Schedule
of Speakers & Abstracts
Morning starts at 9:00 am
Is the internet filling the sexual health information gap for teens?
Senior Research Associate, Guttmacher Institute,
Finding Youth in Their Space: Using Social
Networking Sites to Connect Youth to Sexual
Health Services
Research Associate,
Professor and holder of the Marion Howard Chair in Adolescent Reproductive Health, Jane Fonda Center Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
Key note Speaker: CJ Pascoe, PhD
Assistant
Professor, Department of Sociology,
Encouraging Sexual Literacy in a Digital
Age: Teens, Sexuality and New Media
Lunch on your own
Afternoon
session starts at 1:15 pm
Keynote Speaker: Deb Levine, MA
Director, Internet Sexuality Information Services (ISIS),
Using Technology, New Media, and
Rachel
Jones
Study Objectives: Teen pregnancy rates declined 38% between 1990 and 2004, and evidence indicates that the majority of this decline (86% between 1995 and 2002) can be attributed to improved contraceptive use among adolescents. Yet funding for abstinence-until marriage sex education increased substantially over the last decade, suggesting that fewer adolescents are getting accurate information at school. If fewer teens were getting contraceptive information, but more teens were using contraception more effectively, the question becomes: Where do teens learn about contraception and other sexual health issues? Over the last decade, exposure to the Internet has increased at an almost exponential pace, and this may be one potential way that adolescents are filling the sexual health information gap. In this study we explore the extent to which teens use the internet for this purpose and how they evaluate and negotiate the internet within the spectrum of other sources of sexual health information.
Methods: 58 semi-structured interviews were conducted April-June
2008 with junior and senior high school students from 3 sites: A large public
high school in a mid-sized city in
Findings: We found that teens got information about sexual health issues from a range of sources, most commonly school and family members. However, much of this information was superficial, often presented in the form of “safe sex sound bites” or “abstinence mantras” and few teens got in-depth information from multiple sources. The majority of teens we spoke to were daily internet users, and almost all accessed the internet on a regular basis. However, the internet was not a common source of sexual health information, and, of the teens in the study, only a minority could recall exposure to information about contraception and/or abstinence. Among the minority who did relate that they had acquired information from this source, information was often task-oriented, for example done for school assignments or in search of answers to very specific questions. Only a few of the teens identified the internet as their main source of sexual health information. Most of the teens were wary, if not outright distrustful, of information related to sex on the internet. Reasons for wariness included 1) the openness of the web (“anyone can make a website”), 2) the abundance of sexually explicit material dwarfs its legitimacy as an information source and 3) the internet is commercially driven (i.e. “sex sells”). That said, however, teens voiced trust in those sites they deemed more legitimate, such as those with .gov, .edu and .org suffixes. Websites associated with health care facilities, Departments of Health and webmd.com were also more likely to be trusted and several teens indicated that they trusted information if it corresponded with what they had learned from other sources (e.g., school) or other websites. Overall, the teens we spoke to indicated that more common and trustworthy sources of information included school and family members, and to a lesser extent, friends. Many teens voiced that these sources could be trusted because they were trained to provide correct information (school, health care professionals) or had the teens’ best interests at heart (family, friends).
Conclusion: Our findings suggest that the internet is not filling that sexual health information gap. Some teens are wary of information related to sex on the internet and more likely to rely on and trust more “traditional” sources such as school, family and friends for information about sexual health. However, our study suggests several strategies for increasing awareness among teens that accurate sexual health information is available on the web and linking them to specific sites. The trust that students place in school makes it an ideal venue from which to refer students to appropriate websites. Sexual health educators should also work to develop strategies that take advantage of teens’ strong trust of medical professionals and medical websites. Moreover, since teens acquire sexual health information from a variety of sources, strengthening the trustworthiness of information on the internet can work within existing systems of accessing information and cross-checking against other sources. Finally, while many teens are wary of internet ads, many also recalled sidebar and popup ads; sexual health websites might explore promoting awareness of their content using these types of strategies.
