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



Introduction

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

Go to Section: What's the Difference? > Examples > Learning Exercises

What's the Difference?

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

To return to the page content, select the respective footnote number.

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

Examples

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, Ben's 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.

Carla's 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.

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.

Exercise 2

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

Exercise 3

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

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

Go to Section: The Role of Staff > The Importance of Accuracy > Learning Exercises

The Role of Staff

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.

The Importance of Accuracy

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

Best Practices

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

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

Footnotes

To return to the page content, select the respective footnote number.

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

 

Exercise 1

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

Part 3: Using the Values Question Protocol Tool

Go to Section: Overview > Step-by-Step > Synthesis > Learning Exercises

Overview

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

To return to the page content, select the respective footnote number.

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

Using the Protocol: Step-by-Step

Step 1: Legitimize the Question or Statement

What Can You Say?
  • I am glad someone brought this up.
  • That's an interesting question.
  • People ask me this one every year.

This will encourage program participants to keep asking questions while discouraging snide remarks from other participants about the question or statement. It also gives you more time to think about how you will respond.

Best Practices: Legitimize the question or statement

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

Answer: "That's a really good question. A lot of people have questions about their sexual behavior and what it means about them."

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

What Can You Say?
  • Most of the questions you’ve been asking have been ‘fact questions’ where I could look up an answer all the experts agree on. This question also has a value piece to it where every person, every family, every religion has a different belief.”

Teaching program participants to distinguish facts from opinions is just as important as the content you will convey.

Best Practices: Identify the part of the question that is a belief or value

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

Answer: "Most of the questions you’ve 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."

Step 3: Answer the Factual Part of the Question

What Can You Say?

You can answer the fact-based part of the question and still take the opportunity to have a discussion about the underlying beliefs or values.

Best Practices: Answer the factual part of the question

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

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

Step 4: Help Identify the Range of Beliefs or Values

What Can You Say?
  • Tell me some of the things you've heard that people believe about that.

  • Some people believe____, what do others believe?

Program staff’s role is two-fold: to make sure that every belief gets expressed—or paraphrase—respectfully; and to make sure that a complete range of beliefs get expressed, even if they have to supplement what participants can think of.

Best Practices: Help identify the range of beliefs or values

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

Answer: "Some people may believe that it’s always wrong to have more than one partner, while other people may think that it’s okay to have multiple partners as long as you’re safe about it. What other beliefs may people have about this?"

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

What Can You Say?
  • Because people have such different beliefs about this, I really want to encourage you to speak with your family (parent/guardian, grandparent, aunt, uncle, stepparent, mom/dad's partner), someone at your community of worship if you attend church, synagogue, mosque, or temple, or with some other adult you love and whose opinion matters to you.”

Knowing one’s family’s beliefs and values is developmentally important for young people. It is also important to recognize that not every participant has a parent they can talk with or is part of a community of worship. Help them think of other trusted adults they can reach out to as well.

Best Practices: Refer to family, clergy and other trusted adults

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

Answer: "People have really different beliefs about this, and it’s important for you to figure out what you're comfortable with for yourself. I want to encourage you to speak an adult who you can trust about thisthat could be a parent, a family friend or someone at your church/temple/mosque/synagogue."

Step 6: Check to See if You Answered the Question

What Can You Say?
  • Is that what you were asking?

When appropriate, check with the program participant to make sure their question was answered and provide additional information as necessary.

Step 7: Leave the Door Open

What Can You Say?

Finally, if you can do it sincerely, thank the class—or in a one-on-one situation, the participant—for their maturity, curiosity, compassion, or whatever positive qualities the question/statement has helped them demonstrate. That will not only increase their retention, it will improve the odds of their repeating their positive behavior on the next occasion.

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

Answer: That's a really good question. A lot of people have questions about their sexual behavior and what it means about them.

Most of the questions you've 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 it's always wrong to have more than one partner, while other people may think that it's okay to have multiple partners as long as you're safe about it. What other beliefs may people have about this?

As you can see, people have really different beliefs about this, and it's important for you to figure out what you're 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?

Exercise 1

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

Final Exam

Go to Section: Overview > Exam

Overview

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.

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: 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: 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: 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?

Question 2

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.

What could you say to legitimize the question/statement?

Question 3

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

Question 4

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

Question 5

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

Conclusion

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!

Content created by Office of Adolescent Health
Content last reviewed on June 30, 2017