The Problematic Promotion of Abstinence:

An Overview of Sex Respect

Patricia Goodson, Elizabeth Edmundson

ABSTRACT:A content evaluation of the abstinence-based sexuality education curriculum Sex Respect was conducted.
Jocusing on the curriculum 5. message and presentation. Thefour primary goals for a human sexuality education curriculum
according to the SIECUS guidelines, as well as a methodologyfor designing. using and evaluating health education material.$
developed by the Pan American Health Organization provided thefmmavork for the evaluation. Results indicate Sex Respect
omits basic content and includes misinformation, especially in the areas of reproductive health and human sexual response.
Authors conclude that Sex Respect fails to meet professional standardsfor a comprehensive sexuality education curriculum.
andneehfurther evaluation andmision. Scifc Kopicsforfirture assessments are discussd. ( J Sch Health 1994;64(5):205-210)

D uring the past two decades, the United States has

witnessed a proliferation of sexuality education cur-
ricula that emphasize the teaching of abstinence. Reasons
for this phenomenon are tied to political and socioeco-
nomic forces: the reemergence of religious and political
conservatism, the abortion controversy,and the AIDS and
teen-age pregnancy crises.
The abstinence-based approach to sexuality education
results from a dynamic history of sexuality education in
this country. Kirby? in an historical analysis, divided the
sexuality education curricula into five main groups or
generations. The first group focused primarily on in-
creasing knowledge and emphasizing the risk and conse-
quences of pregnancy and paralleled the first smoking
and substance abuse curricula.2 The second generation
evolved from the first and included both knowledge and
value clarification (and skills), with greater emphasis on
the latter. The third generation was developed in reaction
or opposition to existing sexuality education programs
motivated by concern with the value-free character of
previous sexuality education efforts2These third-genera-
tion curricula systematicallyemphasizedthe message that
teen-agers should postpone sexual activity until marriage.
They also avoided discussing contraception, afraid of the
possibility they would be sending teens a double-mes-
sage by doing SO.^ The fourth generation centered on
HIV/AIDS prevention and targeted changing adolescent
sexual behavior (many of these curricula were developed
independently of the three previous groups).2 The fifth
generation is emerging, and its programs are based on
theoretical approaches with demonstrated effectiveness
in other health areas, successes and failures of previous
programs, and more rigorous evaluations.2
The issue of evaluation is crucial. For curricula of the
third generation (abstinence-based),evaluationshave been
scarce and, in general, poorly implemented, which appears
to be the case with many health education programs. With
few exceptions, results of demonstration abstinence-only
pregnancy prevention programs have not appeared in the
scientific literature nor been made public. The underly-
ing reason for this lack of results is the myriad of prob-
Patricia Goodson. MPh. MA, Doctoral Student; and Elizabeth
Edmundson, PhD, Assistant Professor. Dept. OfKinesiology and Health
Education. University of Texas at Austin, Belmont Hall 222, Austin, TX
78712. This article was submitted November 23, 1993, and revised and
accepted.fbr publication April 7, 1994.
lems encountered in the evaluations themselves5 There-
fore, the effectiveness of this type of curricula has not
been demonstrated, especially where behavior changes are
concerned. Overall, the few published evaluations that
do exist indicated the programs affected a variety of atti-
tudes about premarital intercourse, but only a few pub-
lished studies examined the effect of abstinence programs
on behavior. Those studies that examined behavior indi-
cate that abstinence-only programs do not delay or re-
duce frequency of intercourse.2
Precisely because the effect of abstinence-based sexu-
ality education curricula has been poorly documented, it
is imperativethat professionalsresponsible for implement-
ing sexuality education become familiar with the content
or the message of this type of curricula. Only then can
adequate and informed choices of teaching materials be
made that will benefit students, parents, and school
boards. This paper contributes to the infokned decision-
making process by presenting a content evaluation ofSex
Respects written materials and suggestions for future
evaluation of the curriculum.
