High School Curriculum

A WISCONSIN HUMAN GROWTH & DEVELOPMENT CURRICULUM: HIGH SCHOOL This publication is available from:

Health Care Education and Training 6410 Enterprise Lane Madison, WI 53719 608.274.5455 www.hcet.org

©August 2018 Health Care Education and Training TABLE OF CONTENTS: HIGH SCHOOL EDITION

Human Growth and Development Unit Intro High School Curriculum Scope and Sequence Lesson 1: Introduction to Human Sexuality Lesson 2: Love Language Identification and Healthy Communication Lesson 3: Communicating Consent Lesson 4: Identification and Analysis of Reproductive Anatomy Lesson 5: Sexually Transmitted Infection Information and Prevention Lesson 6: HIV, STIs, Stigma and Using Condoms Lesson 7: Accessing Valid Health Information on Pregnancy Products and Services Lesson 8: Preparing to Parent - Analyzing Influences and Setting Goals Lesson 9: Analyzing Contraception Options Lesson 10: How Can Health Decision-Making Prevent STIs and HIV? Lesson 11: Unit Review - Lifelong Sexual Health Answering Difficult Questions Protocol Human Growth and Development Advisory Committees Human Growth and Development in Wisconsin: Laws and Policy

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Relevant statutes include:

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National Sequence Wisconsin Sexuality Lesson Number Standards for Lesson Name Education Methods Description Health Education Standards 1 Comprehend Introduction ID.12.CC.1 Graffiti The purpose of this is lesson is to introduce the Concepts Related to Human ID.12.CC.2 wall unit and reinforce classroom ground rules to to Health Sexuality ensure students feel safe while discussing human growth and development. Students discuss a wide variety of aspects that comprise human sexuality. Students will be able to differentiate between biological sex, sexual orientation, and gender identity and expression. Students will be able to define terms related to understanding the scope of human sexuality. 2 Interpersonal Love Language HR.12.CC.2 Personal This lesson will allow students to explore their Communication Identification assessment own Love Language and share their findings. & Healthy Students will reflect on their personal Love Communication Language and how they can apply that to a future relationship. The purpose of this lesson is to describe a range of ways to express affection within healthy relationships by identifying the characteristics of the various Love Languages. 3 Interpersonal Communicating HR.12.SM.1 Video, The purpose of this lesson is for students to Communication Consent HR.12.IC.2 interactive practice clear communication around consent HR.12.INF.2 activity for sexual activity. HR.12.CC.3

4 Accessing Valid Identification AP.12.CC.1 Flipped The purpose of this lesson is to have students Health Information and Analysis of game identify internal and external male and female Reproductive reproductive anatomy. Students will also analyze Anatomy how the brain and hormones are involved in the human sexual response cycle in relationship to reproduction. 5 Accessing Valid Sexually SH.12.CC.1 Grouping, The purpose of this lesson is to define and Health Informa- Transmitted SH.12.ADV.1 graffiti examine common STIs and allow students to tion; Infection SH.12.SM.1 sheets, explore resources for treatment. Students will Advocacy Information SH.12.AI.1 role play also analyze their individual responsibility and SH.12.AI.2 regarding getting tested for STIs, understand why Prevention SH.12.IC.1 it is important to get tested for STIs, as well as inform partners about STIs and HIV status. Students will also be able to advocate for sexually active peers to get tested and treated for STIs/ HIV. 6 Self-Management; HIV, STIs SH.12.CC.2 Video, The purpose of this lesson is to explore the role Advocacy Stigma and SH.12.ADV.1 demo of stigma associated with getting tested for HIV Using SH.12.SM.1 and STDs. A condom demonstration is included Condoms SH.12.SM.2 with this lesson to highlight an important means of preventing HIV transmission. 7 Accessing Valid Accessing PR.12.CC.3 Small The purpose of this lesson is to access medically Health Informa- Health PR.12.CC.4 group accurate information and make healthy decisions tion; Information PR.12.AI.2 work about prenatal care services, support services, Decision-Making on Pregnancy PR.12.AI.3 emergency contraception and pregnancy Products & PR.12.AI.4 options. Services PD.12.DM.1

