Originally published by Shape America on February 22, 2022

If you were to travel across the United States asking schools how they approach health education, you’d get a VERY wide range of responses.

Some schools avoid the topic altogether. Some stress strict “Just Say No”-style messages. Others use a more comprehensive approach, emphasizing skills and decision making in class. Some schools even host teen clinics right on campus.

For adults who care about teenagers, it can be challenging to know what approach to take. Luckily, some new remarkable research from the Centers for Disease Control and Prevention (CDC) is helping clarify what actually works, with clear examples schools can emulate and start implementing immediately.

As this new study in the Journal of Adolescent Health explains, schools across the country have seen significant results when they implement these three specific strategies in their schools:

1. Providing quality health education, including sexual health education.

2. Implementing systems to increase student access to health care.

3. Promoting activities to decrease bullying, increase parent engagement, and help students feel more connected to school

The What Works In Schools program’s influence reached beyond the students who directly participated — and improved outcomes were seen for all students at schools where the program was implemented.

Findings from an evaluation of this approach showed that schools that implemented the What Works In Schools program model saw significant benefits for students in six outcome areas:

• Sexual history (have they ever had sex)

• Sexual partners (had 4 or more lifetime sexual partners)

• Sexual activity (they had sex in the last 3 months)

• School safety (have they missed school because of concerns for their safety)

• Rape (have they ever been forced to have sex)

• Drug use (ever used or currently use marijuana)

As a teacher in the San Francisco Unified school district, one of the districts featured in this study, I’ve been able to see firsthand how effective these strategies can be. The schools in the study received CDC funding and technical support through the CDC-DASH program, but the What Works In Schools strategies can be replicated by any district or school that wants to improve outcomes for young people.

If you, as a parent, an educator, or a community member, want to see healthier outcomes for teens, consider this your roadmap for how to get there. I’m thrilled to see this research demonstrating how effective these approaches are, and I hope this study serves as a catalyst for change in schools across the country.

Let’s take a closer look at how each of these three strategies works in schools.

1. PROVIDING QUALITY HEALTH EDUCATION, INCLUDING SEXUAL HEALTH EDUCATION

As an organization, SHAPE America provides guidance and resources about effective health education, and recently published a position paper called “Sex Education Is a Critical Component of School Health Education.” This reflects the guidance from the CDC, which says, “Quality sexual health education is a systematic approach to preparing students with the knowledge and skills needed to make informed health decisions to prevent HIV, STDs, and unintended pregnancy.”

Comprehensive, skills-based sexuality education is very effective, not just at reducing unplanned pregnancies and sexually transmitted infections, but also for helping students understand consent, avoid sexual harassment, and establish healthy relationships. Research even shows that sex ed in high school can be a powerful rape reduction tool.

The CDC details some of the characteristics of a quality sexual health education program:

• Sexual health education includes planned, progressive learning objectives and outcomes across grade levels (K–12).

• Sexual health education addresses knowledge and skills students need before risk behaviors and health issues emerge.

• Effective sexual health education programs:

  • Are taught by qualified and trained teachers

  • Connect students to health services

  • Engage parents and community partners

  • Foster positive relationships between students and trusted adults.

In my district, we’ve been working diligently to expand our health classes into middle schools, partially in response to the California Healthy Youth Act, a 2016 law that requires that all students receive comprehensive sexuality education lessons at least once in middle school and once in high school.

I know that bringing programs like this to schools is hard work and sometimes encounters resistance. That’s part of the reason I’m so excited about this “What Works in Schools” report — it provides strong evidence that all those advocacy efforts really are worth it.

2. IMPLEMENTING SYSTEMS TO INCREASE STUDENT ACCESS TO HEALTH CARE

We have become used to the idea of school nurses, but people don’t always think of schools becoming access points for sexual health care. According to this research, however, it’s something more schools should consider. Schools can connect students to sexual health services by providing the services on site or by referring students to youth-friendly health care providers in the community.

Sexual health services give students access to preventive health care, such as STD testing, HIV testing, contraception, and condoms, and referrals to appropriate treatment if needed. Although students may initially come in with a specific sexual health concern, these services can provide students with information, education, support, referrals, and counseling for a broad range of health behaviors and experiences that can affect healthy development.

As examples, educators can look to places like the Cleveland Metropolitan School District, which greatly expanded the number of middle and high school students it refers each year for sexual health services.

3. PROMOTING ACTIVITIES TO DECREASE BULLYING, INCREASE PARENT ENGAGEMENT, AND HELP STUDENTS FEEL MORE CONNECTED TO SCHOOL

Creating safe and supportive environments involves schools, communities, families, and youth working together to protect students’ health and improve academic performance. According to the CDC, these changes emphasize aspects of school settings and family relationships that can protect adolescents and reduce their risk for HIV, STDs, and unintended pregnancy.

The “What Works in Schools” report identifies some of the ways this can work:

• Protective factors include school connectedness, parental monitoring, and parent-adolescent communication (both generally and specifically about sex).

• Safe and supportive environments connect adolescents to a network of caring peers and adults, including parents, other primary caregivers, and teachers.

• Improving environments can have a broad and lasting positive impact on health. It also establishes a context for sexual health education and sexual health services to be effective.

For example, the San Diego Unified School District improved the environment in its schools by creating safe spaces to report bullying and harassment, and visibly taking actions to address incidents and ensure that students feel supported. Each one of the three strategies identified by the CDC — Sexual Health Education, Sexual Health Services, and Creating a Safe and Supportive Environment — is powerful on its own. In combination, they work even better. “What Works In Schools” is a fantastic guide for anyone trying to make healthy changes in our schools.