Why focus on Sex Respect? Widespread use of the
curriculum,6 combined with the fact that it has received
finding from the US Office of Adolescent Pregnancy
Programs for field testing and promotion, make this one
of the highest profiled abstinence-based curricula in the
United States today.
CONTENT EVALUATION METHODS
According to Green and Lewis: the goal of forma-
tive evaluation in health education or health promotion is
the control and assurance of quality in practice. A for-
mative evaluation framework that targeted several dimen-
sions of professional quality guided this review of the
contents of Sex Respect. The scope of the review per-
tained to the educational and scientific integrity of the
objectives, content, and activities of the curriculum.Three
dimensions of primary concern were accuracy of infor-
mation, comprehensiveness of the curriculum, and the
degree to which the needs and interests of the target audi-
ence were addressed, including avoidance of gender,
ethnic, and racial bias in the content and activities.
Two professionally recognized guidelines were selected
to assess the professional integrity of Sex Respect. For
content evaluation, the Guidelines for Comprehensive

Journal of School Health May 1994, Vol. 64. No. 5 205

SexuufiaJ,Education. developed by the Sex Information substituted by a set of prescribed concepts, and the do-
and Education Council of the U.S. (SIECUS),9 were ap- mains of relationship, interpersonal skills, and responsi-
plied as standard measure. These guidelines were devel- bility have as their main focus describing various ways
oped in 1990 by a task force comprised of professionals
from various disciplines, with the main purpose of pro-
Figure 1
viding a framework for developing curricula, textbooks, Comparison of SIECUS and Sex Respects Goals/Outcomes
and programs as well as for evaluating existing programs Fw Sexuality Education
in human sexuality education.They are based on four
primary goals for sexuality education: Information; Atti- SIECUS
tudes, Values, and Insights; Relationships and Interper- Few Rimy Goib
sonal Skills; and Re~ponsibility.~ 1. lnforrnrtion
To evaluate Sex Respects presentation of written ma- Growth and Development Not among outcomes
terials, the methodology for designing, using, and evalu- Human Reproduction Compare and contrast human pro-
ating health education materials developed by the Pan creation and animl repr~7Iuclion.
American Health Organization (PAHO) was applied. Anatomy Not among oulcomes
There are two small drawings at the
This methodology, used in many different countries, has end of SW . p. 106 - that show only
successfully assisted in detecting poorly designed, inad- reproductlve organs. The vulva is
neither shown nor mention&. The
equately distributed, and ineffective health education lablas and the clitoris are neither
materials. The PAHO guide consists of two sets of crite- mentioned nor illustrated anywhere.
ria: general and specific. General criteria refer to all types Physiology Not among outcomes
of educational materials, and the specific criteria refer to Masturbation Not among OutcomeS
qualities of a particular type of material, such as visual, Family Life Explore some of fhe responsibilities of
audio, audiovisual, or printed. parenthwd.
The general criteria for evaluation included 13 ques- Pregnancy Compare and contrast human pro-
creatMn and animal reproduction.
tions answered yes or no. According to the PAHO, Childbirth Not among outcomes
materials should fulfill at least eight criteria before being Parenthwd Exprore s m of the responsibilities of
accepted for use. For Sex Respect, the procedures pre- parenthood.
sented extended responses to the general criteria ques- Sexual response Not amng outcomes
tions since many of the yes or no answers require Sexual orientation Not among oulcomes
qualification. The specific criteria have a different rating Contraception Not amng outcomes
system employing a five-point scale: five indicating the Abortion Not among outcomes
criterion was completely satisfied and one meaning the Sexual abuse Not among OutUHnes
criterion was completely unsatisfied. At the end of the HIWAIDS and other STDs Explain the physical, emotional, and
instrument, a range is provided that helps the evaluator psychological risks associated with
premadtal sexual aclivily
decide, based on the total score, if the material should be
used as it is, revised, or discarded. 2. Attthidas, wlws and inrl!jmt
Opportunity to question, explore. Recognize fhat sexual frsedom IS not
and assess sexual attitudes to Nw, sam as sexual impulsiveness.
develop own values and increase Define Human Sexualily.