8 Goal Setting; Preparing to PR.12.INF.3 Video, The purpose of this lesson is to understand the Analyzing Parent: PR.12.DM.2 lecture commitment necessary to raise a child. Influences Analyzing Information is also provided about Shaken Baby Influences and Syndrome. Setting Goals 9 Analyzing Analyzing PR.12.CC.1 Sorting The purpose of this lesson is to identify and Influences Contraception PR.12.INF.1 game, categorize the various forms of contraception Options SH.12.INF.1 analyzing and discuss influences on, and reasons why, scenarios students may or may not choose to utilize contraceptive methods. 10 Decision-Making How Can PD.12.DM.1 Scenarios, The purpose of this lesson is to engage students Healthy SH.12.DM.1 demos, in exploring the health consequences of different Decision SH.12.CC.2 peer choices. Making SH.12.SM.2 feedback Prevent STDs or HIV? 11 Advocacy; Lifelong Review of Role play The purpose of this lesson is to provide a review Accessing valid Sexual Health all skills game of the entire Human Growth and Development health unit of instruction focusing on the skills, and information; emphasizing the importance of using these skills Interpersonal as students move into adulthood. Communication; Decision-making; Goal setting; Self-management

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Activity 1.1: Discuss classroom ground rules and

the Anonymous Question Box (10 minutes) If this is one of the last units in most health classes, you probably have established classroom ground rules. Let students know that for the next two weeks you will be learning about human growth and development. Ask them to reflect on the idea of the

classroom ground rules and think about whether any of the rules need to be added or changed based on the content of the human growth and development unit. Ask them how the rules feel and sound. Write down any reactions shared by the students. Be sure to highlight those rules that you think will be the most important in establishing a safe

and supportive classroom environment. Restate how rules are enforced in your classroom. Some rules that may be particularly relevant to human growth and development are:

• Use active listening • Use respectful, courteous language, and proper terminology • Respect others’ opinions, beliefs, attitudes, and cultures

• Keep personal, private business of self and others confidential: respect privacy • Treat others’ comments/questions seriously • Be kind • Pay attention and get the facts straight

Additionally, the classroom will have an anonymous question box. Students may write questions anonymously and put them in the question box or give them directly to the teacher prior to, during, or after class.

Anonymous Question Box (recommended)

If you are setting up an anonymous question box, review with the students the meaning

of the word anonymous (not identified by name), and encourage students to use this box before, during, or at the end of a lesson. Let students know when you will be addressing the answers to the questions that are put in the box.

Activity 1.2: Sex, Gender, and Human Sexuality (20 minutes)

Write the words sex , gender , and sexuality on the board. Have a discussion with students around the following questions:

 What do you think the term sex means?  What do you think gender means?  What do you think the term sexuality means?  In what ways are the terms similar?  In what ways are the terms different?

Clarify for students that sex , gender and sexuality are different concepts.

Sex refers to whether a person is biologically male or female, with male or female anatomy, chromosomes, and reproductive parts. The term sex can also mean sexual intercourse or sexual activity of various kinds.

Gender refers to the social and cultural expression of sex; not biological sex.

Sexuality refers to the total expression of who people are as human beings, including gender, sexual orientation, biological sex, intimacy, relationships, love and affection.

Break it down further for students by defining the following terms:

 Gender identity : An individual's innermost sense of self as male or female, as lying somewhere between these two genders, or as lying somewhere outside gender lines altogether.

 Gender expression : The ways in which an individual communicates gender identity to others through behavior, clothing, hairstyle, voice, and/or the emphasis or de-emphasis of bodily characteristics. Not an indication of sexual orientation. Behaviors and traits used publicly to express gender identity—as masculine or feminine or something else.

 Sexual orientation : A feeling of attraction to others, based on biological sex and gender expression, over which individuals have no choice. Different from sexual behavior; romantic, sexual, and emotional attraction to others, categorized by the sex of the person to whom one is attracted—such as: heterosexual (attracted to the opposite sex); homosexual (attracted to the same sex); or bisexual (attracted to individuals irrespective of their sex).

 Biological sex : The biological state of having: 1) female or male genitalia (vulva, labia, clitoris, and vagina for females; penis and testicles for males); 2) female or male chromosomes (XX for females; XY for males); and 3) female or male hormones (estrogen and progesterone for females; testosterone for males); perhaps one in 2,000 babies is born with the biological characteristics of both sexes or of neither sex entirely (see intersex); see also gender and gender identity which are different than biological sex.

 Intimacy : a close, familiar, and usually affectionate or loving personal relationship with another person.

Reiterate that sexuality begins at birth and ends at death. Biological sex, gender identity and expression, sexual orientation, and intimacy are all elements of human sexuality. Additionally, knowledge, attitudes, and values affect people’s sexuality. How people express their sexuality is influenced by their families, culture, society, and beliefs.

Ask students to think about the benefits of respecting individual differences in relationship to the various components that make up a person’s sexuality, including sexual orientation, gender identity and expression, sexual abstinence, sexual activity, growth and development, and physical appearance. Relate it back your classroom ground rules – all are welcome here, all are accepted and respected.

Post the following terms around the room on large pieces of butcher block paper (one on each paper): Biology , Feelings , Behavior , Identity , and Society .

