P0166 - Sex Ed by Brown Med: Evaluating the Impact of Medical Student-Led Sexual Health Curriculum on Middle Schoolers’ Attitudes, Beliefs, and Knowledge

Background: School-based HIV/STI prevention initiatives can reduce sexual risk behaviors and prevent teen pregnancy among school-age youth. However, only 27 states and D.C. mandate both sex education and HIV education, and access to formal sexual health education continues to decline.

The American Academy of Pediatrics (AAP) emphasizes the importance of age-appropriate sexual health education, and the 2016 Sexuality Education for Children and Adolescents clinical report recommends dissemination through three learning domains: “cognitive (information), affective (feelings, values, and attitudes), and behaviors (communication, decision-making, and other skills)”.

Sex Ed by Brown Med was founded in 2014 in response to a community-defined need for sexual health education at a local, underserved middle school. Medical students provide comprehensive sexual health education to 150+ seventh-grade students each year. Previous program evaluation demonstrated success in the “cognitive” domain with increased student knowledge, but did not address attitudes. In addition to measuring knowledge gained, this study targets the “affective” domain and evaluates the program’s influence on seventh-grade students’ beliefs and attitudes about sexual health.

Methods: A questionnaire was developed to assess middle school students’ attitudes (measured on a 5-point Likert scale) and knowledge surrounding sexual health before and after completion of the 2018-2019 twelve-lesson curriculum. Pre- and post-survey data were matched using unique identification codes and analyzed using IBM SPSS Statistics.

Results: 135 seventh grade students completed pre-assessments; 130 completed post-assessments. Students showed significant improvements in sexual health knowledge on post-assessments compared to pre-assessments in the following content areas: communication & consent (15.4% difference, p<0.001), sexual health decision making & safe sex practices (7.49% difference, p=0.005), puberty & reproductive health (12.4% difference, p<0.001), and accessing community resources (19.5% difference, p<0.001). There was a non-significant increase related to gender identity and sexual orientation (4.7% difference, p=0.179). Overall, students showed a significant increase in total knowledge across sexual health domains (9.2% difference, p<0.001).

On average, students demonstrated significant change towards healthier attitudes related to sexual health following completion of the program in the following domains: communication and consent (11.4 % change, p<0.001); puberty and reproductive health (9.5% change, p<0.001), and accessing community resources (9.0% change, p=0.003). Students showed no significant difference in sexual health attitudes in the domains of sexual health decision making & safe sex practices, healthy relationships, or gender identity & sexual orientation. Overall, students showed significant change across attitude domains (6.9% change, p<0.001).

Conclusions: Seventh grade students showed significant improvements in both sexual health knowledge and healthy, safe, and de-stigmatized attitudes after completing a yearlong sexual health curriculum taught and developed by medical students. Medical students in teaching roles can empower school-age youth in their sexual health through comprehensive, age-appropriate sexual education that addresses the AAP’s cognitive and affective learning domains.