CONTENT EVA1U AT I0N RESU LTS self-esteem.
The Sex Respect package contains three manuals: Develop insights concerning ExainM fhe physical, emotional, and
teacher manual, parent guide, and student workbo~k.l*-~~ relationshipswith members of both psychdagicalbenefits to a teen /iiesfy/e
genders. free im genitally arousing activi/y.
Content is divided into 1 1 lessons corresponding to 11
Understand obligations and List s m of the responsiMli?ies
chapters in each manual and may be administered in dif- responsibilities to others. involved in datlng.
ferent classes or in a three-week unit, with daily meet-
ings. 3. RtWMaMp and InbrpmomlrMllr
The teacher manual as well as the parent guide present Communication Describe various ways for teens to say
-noH)to sex.
one long-range goal, one overall objective, and 11 ex- Decision-making ldenfify various influences on sexual
pected outcomes for the program. The long-range goal is decision-making.
defined as, To enable each individual to progressively Assertiveness Describe various ways for teens to say
develop responsible behavior, positive self-esteem, and no to sex.
respect for others as he/she makes decisions involving Peer-refusal skills Describe various ways for teens to say
no to sex.
the use of hisher sexual freedom. The overall objective
Create satisfying relationships Not among outcomes
reads, Realize that true sexual freedom includes the free-
dom to say no to sex outside of marriage.* 4. Rmp#uIbUHy
Figure 1 presents Sex Respects expected outcomes Responsibility regarding sexual Explain why adoption is a Wlfhy
contrasted with the SZECUS Guidelines. On comparison, relationships alfernatiw to abortion.
substantial gaps and significant reductionism when deal- Abstinence [overall objective] Realize that true
sexual freedom inc/u&s t/m freedwn to
ing with specific topics are observed in the curriculum say no to sex outside marriage.
goals. Basic information on growth and development, How to resist pressure to become 5sscribe various ways for &ens to
anatomy, physiology, masturbation, childbirth, sexual re- prematurely involved in sexual say no M sex.
intercouw.
sponse, sexual orientation, contraception, abortion, and
Encourage use of contraception and Not among outcomes
sexual abuse are not among Sex Respects objectives. other sexual health measures.
Exploration of personal attitudes, values, and insights is

206 Journal of School Health May 1994, Vol. 64, No. 5


Figure 2
Sex Respects Ratings According ta
SpscMc Criteria for Evaluating Rfnlsd Materials
p a n American Health Organization Methodology)
mw
nw:14
l-chl,
z2d
S-CMl
Crihrk Comnnmts
1, Material presents one Curriculum encompasses a
specific theme, variety of related themes.
Each individual chapter is
focused on specific topics.
2. Content or message easily Questionableat Junior High
understood. Level,
Questionable for PG. when
parents with lower levels of
schooling or parents for
whom English is not a first
language are considered.
3. illustrations clarify or Several useless illustrations.
complement the written parts. For instance, the pairs of
feetlshoes on the bottom
right corner of each right-
hand page. Apple cartoon
character in TM portrayed in
actions that are only indirectly
related to the topic of the
page. These appear more
appropriate for SW than TM.
Sex Respect is usually refer-
red to as a program that uses
cartoons. It remains unclear
what definition of cartoon is
being used to qualify the
curriculum.
4. Size of letters easy to read. No special edition for
students with visual impair-
ment.
5. Printed material provides TM: outiine for the entire
synopsis of message or Manual.
content. Each chapter lists contents
before initiating discussion.
SW: aside from a table of
contents. has no synopsis in
individual chapters.
PG: detailed table of contents.
in each chapter the corres-
ponding pages of the SW are
presented in reduced format.
