STI Education Efficacy Survey

Abstract

The STI Education Efficacy Survey (SEES) is a specialized psychometric instrument designed to assess the preparedness of educators—specifically those working in school or community educational settings—to deliver effective instruction regarding Sexually Transmitted Infections (STIs) and HIV prevention. The SEES is structured into four distinct subscales: Knowledge of Sexually Transmitted Infections (25 items), Attitudes Toward Adolescent Sexuality and Sexuality Education (10 items), STI Education Confidence (8 items), and STI Education Readiness (5 items). By measuring these four crucial dimensions, the survey helps identify specific areas where educators may require additional training, resources, or support to effectively implement mandated STI/HIV curricula.

Keywords

STI Education Efficacy Survey, SEES, Sexually Transmitted Infections, HIV education, teacher training, adolescent sexuality, education confidence, educational readiness, public health, psychometric scale.

Authors

Patricia Barthalow Koch, Andrew W. Porter, Clinton Colaco

Purpose

The primary purpose of the STI Education Efficacy Survey (SEES) is to empirically measure the requisite components for effective STI/HIV education delivery among professional educators. The development of the SEES was motivated by findings that, despite mandatory STI/HIV education laws in many U.S. states (Guttmacher Institute, 2009), teachers often lack the necessary training, accurate knowledge, appropriate attitudes, and practical skills to teach the subject effectively.

The scale thus serves as a diagnostic tool to ascertain educators’ current levels of competence across four key domains: factual knowledge, positive attitudes toward sexuality education, self-reported confidence in teaching complex topics, and practical readiness to implement curricula. By improving the educational efficacy of educators, the ultimate goal is to enhance student learning outcomes and improve public health outcomes related to STIs prevention.

Construct

The SEES measures the multifaceted construct of Educator Efficacy in STI Instruction, which is operationalized through four distinct but related subscales, reflecting the comprehensive nature of effective teaching. These four constructs collectively ascertain an educator’s capacity and willingness to deliver mandated sexuality education content.

• Knowledge of Sexually Transmitted Infections (25 items): Measures factual accuracy regarding STIs, transmission, symptoms, and prevention methods.
• Attitudes Toward Adolescent Sexuality and Sexuality Education (10 items): Assesses the educator’s beliefs and perspectives regarding adolescent sexual development, the role of comprehensive sexuality education, and issues such as abstinence and contraception.
• STI Education Confidence (8 items): Measures the educator’s self-efficacy concerning their ability to perform tasks related to teaching STIs/HIV, including comfort level, curriculum development skills, and communication with students and colleagues.
• STI Education Readiness (5 items): Assesses the educator’s willingness and ability to engage in broader professional tasks, such as advocating for better services, influencing policy, and serving as a resource person.

Validity

The scale development process incorporated rigorous methods to establish content validity across all subscales. For the Knowledge of Sexually Transmitted Infections scale, content validity was ensured by deriving items from authoritative sources, specifically the Centers for Disease Control and Prevention (2009) and the Kaiser Family Foundation (2006).

Furthermore, a panel of five experienced sexuality educators utilized the Delphi method to achieve consensus on item selection and relevance for all four sections of the survey. The development of the Attitudes Toward Adolescent Sexuality and Sexuality Education scale was theoretically guided by Ajzen and Fishbein’s attitudinal theory (1980), using guidelines provided by the Sexuality Information and Education Council of the United States (2004). Empirical evidence of the scale’s sensitivity was demonstrated through a pre- and posttest evaluation of professional workshops, where participants showed significant improvement in STI knowledge (p < .001), positive attitudes (p < .05), and STI education confidence (p < .001).

Reliability

Reliability coefficients were calculated using data collected from a sample of 120 middle and high school teachers in Pennsylvania. The sample demographics indicated that approximately two-thirds were women, and 75% had more than five years of experience in their current positions.

