Factors facilitating implementation of school-based sexuality education in Portugal

Rocha, Ana Cristina; Duarte, Cidália

doi:10.3109/13625187.2015.1057809

Cited by 8 publications

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“…By collaborating and referring out to other organizations, LEA were able to share responsibility and also ensure provision of culturallycompetent services. Therefore, inviting community agencies and organizations with similar visions of improving student health and academic outcomes to partner with local school districts is another promising approach for strengthening school-based referral systems [27].…”

Section: Discussionmentioning

confidence: 99%

What will it take? Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services

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Senter

et al. 2020

BMC Health Serv Res

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Background: Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school-and community-based SHS. From 2013 to 2018, the Centers for Disease Control and Prevention's Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. Methods: Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n = 9) and Western U.S. (n = 10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. Results: Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students' educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies.

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Section: Discussionmentioning

confidence: 99%

What will it take? Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services

Leung

Wanner

Senter

et al. 2020

BMC Health Serv Res

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“…Therefore, inviting community agencies and organizations with similar visions of improving student health and academic outcomes to partner with local school districts is another promising approach for strengthening school-based referral systems. 27 Other influencing factors with the outer context domain included statewide policies, which were shown to heavily impact referral system implementation in both settings. Not only did prohibitive policies emerge as a significant barrier, we also found that having supportive statewide policies alone are not always sufficient.…”

Section: Discussionmentioning

confidence: 99%

What will it take? Using an Implementation Research Framework to Identify Facilitators and Barriers in Implementing a School-Based Referral System for Sexual Health Services

Leung

Wanner

Senter

et al. 2020

Preprint

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Background Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school- and community-based SHS. From 2013-2018, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. Methods Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n=9) and Western U.S. (n=10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. Results Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students’ educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies. Conclusions Through the use of the CFIR framework, the interviews identified important contextual factors and themes associated with LEAs’ implementation barriers and facilitators. The study’s results present key recommendations that other LEA can consider to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.

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“…It usually prepares guidelines for the implementation of sexuality education in that school, for example, in the form of a sexuality education programme (Rocha and Duarte 2015a). The likelihood of a school setting up such a programme has been found to be about 10 times higher if such a team is in place (Rocha and Duarte 2015b).…”

Section: School-based Sexuality Education In Portugalmentioning

confidence: 99%

School-based sexuality education in Portugal: strengths and weaknesses

2015

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IntroductionSexuality education is a recognised strategy to promote sexual health, and a subject on which there is a growing body of research. International organisations have emphasised the importance of sharing expertise among countries (BZgA/WHO 2006; IPPF 2006) and recent publications have responded to this call, making available country-specific experiences of sexuality education (Fu 2011;Haldre, Part, and Ketting 2012;Loeber et al. 2010). Likewise, a few cross-national comparisons have been conducted, revealing common policies, practices and factors affecting the implementation of sexuality education in schools (IPPF 2006;UNESCO 2010;Weaver, Smith, and Kippax 2005).The IPPF (2006) has published a reference guide on the state of sexuality education in Europe that highlighted countries such as France, Belgium, Cyprus, and Portugal, with a long history of sexuality education. In these countries, sexuality education programmes were established in parallel with broader cultural changes regarding sexual issues. After ABSTRACT Portugal, like many other countries, faces obstacles regarding schoolbased sexuality education. This paper explores Portuguese schools' approaches to implementing sexuality education at a local level, and provides a critical analysis of potential strengths and weaknesses. Documents related to sexuality education in a convenience sample of 89 schools were analysed and findings confirm both the results of the few existing Portuguese studies on the subject and commonalities in sexuality education between Portugal and other European countries. These include strengths, such as the existence of teams in charge of sexuality education in schools and the provision of resources, but also weaknesses, such as too heavy a focus on health-related issues, difficulties in cross-curricular teaching, low levels of community participation and poor-quality evaluation. Findings point to the need for a greater sharing of information and good practice between countries, and the need for clearer guidelines. Suggestions are made for improving the quality of sexuality education in Portuguese schools. CONTACT ana cristina Rocha anarocha@fpce.up.pt Downloaded by [University of New England] at 09:02 04 October 2015 2 A. C. ROCHA ET AL.school-based sexuality education became mandatory, schools and education authorities enhanced their efforts to more effectively implement sexuality education. However, each country has had to deal with specific difficulties in enforcing guidelines. The difficulties faced in Portugal regarding sexuality education are typical of those faced in other developed countries (Fernández, Fernández, and Castro 2007;Haberland and Rogow 2015; IPPF 2006;Martínez et al. 2012;Parker, Wellings, and Lazarus 2009;Peter, Tasker, and Horn 2015). Despite the efforts of international organisations to share national experiences (IPPF 2006;UNESCO 2010) and to develop guidelines and standards (UNESCO 2009;WHO/BZgA 2010, 2013, few existing studies have focused on the local or school level. Understanding the chal...

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Factors facilitating implementation of school-based sexuality education in Portugal

Abstract: The results highlight the importance of variables at micro- and exosystem levels as facilitating factors, and reinforce the ecological approach as being well suited for SE/health education in schools. The findings have implications for policy-makers as well as for practice.

Cited by 8 publications

References 10 publications

What will it take? Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services

What will it take? Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services

What will it take? Using an Implementation Research Framework to Identify Facilitators and Barriers in Implementing a School-Based Referral System for Sexual Health Services

School-based sexuality education in Portugal: strengths and weaknesses

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