6. Aspects that emphasize
Text (3 manuals): black &
important ideas, such as whlte.
type, size. style, or color of Use of several font sizes and
certain parts. styles, along with boxed text,
photographs and drawings
highlight important ideas and
give variety to text.
7. Writing style. grammar, Certain sagments of text
and punctuation appropriate appear to be at a reading level
for the audience. not suitable for junior high
school students: complex
vocabulary and sentence
structure.
8. Avoids information OVBI- Most pages are cluttered with
load or too much writing in text and drawings. SMOG
one place. readability index: 11th grade
9. Uses language easily Cf. Item number 7, above
understood by target
audience.
Total Points: 24
Decision:
Use as is (40-50 points)
fl Needs Revision (21-39 points)
Reject (less than 20 points)
~
for teens to say no to sex (Figure 1).
The questions and respective ratings for the PAHOs
specific criteria are presented in Figure 2. An overall evalu-
ation of Sex Respect ratings suggests that its printed
materials need revision, since the issues related to easy
understanding of language style, grammar, and punctua-
tion, as well as overloading of information and usehl-
new of illustrations appear problematic (Figure 2).
Results for the 13 basic questions pertaining to the
PAHO guides general criteria are presented.
1. Did the target audience participate in the se-
lection, development, or evaluation of the material?
This information is not indicated in the manuals. The
only mention of target audiences needs is on page seven
of the teacher manual, but how such needs were deter-
mined is not known:
Students today want and need alternatives to sexual
activity whichpmvide for greater relational growth
and contribute to sexual maturity of the mind and
emotions. They need to know how to integrate their
sexuality in harmony with the powers of the whole
person. [emphasis added]lz
2. Are everyday situations represented?
Yes. However, everyday people are not; except for
one photograph on page 8 1 of the student workbook, all
photos are of Anglo-American teens (usually fair-skinned
and blond-haired). The single exception is a photograph
that portrays an African-American couple, apparently
ready for prom (not exactly an everyday situation). How-
ever, some drawings depict African-American teens. For
instance, a drawing in the student workbook depicts what
appears to be three generations of African-American men
embracing. No other ethnic groups nor persons with physi-
cal disabilities are portrayed.
3. Do the materials pertain to an educational
program?
Yes. Although they can be taught outside of a formal/
structured educational program, in youth clubs, camps,
homes for unwed mothers as well as in private homes for
youth groups or individuals,I2they are:
adaptable tojunior high or senior high school cur-
ricula in personal health classes, sex education.fum-
ily life education, ethics and values clarification,
environmental health, anatomy, biology,sociology,
community health, social concerns or growth and
development.l2
4. Are the services or resources being promoted
available?
Sex Respect does not promote the use of any services,
but it does list three adoption and crisis pregnancy cen-
ters in the teacher manual and the parent guide, with
toll-free numbers (Bethany Services, Birthright Inter-
national, and Pearson Foundation). However, these
resources are not listed in the student workbook.
5. Are other materials or techniques available to
reinforce the messages?
Yes. Several resources and strategies are employed and
presented in Figure 3.
6. Have the materials been tested before being
finalized?
No evidence (published or otherwise) indicates these
materials were pretested for content validity or for read-
Journal of School Health May 1994, Vol. 64, No. 5 207
ability. The SMOG grading formula for testing the read-
ability of educational materials4was applied to a sample
of 30 sentences taken from the student workbook (pages
5 , 5 2 , and 98) and indicated an 1 1th grade reading level.
This is troublesome if the materials are to be used with
junior high school students.
7. Are instructions available on how to use the
materials?
Yes. The teacher manual has, under the title of
Methods, a summarized description of what activities
should be carried out in each lesson and chapter. Specific
instructions also are given about what should not be done
in the classroom, For instance, on page 17 of the teacher
manual, it reads,
Do not have students read the ALBRIGHT/SPEC-
TER INTERVIEW aloud in class. The sensitive na-
ture of the subject matter, as well as the vocabulary,
may cause embarrassment, laughter, or desensiti-
zation.
