Talking with Teens about Reproductive Health: How To Tackle the Tough Topics

Introduction

Please note: This course will take approximately 30 minutes to complete; do not refresh your browser window or you will have to begin again. Instead, use the next/previous buttons to work your way through the course.

It’s not always easy to speak with young people about sensitive topics, such as reproductive health or teen pregnancy. This course provides staff working with young people a concrete protocol and steps that can be followed to ease discomfort and create an open, supportive environment for sharing.

Course Overview

This course covers the following areas:

  • Purpose and objectives of the online course
  • Distinguishing among values, beliefs and facts
  • Managing personal beliefs, personal values and facts
  • Using the Values Question Protocol Tool to answer values-based questions
  • Course summary

Course Goal and Objectives

The course goal is to strengthen skills for identifying and communicating about challenging topics in reproductive health.

By the end of this online course, participants will be able to:

  • Describe the difference between a fact, a belief, and a value;
  • Answer value-based questions using the Values Question Protocol; and
  • Identify sources of medically accurate reproductive health information.

Part 1: Distinguishing Between Facts, Beliefs and Values

Definitions

A fact is:

  • A piece of information presented as having objective reality
  • A true piece of information; something that truly exists or happens

For example:

  • According to the CDC 2011 Youth Risk Behavior Survey, 63.1% of 12th grade students reported having ever had sexual intercourse.[1]

A belief is:

  • Something that a person accepts as true or right
  • A strongly held opinion about something

For example:

  • Some people believe adolescents are too young to handle the potential consequences of engaging in sexual relationships.

A value is:

  • A strongly held belief about what is valuable, important, or acceptable — usually plural

For example:

  • Sexual intercourse should only take place within the context of adult romantic relationships.

Discussion 

The previous examples of facts, beliefs, and values demonstrate the potential conflict between the facts as supported by public health data and possible individual/community beliefs or values.

For example, take this fact from the CDC 2011 Youth Risk Behavior Survey: 63.1% of 12th grade students reported having ever had sexual intercourse.

This fact may conflict with an individual or community’s belief that teenagers are too young to handle the potential consequences of engaging in sexual intercourse, or may go against an individual or community’s value that sexual intercourse should only take place within the context of adult romantic relationships.

Beliefs and values are present at the individual, family and community level. Each individual is part of a variety of communities (religious, cultural, family, school, etc.) that may have conflicting or mutually re-enforcing beliefs and values.

Footnotes

1
Source: Centers for Disease Control and Prevention.  Youth Risk Behavior Surveillance-United States, 2011.

Carla and Ben

The following is an example of a scenario in which individual, family and community beliefs conflict:

Carla and Ben have been dating for two years and are in their senior year of high school. They have a healthy, respectful and exclusive relationship. For the past few weeks, Bens been asking Carla if she feels ready to have sex.

Carla loves and trusts Ben and knows they will use protection. She values the love and trust that they share and believes that sex would be taking the next step in their relationship.

Carlas family is traditional, and they feel that Carla should focus exclusively on academics. Her parents believe that Carla is an obedient daughter and are proud of her accomplishments. They believe that Carla is spending too much time with Ben and do not believe that relationships should be a priority for teenagers.      

Carla comes from a conservative, family-centric community centered around frequent cultural gatherings and events. Her parents are seen as informal leaders and model citizens. The community values tradition and rewards achievements.

Carla is conflicted between her personal beliefs and values and those of her family and community.

Eric and Gabby

The following is an example of a scenario in which individual, family and community beliefs are mutually re-enforcing:

Eric’s girlfriend, Gabby, has been pressuring Eric to have sex. Eric likes Gabby, but doesn’t feel ready. He believes that sex is an expression of love and values waiting for the right person.

Eric’s parents were high school sweethearts who got married and are still happily together. They value commitment and believe that there is one right person for everyone.

Eric’s community is based around his religious institution, which supports abstinence until marriage. The community values tradition and conformity.

In this case, Eric’s personal beliefs are re-enforced and supported by his family and community beliefs.

Discussion

It is important to acknowledge and respect the range of beliefs and values that individuals or communities may hold. It is also important to realize that we live in a diverse society and not everyone believes in the same things or holds the same values. Program staff must not let their own beliefs or values prevent them from sharing medically accurate information with program participants.

