Parents' opinions and attitudes towards sexuality education in the schools.
Acknowledgements: The authors wish to acknowledge the contributions of Sharon Thompson, Dr. Alexander Hukowich and Brian Laundry from the Haliburton, Kawartha, Pine Ridge District Health Unit, Port Hope, Ontario, Betty-Ann Knutson from the Durham Region Health Department, Whitby, Ontario, and Trudy Lum and Jan Pomeroy from the Kawartha Pine Ridge District School Board, Peterborough, Ontario.
Does sexual health education belong in the schools? At what age should sexual health education begin? Should sexual health education recognize and respect the different moral beliefs about sexuality that may exist in the community? Should sexual health education in the schools include sometimes controversial topics such as birth control and sexual orientation? Previous research has consistently shown that a strong majority of parents in both Canada (Langille, Langille, Beazley, & Doncaster, 1996; Lawlor & Purcell, 1988; Marsmen & Herold, 1986; McKay, 1996; Verby & Herold, 1992) and the United States (Janus & Janus, 1993: Kenney, Guardado, & Brown, 1989) want sexuality education to be taught in the schools. Survey research also suggests that parents want sexual health education programs to include a wide range of topics, and that schools should begin addressing most of these topics at the elementary level (Langille et al., 1996; McKay, 1996).
However, perceptions of parental support for broadly-based sexual health education in the schools can be influenced, particularly at the local level, by a number of factors. For example, in a particular community, those who oppose the provision of sexual health education in the schools or who argue that sexual health education should only embody a particular ideological vision of sexual health may be highly vocal and persistent in promoting their point of view, thereby giving the impression that they represent a large proportion of community opinion. Letters to the editor in local newspapers, presentations to boards of health and/or education, demonstrations, and media reports on these events can all potentially create a false impression of parental opinions and attitudes related to sexual health education in the schools.
Given that educators and policy makers will want to take into account parents' perspectives when making decisions about the existence, extent, and nature of school-based sexual health education in their communities, it is important to ascertain parental opinions on these issues as accurately as possible. This may be particularly important in communities where clear differences of opinion are already evident or seem likely.
Surveys of parents of children attending local schools can be a productive and cost-effective way of measuring parents' support for sexual health education at the community level. Such surveys can play an integral role in facilitating the development of sexual health education policy at various levels of government and public administration, and provide a key impetus for the development and implementation of school-based sexual health education curricula.
The goal of the present study was to measure parental support for sexual health education in an area served by a large rural school board in southern Ontario. In collaboration with the public health units serving the area, the school board had recently begun the process of revising its sexual health education policy and curriculum. A parent survey was planned as an important means of community consultation oil issues related to policy and curriculum, as well as a means of documenting support for sexual health education in the schools. Based on the success of similar initiatives in other communities (for example see Burgoyne, 1998), the present study replicates two earlier surveys of parental attitudes that took place in the provinces of Ontario (McKay, 1996) and Nova Scotia (Langille et al., 1996). The use of an almost identical survey instrument to that used in the previous studies allows for direct comparisons of parental attitudes towards sexual health education in different communities and regions.
Our primary objectives were to identify the percentage of parents in the community who wanted sexual health education to be taught in the schools, what topics they thought should be included at what grade level. In addition to the content of sexual health education, we also wanted to find out from parents who they felt would be the most appropriate people to provide sexual health education in the schools and community. In order to further our understanding of parental opinions and attitudes towards sexual health education in the schools, we also sought to discover from parents how well they felt they were doing in providing sexual health education to their own children, and how well they felt other parents were doing in this regard.
It has been proposed that people's opinions and attitudes related to sexual health education in the schools are often linked to their more general, and sometimes very strongly held sexual ideologies which encompass their basic moral perspectives regarding the nature and purpose of human sexuality (McKay, 1998). According to this perspective, a strong belief in and adherence to a particular sexual ideology may lead some people to disapprove of any sexual health education content that does not conform to their own ideology. Although we did not investigate the link between particular sexual ideologies and parental opinions and attitudes related to sexual health education, we did ask parents to indicate if they felt sexual health education in the schools should recognize and respect the different moral beliefs about sexuality that exist in the community, an issue which has important implications for the form and content of educational programs. In addition, because some opinions and attitudes related to sexuality can be subject to age and gender differences, we also examined our data to discern if any significant differences existed between male and female respondents, and between respondents from different age groups in their opinions and attitudes related to sexual health education in the schools.