However, instructions under Methods are confusing.
Since no timeframe is given for each lesson, readers must
guess how much should be allocated to each activity, and
Figure 3
Materlals and Techniques Avallable
to Reinforce Sex Respects Message
Staff training Certified Sex Respect teacher trainers pro-
vide a day-long seminar In the schools. All
staff, parents, minislers, and local school
board members are allowed to participate
(TM-8).
Individual study A student workbook is designed to help
students apply the content materials to
their own lives. Because of the personal
nature of the material presented, It is
considered very important that students
have their own text to work on, when no
one else is around to watch, to tease, or
to be impressed (TM-8). This is not
mentioned, however, in the SW.
Parent program Parental permission or notification.
An lnformatlon/discusslon session
before the classroom program begins.
Parent guidebook - designed to accom-
pany the student workbook with back-
ground Information and helpful hints for
communication of each chapters
concepts (TM-8).
Specific assignments for teens and
parents to do together (in PG).
Community involvement For participation and reinforcement of
abstinence-only messages, through public
service radio announcements to teen
recreation clubs, medical auxiliaries, local
hospitals. and service clubs (TM-8-9).
Videotapes Not listed on the bibliography of teaching
materials (TM-91) Is The Chasfity
Challenge, a videotape available from
Respect Incorporated, designed for use by
iocal churches that wish to supplement the
religious values In Sex Respect (TM-9).
Listed on TM-91: Second Thoughts, Who
Do You listen To? Sex in the Age of AIDS.
Sex Respecr Promo Video.
leaching materiais 16 pamphlets, three filmstrips, and
several books are listed on TM-90.
Posters, stickers, 1-shirts. Set of Four Posters (with slogans)
buttons Tee Shirt: Stop At The Lips
Tee Shirt: Pet Your Dog
Button: Im Worth Waiting For
Button: Pet Your Dog
Sticker: Im Worth Waiting For
208 Journal of School Health 9 May 1994, Vol. 64, No. 5
what is the appropriate sequencing of activities. Appar-
ently, Methods are listed as possible alternatives from
which the teacher can choose, and this may mean that
effective use of the curriculum may only be achieved with
prior training.
8. Has the target audience been determined ac-
cording to educational level and cultural, geographic,
and socioeconomic characteristics?
Explicitly, the audience has been determined only by
educational level: junior and senior high school students.
However, several assumptions exist about the target au-
dience. Sex Respect contains several suggestions of ac-
tivities only accessible to people who are fairly well-off
economically. For instance, Lesson 8 in the student work-
book contains a list of activities for dating, under the title
What can you do on a date that is fun? Among the ac-
tivities suggested are bicycling, sledding, skating, having
gourmet dinner parties, seeing a good play or concert,
renting a video camera and staging your own game show,
and playing charades, Monopoly, Trivial Pursuit, and
Pictionary.As mentioned previously (question two), the
contents also omit many racial and ethnic groups, focus-
ing mostly on Anglo-American teens.
9.Has care been taken to ensure that fhe material
does not offend community traditions?
Here, once more, the problem of defining the commu-
nity this curriculum intends to address is encountered.
Since only educational level of the target audience is
mentioned explicitly, one may infer that the curriculum
applies to any community. However, closer analysis
reveals that minorities are absent from the contents and
illustrations, and that diversity of ethnicity,socioeconomic
status, and lifestyles is not represented. Again, the
question of what community and what traditions are or
are not being offended depends on these a priori defini-
tions, which are not present in Sex Respect (see also ques-
tion 11).
10. Did health personnel actively participate in
the design!
Credentials of the Sex Respect author, Coleen Kelly
Mast, are presented on the back cover of the three manu-
als. The text indicates she received her masters of sci-
ence degree in health education from Western Illinois
University. Other than that, no other mention of health
personnel is indicated.