Lauren Ralph
MPH, Sarah Schwarz MPH, Nancy Berglas
MHS, Claire Brindis DrPH
Philip R.
Lee Institute for Health Policy Studies
Study
Objectives: Given
the increasing popularity of and access
to the internet among youth, some
family planning clinics in California have
created their own presence on social
networking sites (SNS) such as MySpace.
This study presents findings from UCSF’s
evaluation of these efforts, which were
funded by the state’s TeenSMART Outreach
(TSO) Program to increase access to
clinic services among youth in communities
with high teen birth rates. The
evaluation focused particular attention on
questions of a potential “Digital Divide”
in internet access and use in low‐income communities, which
could greatly impact the success of
this type of intervention.
Specifically,
the study sought to answer the following questions:
1)
Do youth in TSO communities have access
to the internet and social networking
sites?
Does access differ
by race/ethnicity, age, and/or gender?
2) How do youth in
TSO communities use the internet to
find sexual health information?
What do youth think
about the information available to them
online?
3) How have TSO‐funded clinics used
MySpace to connect with youth?
How do clinics
decide to adopt this strategy?
What types of
information are available on TSO MySpace
pages?
To
what extent are youth willing to
connect with a family planning clinic
through a social networking site?
Methods:
The
following four data sources were developed
and collected by the UCSF research
team in the spring and summer of
2008.
1.
Teen Internet Access & Use Survey:
This brief survey assessed teens’ access
to and use of the Internet, in
particular social networking sites such as
MySpace, and interest in seeking sexual
health information online. A total of
994 surveys were collected from teens
(ages 14‐19) participating in
outreach activities at 19 TSO clinics
over a three‐month period.
2.
Teen Focus Groups: Focus groups
addressed teens’ perception of social
networking sites, use of the internet,
and views on using technology for
seeking health information. Focus groups
were conducted with 58 teens (ages 14‐19) at six sites.
The group size ranged from 6 to
14.
3.
Staff Interviews: Group interviews were
conducted with adult and peer staff
at TSO clinics. Questions focused on
the development, implementation, resource requirements,
successes, and challenges of web‐based outreach, as well
as the perception of its effectiveness
as an outreach strategy. Group
interviews were conducted with 22 staff
at six sites throughout California.
4. Website Content
Review: Using a standardized checklist,
research staff examined the content of
10 TSO clinics’ MySpace sites. Checklist
items addressed the site’s accessibility
through common search techniques, its youth‐friendliness, information
about the clinic and its services,
and opportunities for online interaction.
Data were validated through assessment
by at least two researchers over a
three‐month period.
Findings:
Nearly all
youth (94%) surveyed reported using the
internet at least occasionally, including
more than 90% of teens from all
racial/ethnic groups. However, African American
and Latino teens were less likely
than white teens to report using the
internet every day (p<.05). Furthermore,
African American, Latino, and multiracial
teens were less likely to report
accessing the internet most often from
home (p<.05). Among online teens, 90%
reported using social networking sites, and
nearly half (46%) reported visiting these
sites daily. MySpace was, by far, the
most popular site.
Youth have experience finding information online,
and 40% of those surveyed reported
having used the internet to find
information about their own sexual health.
In focus groups, youth described both
benefits (privacy and convenience) and
drawbacks (lack of interpersonal connection)
involved in searching for online health
information. Many teens were open to
receiving sexual health information online
from a TSO clinic through various
methods, including websites, email, and
MySpace. However, they were deliberate and
thoughtful about whether they would be “friends” with a clinic that
provides sexual health services, often
noting conditions such as having visited
the clinic previously or verifying the
credibility and trustworthiness of the ste.
