Collision Course

Abstinence advocates may be more dangerous than the opposition. The damage will be done not by design but by cooperation. Be cautious of the following five co-operative plans which could hold danger for abstinence education if they are mismanaged.

This article may sound negative but if you learn where to be cautious the outcome for all of us will be positive.

Brand new groups (one to five years of abstinence experience) are being expected to scientifically evaluate brand new programs that are just getting started within communities while 30 year old family planning programs continue without so much as a wink of accountability.

The political climate within schools, the most common and cost effective site for primary prevention, is unstable at best and usually hostile towards abstinence until marriage education. The political climate regarding sexuality in any given school or community administration is volatile over gay rights, abortion rights, age of sexual consent and reproduction freedom issues. The Political climate, with a capital ‘P,’ which deals with the Democrats and Republicans, is nearly open warfare over welfare reform, gay rights, pro-life, pro-choice legislation and funding. Considering that weather report, why are neophyte abstinence educators expected to find cooperative sites, well-informed administrators and evaluators, experienced, convinced teachers to administer and then evaluate program effects – all in less than five years?

Public health data on program effects will be two years behind their program implementation. Some will receive funding for one year with new competitive grant applications due annually. (Even politicians get two years to show their stuff.) Many will be forced to design programs that have high profile and high public appeal at the expense of complete and systematically delivered content because their funding is contingent on performance. (Performance as measured by opinion, since data will lag years behind and cannot be compared.) And to make matters worse, most will be only marginally funded as compared to virtually any other service or government education program.

Thus far, the dollar amounts spent for school implementation by private grantees doesn’t compare to public school districts expenditures on these same abstinence education programs. Repeatedly, a district will spend $3-7 per student reached but non-profit grantees only spend one to two dollars to reach their students even if the students are being taught in public school settings. The true test of the acceptance of abstinence education is when the school pays for the program with their own funds.

The Request For Proposals (RFP) used in many states is so much more demanding and complicated than other departments use. The dollars are smaller but the accountability and reporting is incredible. Family planning programs get their matching funds from the state’s general budget. Most teen pregnancy prevention (mixed message) programs which are required to have matching funds are allowed to count funds from similar programs and referrals. In at least one instance, a Title V grantee estimated an optimistic amount of matching funds from the community. That portion of the project is going very slowly but the state is still requiring the grantee to make a 6 to 4 match. (That is $6 from the community efforts for $4 government funding) Congress authorized HHS to require 3 to 4 match. The state health department is going to use the additional matching efforts to match their own in-house projects.

Be cautious – materials are censored for politically correct medical “facts.” Condom and birth control failure information is at the heart of the challenge.

Religious groups were solicited to apply and community involvement was required but as grantees do the work, department of health officials in some states, fall back on the Kendrick Settlement from Title XX (the Adolescent Family Life Act) guidelines which expired (January 21, 1998) and do not deal with Title V. The interpretation of these guidelines precludes religious organizations from participating because of their demeaning nature. When charges of sectarianism arise by the opposition, these defunct guidelines are used to solidify the ACLU/family planning position in some of the most bizarre ways. One example is a grantee, who is controlling for the effect of the teacher adding contraceptive information to their abstinence curriculum, by asking students a question about receiving birth control information in the program. The grantee was put on probation for having a religious bias in the implementation of a non-sectarian program.

Positive Action Item: Weigh the demands being made. Make sure that the requirements are the same for everyone. Your politicians need to know if discrimination is going on in your state. Help them set up an oversight committee. It will bring accountability in government.

When you spill a bowl of soup, even a young child knows that you start cleaning the mess at the outside and move in to the center. By the time you have used several paper towels on the periphery, you have enough absorbency to pick up the heavier part of the spill or the big pieces.

In out-of-wedlock pregnancy reduction, states want grantees to go into the worst crime infested, poverty stricken areas of the inner cities, the jails and the alternative schools before the grantees have fully developed their programs. Grantees haven’t enough experience or data in controlling the newest growth center of out-of-wedlock pregnancies which is among the middle class (of all races). Many of these families are still in-tact with no history of illegitimacy, have employment skills and financial resources to assist in the positive outcome for their children. Starting here only makes sense.

