The impact of aging on human sexuality.

Review of gerontological and medical literature reveals the need for education for lay persons and professionals about the effects of the aging process on human sexuality. Primary prevention of psychosocial problems and sexual dysfunction could be abated by including accurate information about sexuality and aging and effective communication techniques in sexuality education programs, including those with young adults. In addition, professional preparation of health educators must include the skills and knowledge needed in this area.

PIP: This article discusses the changes in sexual response that are experienced by the aging, and tries to eliminate some of the stereotypes, myths, and misconceptions that often discourage older persons from participating in sexual activity. Although menopause reduces the production of lubrication and slows the sexual response of females, most women report that sexual response of females, most women report that sexual satisfaction does not change; in fact, many women experience a more satisfactory sexual experience due to loss of traditional inhibitions created by fear of unwanted pregnancy. Men also experience decreasing levels of testoterone and changes in sexual responses. However, if these biological changes are not misinterpreted and do not result in anxiety, men may be sexually competent into their 70s and 80s, with regular sexual activity and reasonably good health. Health education programs can play a critical role in the sexual activity of older persons. Increased knowledge and awareness in the areas of sexual communication, gender roles, sexual dysfunction, and therapy can contribute to a greater acceptance of sexuality. One goal of health education should be to help individuals make informed choices based on an accurate understanding of facts -- not on ignorance, myths, or stereotypic beliefs.

Utilizing the SIECUS Guidelines to assess sexuality education in one state: content scope and importance.

Comprehensive sexuality education programs, advocated as the most effective means of promoting sexual health for youth, include a broad range of sexuality topics taught throughout the school years as a part of comprehensive health education. Programs must include not only the negative consequences of sexual behavior, but content that cultivates a positive view of sexuality as well. This study assessed the scope of sexuality education topics taught, using the SIECUS Guidelines for Comprehensive Sexuality Education: Kindergarten--12th Grade, and rated importance of these topics, by public high school teachers within a state that mandates sexuality education. The majority of the 261 teachers responding to the survey reported they taught most of the topics recommended by the Guidelines. They also rated most Guidelines' topics as "important" to teach. However, numerous teachers omitted topics crucial to comprehensive sexuality education. The relationship between teacher ratings of importance and what was taught, and implications for future research are discussed.

Sexual harassment policies in Florida school districts.

Until recently, little attention has focused on the sexual harassment that occurs in primary and secondary schools. Several school-related lawsuits and study results heightened awareness of the issue. This study investigated the extent to which Florida's school districts complied with the Florida Department of Education's (FDOE) recommendation and guidelines for addressing sexual harassment in schools. District equity coordinators were surveyed regarding policy development, implementation, promotion, education, and effects. Policies were collected for analysis. Most districts responded to the strong encouragement of the FDOE and approved a sexual harassment policy incorporating many of the suggested components. However, policies included only basic information when compared with suggestions from the literature. Results suggest problems with sexual harassment will continue due to lack of efforts in promoting awareness of the policy and education about the issue, which scholars insist are necessary for effectiveness.

The politics of school-based clinics: a community-level analysis.

School-based primary health care, supported as an effective means for addressing the health needs of youth, also tends to be perceived as controversial partly due to opposition by national and state level organizations. This investigation used case studies of four selected school-based clinic (SBC) sites, and of one community in which an SBC was disputed, to investigate the existence of organized opposition, how proponents contended with opposition, and effects of organized opposition on SBC approval and implementation. Four sites experienced opposition affiliated with larger conservative organizations. Opponents' strategies and proponents counterstrategies were identified. Effects ranged from limiting SBC services to preventing an SBC's establishment. Proponents, consisting largely of medical and school administrative professionals, overcame opposition through strategies to increase public awareness about youth health issues and to demonstrate public support in the face of expressed opposition. Implications for planning and implementing potentially controversial programs are offered.

The politics of school-based programs which address sexual orientation.

This study examined both the content of school district programs related to sexual orientation, and the social and political determinants of these school programs. Data were collected from districts within all 126 U.S. communities with legal protection against discrimination on the basis of sexual orientation, and from a random sample of 129 U.S. jurisdictions without such legislation. Results showed that most school districts are not offering recommended program elements related to sexual orientation issues. Districts within localities with gay rights protection are doing more than those without. Although compositional factors account for some of the differences in educational efforts, a politically engaged constituency also made a major difference in school district efforts. To the extent that gays and lesbians served in local public office and mobilized to influence school elections, they were able to affect school programs and policies.

Using focus groups to develop a nutrition education video for high school students.