When
asked why they use MySpace as an
outreach strategy, TSO staff noted its
extreme popularity, its low cost and
convenience, its youth‐friendliness,
and its “viral” effect in
reaching large number of youth. They
described using their MySpace pages to
build ongoing relationships with youth and
reinforce messages given during in‐person outreach and
education sessions. The content of their
MySpace pages reflected these decisions,
emphasizing the clinic’s location and services,
upcoming events such as health fairs
and clinic tours, and opportunities for
interaction with clinic staff through
blogs, wall posts, and private messaging.
Pages incorporated fun, youth‐friendly components such
as Flash images, popular music, and
photos of youth, and were less
focused on instructional health education,
which both staff and youth preferred
to discuss in person. Common challenges
included gaining support from management
and IT staff, designating staff time to
update the site and monitor content,
convincing teens to join their network
of “friends”, and evaluating the site’s
impact on teens’ use of and
satisfaction with clinic services.
Conclusions:
Study findings
suggest that the Digital Divide is
shrinking. Teens in low‐income
communities are regular users of the
internet and social networking sites,
although disparities in access remain that
may impact the success of such
interventions with some populations. Certain
aspects of social networking sites make
them well‐suited for sexual
health programs to conduct outreach, and
MySpace is a low‐cost,
high‐profile strategy which
has promise for reaching teens in need
of sexual health services. More
investigation is necessary to measure the
impact of MySpace outreach on the
recruitment and retention of youth at
the clinic, as well as its potential
to change health behaviors among youth.
Marion Howard PhD, Professor: Department of
Gynecology and Obstetrics:
Overview: Despiite general perceptions that issues of
access to technology have largely been resolved, among some of the most
vulnerable teen populations, these issues still loom large. The problem is compounded by the fact that publicly
funded institutions under provisions of the Children’s Internet Protection Act
are required to restrict availability to some of the information most needed by
low-income teens—for example, the means and importance of protecting themselves
against pregnancy and sexually transmitted infections—areas of
disproportionatly high incidence among minority youth.
Organization and Target Population:
(Issues of Access}
Concerned
about how technology deficits were impacting the minority teens in its
community (86% of the adolescents
in the city school system are African American and 71% are economically
disadvantaged). the local teaching hospital in one southern city surveyed 1,318 teens attending its teen
family planning program in 2002. It
found that 48% of the teens did not have computers in their homes. Even more troubling, only 23% of all the
teens had Internet connections at home (not even half of the state’s
average).
To address the obvious disparity between its population and those who were more affluent, the hospital decided to turn its teen clinic waiting room into a health-focused computer center featuring 8 computers with high speed Internet connections. Pre-change, 93% of sampled sexually active teens said they liked the idea of putting computers/Internet access in the teen clinic—post-change 98% of surveyed teens indicated the computers ”were a good way to give health information to teens” (3/4 strongly agreed with that statement) and 94% of the teens felt that “all clinics should have computers for teens to use while they are waiting for care” (3/4 strongly agreed with that statement). Moreover, 23% of the teens said they learned more about computers; 13% said they learned how to get online health information.
Study Objectives: (Validating the Merit of the
Approach) The hospital then undertook a study
to learn if the web-linked approach would change knowledge, attitudes, and
actual behaviors of teens. Two of the 19
interventons were chosen for testing—both focused on condom use. (It Takes Two and STI’s).
Methods: Clinics were randomly assigned to
treatment and control conditions, The clinic study consisted of giving the teen
intervention groups one of the two selected PowerPoint web-linked presentations
during normal clinic waiting times. The
intervention groups also received regular family planning services including
standard clinic health education. The control groups received no
intervention--only the regular family planning services including standard
clinic health education. Ninety-nine
(99%) of the clinic population studied were school-age African American female
youth.
Findings: Three to six months following implementation, both of the
technology–based interventions appeared to have important and lasting effects
on teen knowledge, attitudes, and behaviors.
