Teaching about HIV/AIDS through online education.

Abstract

HIV/AIDS prevention/education has been taught in classrooms for several years, yet exposure to infection remains to be a worldwide concern as behaviors have been slow to change in many cultures. It's important to be able to reach K-12 teachers and their students on a global scale. This article addresses how one model attempts to achieve such access through implementation of a worldwide online teacher-education platform.

Introduction

Although many Americans could believe that the Human Immunodeficiency Virus / Acquired Immune-Deficiency Syndrome (HIV/AIDS) crisis may be over because recent data demonstrate that with proper intervention, a decrease in high-risk behavior among adolescents occurs (CDC, 2000a), (Bryan, Rocheleau, Robbins and Hutchison, 2005), it is still an ever present danger to our society and the world at large (CDC,2000b). Dr. Peter Plot, the Executive Director of UNAIDS, has stated, "On current trends, AIDS will kill tens of millions of people over the next 20 years. But this need not happen. We know prevention works." (Clifton, 2006). Likewise, Piot, Bartos, Ghys, Walker and Schwartlander (2001) determined that

   ... the scale of the human immunodeficiency virus (HIV)/AIDS
   epidemic has exceeded all expectations ... an estimated 36
   million people are currently living with HIV, and some 20
   million people have already died, with the worst of the
   epidemic centered on sub-Saharan Africa ... as the spread
   of HIV has been greater than predicted, so too has been its
   impact on social capital, population structure and economic
   growth. Responding to AIDS on a scale commensurate with the
   epidemic is a global imperative, and the tools for an effective
   response are known.

American teenagers continue to practice unsafe behaviors related to HIV/AIDS, specifically as related to alcohol and tobacco use, while teenagers in other Western cultures feel that it's a "crisis of the 1980's". Likewise, educators in sub-Saharan Africa are perplexed to witness an explosion of the infection among students from all socioeconomic levels. Hence, a worldwide educational plan is needed to promote awareness and safer behaviors among students from all walks of life. Online teaching and learning represents an opportunity to achieve such worldwide social change.

In Western cultures the real crisis is a crisis of arrogance that is reflected in the idea that the spread of the disease is a "past crisis" and that we can "move on". In fact, although there has been a decrease in the practice of high-risk behaviors, many adolescents are still not getting the message. According to the Center for Disease Control (2006):

   ... many students still engage in (risk)-related ... behaviors
   ... During 1991--2005, the prevalence of sexual experience
   decreased 13% from 54.1% to 46.8% among high school students.
   Logistic regression analyses indicated a significant linear
   decrease overall and among female, male, 9th-grade, 10th-grade,
   11th-grade, 12th-grade, black, and white students. A significant
   quadratic trend also was detected among black students and
   11th-grade students. Among black students, this trend indicated
   that the prevalence of sexual experience declined during 1991-2001
   and then leveled off through 2005. Among 11th-grade students, the
   prevalence of sexual experience declined during 1991--1997 and
   then leveled off through 2005. Prevalence of sexual experience did
   not decrease significantly among Hispanic students."

Likewise, in sub-Saharan Africa, the impact of the disease has reached catastrophic proportions. A charity based in the United Kingdom, with a large focus of its work in Africa, cites:

   Many countries in sub-Saharan Africa have failed to bring the
   epidemic under control ... There is a significant risk that some
   countries will be locked in a vicious cycle, as the number of
   people falling ill and subsequently dying from AIDS has a
   tremendous impact on many parts of African society, including
   demographic, household, health sector, educational, workplace and
   economic aspects. (Adopt a Village in Africa, 2006)

The American Association of Colleges for Teacher Education (AACTE) recognized this challenge at achieving competent HIV/AIDS education and the resulting social change worldwide, and partnered with the Center for Disease Control in the Build a Future without AIDS (BaFWA) project (1995-2005). The first part of the project (1995-2000) allowed AACTE and its members to explore best methods of promoting the inclusion of such prevention education into teacher preparation, identify available curriculum resources, and develop, package, and disseminate learning resources and materials to schools, colleges, and departments of education ... while the second cooperative agreement (2002-2005) was designed to establish and expand the knowledge base for preventing the spread of this disease and other serous health problems by increasing the comfort, confidence, and abilities of pre-service teachers. (AACTE, 2006)

One effort designed to expand the knowledge base included establishing field sites at three universities from different parts of the country that served very different Teacher Education candidates populations: California State University East Bay (formerly Hayward), Langston University in Oklahoma, and the University of Puerto Rico, Rio Piedras Campus. An online learning course resulted from these on-site implementations. This newly-created course has now been accepted by one of the world's largest online universities as part of its curiculum investigation in its Ed.D program for teacher and administrator leaders.