Staff members have a responsibility to ensure that all program participants receive accurate and objective answers to their questions. The following section introduces an effective tool for answering challenging questions.

Exercise 1

Correctly label the following statements as a Fact, a Belief, or a Value:

Exercise 1

Physical aggression is a sure sign of an individual’s romantic interest in a partner.

Correct!

Answer: B

Explanation:

  1. The correct answer is b, belief.

Exercise 2

Consistent and correct use of male latex condoms can reduce the risk of STI transmission.

Correct!

Answer: A

Explanation:

  1. The correct answer is a, fact.

Exercise 3

Responsible intimate relationships should be consensual, honest, and protected (if shared sexual behavior occurs).

Correct!

Answer: C

Explanation:

  1. The correct answer is c, value.

Congratulations! You've successfully completed Part 1. Please continue to Part 2 by clicking Next below.

Part 2: Managing Personal Beliefs, Personal Values, and Facts

Handling conflicts between personal beliefs, values, and facts can be uncomfortable for some staff to deal with internally and with program participants.

Staff may be uncomfortable confronting these conflicts because they may be related to topics that are perceived to be controversial or because they are rooted in strongly held, and sometimes very emotional, convictions.

Adolescents may receive misinformation and conflicting messages about their reproductive health. The facilitator’s role is to be an impartial and credible source of information that program participants can rely on.

Overview

It is important that program staff be able to provide young people with medically accurate, factual information.

In a teen pregnancy prevention program, the goal is to make sure that medically accurate information is shared with program participants while acknowledging the range of beliefs and values that exist in our society. 

Let’s start by identifying what it means for information to be medically accurate.

Accurate Information

The definition of “medically accurate and complete” was adopted from the Patient Protection and Affordable Care Act:

Medically accurate and complete programs are verified or supported by the weight of research conducted in compliance with accepted scientific methods and published in peer-reviewed journals, where applicable; or comprising information that leading professional organizations and agencies with relevant expertise in the field recognized as accurate, objective, and complete.[1]

Reliable Sources

To ensure that the information program participants are receiving is medically accurate, staff should ensure that facts are referenced from reliable sources.

Some reliable sources include:

  • U.S. Government sources
  • Publications from leading medical organizations
  • Peer-reviewed sources
Best Practices

Whenever possible, and especially when in doubt, staff should verify the accuracy of a particular fact with a second reliable source.

Footnotes

1
Source: Patient Protection and Affordable Care Act (Public Law 111-148 – March 23, 2010)

Sorry!

You must correctly answer the questions in all previous sections before proceeding.

Exercise 1

Which of the following are reliable sources for medically accurate information? Select all that apply:

Correct!

Answer: A, B, C and D

Explanation:

  1. The correct answer is A, B, C and D. All of these are reliable sources for factual information. The American Medical Association and the American Academy of Pediatrics are leading medical organizations. Government publications are also factual, which include all CDC and NIH materials..

Congratulations! You've successfully completed Part 2. Please continue to Part 3 by clicking "Next" below.

Part 3: Using the Values Question Protocol Tool

Throughout the program, participants may ask questions with value components. It is important to address questions while being mindful of the overall lesson plan and time constraints.

The Values Question Protocol is one tool that staff can use to answer values-based questions in a respectful way.

Once the question is asked or the statement is said, follow these steps:[1]

  1. Legitimize the question/statement
  2. Identify the part that is a belief/value
  3. Answer the factual part
  4. Help participants identify the range of beliefs/values on the issue
  5. Refer to family, clergy, and other trusted adults
  6. Check to see if you answered the question
  7. Leave the door open

Next, we will go through the steps in more detail and provide suggestions for how to phrase responses.

Footnotes

1
Source: Adapted from the Values Question Protocol, Public Health—Seattle & King County

Step 1: Legitimize the Question or Statement

Step 2: Identify the Part That Is a Belief or Value

Step 3: Answer the Factual Part of the Question

Step 4: Help Identify the Range of Beliefs or Values

Step 5: Refer to Family, Clergy, and Other Trusted Adults

Step 6: Check to See if You Answered the Question

Step 7: Leave the Door Open

Question

Does hooking up with lots of people make you a bad person?