The survey was conducted in January and February of 1997. Twenty thousand survey questionnaires were provided to the public schools in the six communities served by the local school board (total student population=26,000). Most of the questionnaires were sent home along with students' report cards, with the rest being attached to other correspondence that was given to students to take home to their parents or guardians. Parents were asked to complete the questionnaire, seal it in the envelope provided, and return it to the schools. Parents either asked their children to return it, mailed it in or dropped the questionnaire off themselves.
The two-page survey instrument was a slightly modified version of the questionnaire used in previous studies (Langille et al., 1996; McKay, 1996). The questionnaire included demographic items regarding the respondents' age and sex. On the first section of the questionnaire, respondents were asked to use a 5-point Likert scale with responses ranging from "strongly agree" to "not sure" to "strongly disagree" to respond to 7 statements about basic issues related to sexual health education in the schools. Respondents were also asked to indicate who among parents, teachers, health professionals, clergy, and leaders of child and youth organizations (or any combination of these) should provide sexual health education. With respect to the content of sexual health education in the schools, respondents were asked to indicate which of 15 suggested topics they believed should be included in school-based sexual health education in grades Junior Kindergarten (JK)-4, 5-6, 7-8, and 9-12 and to indicate which of these topics, if any, were inappropriate for school-based sexual health education.
RESPONSE RATE AND SAMPLE CHARACTERISTICS
Of the 20,000 questionnaires given to students for delivery to parents, 6,833 completed questionnaires were returned to the schools for a response rate of 34.2%. It should be noted, however, that over 85% of the parents or guardians responding to the survey indicated that they had two or more children, thus making it likely that many of these families received more than one questionnaire. Since it was asked on the questionnaire that each family return only one questionnaire, it is likely that the actual response rate for families who did receive questionnaires was considerably higher than 34%.
Most questionnaires (78%) were completed by one parent (70% females, 8% males), and 22% were completed by both parents together (4% did not indicate their gender). The majority (61%) of parents who completed the questionnaire were aged 30-39 years, 31% were aged 40-49, 7% were under 30 and 2% were over the age of 49.
PARENTAL OPINIONS AND ATTITUDES ON BASIC ISSUES RELATED TO SEXUAL HEALTH EDUCATION
Responses on a 5-point Likert-type scale elicited parental opinions and attitudes towards several key aspects of sexual health at home and in school (Table 1). A strong majority (95%) of parents strongly agreed or agreed with the statement "sexual health education should be provided in the schools." Most parents (82%) were also in favour of school-based sexual health education that begins in the primary grades and continues through the senior grades of high-school. Parents took a pluralistic approach to teaching about the moral dimensions of sexual health with 81% strongly agreeing or agreeing that," It is important for sexual health education to recognize and respect the different moral beliefs about sexuality that may exist in the community."
Table 1 Percentages of parents agreeing/disagreeing with statements about sexual health education (n=6833)(*)(+)
Statement Strongly Agree Not Disagree Agree Sure Sexual health education 49 46 2 2 should be provided in the schools Sexual health education in 43 39 3 11 the schools should be provided from primary through senior grades using material that is appropriate for the different ages of children. It is important for sexual 36 45 5 10 health education programs to recognize and respect the different moral beliefs about sexuality that may exist in the community. Personally, I provide adequate 24 49 10 17 sexual health education for my children Most parents know how to 3 20 8 56 give their children the sexual health education they need. Teen pregnancy is a 20 41 26 12 problem in our community Learning how to prevent 88 10 1 1 infection from sexually transmitted diseases (including HIV/AIDS) is important. Statement Strongly Disagree Sexual health education 2 should be provided in the schools Sexual health education in 5 the schools should be provided from primary through senior grades using material that is appropriate for the different ages of children. It is important for sexual 5 health education programs to recognize and respect the different moral beliefs about sexuality that may exist in the community. Personally, I provide adequate 1 sexual health education for my children Most parents know how to 14 give their children the sexual health education they need. Teen pregnancy is a 2 problem in our community Learning how to prevent 1 infection from sexually transmitted diseases (including HIV/AIDS) is important.
(*) Percentages have been rounded to the nearest whole number
(+) Missing responses range from 2-8%
With respect to parental provision of sexual health education, 73% strongly agreed or agreed that, "Personally, I provide adequate sexual health education for my children." However, 70% strongly disagreed or disagreed that, "Most parents know how to give their children the sexual health education that they need." Sixty-one percent of the parents in this survey felt that teen pregnancy was a problem in their community, while 14% disagreed and 26% were not sure. Nearly all parents (98%) strongly agreed (88%) or agreed (10%) that, "Learning how to prevent infection from sexually transmitted diseases (including HIV/AIDS) is important."
