The Experiences and Needs of School Health Teachers in Delivering Sexual Health Education in Schools: A Phenomenological Study
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Abstract
This phenomenological research aimed to study the experiences and needs of health teachers in teaching sexual health in schools. The informants were selected through purposive sampling, consisting of 20 health teachers in Health Region 2. The research instrument was a semi-structured interview guide that underwent content validity testing by 3 experts and was piloted with 2 health teachers who had similar characteristics to the target group. Data were collected through in-depth interviews and analyzed using interpretative phenomenological analysis. The findings revealed four challenges: (1) lack of confidence and discomfort in teaching; (2) cultural and social norm constraints; (3) limitations in knowledge and teaching skills; and (4) limited resources and support. Teachers employed five teaching strategies: adapting language and communication methods, using media and technology, organizing active learning activities, separating learning groups by gender, and integrating local values and culture. Teachers' support needs included four aspects: developing knowledge and teaching skills, educational media and innovations, policy and environmental support, and networking and knowledge sharing. Key recommendations include developing context-specific teacher training curricula, creating appropriate and modern teaching materials, establishing clear policies, and building support networks for sexuality education teachers. These findings lead to recommendations for developing health teachers' capacity in effective sexual health education.
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References
Goldfarb ES, Lieberman LD. Three decades of research: the case for comprehensive sex education. J Adolesc Health 2021;68(1):13-27.
Shibuya F, Estrada CA, Sari DP, Takeuchi R, Sasaki H, Warnaini C, et al. Teachers’ conflicts in implementing comprehensive sexuality education: a qualitative systematic review and meta-synthesis. Trop Med Health 2023;51:18.
Kim EJ, Park B, Kim SK, Park MJ, Lee JY, Jo AR, et al. A meta-analysis of the effects of comprehensive sexuality education programs on children and adolescents. Healthcare (Basel) 2023;11(18):2511.
Barriuso-Ortega S, Fernández-Hawrylak M, Heras-Sevilla D. Sex education in adolescence: a systematic review of programmes and meta-analysis. Child Youth Serv Rev 2024;166:107926.
Belcher K, Fishman E, Ramirez-Mercado K, Marshall B, DiPaolo M, Jarpe-Ratner E. Facilitators and barriers to implementing a comprehensive sexual health education policy in Chicago public schools. J Sch Health 2024;94(9):838-47.
Szucs LE, Andrzejewski JD, Robin L, Telljohann S, Barnes SP, Hunt P. The health education teacher instructional competency framework: a conceptual guide for quality instruction in school health. J Sch Health 2021;91(10):774-87.
Chavula MP, Zulu JM, Hurtig AK. Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review. Reprod Health 2022;19(1):196.
Chen M, Zimmer C, Huang S, Tian R, Yang B, Li M. The effectiveness of an online sexuality education module in promoting sexual knowledge and attitude change: a cluster randomized controlled trial. Health Educ Res 2023;38(2):119-38.
Smith JA, Flowers P, Larkin M. Interpretative phenomenological analysis: theory, method and research. 2nd ed. London: SAGE; 2022.
UNESCO. The journey towards CSE captured in UNESCO’s new Global Status Report. [Internet]. Paris: UNESCO; 2024. [cited 2025 Jul 11]. Available from: https://www.unesco.org/en/articles/journey-towards-cse-captured-unescos-new-global-status-report.
Bureau of Reproductive Health, Department of Health. Report on the surveillance of adolescent pregnancy in Thailand 2021. [Internet]. Nonthaburi: Ministry of Public Health; 2022. [cited 2025 Jul 11]. Available from: https://www.lampanghealth.go.th/Lampanghealth/news/data/1700206950-1.pdf (in Thai).
Sexually Transmitted Infections Division, Bureau of AIDS, TB and STIs, Department of Disease Control. Operational plan for prevention and control of sexually transmitted infections 2023–2030. [Internet]. Nonthaburi: Ministry of Public Health; 2023. [cited 2025 Jul 11]. Available from: https://ddc.moph.go.th/uploads/publish/1647320241206082450.pdf. (in Thai).
Coyle K, Anderson P, Laris B, Barrett M, Unti T, Baumler E. A group randomized trial evaluating high school FLASH, a comprehensive sexual health curriculum. J Adolesc Health 2021;68(4):686-95.
Department of Disease Control. Annual report 2024. [Internet]. Nonthaburi: Ministry of Public Health; 2025. [cited 2025 Jul 11]. Available from: https://ddc.moph.go.th/uploads/files/AuthenticReport_DDC2567.pdf. (in Thai).
Scull TM, Dodson CV, Geller JG, Reeder LC, Stump KN. A media literacy education approach to high school sexual health education: immediate effects of Media Aware on adolescents’ media, sexual health, and communication outcomes. J Youth Adolesc 2022;51(4):708-23.
United Nations Educational, Scientific and Cultural Organization (UNESCO). Comprehensive sexuality education: for healthy, informed and empowered lives. [Internet]. Paris: UNESCO; 2024 [cited 2025 Jul 11]. Available from: https://www.unesco.org/en/health-education/cse.
UNICEF Thailand. Thailand multiple indicator cluster survey 2022: survey findings report. [Internet]. Bangkok: UNICEF; 2023. [cited 2025 Jul 11]. Available from: https://www.unicef.org/thailand/reports/thailand-multiple-indicator-cluster-survey-2022
Hegdahl HK, Musonda P, Svanemyr J, Zulu JM, Grønvik T, Jacobs C, et al. Effects of economic support, comprehensive sexuality education and community dialogue on sexual behaviour: findings from a cluster-RCT among adolescent girls in rural Zambia. Soc Sci Med 2022;306:115125.
Office of Health Promotion Region 2. Annual report 2022. [Internet]. Phitsanulok: Ministry of Public Health; 2022. [cited 2025 Jul 11]. Available from: https://www.hosphi.moph.go.th/ops2/index.php/documents/finish/38-1.../537-annual-report-2565-docx. (in Thai).