Answer

Thats a really good question. A lot of people have questions about their sexual behavior and what it means about them.


Most of the questions youve asked me have been about facts where I can find an answer based in evidence and research. You asked me to share a belief about what makes someone a good or bad person. People have lots of different opinions about what makes someone a bad person. These beliefs can come from family, religion, culture and personal opinion.

Having unprotected sexual intercourse puts you at increased risk of pregnancy, HIV/AIDS and sexually transmitted infections, or STIs. 

Some people may believe that its always wrong to have more than one partner, while other people may think that its okay to have multiple partners as long as youre safe about it. What other beliefs may people have about this?

As you can see, people have really different beliefs about this, and its important for you to figure out what youre comfortable with for yourself. I want to encourage you to speak an adult who you can trust about this that could be a parent, a family friend or someone at your church/temple/mosque/synagogue.

Does that answer your question?

Sorry!

You must correctly answer the questions in all previous sections before proceeding.

Exercise 1

Which of these steps is NOT part of the Values Question Protocol?

Correct!

Answer: B

Explanation:

  1. The correct answer is: B, Share your personal beliefs. Program staff can discuss questions/statements with a value component by acknowledging the value/belief component, providing medically accurate information, exploring the range of community beliefs about the issue, and referring program participants to their family and other trusted adults for further conversation. Program staff should not express their own personal values or beliefs.

Congratulations! You've successfully completed Part 3. Please continue to the Final Exam by clicking "Next" below.

Final Exam: The Values Protocol Question in Practice

This section provides an opportunity to practice using the Values Question Protocol. Remember, you want to separate opinion from fact and provide medically accurate information while respecting the participant who asked the question. To successfully complete this e-learning module and earn a certificate, you need to correctly answer four of the five questions.

Sorry!

You must complete all the Learning Exercises correctly in Parts 1-3 before you can take the Final Exam.

Question 1

The following is an example of a question that an adolescent may ask:

Is it okay to have sex on the first date if you really like the guy?

Read the following responses and see which one best addresses the question using the Values Question Protocol.

Keep the following criteria in mind:

  • Does the response legitimize the question/statement?
  • Does the response explain which part is a belief/value? How?
  • Does the response answer the factual part? What are the sources for those facts?
  • Does the response offer some examples of the range of beliefs/values on the issue?

Response A

Question: Is it okay to have sex on the first date if you really like the guy?

Thanks for bringing that up. No matter how much you like the guy, it’s not a good idea to have sex on the first date. Some people may say that it’s okay, but really you should wait until you’re sure that he’s the right one for you.

It may seem like everyone’s having sex, but lots of teens are not. The Centers for Disease Control and Prevention did a study that showed that more then half of teens in high school have never had sex, and only about a third are sexually active. So see, you don’t need to do it – lots of people aren’t. The National Survey on Family Growth showed that over two-thirds of teens were in serious relationships the first time they had sex.

You should talk to your family or another adult you trust about this. There are also hotlines and websites I can recommend.

Does that answer your question?

Response B

Question: Is it okay to have sex on the first date if you really like the guy?

That’s a really important question and I’m glad you asked it. A lot of the questions you’ve been asking me have been fact-based questions where I can look up an answer, but this one also has a value piece where different people will have different opinions about when sex is appropriate. Some people may think that sex is always okay as long as it’s safe and consensual, and others may believe that you should only have sex after you’re married.

Most teens are in serious relationships the first time they have sex, according to the National Survey on Family Growth. No matter how well you know your partner, having unprotected sexual intercourse puts you at an increased risk of pregnancy, HIV/AIDS and other sexually transmitted infections, or STIs. The Centers for Disease Control and Prevention reports that condoms, when used consistently and correctly, reduce your risk of HIV/AIDS, other STIs and pregnancy, and birth control reduces your risk of becoming pregnant.

It could really help to talk to your family or another adult you trust about this to help you decide how you feel about sex and how to know if you’re ready. There are also hotlines and websites I can recommend.

Did that answer your question?

Response C

Question: Is it okay to have sex on the first date if you really like the guy?

I’m surprised that you asked me that; it seems like a really personal question.