Internal consistency reliability was strong across the subscales:

• For the Knowledge of Sexually Transmitted Infections scale, the reliability, assessed using the Kuder-Richardson alpha statistic, was calculated at .89.
• For the remaining subscales, using the Cronbach alpha statistical method, the reliabilities were determined as follows: Attitudes Toward Adolescents and Sexuality and Sexuality Education (.75), STI Education Confidence (.92), and STI Education Readiness (.89). These values indicate acceptable to excellent internal consistency for the instrument’s components.

Factor Analysis

The source documentation describes the STI Education Efficacy Survey (SEES) as consisting of four theoretically distinct sections (Knowledge, Attitudes, Confidence, and Readiness). However, specific details regarding confirmatory or exploratory factor analysis used to validate this four-factor structure were not reported in the provided source material.

Instrument

Test Type: Psychometric Survey / Attitude and Knowledge Assessment

Format: Multi-format questionnaire consisting of True/False/Don’t Know items and 5-point Likert scale items.

Language Available: English (as presented in the source content).

Population Group: Educators and professionals working with youth in school or community educational settings.

Age Group: Adults (professional educators).

Population Details: Based on the reliability sample, the scale is validated for middle and high school teachers.

Test Methodology: Self-report questionnaire, typically requiring approximately 20 minutes to complete.

Keywords

STI education, educator confidence, sexuality knowledge, pedagogical readiness, psychometric testing, Cronbach’s alpha, Delphi method, Ajzen and Fishbein, public health education.

Authors

Author ORCID Identifier: Not provided in the source material.

Affiliation Email addresses: Not provided in the source material.

Correspondence Address: The Pennsylvania State University (Affiliation of primary authors).

Permissions & Fee and Test Year

Information regarding specific permissions, licensing fees, and full scale access is not detailed in the source material. The research and development of the scale were documented in 2009 (Koch, 2009), establishing the test year as 2009.

Reference’s

Adler, M., & Ziglio, E. (1996). Gazing into the oracle: The Delphi method and its application to social policy and public health. London: Jessica Kingsley.

Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behaviors. Englewood Cliffs, NJ: Prentice Hall.

Centers for Disease Control and Prevention. (2009). Sexual health. Retrieved June 22, 2009, from http://www.cdc.gov/sexualhealth

Cozzens, J. (2006). Assessing the awareness of adolescent sexual health among teachers-in-training. American Journal of Sexuality Education, 1(3), 25–50.

Guttmacher Institute (2009). Sex and STD/HIV education, state policies in brief. Retrieved June 22, 2009. The original PDF describing state policies can be downloaded here: http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf

James-Traore, T. A., Finger, W., Ruland, C. D., & Savariaud, S. (2004). Teacher training: Essential for school health and HIV/AIDS education. Youthnet Issues, Paper 3. Arlington, VA: Family Health International.

Kaiser Family Foundation. (2006). Sexual health statistics for teenagers and young adults in the United States. Retrieved June 22, 2009. The original PDF can be downloaded here: http://www.kff.org/womenshealth/upload/3040-03.pdf

Koch, P. B. (2009). STI/HIV workshops for K-16 educators: Report to the Pennsylvania Department of Education. University Park: Pennsylvania State University, The Pennsylvania Learning Academy for Sexuality Education.

Rodriguez, M., Young, R., Renfro, S., Ascencio, M., & Haffner, D. (1995– 1996). Teaching our teachers to teach: A SIECUS study on training and preparation for HIV/AIDS prevention and sexuality education. SIECUS Report, 28(2), 15–23.

Sexuality Information and Education Council of the United States. (2004). Guidelines for comprehensive sexuality education. Retrieved June 22, 2009. The original PDF can be downloaded here: http://www.siecus.org/_data/images/guidelines.pdf

Items of the STI Education Efficacy Survey

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The following statements are to assess your understanding of STIs.