11. Do the materials respect free choice instead
of manipulation of the target audience?
No. Manipulation of the target audience is a key ele-
ment of the curriculum. If the principle of free choice
involves knowledge of all available options, Sex Respect
does not respect free choice. The curriculum omits dis-
cussion of contraceptive methods, abortion, and keeping
a child in the case of unplanned and unwanted pregnancy.
The question Why not teach birth control? is posed
in the introduction to the teacher manual and parent guide.
Answers presented involve several elements, which are
summarized in Figure 4. Most information given in the
rationale is unsubstantiated.
The other issue in which Sex Respect apparently vio-
lates the principle of free choice refers to unplanned and
unwanted teen pregnancies. Chapter 10 of the student
workbook discusses motherhood and parenthood, stress-
ing the point that a child deserves the best: mature
parents. Therefore, if a female teen-ager finds herself
pregnant but recognizes that she doesnt yet have the
emotional, psychological, spiritual, or financial resources
to be a good parent, then adoption is presented as an
equally mature choice.13None of the manuals mention
keeping the baby and having it reared by the mother and
her extended family as also a mature choice and possi-
bility. In this instance, one could argue that Sex Respect
poses complete disregard for the most common pattern
among African-American and Hispanic teen-agers, who
tend to keep and rear their babies while living with their
family member^.^^.^^
12. Do the materials relate to a specific educa-
tional objective?
Yes and no. They relate only to the expected out-
comes, presented in the teacher manual and parent guide.
However, they do not relate to the Long Range Goal
of the program:
To enable each individual to progressively develop
responsible behavior, positive self esteem, and re-
spect for others as he/she makes decisions involv-
ing the use of hidher sexual freedom.I2
Since the curriculum does not deal with the topics of
contraception, gender inequity, sexual identity, and all
available options for pregnancy outcomes, how can the
materials be related to a progressive development of re-
sponsible behavior and with making decisions involving
sexual freedom?
13. Are the actions being promoted feasible and
appropriate?
Abstinence is certainly the most appropriate behavior
for teens who wish to avoid sexual risk-taking behavior.
However, as a strategy, it may not be very effective. If
human sexuality educators are going to teach methods,
strategies, or techniques for prevention, it is their moral
responsibility to advise pupils about the failure rates of
such techniques. The measure of risk when assessing
abstinence must include the proportion of people who
fail in the pursuit of abstinence.
Therefore, consideringabstinence is not fail-proof, and
considering many students exposed to Sex Respect
already are sexually active: questions regarding appro-
priateness of teaching solely abstinence are raised. And it
is not merely the teaching of abstinence-onlythat is prob-
lematic; the concept of secondary virginity also merits
attention. If teen-agers are led to firmly believe they are
still virgins (basing their definition on the concept of
secondary virginity), this belief may lead to denial of
previous sexual relationships. Such denial (even if invol-
untary: they forget) may have significant implications
for the sexual health of teens and their partners. If, for
instance,previous sexual interactions resulted in contrac-
tion of a sexually transmitted disease, no precautions are
taken to avoid further transmission to the teen-agers
spouse or future partners because of denial. In addition,
the term secondary virginity may lend itself to
reinforcement of the second-class status of students who
already have had sexual intercourse.
SUGGESTIONS FOR FURTHER EVALUATION
Given the findings of this evaluation, including that
the program did not meet at least eight of the PAHOs
Figure 4
Reasons for Not Teaching Contraception
According to Sex Respect (Summary)
1. Teaching contraception leads teens to believe that birth control is a
legitimate option for them.
2. Teens are still reasoning at a concrete level.
3. To avoid giving teens a double message.
4. Birth control education has not reduced teen pregnancy or abortion
rates.
5. Single women younger than age 18 who use birth control pills have 11K
failure rate.
6. Teenagers who use the pill with a high rate of compliance reported an
18% pregnancy rate within the first year of use.