The experts have said for years that poverty, lack of hope and previous teen pregnancy within a family are major contributing factors. These are givens, historical events in the lives of teens who live in the risk-saturated subculture. Even the smallest change becomes more difficult in this transient, often under educated and needy population. However, some grantees are expected to move these adolescent and even pre adolescents in a positive direction with statistically significant data that holds over a one or two year follow-up period.

To further impede community acceptance, welfare reform especially, the reduction of children being born has become another attack on certain ethnic and religious populations. So instead of attacking the newest and fastest growing segment of the population to become out-of-wedlock parents, white middle class 18-24 year olds, the policy makers continue to harangue at the poor minority teen. Title V states that funding should go to those most likely to become pregnant out-of-wedlock but it doesn’t demand that programs address the hard-core poverty/minority combination first, that, by the way, family planners have failed to reach in 30 years.

Paradoxically, HHS guidelines target teens 17 and under instead of the 18-24 year olds who comprise only 1/3 of all out-of-wedlock pregnancies. This 18-24 year old population is truly the most likely to experience an out-of-wedlock birth. Then to further compound the problem, most states targeted 10-17 year olds but the majority of the efforts in abstinence education are aimed at teens 14 and under. These girls comprise less than 2-5% of all teen pregnancies. The boys in this age group account for less than 1% of pregnancies. State agencies still have their focus on age rather than marital status. Will abstinence grantees become their accomplices? No statistically significant change can be shown in a population who is only 5-15% sexually experienced, most through sexual assault or coercion.

Positive Action Item: Help in the difficult settings but also gather data in healthy environments too. Remember that 18 year olds are considered and consider themselves adults in every area but teen pregnancy. Spread the word about where out-of-wedlockness has its greatest impact. Let the policy makers know that welfare will not be reduced without addressing adult sexual fidelity.

The opposition knows that changes in behavior take a considerable amount of coaching, practice, indoctrination and guilt, and just to get someone to put on a condom each and every time. They can still have sex, be told how adult and responsible they are and yet they still fail to effectively use condoms for birth control. Any family planner will tell you that an IUD, Norplant and now a Depro provera shot is the only way to get teens to comply.

By contrast, abstinence requires that young people change their focus and embrace a lifestyle of moderation. They have to manage relationships with their parents, their peers and refuse to have sex with the current love of their life. Most will have to abstain from drugs and even recreational use of alcohol to make abstinence possible.

The opposition knows that teachers need to be “for the program” and that they need to teach all of the lessons. Both comprehensive and the pseudo abstinence programs discourage the “pick and choose approach” to curriculum implementation that is so common among educators. Developing curricula that intends to impact a lifestyle can’t be done in a matter of a few hours of contact time with the student. The concepts must be repeated systematically and often and they must be reinforced by parents throughout and after the program. If abstinence educators compromise on the number of hours needed to thoroughly present the program, failure will follow.

Abstinence educators who are excited about the new-found acceptance of abstinence become willing to alter, shorten and mix or match materials to gain access to the schools. In time that may develop improvements but if these abbreviated programs are evaluated, the results will be attributed to the curricula not the program provider. The reputation of the curricula developer is at stake no matter how closely or how far afield the program took the written materials.

The limited resources combined with the elevated expectations cause abstinence staff to be stretched beyond their levels of expertise or ability to complete all of the promises required in some of the voluminous RFPs. Financially, abstinence education is more cost-effective than family planning but if abstinence educators continue to merely give away their services ultimately, their services will be valued at their cost.

Positive Action Item: Compromise of content or principle can be dangerous. Demand a full hearing with quality facilities. You know what it takes to be successful and if you don’t, ask an old timer in the abstinence movement. Don’t settle for just what they are willing to give. Abstinence is what the community wants.

Optimists and big thinkers can get caught in this trap. Changing the paradigm is not the domain of the liberal society “changers”, in fact, that is what abstinence education is about. The change doesn’t happen by a fairy passing whiffel dust over a town or county, opposition still holds the cards in most health and education positions. And it can’t be done by talking about it, by merely gaining community consensus. It requires abstinence educators to roll up their sleeves with specific programs that have identifiable philosophy and sound educational principles. Most adults do not know enough about abstinence philosophy, skills and motivational theory to appreciate the complexity needed in an abstinence education program. Getting the school to say they emphasize abstinence or adding a lesson or special speaker is “entering” but not finishing in the race to prove abstinence works. Merely talking about abstinence and getting a mayor to proclaim a day of abstinence or a “community of values” is demeaning and belittling to the abstinence education movement. The gay movement will tell you that, too.