Online learning and HIV/AIDS Education

The Build a Future without AIDS sites at the California State University, East Bay, Langston University and the University of Puerto Rico--Rio Piedras Campus had been field testing the project from 2001 through 2004. All three sites determined that the program had demonstrated a positive impact at achieving social change and stronger awareness of HIV/AIDS education principles among their teacher education candidates, with hopes of promoting a positive social change among K-12 students who were later taught by these candidates. Since two of the three site investigators possessed significant experience in online teaching, it was decided that an online course should be pilot-tested in summer 2005. Results of this effort were published in Humanizing Pedagogy through HIV and AIDS Prevention, an anthology of chapters from selected experts published by AACTE in 2006.

In their chapter Preparing Teachers as Prevention Agents: An Online Learning Course, Mitchell, Ramirez-Marrero and Hooks (2006) recognize that learners must be presented HIV/AIDS education material in a "non-threatening atmosphere", with an "ambiance of mutual respect" and appreciation for the learner's previous experience with the subject matter (Mitchell, Ramirez-Marerro, and Hooks, 2006). They relied on the work of Knowles (1984) who believed in the "learner-centered instructional setting that provides opportunities for self-directed, task-oriented experiences from learners who bring experiences and motivation to the learning venue" (Knowles, 1984). As a result, Mitchell, Ramirez-Marerro, and Hooks developed an online course that focused on the biological, psychosocial and curriculum issues of HIV/AIDS education that hold true to these principles.

The first consideration of the course was to focus on a worldwide platform for disease prevention education. Although there have been some successful attempts at achieving learning about the disease via an online platform, most notably PBS and its NOVA Teachers program (2006), which offers a newspaper supplement-creation activity for students, there have been limited opportunities for teacher education students from across the world who are interested in HIV/AIDS prevention to interact in an online course. The Build a Future without Aids program wanted to offer such a platform so that teacher education candidates could cite similarities and differences in the populations they intend to work with, and potential obstacles that may exist in their different local societies. For instance, in the pilot testing of their course, HIV/AIDS Education for Teacher Educators, Ramirez-Marerro, Mitchell, and Hooks, (2005) offered such a global platform during a four-week period in summer 2005. Students at Cal. State East Bay, many of whom were of Western European and Latino heritage, described challenges with conveying the message to their K-12 students, many of whom were African American. Students at the University of Puerto-Rico, Rio-Piedras cited religious influences in the populations they teach, impacting how recipients of the material may or may not understand the intention of the initiative and, therefore, may block its implementation; while students at Langston University spoke of time limitations in their prospective classrooms that might hinder dissemination of the information to their students.

The co-creators also co-instructed the class in summer 2005, using curriculum material that focused on the aforementioned biological, psychosocial and curriculum perspectives. For the biological section, students were asked to examine and discuss web links that articulated how people get HIV/AIDS, and the available diagnostic tools and treatments; while for the psychosocial section, students investigated information that dealt with the topic as a disease of social consequence, girls and the disease as well as how household income relates to risk and infection. The curriculum section of the course related to specific models that had previously been implemented, most notably a model at a high school in Minnesota as well as state models that had been adopted. For each of the three sections the students from the three universities were asked to write 500-word individual response papers and submit them to the instructor. Students were also asked to respond on the threaded discussion to the same question for each section:

   Make reference to these materials as you respond to this question:
   It is important to convey knowledge to those whom we want to make
   changes. People need to know the facts about HIV/AIDS; its risks,
   its spread, and its prevention. The cognitive principle involves
   sharing new information and at times correcting misinformation.
   What should the cognitive information about H1V/AIDS include? Give
   examples of an academic subject and the information that can be
   shared in the curriculum regarding HIV/AIDS as related to the
   section being discussed. Give a 50 word reply to two classmates
   (Ramirez-Marerro, Mitchell, and Hooks, 2005).

As previously stated, the course lasted four weeks, one week for each section, preceded by a one-week introduction. Overall, students who participated in the course responded on their end-of-course course surveys with positive remarks. Of the eleven total respondents, 10 stated that they would take the course again and would recommend it to others. This finding brought credibility to the effort. Some of the comments ranged from "I never thought of learning in this format before, I intend to share this information with my students", to "It was fantastic to share this learning experience with other students from across the country. I felt like they were actually in the class with me, even though they were thousands of miles away."

Building upon Achieved Successes

The next phase of the initiative was to take the template developed with the students from the three campuses in 2005, and find a place where the online course could be permanently housed. Walden University was chosen as the next site to make use of the online course.

The Ed.D. Program at Walden University serves over 1600 students who are already teaching or serving as administrators in K-12 schools worldwide, and are earning their Doctorates in Teacher or Administrator Leadership. All students are required to complete the course Proseminar: Teacher Leadership Beyond the School, in which students are asked to "look at educational models and organizations from an international perspective ... and compare, contrast, and analyze educational organizations and leadership theories and models from an international comparative perspective" (Walden University, 2006). The four-week module that was pilot-tested by the three campuses in 2005 has been inserted into the Walden University course as part of the third unit in a four-unit, 16-week course. During this third module, students are required to respond to a threaded discussion in which they apply the skills and competencies they have acquired over the term of the course. Walden students are asked

   to examine theories, research, and current issues impacting today's
   educational system--from the school to the local and community
   levels, and review the AACTE/Build a Future without AIDS course
   that was developed, and assess its potential impact on social
   change as related to both individuals and schools. Students are
   presented instructions for accessing the course model. After they
   have accessed the course model and evaluated its content, they are
   required to post a response to the following questions with a
   one-to-two paragraph posting: Does this course provide a model for
   social change that could be applied at school sites? Could you
   follow this model in creating a new model within your own
   leadership network? What are the strengths of the course model?
   What are its weaknesses? (Walden University, 2006)