EFFECTS OF AGE AND SEX OF RESPONDING PARENT ON OPINIONS ABOUT SEXUAL HEALTH EDUCATION
While Chi-square tests (p. [is less than] .05) revealed some statistically significant effects of respondents' age and sex on their opinions about sexual health education, for practical purposes, the actual percentage differences between comparison groups were slight even when the test indicated a significant effect. One notable finding is that older parents are progressively more likely to strongly agree or agree with the statement, "It is important for sexual health education programs to recognize the different moral beliefs about sexuality that may exist in the community" (under 30 = 77%, 30-39 = 81%, 40-49 = 84%, 50 and older = 89%) (p. = .001). Also, males (43%) were significantly more likely than females (35%) to strongly agree with this statement (p. = .000). All other tests for the effect of age and sex on opinions revealed small or no effects.
PARENTS' IDENTIFICATION OF SEXUAL HEALTH EDUCATION TOPICS THAT SHOULD BE TAUGHT AT DIFFERENT GRADE LEVELS
For each of 15 sexual health education topics, respondents were asked to check the grade levels (JK-grade 4, grades 5-6, grades 7-8, grades 9-12) at which they felt the topic should be taught. A separate box offered the option "Topic should not be taught." The results (Table 2) indicate that most parents wanted all 15 topics taught at some point in their child's school-based sexual health education. For 12 of the 15 topics, only 2% or less of parents unambiguously stated that a particular topic should not be taught at any grade level. For 5 topics, however, (Helping children and youth avoid sexual abuse, Sexual assault/rape, Teen parenting, Individual, family, religious, and community moral beliefs about sexuality, Abortion/alternatives to abortion) between 10% and 22% of parents gave a multiple response in that they checked one or more grade levels, but also checked the "Topic should not be taught" box. The frequency of these dual contradictory responses for these particular topics suggests that they may not be simply the result of clerical errors on the part of the respondents. Such dual responses may reflect some degree of ambivalence with respect to respondents' opinion about the teaching of a particular topic, or that the respondents changed their opinion while filling out the questionnaire, or that they were simply reinforcing their view that a topic "should not be taught" at a particular grade level.
Table 2 Percentages of parents indicating that sexual health education topics should be taught at different grade levels (n=6,833).(*)
Topic Grades Grades JK-4 5-6 Building equal, healthy relationships 95 88 Helping children and youth avoid 83 81 sexual abuse Prevention of STD/AIDS 1 83 Attraction/love/intimacy 36 33 Communicating about sex 33 44 Puberty 31 83 Abstinence from sexual activity 0 1 Sexual decision-making 0 33 Reproduction 1 2 Sexual orientation 0 1 Methods for preventing 1 1 pregnancy (birth control) Sexual Assault/rape 6 23 Teen parenting 17 13 Individual, family, religious, and 1 40 community moral beliefs about sexuality Abortion/alternatives to abortion 0 0 Topic Grades Grades 7-8 9-12 Building equal, healthy relationships 86 86 Helping children and youth avoid 79 77 sexual abuse Prevention of STD/AIDS 93 95 Attraction/love/intimacy 77 89 Communicating about sex 71 67 Puberty 63 20 Abstinence from sexual activity 95 94 Sexual decision-making 75 82 Reproduction 94 89 Sexual orientation 87 95 Methods for preventing 83 76 pregnancy (birth control) Sexual Assault/rape 61 64 Teen parenting 41 61 Individual, family, religious, and 53 46 community moral beliefs about sexuality Abortion/alternatives to abortion 40 78 Topic Topic should Multiple not be taught response(+) Building equal, healthy relationships 0 1 Helping children and youth avoid 0 14 sexual abuse Prevention of STD/AIDS 0 0 Attraction/love/intimacy 0 1 Communicating about sex 2 3 Puberty 1 2 Abstinence from sexual activity 0 0 Sexual decision-making 1 1 Reproduction 0 1 Sexual orientation 1 1 Methods for preventing 2 2 pregnancy (birth control) Sexual Assault/rape 2 20 Teen parenting 5 22 Individual, family, religious, and 13 10 community moral beliefs about sexuality Abortion/alternatives to abortion 6 15
(*) Percentages have been rounded to the nearest whole number
(+) Multiple response denotes the percentage who indicated that the topic should be taught at one or more grade level, but also checked the "Topic should not be taught" box.
