No, We Didn't": Exploring Adolescent and Parent Agreement About Sexuality Communication

By Samantha Lowe

Adolescent perceptions of parental interactions do not get as much attention as they deserve, gone are the days of the common "because I said so" parent reasoning, it is now time for open, honest, and factual conversations about sex and contraception.  Speaking with your adolescents about sexual encounters is important, currently over 40% of adolescents report they had sex before any conversation with their parents about contraception  (Grossman et al., 2017).  Research has shown that having a conversation with your child in early adolescence can post-pone sexual activity along with reducing risky sexual behaviors (Grossman et al., 2017). 

Recently, an article was published in November of 2017, using qualitative and quantitative data to compare thoughts and feeling of 27 parent and adolescent dyads in relation to a discussion about sexual topics.  Agreement between the dyad was analyzed and then given a low, medium, or high agreement rating. Adolescents and parents who had high agreement were more likely to report positive parental approaches to sexuality communication and awareness of parental perspectives (Grossman et al., 2017). 

What were the authors trying to get them to agree on? Basically… if the conversation happened. Nine topics were outlined, and adolescents and parents were presented with open and closed ended questions, these topics included; puberty, the biology of pregnancy, when it's okay to date, avoiding STI's, condoms, when it is okay to have sex, religious beliefs and sex, adolescent pregnancy, and LGBTQ issues (Grossman et al., 2017). Interview questions also addressed perceptions of parental messages about sex, comfort talking with a parent about sex, and perceptions of parental rules for dating and sexual behavior (Grossman et al., 2017). Dyads were divided into high-(6-9), medium-(3-5), and low-(0-2) match groups based on agreement of the nine outlined topics and the adolescents’ perceptions of the quality of the conversation (Grossman et al., 2017).

Demographics: Dyads consisted mostly of mothers and adolescent children, keeping the psychological trend of the "not likely to participate in the study" father alive. Out of 27 dyads, 25 included the mother while the remaining 2 included the father. Twelve dyads (44%) included adolescent females, with an adolescent mean age of 12 years, 19% of the adolescents reported already having sexual intercourse.  52% of dyads self-reported as African American, reporting a moderate level of religious importance  (Grossman et al., 2017).

While dyads were analyzed results focused on the adolescents perception of the conversation, it is the adolescents perceptions, not the parents, that are going to shape their experiences and behaviors (Grossman et al., 2017). Even if a parent believes they are communicating effectively, the perception of the adolescent can be completely different. Focusing on the adolescents perception is key, if they do not feel like the communication was effective then the positive consequences from the discussion (delayed sexual involvement and lowered risky sexual behaviors) could never manifest.

Results: No dyad reported agreement of having discussed all nice topics, the highest level of dyad agreement on if a topic was discussed was for puberty (74%), followed by dating and LGBTQ issues (56%). Lower levels of agreement included religious beliefs about sex (15%), readiness for sex and teen pregnancy (33%) (Grossman et al., 2017). The fact that 56% of dyads had discussed LBTQ issues and only 15% had discussed religious beliefs about sex was amazingly shocking to me, I would like to see how these results changed in an a strictly Appalachian sample. I would predict that the numbers would be reversed, with more conversations about religion and less about LGBTQ culture.  Based off the research I conducted in graduate school I suspect this percentage would be MUCH lower as about 25% of my Appalachian participants did not know how to identify their own sexuality and struggled with the difference between "Asexual" and "Heterosexual". Further research needs to be done within specific sub-populations.

Three main themes became apparent from adolescent responses related to their experience with sexuality communication with their parent: Comfort with sexuality communication, Responses to parents viewpoints, and Awareness of parental perspectives (Grossman et al., 2017). Results when on to show that dyads in the high match group expressed a more positive parental approach, agreed with their parents viewpoints, and could explain why their parent held their viewpoints. Parents were open, honest, and practiced good listening skills (Grossman et al., 2017).

Adolescent quotes from the high match group included:

  • "My Mom is just like all out and makes sure I know everything"
  • "I am very comfortable because she has all the information"
  • "She tells me what happened and why it happened, because it happened to her"
  • "I think it is smart of her, she doesn’t want me to get the wrong information"
  • "My Mom is overreactive because she got pregnant at a young age and she does not want me to do the same and miss out on educational opportunities"

Low match groups exhibited poor listening skills and adolescents felt like parents did not give adolescents enough credit for their understanding of the topic, and their uncomfortableness of speaking about the topic was obvious to the adolescent (Grossman et al., 2017).

Low match adolescent quotes included:

  • "Because she makes jokes about everything"
  • "They talk about it like it is a bad word, like you shouldn’t talk about it and you shouldn’t be doing it"
  • "They talked to me in kiddie talk and say it like I am a little kid"
  • "I don’t think they know about STI's, they only know about the simple ones"
  • "My Mom doesn’t know much about condoms because I don’t think she has used one"
  • "They are too overprotective, I don’t think that they know that I do understand and want to make the right decision"

Topics of dating and puberty seemed to be easier for parents to discuss with their adolescents while topics of pregnancy and contraception seemed to cause some uneasiness in the parent (Grossman et al., 2017). Results in this study show that uncomfortableness, inability to explain why they hold their views and ineffective listening on the parents’ end can doom the conversation. These findings support sex education courses that include both parents and adolescents with in the middle school setting. These programs can provide support for topics of potential discomfort and encourage the parent to be open despite their hesitancies. These courses also open the floor for more than one conversation about sexual topics, as following up about what was heard in the conversation can reduce gaps in communication (Grossman et al., 2017).

The study needs to be replicated with a larger N than 27 so the results are more generalizable. It would be interesting to compare cross cultural agreement and topics between dyads. From previous research we understand some cultural differences, for example in the Netherlands romance and consent are two highly discussed topics between adolescent and parent dyads, which is a stark difference from the typical abstinence, STI, and pregnancy topics covered in American dyads (Grossman et al., 2017).)

The sample was a convenience sample which comes with its own problems, but I don’t believe they need to be discussed. However dyads were thrown out of the study when the parental figure identified as another adult family member. In my opinion, this should not have made a difference as they are still the person who is likely to have this conversation with the adolescent. Future studies should include these dyads as modern families are not likely fit the cookie-cutter mold of the typical nuclear family.


Grossman, J., Sarwar, P., Richer, A. and Erkut, S. (2017). “We Talked About Sex.” “No, We Didn't”: Exploring Adolescent and Parent Agreement About Sexuality Communication. American Journal of Sexuality Education, 12(4), pp.343-357.