Students are then asked to read a sampling of their colleagues' postings, and respond to at least two of their colleagues' postings in one or more of the following suggested ways: Ask a probing or clarifying question. Share an insight from having read the colleague's posting. Offer and support an opinion. Validate a posting with your own experience. Suggest why they might see things differently. They are then required to review and reflect on the responses to their original posting, making note of what they have learned and/or any insights they have gained as a result of the comments made by their colleagues. They are also asked to consider how their insights/learning might impact your future actions. (Walden University, 2006)

The course sequence in the Ed.D. Program at Walden University requires that after completing this course: Proseminar: Teacher Leadership Beyond the School, students go on and study either quantitative or qualitative research, so that they may formulate a hypothesis to conduct a study that will promote positive social change as they complete the requirements of their Ed.D. programs. By placing the AACTE Build a Future without AIDS model in the third section of the Walden University course, it is expected that students will strongly consider using the information investigated in their own individual K-12 classrooms, while they also consider investigating HIV/AIDS education as a vehicle for them to study toward completing their Ed.D. degrees. The overall intention is to foster a promotion of best practices in K-12 classrooms and research that will further the mission of social change as related to HIV/AIDS education.

Conclusion

The development of the online course for the Build a Future without AIDS project has been an exercise in consensus building, field testing and strong reflection-on-practice. The course began its formation with three different instructors, from three different universities, collaborating in its development with the "coaching" by staff at the American Association of Colleges of Teacher Education. Lessons were learned during summer 2005, when students from these three universities participated in the pilot testing of the course. The instructors reflected on practice and promoted the course to Walden University, with hopes that the message of achieving greater awareness of HIV/AIDS education among the world's educational community could be realized. As the Walden course is launched in January 2007, hopes are high and prospects for achieving the successful worldwide platform that was initially mentioned seem possible.

References

AACTE (2006), Build a Future without AIDS, Washington DC. Retrieved December 18, 2006, http://www.aacte.org

Adopt a Village in Africa (2006), The Impact of HIV/AIDS in Africa, Retrieved December 16, 2006 from http://www.adoptavillageinafrica.com/AboutUs.htm

Bryan A., Rocheleau C., Robbins, R. and Hutchison K., (2005). Condom Use Among High-Risk Adolescents: Testing the Influence of Alcohol Use on the Relationship of Cognitive Correlates of Behavior. Psychological Health. March 2005. (24)(2)(133-142).

Centers for Disease Control and Prevention. (2000a). Tracking the hidden epidemic: Trends in STDs in the United States 2000. Retrieved December 17, 2006, from http://www.cdc.gov/hiv/pubs/facts/youth.htm.

Centers for Disease Control and Prevention. (2000b). Young people at risk: HIV/AIDS among America's youth.. Retrieved December 16, 2006, from http://www.thebody.com/cdc/youth.html.

Centers for Disease Control and Prevention. (2006). Trends in HIV-Related Risk Behavior among High School Students--United States, 1991-2005.. Retrieved December 18, 2006, from http://www.freespeechonline.org/webdocs/CDC_TeenSexReportAugust06.pdf

Clifton, C.E. One-on-One with Dr. Peter Piot, Retrieved December 18, 2006, from http://www.tpan.com/publications/positively aware/mar_apr 03/one on oneAaiot.html

Knowles, M.S.(1984) Introduction: The art and science of helping adults learn. In Androgogy in action. Applying modern principles of adult learning. San Francisco,: Jossey-Bass.

Mitchell, J., Ramirez-Marerro, F., and Hooks, M.Y.(2006) Preparing teachers as prevention agents: An online learning course, In Humanizing Pedagogy through HIV and AIDS Prevention. Boulder-London: Paradigm Publishers

PBS (2006). NOVA online: Surviving AIDS. Retrieved December 18, 2006, from http://www.pbs.org/wgbh/nova/aids/

Ramirez-Marerro, F., Mitchell, J., and Hooks, M.Y.(2005), HIV/AIDS education for teacher educators, University of PuertoRico: Rio Piedras, 2005

Walden University; EDUC 8030 Proseminar: Teacher Leadership Beyond the School (2007); Minneapolis MN:

James M. Mitchell, California State University, East Bay

Mose Yvonne Brooks Hooks, Langston University, OK

Farah A. Ramirez-Marerro. University of Puerto Rico, Rio Piedras

Mitchel, Ph.D. is Assistant Professor of Education, Hooks, Ed.D. is Professor of Education, and Ramirez-Marrero, Ph.D. is Professor of Exercise Sciences