Teach the following concepts:

Biology : refers to the anatomy and physiology that is related to sexuality. Ask students to define what anatomy is (structure).

Feelings : Ask students what feelings are (emotions). Ask how feelings apply to sexuality. For example: being “in love” would constitute a feeling.

Behavior : This is what people do based on feelings or perception of identity. Being in relationships, having sex, or how they dress would be an example of behaviors.

Identity : This is how people see themselves or what groups they belong to based on how they perceive their sexuality. This could be if they perceive themselves as male or female. This can change throughout a person’s lifetime.

Society : Society is the community in which you live, the cultural beliefs that a community adopts, etc. Different societies have different expectations related to sexuality and sexual behavior. Ask students how they feel society shapes people’s perceptions of sex and sexuality. Societies often define cultural norms around sexual behaviors like age of consent, what the act of sex is, as well as what is included in sexuality education.

Let students know that to analyze these concepts more deeply, the class will do an activity called the Human Sexuality Carousel . Pass out the Human Sexuality Terms

Handout . Break the class into small groups of four-to-six or create five groups. Have each group stand in front of one of the large sheets on the wall. Give each group a marker. Ask the groups to write down any terms from their handout that they feel fit on

the corresponding large sheet of paper in front of them. Explain that some of the terms on their handouts may go on more than one sheet of paper that is hung on the wall. Keep the energy high and have groups rotate to a new sheet of paper (making each rotation shorter as the sheets get filled). Ask students to circle any terms they would like

explained further or that their groups did not agree on the categorization.

Once students have rotated through all the sheets, have them return to their seats. Discuss each of the sheets as a large group, addressing all the terms and paying attention to the terms that are circled. Pass out the Human Sexuality Terms Definitions Handout .

Discuss society’s values and attitudes as an important piece of whether people are honest about their sexual behavior, particularly when it comes to getting tested for sexually transmitted infections and HIV or expressing different identities.

Ask students to keep in mind the complexity of human sexuality and how it may change over the course of a person’s lifetime. Also explain the complexity of society and how micro-cultures or sub-populations within a society may view human sexuality differently.

Tell them that for the duration of the Human Growth and Development unit, the curriculum will go more in depth into many of the terms listed on their handouts. Remind them of the anonymous question box that will be available throughout the unit and that it’s available to address any questions or concerns they may have.

Use the following rubric to assess student learning in this lesson:

Human Sexuality Terms Definitions Handout

Abstinence : the act or practice of abstaining from sexual activity or sexual intercourse

Age : one’s chronological age, number of years since birth

Anus : the opening from the rectum from which solid waste leaves the body

Assault : unwanted physical contact, of a sexual nature in reference to sexual assault

Asexuality : the lack of sexual attraction to others, or low-to-absent interest in, or desire for, sexual activity; a normal sexual orientation

Attraction : evoking interest, pleasure, or like for someone or something

Bisexual : feeling romantic, emotional, and sexual attraction to both males and females; a normal sexual orientation

Body hair : hair that develops on the human body during and after puberty

Body image : the subjective picture or mental image of one's own body,

encompassing your beliefs about your own appearance and how you feel about your body

Breasts : sex organs on the front of a female body that secrete milk after pregnancy and birth

Cisgender : denoting or relating to a person whose gender identity corresponds with their birth sex

Chromosomes : a threadlike structure in one’s DNA cells carrying genetic information in the form of genes; the typical male chromosome is XY and the typical female chromosome is XX, though there are many natural variations

Circumcision : the removal of foreskin from the penis, sometimes performed on male babies shortly after birth; may also refer to female circumcision involving the removal of the clitoris from the vulva

Clitoris : a small erectile organ located at the top/front of the vulva, right next to the urethra

Condom : a thin rubber sheath used during sexual intercourse as a contraceptive or as protection against infection; a common barrier method of contraceptive that also protects against many sexually transmitted infection

Consent (health care): agreeing to receive health care services; young people of reproductive age can consent to receive confidential reproductive health care services in Wisconsin

Consent (sex): agreeing to sexual activity; consent should be sought and affirmed by all parties engaged in a sexual act every time; also refers to the age of consent for sexual activity; in Wisconsin the age of consent to sexual activity is 18

Contraception : birth control methods that prevent conception during sexual intercourse; examples include: IUD, birth control pills, condoms, the implant (Nexplanon), and the emergency contraception pill (Plan B/Ella)

Dating : when someone is going on dates; actively getting out there and meeting people and spending time with them; “dating someone” means you're seeing somebody specific, with purpose and on a regular basis

Disease : a condition that impairs healthy functioning and is typically manifested by distinguishing signs and symptoms; also known as a sickness or infection

Ejaculation : most commonly refers to the release of semen from the penis during orgasm; can also refer to the release of fluid from the vagina during orgasm