If you definitely know that a statement is True, answer 1

If you definitely know that a statement is False, answer 2

If you do not definitely know the answer (Don’t Know), answer 3

1. About one-half of 12th graders have engaged in intercourse and one-half have not.
2. About one in five young people have had intercourse before their 15th birthday.
3. Oral sex is more common among many teenagers than is engaging in vaginal-penile intercourse.
4. About one in 10 sexually active youth have a sexually transmitted infection (STI).
5. Half of the people in the U.S. will acquire at least one STI by age 35.
6. Human papilloma virus (HPV) is the most common bacterial STI in the U.S.
7. The majority of females with chlamydia do not have any detectable symptoms.
8. Vaginal infections, like trichomoniasis, can not be transmitted to males.
9. People know when they get syphilis because a very painful sore, or chancre, appears.
10. Females are more likely to have symptoms of gonorrhea than are males.
11. All bacterial STIs can be cured with penicillin.
12. HPV accounts for about 90% of cervical cancer risk.
13. HPV can still be spread even when there are no warts present.
14. The most effective method to cure genital warts is through surgical removal.
15. Herpes is only infectious when there are open lesions present.
16. Herpes Simplex I (oral herpes/cold sores) can not be transmitted to the genital area.
17. Hepatitis B is more infectious than HIV.
18. HIV can not be transmitted through oral sex.
19. A person can be HIV-infected but still test negative.
20. Heterosexual females and males are at little risk for AIDS.
21. The most common cause of infertility among U.S. females is chlamydial infection.
22. Currently there are no vaccines to prevent becoming infected with any type of STI caused by a virus.
23. Natural membrane condoms are more effective in preventing STIs than latex condoms.
24. Oil-based products, such as Vaseline, are good to use for added lubrication with condoms so that they don’t break.
25. Because of an emphasis on abstinence-only education, the U.S. has lower rates of STIs than western European countries.

Adolescents and Sexuality/Sex Education

Please indicate your reactions to the following statements on your response sheet:

1. Strongly Disagree
2. Disagree
3. Uncertain
4. Agree
5. Strongly Agree

1. Sexual expression is a natural part of development for adolescents.
2. Most high school students are not mature enough to act sexually responsible even when they know the facts.
3. Young people need to remain sexually abstinent until marriage.
4. Young people should not think of sexuality as taboo, shameful, or dirty.
5. Most teenagers do not want sexuality education from their parents or in school.
6. Having information about contraceptives, including condoms, only encourages young people to be promiscuous.
7. Young people need as much information as possible in order to make responsible decisions.
8. Abstinence-only education is more effective in preventing STIs than education that discusses safer sex as well.
9. Young people who receive more comprehensive sexuality education are less likely to engage in intercourse at younger ages and are
10. more likely to use contraception when they do have intercourse.
11. Most parents in the U.S. do not support the teaching of sexuality education in the schools.

STI Education Efficacy‌

In teaching about STIs/HIV, please indicate how you feel about the following using this scale:

1. No Confidence at all
2. Very Little Confidence
3. Somewhat Confident
4. Very Confident
5. Extremely Confident

1. The currency and accuracy of my knowledge.
2. The comprehensiveness of my knowledge.
3. My comfort level in talking about these topics with young people.
4. My comfort level in talking about these topics with my colleagues and supervisors.‌
5. My ability to develop lessons and learning activities to effectively teach about these topics.
6. My skill in developing open communication with young people about these topics.
7. My ability to develop curriculum or programs on these topics.
8. My understanding of the experiences of today’s young people that impact their sexuality and STI risk.

When it comes to STI education, how would you describe your readiness (including your willingness and ability) to:

1. Not Ready at all
2. Hardly Ready
3. Somewhat Ready
4. Very Ready
5. Extremely Ready

1. Advocate for better education and services for teens.
2. Share my knowledge and skills with my colleagues.
3. Serve as a resource person for people who need help with these topics.
4. Influence curriculum/program development in my school or agency related to these topics.
5. Influence policy either in my school, agency, or community related to these topics.