Focus group interviews were used to develop a nutrition education video and a teacher's guide for use in Florida high schools. Authors conducted a pilot and four focus group interviews with ninth grade students in five geographically distinct regions of Florida. Most students agreed that a video with scenarios or success stories would work well. Teens expressed interest in 10 topics: eating disorders; consequences of unhealthy eating; preparing quick, healthy meals; what constitutes a balanced diet; nutrition and fitness; weight control; food and the environment; the food guide pyramid; nutrition facts and fallacies; and food labels. Students suggested no more than three or four topics should be covered in the video, and the video cast should consist mainly of teen-agers with different body sizes, who were average, attractive, and from different ethnic backgrounds. Music was recommended only for transitions between scenes, as background, or during the credits.

Using focus group interviews to understand school meal choices.

Focus groups were used to examine adolescents' participation in school nutrition programs, their opinions about the meals served in these programs, and their suggestions for improving the meals. A pilot and four focus group interviews were conducted with ninth grade students in five geographically distinct regions of Florida. Male students and those from rural areas were more likely to participate in school meal programs than were females and those from suburban and urban areas. Students expressed intense dislike and distrust of school meals. School meals were criticized for taste, appearance, small serving sizes, and cost. Students overwhelmingly favored commercial food vendors serving lunch at school. Suggestions for improving school meals included improving the taste and appearance of food, offering a wider variety of foods, serving more fresh fruit and vegetables, lowering the price, increasing the serving sizes, teaching food service workers how to cook, and offering more condiments.

Politics and the success of school-based health centers.

School-based health centers (SBHCs) provide access to health services by bringing providers to children (and sometimes parents) and furnishing low cost services in an atmosphere of trust. While the number of SBHCs has continued to grow and some clinics have continued to expand their services, others have barely survived and some have even closed. This study investigated factors, particularly political forces, that affected the success of SBHCs. Using a national survey of clinic directors, this study assessed clinic success in terms both of longevity and service delivery. Findings indicate the factors most consistently and significantly associated with success include not only measures of "need" (school size and percent African-American enrollment or population) but of "politics" (citizen political ideology and Southern conservatism). Thus, politics matters more than previous studies suggested.

An assessment of 23 selected school-based sexuality education curricula.

While quality sexuality education curricula are available, those responsible for selecting a curriculum may not feel confident to choose one to meet the needs of their students and community. This paper presents a method to guide in selecting sexuality education curricula as well as results from an evaluation of 23 school-based sexuality education curricula. School administrators, curriculum specialists, health educators, school nurses, teachers, and parents involved in curriculum adoption or development can use the process described to select or develop a sexuality education curriculum to meet the needs of their school and community.

Roles of physicians, genetic counselors, and nurses in the genetic counseling process.

A self-administered questionnaire was mailed to 325 genetic counseling professionals in the southeastern United States and 204 (63%) completed it. Among those responding, 32% held master's degrees in genetic counseling, 30% M.D. degrees, 23% degrees in nursing, and 3% master's degrees in social work. While genetic counseling typically involves team effort, members were generally unclear regarding their roles in the process. Respondents rarely referred their clients to social workers but believe they should. Most did not believe that master's trained genetic counselors should be the only health professional who provide counseling. The respondents strongly supported goals that dealt with the educative aspect of counseling and protection of patient autonomy.

Professional preparation of individuals who provide genetic counseling services.

An unprecedented increase has occurred in demand for genetic counseling services during the current decade. This study examined the complex issue of who currently provides genetic counseling services and the professional preparation of these personnel. A self-administered questionnaire was mailed to 325 genetic counseling professionals in the southeastern United States who were members of the Southeast Regional Genetics Group (SERGG), National Society of Genetic Counselors, or American Society of Human Genetics States; 204 completed the questionnaire (63%). Seventy percent of respondents were female and 30% were male. Thirty percent of respondents held MD degrees; nine physicians held PhD degrees. Most physicians were male. Thirty-two percent of respondents held master's degrees in genetic counseling; five counselors held PhD degrees. Twenty-three percent of respondents were nurses; eight nurses held master's degrees. Three percent of respondents were social workers. Individuals with other degrees, such as an associate of science in medical technology and a doctoral degree in education, also provided genetic counseling. Genetic counseling typically involved a team effort, consisting mainly of physicians and genetic counselors. Most respondents reported college coursework in human genetics, supervised training, and seminar/workshop training. Thirty percent reported college coursework in counseling techniques, supervised training, and seminar/workshop training. Policy recommendations are offered concerning professional preparation of genetic counselors.