At three to six months, returning teens who had one or the other
interventions knew more of the intervention information than did the returning
control teens. Teens who had the web-linked computer-based interventions also
were more likely to view the Internet as a resource for additional information
and were actually more likely to have used it for that purpose. Most important,
returning teens who had the interventions were more likely to say that since
the last time they had been in the clinic they had protected themselves from
pregnancy and sexually transmitted infections through 1) Refusing to have sex
when condoms were not going to be used. 2) Increasing their use of condoms
since their last clinic visit. 3) More
often “always” using a condom than did the control group.
Conclusions: Taking
advantage of the average 15 minute waiting room time through Web-linked
computer-based reproductive health interventions has the potential to not only
make clinic health education more relevant and effective for young teens, but
may result in teens actually behaving in ways that are healthier and more
protective of their futures. It also may make a contribution toward
reducing racial and ethnic disparities by using computers when minority teens
Background
The National Campaign to Prevent Teen and
Unplanned Pregnancy
The National Campaign to Prevent Teen and
Unplanned Pregnancy seeks to improve the lives and future prospects of children
and families and, in particular, to help ensure that children are born into
stable, two-parent families who are committed to and ready for the demanding
task of raising the next generation. Our specific strategy is to prevent teen
pregnancy and unplanned pregnancy among single, young adults. We support a
combination of responsible values and behavior by both men and women and
responsible policies in both the public and private sectors. If we are
successful, child and family well-being will improve. There will be less
poverty, more opportunities for young men and women to complete their education
or achieve other life goals, fewer abortions, and a stronger nation.
The
Problem and Target Populations
In the
Friends may offer some advice, sometimes
health care providers assist as well, but the reality is that many women are
essentially on their own in the contraceptive and relationship journey, and it
is this gap that the Campaign hopes to fill.
The five key segments at risk for unplanned
pregnancy in the young adult population are:
Players
– ethnically diverse and less educated males, who think unplanned pregnancy is
“someone else’s problem”;
Maybe
Babies – older and less educated females who believe a baby may add direction
to their lives;
Safety
Firsts – suburban males with a solid income who, while partaking in casual sex,
find unplanned pregnancy unacceptable;
Savvy
and Sexy – highly intelligent, urban females that believe in casual, but safe
sex
Good
Kids – the youngest demographic who care what their family and friends think
and who believe pregnancy should come with marriage.
Project
Description
One of the most significant changes over the
last decade in the overall environment in which The Campaign operates is the
primacy of media in the lives of teens and young adults. As we were getting
organized in the mid-1990s, we often said that we rarely communicated directly
with our target audiences but, rather, went through intermediaries. In 2009,
that picture has changed completely. Through digital media in particular, which
is interactive and pervasive, we now can communicate and converse with
individual teens and young adults in ever-expanding and powerful ways.
Over the last year, The Campaign’s digital
presence and plans have increased significantly. Our digital presence now
includes the following activities and properties:
·
We
continue to embed our messages in the content of entertainment media, but in
the last few years, such media now routinely and increasingly includes
interactive digital components – blogs, chats and more that allow us to
continue the conversation with our audiences;
·
Our
StayTeen website offers an interactive setting to engage teens directly about
sex, love and relationships;
·
We also
now have a presence on MySpace, Facebook, Twitter, and YouTube—properties that
are intensely interactive and also support/drive traffic to our other sites.
·
We are
developing a digital support system to improve the use of contraception by
sexually active young women.
Our newest effort is a new site for young
adults—Sex.Really.—which will include extensive materials and opportunities to
interact regarding young adult relationships, with our flagship offering being
a series of podcasts by our Senior Fellow, Laura Sessions Stepp that highlights
the voices of young adults. This site will also begin addressing major gaps in
knowledge through polling and there will also be places to view short videos
and related materials.
Message platforms for each of the audience
segments (above) embody several, key underlying themes, including, but not
limited to:
·
The cost
of raising a child;
·
The
elements of a good relationship;
·
Busting
myths about sex and relationships;
·
Move to
a more consistent use of contraception;
·
Explore
contraception choices right for you.