A lot of times, men don’t respect women who have sex with them right away. Most teens are in serious relationships the first time they have sex, according to the National Survey on Family Growth.

If you’re serious about having sex with someone on a first date at your age, you need to talk to a parent or another adult you can trust.

Did that answer your question?

Which of the responses above best addresses the question using the Values Question Protocol?

Correct!

Answer: Response B best meets the criteria of the Values Question Protocol. The table below illustrates how response B meets the different components of the protocol.

Step Example
Legitimize the question/statement Legitimize the question/statement
Identify the part that is a belief/value A lot of the questions you’ve been asking me have been fact-based questions where I can look up an answer, but this one also has a value piece where different people will have different opinions about when sex is appropriate.
Answer the factual part Most teens are in serious relationships the first time they have sex, according to the National Survey on Family Growth. No matter how well you know your partner, having unprotected sexual intercourse puts you at an increased risk of pregnancy, HIV/AIDS and other sexually transmitted infections, or STIs. The Centers for Disease Control and Prevention report that condoms, when used consistently and correctly, reduce your risk of HIV/AIDS, other STIs and pregnancy, and birth control reduces your risk of becoming pregnant.
Help participants identify the range of beliefs/values on the issue Some people may think that sex is always okay as long as it’s safe and consensual, and others may believe that you should only have sex after you’re married.
Refer to family, clergy, and other trusted adults It could really help to talk to your family or another adult you trust about this to help you decide how you feel about sex and how to know if you’re ready. There are also hotlines and websites I can recommend.

The following is another example of a question that an adolescent may ask. Choose the best response from each set of two to create the best answer:

My mother says birth control pills are for dirty girls and won’t let me take them. I don’t have sex all that much so I’m not too worried about getting pregnant. Most of the time I don’t use anything at all.

Question 2

What could you say to legitimize the question/statement?

Correct!

Answer: A is the correct answer because it encourages questions and normalizes the question by saying that many people are interested in the same topic. B is incorrect; though the facilitator expresses being glad that the question was raised, he or she also says that question is unusual and misinformed. This places a judgment on the question and may discourage this participant from continuing to engage.

Question 3

How would you clarify that this may be an issue of different beliefs and values?

Correct!

Answer: B is the correct answer because it identifies the value being discussed without judgment and identifies a range of beliefs on the topic. Answer A identifies a belief but places a judgment on it and does not acknowledge the range of beliefs.

Question 4

How would you answer the factual part? What are the sources for those facts?

Correct!

Answer: : A is the correct answer because it explains factual information that is relevant to the question. B is incorrect because, while it offers factual information, it does not address the participant’s main concern about pregnancy prevention.

Question 5

How would you phrase the referral to family, clergy, and other trusted adults for the specific participants you are working with?

Correct!

Answer: B is the correct answer because it suggests talking to more than one adult. A is incorrect because it is judgmental and discredits the parent.

You have completed the exam!

Your Score

  • Total Correct:
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Congratulations! You've successfully completed the 'Talking with Teens about Reproductive Health: How to Tackle the Tough Topics' E-Learning Module!

The Complete Answer

“Lots of people have questions about birth control and if it’s right for them, so I’m glad you brought that up. Whether or not someone uses birth control has a lot to do with their values and beliefs. Some people believe that all sexually active people should be on birth control to reduce their risk of becoming pregnant, while others believe that birth control is wrong.

The Centers for Disease Control and Prevention (CDC) report that, in 2002, 82 percent of women who were sexually active used the oral contraceptive pill, which is over 10 million women. Every time you have unprotected sex, even if you don’t have sex very often, it is possible to become pregnant or to get a sexually transmitted infection (STI) including HIV.

It could be helpful to talk to a trusted adult to see if birth control is a good choice for you.

Does that answer your question?”

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Conclusion

This course was designed to strengthen the skills necessary for identifying and communicating medically accurate information about reproductive health.

In addition to knowing the current facts—or where to go for facts—it is also important that program staff help participants recognize the difference between beliefs, values, and facts.

It is possible to teach about reproductive health issues, communicate medically accurate information, and be respectful of the range of beliefs and values that exist in our society.

Thanks for all that you are doing to improve the lives of young people!

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Last updated: February 12, 2016