The gay movement knows that to change a paradigm, the entire community has to speak the same message or at least be afraid to voice an opposing view. Laws must be changed and the focus of elected officials all must change. The heads of key departments of government at every level must be convinced or moved. Educational program content must completely embrace abstinence until marriage and provide the motivation and skills to achieve that goal. Teacher in-service and school district policy must reflect abstinence as the expected norm for school age children. Providing a way to get by with taking risks is not tolerated in smoke-free schools, why not fornication-free schools? Local media coverage is a start but promotion of premarital abstinence in programming is the ultimate responsible position for the media. If we can’t expect the most responsible citizens to challenge the current sexual environment and embrace abstinence and fidelity as the best standard of behavior, why do we expect children to accomplish the feat?

A societal paradigm change is not accomplished with a PR campaign or negotiations for a token funded program, even though they help. Systematic programs from legislation to written school policies including and especially curricula for all settings (school, recreation program, religious setting, community service project) must be adopted and used over time to make a cultural change. Change happens when specific, written, programs are used, refined and reused. And when those tools are criticized as they will be, abstinence educators should not lay the tool down or alter it to fit the opposition’s demands. This brings us to the topic of evaluation. Is its purpose to pronounce judgment – prove that it works or is evaluation intended to improve and enhance a program over time?

Positive Action Item: DO NOT DESPAIR!! The momentum is with us if only we hold a true course. Use evaluations to improve not prove. Keep the size of the dream within a practical reality. Big is only better if it has been perfected. A project is the sum of its parts. If you can’t design, improve and describe the parts the sum will also be indefinable.

The opposition knows that evaluation of one component is dangerous to test. They haven’t submitted their “star” abstinence-only programs for scrutiny. (Don’t confuse abstinence-only with abstinence until marriage programs. The opposition has programs that teach how to say no and nothing more.) They will submit the pseudo abstinence programs that teach teens to just say no but fail to give teens the adequate information, motivation or parental support to trigger the refusal skills. These can fail and then call all abstinence programs failures. The Brian Wilcox article cited in the RFP for the six million dollar national research project is a prime example of the stereotypical discrimination that can be done with research.

Make sure that research is designed to improve the program and further the concepts that build strong families. Printed peer reviews sound prestigious but the peers can be philosophically opposed to abstinence. The result is that good abstinence research has been done, it just hasn’t been printed.

Be cautious of how your evaluator sets up your project. Get a second opinion. You don’t want to compare part of your program to your full program as one state funded evaluator designed the groups for the only abstinence grantee in his state. Comparing among other abstinence programs is paramount to having the “good guys” stand in a circle and shoot at each other. What we need to know is, does an abstinence until marriage program reduce illegitimacy more than a mixed message or comprehensive program?

Be detailed. Read the research. Talk to other abstinence educators and share articles with them. Know who the evaluator is aligned with. Look at the questionnaire. Make sure it asks for the date of birth for each student, otherwise you will never be able to track the students for follow-up. Make the program dictate the questions not the evaluator and don’t let graphic (not age-appropriate) questions be asked. However, you must ask about sexual activity. Has the student ever had sex?

Don’t become a “super site” for the six million dollar research project unless your sites and materials are ready. You may do more damage to your new program, particularly considering how the Wilcox article maligns without information or fair rebuttal. The six million dollar man could catapult you to fame but he could shoot you dead as has been the history for peer review journal articles on abstinence education.

Positive Action Item: Be cautious. Talk to others. Make sure you know what you are signing up for; it could be a major expense and headache, without compensation. Ask for postponement of research until groups are ready and then ask that family planning projects have the same guidelines and be the control group for you.

Conclusion: Persistence in upholding the standard of marriage and recognizing the whole person theory of development will prevail. Compromise and even cooperation sound so good but in this new arena caution must reign. The collision is not inevitable anymore than sex before marriage is inevitable. Our course must be persistence, support from the abstinence education family and the dawning awareness that virtue can prevail, even in the face of national compromise and deception. This must be our watchword.