Given the generally high level of agreement that all of the 15 topics should be taught at one or more grade levels, we highlight here the different grade levels at which parents wanted specific topics to be taught. Two topics (Building equal, healthy relationships, Helping children and youth avoid sexual abuse) received over 80% support at grades JK-4, and subsequently remained popular for the higher grade levels. The concepts of sequencing and age-appropriateness are apparent in the finding that, for example, 83% of parents wanted puberty taught at the grade 5-6 level, but only 20% felt it should be taught at grades 9-12. A number of topics (i.e., abstinence, sexual decision-making, reproduction, sexual orientation, birth control, prevention of STDs/ AIDS) were selected by small percentages of parents for teaching at the early grades, but were selected by 75%-95% by grades 7 to 8. Others that received lower endorsement in the earlier grades were approved for high school.
PARENTAL OPINIONS ON WHO SHOULD PROVIDE SEXUAL HEALTH EDUCATION
Parents were asked to choose one or more of five options (parents, teachers, health professionals, clergy, leaders of child and youth organizations) to complete the statement, "Sexual health education in the schools/in the community should be provided by ...". The most popular choices were parents (88%) and health professionals (88%), followed by teachers (77%), while leaders of child and youth organizations (21%) and clergy (20%) were cited less often.
Many of the findings reported here are strikingly similar to those obtained in other studies using the same survey instrument. For example, 95% of parents in the current study strongly agreed or agreed that sexual health education belongs in the schools, compared to 95% for parents in Nova Scotia (Langille et al., 1996) and 91% for parents in northern Ontario (McKay, 1996). Among these three surveys, parents strongly agreed or agreed (80%-85%) that sexual health education programs should recognize and respect the different moral beliefs that may exist in the community, and 72%-86% strongly agreed or agreed that sexual health education should be provided from the primary through senior grades. While additional surveys may reveal regional differences, the results of these three different studies may indicate a general consensus among parents with respect to their support for sexual health education in the schools.
By a wide margin, the topic "Building equal, healthy relationships" received the highest percentage support, ranging from 86% to 95% over the four grade levels. It is noteworthy that this same topic was also rated as important in a survey of high school students' self-perceived needs in sexual health education (McKay & Holowaty, 1997). These findings are important given the tendency for the public discourse around sexuality education to focus, sometimes exclusively, on the issues of STD and pregnancy prevention.
The current study is the fourth to find that parents tend to have more confidence in their own abilities to provide adequate sexual health education to their children than they have in other parents to do likewise (see also Langille et al., 1996; McKay, 1996: Welshimer & Harris, 1994). Future research should investigate the ways in which this somewhat paradoxical finding may have an impact upon parents' attitudes towards sexual health education in the schools.
Some aspects of sexuality education in the schools remain controversial. For example, it is sometimes suggested that large numbers of parents oppose teaching about sexual orientation, birth control, and abortion in sexual health education programs. This was clearly not the case in the current study. Indeed, for the grades 9-12 level, sexual orientation, along with STD/AIDS prevention, received the highest percentage support, with 95% of parents' indicating that they wanted the topic of sexual orientation addressed in the classroom. This level of support is higher than in the previous studies where 70% (Langille et al., 1996) and 76% (McKay, 1996) of parents stated their support for teaching the topic of sexual orientation. It is noteworthy that although nearly all parents in the current study wanted sexual orientation addressed at the upper grade levels, very few wanted it addressed before grade 7. This pattern of support was evident for several other topics, namely abstinence, pregnancy prevention, reproduction, and abortion. However, for these topics, parents may have based their responses on the assumption that children in the primary grades are unlikely to be sexually active, and therefore do not require information on these topics. Thus, it is curious that while a third of parents indicated that "attraction/love/intimacy" was an appropriate topic for the primary grades, less than 2% indicated that sexual orientation was also appropriate. With respect to teaching about birth control, the finding of the current study that 83% of parents want the topic to be taught at grades 7-8 supports previous research showing that over 80% of parents want this topic taught at some point during the high school years (Langille et al., 1996; McKay, 1996). Although abortion is a highly controversial issue, such controversy apparently does not translate into widespread parental disapproval for teaching about the topic in school-based sexual health education. In all three studies, the topic "Abortion/alternatives to abortion" was approved at some point in the high school years by 70% or more of parents.
In conclusion, the current study supports the findings of previous studies which indicate that Canadian parents want sexual health education taught in the schools and that they want it to begin at the primary grades and continue through to the senior grades of high school. The parents in these studies also endorse a wide range of topics for sexual health education, and they want such programs to recognize and respect the diversity of moral beliefs that may exist in the community. Future studies are needed to ascertain whether the pattern of results described in this and other studies carries over into other regions of Canada.
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Correspondence concerning this paper should be addressed to Alexander McKay, SIECCAN Research Coordinator, SIECAN, 850 Coxwell Avenue, Toronto, Ontario, M4C 5R1, Tel: 416-466-5304; Fax: 416-78-0785; email: firstname.lastname@example.org.