7. Teaching contraception leads to increased promiscuity among teens.
8. Teens exposed to birth control education have higher sexual activity
rates than teens who were not exposed.
9. Birth control education does not address all the factors associated with
teen pregnancy (illiteracy, lack 01 educational motivation, insecurity,
loneliness, etc.).
10. Many taxpayers oppose birth control Instruction in the public schools as
an infringement of their religious beliefs.
11. Most birth control methods offer little or no protection from sexually
transmitted disease.
12. Teen sexual activity, wen with birth control. can prolong an unhealthy
infatuation that should have ended sooner.
evaluation criteria, Sex Respect fails to measure up to the
standardsof a comprehensivesexuality education curricu-
lum. It merits thorough evaluation before decisions are
made by teachers, parents, school boards, and districts to
adopt the curriculum for teaching human sexuality. Sub-
sequent evaluations and revisions of its contents and mes-
sages, therefore, should target:
0 all factual information presented, checking for ac-
curacy and substantiation in scientific literature;
relationships between basic concepts. How are re-
spect and abstinence actually related, and how are they
promoted? In a positive manner, or through fear-based
messages?;
precision of definitions and clarity of concepts. For
instance, on page two of the student workbook, Matu-
rity is the main topic of the text, but the term is never
clearly defined. Another example could be the chart on
the Progression of Sexual Feeling which contains ba-
sic misconceptions about human sexual response. Being
together, hand holding and simple good night kiss are
placed at one end of the progression, directly associated
with no genital feeling arousedL3ignoring the fact that
arousal may occur in any and all of those circumstances;
and
0 gender inequitypromotion. When reviewing one stu-
dent activity on page nine of the student workbook, women
are depicted sexually in a very negative manner. The ac-
tivity asks students to list differences between the gen-
ders found in the antecedent text. According to the data
in that text, students would eventually come up with the
list of differences described in Figure 5.
CONCLUSION
The alarming incidence of sex-related health problems
among American teens have educators in general, and
health educators in particular, searching for effective pre-
vention programs aiming at behavioral changes. Such
desire and urgent need to find or create programs and
Journal of School Health May 1994, Vol. 64, No. 5 209
curricula that work have generated a myriad of different sible diseases, including AIDS,*other reviews of absti-
approaches, philosophies, and educational strategies nence-based curricula have shown that most of them
throughout the past two decades. However, this haste also typically omit critical information, contain medical
may have produced generations of programs and materi- misinformation, include sexist and anti-choice bias and
als that have not benefited from a carefil and thorough often have a foundation in fundamentalist religious
evaluation: neither evaluation of content and message nor, beliefs that render them as problematic for use in the
ultimately, of the cognitive and behavioral effect. public school ~etting.~.~
Green and Lewis8 recommended a broader view of This does not mean that Sex Respect does not contain
formative evaluation for any health education program, positive elements; the emphasis on respect may be its
encompassinga critical review of the scope and sequence major strength. However, the curriculum has not been ad-
of the program as well as strategies for implementation. equately or sufficiently evaluated to demonstrate if the
More specifically, they suggest procedures such as pre- positive aspects outweigh negative ones and to what ex-
testing, pilot studies, and conducting focus groups prior tent. Thus, Sex Respect needs adequate evaluation, revi-
to implementation to ensure content validity, cultural sen- sion, and validation prior to hrther widespread adoption,
sitivity, and preliminary evidence of efficacy, They also not because of the program itself, but because of the stu-
suggest obtaining immediate response of people directly dents exposed to this program. Their lives, wellness, and
or indirectly involved with and affected by implementa- growth are worth the investment and efforts. m
tion of the program.8Information obtained from this type
of evaluation provides important evidence of professional References
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3. Kirby D. Sexuality education: It can reduce unprotected inter-
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Health Promotion and Education Programs. Palo Alto, Calif: May field
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210 Journal of School Health May 1994, Vol. 64, No. 5