The website will work on changing
social-psychological constructs that ultimately lead to behavior change.
It will be a kind of “relationships 101” site that includes presences on
YouTube, Twitter, and Facebook and that reaches across a broad demographic that
includes men. Our first content, launched even before the debut of the
main website, was a series of "sex comedies" meant to attract the
attention of men to the issue.
By the time of the conference it will be too
soon to share about outcomes, but there are already many lessons learned that
should be of interest to the conference attendees.
Karyn Sandlos, Art Education
Department, School of the Art Institute (SAIC),
Co-researchers Jen Gilbert,
Study Objectives
The title of
this presentation is taken from a qualitative study of the current social and
political context for sex education in the
Framing our project as a conversation between the fields of sex
education and education—as well as between adults and youth on the meanings of
sexuality— has the strategic goal of both improving the theories of teaching
and learning that structure sex education programs, and introducing the field
of education, especially teacher education, to the very difficult questions
about sexuality and health that sex education grapples with. Another objective of the project, therefore,
is to emphasize the processes of inquiry and interpretation at the core both of
sexual health education and experiences of growing up.
Methods
Our research project uses independent film to prompt conversation in a
series of focus group discussions with adolescents, teachers, and community
based sexual health educators in two urban settings,
Following
the findings of media arts based research in education (Goldfarb 2002, Goodman 2003, Ellsworth 2004), we argue that this
method—using film to prompt conversations amongst diverse groups of people—can
be a democratizing force in education, in particular by enabling greater
participation in these conversations by marginalized students. Moreover, we are
interested in understanding how film may open up conversations about sexual
health, an issue of public debate that has become deeply polarized.
Findings
The
presentation will explore this methodological approach of using encounters with
film as a means for educators to talk with adolescents about aspects of adolescent
sexuality, feelings of ambivalence and conflict, and experiences of learning
that the abstinence debates render mute. I will discuss excerpts from
focus group data that are helping us to re-focus our attention on what it means
for educators to participate in conversations about the intersection of
sexuality and learning. Aesthetic narratives of adolescent sexuality invite us
to find an education in the affective; in the emotional contexts where
sexuality emerges, “in all of its guises and passions” (Gilbert 2004, 233). A
tension arises, however, with the adult response to the adolescent because, in
the context of the abstinence debates, there is confusion between talking about
sex and the consequences of participating in sex. For the adult who creates
sexual health curricula, there is a fantasy that the right information conveyed
in the right way and at the right time can hold at bay the consequences of
adolescent sex. Put differently, when abstinence is the answer to the question
of youth sexuality, even talking about sex can feel dangerous. In our
interpretations of the focus group conversation, we pay attention to the ways
in which talk about sex attempts to contain and circumvent the consequences of
adolescent sex. And we speculate on the ways in which the kind of talk adults
engage in with adolescents also functions to contain adult anxieties about
adolescent sexuality.
Conclusions
One effect of the divisive debates within the field of sex education is
the tendency to see education as a problem of information provision, at best,
or indoctrination, at worst. The focus on giving students information, while
absolutely necessary, tends to reduce teaching and learning to a technical
procedure that can be managed through good methods or the right lesson plan.
Research in the field of education (Atwell-Vasey 1998; Boler 1999; Britzman 2003, 2007;
Taubman 2007), however, suggests
that our engagements with knowledge are much more complex and are affected and
shaped by past experiences, states of mind, worries, hopes and a whole host of
factors that we might group under the umbrella of emotion. We argue that
understanding the emotional terrain of sexuality and sex education could create
the conditions for more meaningful conversations to emerge between teachers,
sex educators and youth on the difficulty of learning to live well in our
bodies. But just as important, we investigate how independent film functions as
a unique research tool, an open-ended form of curricular text that offers a
space for teachers and parents to meet youth on their own terms.
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