Gender role : culturally or socially determined sets of attitudes and behaviors that are expected of an individual based on their biological sex

Erotica/porn : printed or visual material containing the explicit description or display of sexual organs or activity, intended to stimulate erotic or sexual feelings of arousal

Fantasy : in a sexual context, refers to mental images of an erotic nature that can lead to sexual arousal; private mental imagery associated with explicitly erotic feelings, accompanied by physiologic response to sexual arousal; a sexual fantasy may be defined as an erotic yearning or constellation of mental images that evoke sexual arousal

Flirting : a social and sometimes sexual behavior involving verbal or written communication, as well as body language, by one person to another, either to suggest interest in a deeper relationship with the other person or, if done playfully, for amusement

Gay : feeling romantic, emotional, and sexual attraction to the same sex; a normal sexual orientation; often refers specifically to men who are attracted to other men, as opposed to women who are attracted to other women (lesbians)

Gonads : an organ that produces gametes; a testes or ovaries

Harassment : in a sexual context, the making of unwanted sexual advances or obscene remarks about an aspect of someone’s sexuality

Health : one’s state of physical, mental, and social well-being

Health care : the maintenance and improvement of physical and mental health, especially through the provision of medical services

Hugging : squeezing someone tightly in one's arms or holding them close to one’s own body, typically to express affection

Laws : the system of rules that a country or community recognizes as regulating the actions of its members and may enforce by the imposition of penalties

Love : an intense feeling of deep affection; may include feelings of a deep romantic or sexual attachment to someone

Marriage : the legally or formally recognized union of two people as partners in a personal relationship

Masturbation : stimulation of one’s own genitals for sexual pleasure

Menopause : the ceasing of menstruation; typically occurs between 45 and 50 years of age

Monogamy : the practice or state of being married to one person at a time, or of having a sexual relationship with only one partner at a time

Orgasm : a climax of sexual excitement, characterized by feelings of pleasure centered in the genitals

Pansexual : a normal sexual orientation that is not limited in attraction or sexual choice with regard to biological sex, gender, or gender identity; a term of choice for people who do not self-identify as bisexual, finding themselves attracted to people across a spectrum of genders

Sex : refers to whether a person is biologically mal e or female, with male or female anatomy, chromosomes, and reproductive parts; the term sex can also mean sexual intercourse or sexual activity of various kinds

Penis : the male genital organ, carrying the duct for the transfer of sperm; consists largely of erectile tissue and serves also for the elimination of urine

Pleasure : a feeling of happy satisfaction and enjoyment, sensual gratification

Polyamory : the philosophy or state of being in love or romantically involved with more than one person at the same time

Pregnancy : the condition or state of being pregnant; having a fetus developing in the uterus

Puberty : the period during which adolescents reach sexual maturity and become capable of reproduction

Queer : formerly an exclusively derogatory term for all LGBT people; now proudly used by some as an umbrella term for the entire LGBT community; also used by those who see their own gender identity, sexual identity, and/or sexual orientation as not fitting the widely recognized pattern of straight, gay or lesbian, bisexual, transgender, or questioning

Relationship : an emotional, romantic, and/or sexual association between two people

Romance : a feeling of excitement and mystery associated with love

Straight : slang term for a person with heterosexual orientation; feeling romantic, emotional, and sexual attraction to the opposite sex; a normal sexual orientation

Transgender : an umbrella term for all who feel that they are outside the boundaries of biological sex and culturally determined gender expression; may include transsexuals, crossdressers, Two-Spirit people, drag performers, etc., and people who do not identify with their biological sex

Vagina : the muscular tube leading from the external genitals to the cervix of the uterus in females

Values : a person's principles or standards of behavior; one's judgment of what is important in life

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Activity 2.1: Revisit classroom ground rules and the Anonymous Question Box (5 minutes)

Take a moment to check in on the ground rules. Ask if there are any questions or observations from Lesson 1 . Remind students of the anonymous question box. If there were questions in the box, answer them. Refer to the Answering Difficult Questions Protocol referenced in the Introduction if you have questions about how to incorporate the anonymous question box in your classroom. Remind students that the box will be available throughout the entire Human Growth and Development unit.

Activity 2.2: What is your Love Language? (40 minutes)

Tell students the learning objective for this lesson is for students to be able to describe a range of ways to express affection within healthy relationships by identifying the characteristics of the various Love Languages.

STEP 1: Let students know that today they will have the opportunity to identify their own personal Love Language. A Love Language is the way that a person expresses or experiences love. By completing the Love Language profile, a person will be able to identify their primary Love Language, explore what it means, and use it to connect to others by expressing affection in personally meaningful ways within a relationship.

Have students access the Love Languages Personal Profile for Children online by going to the following web address:

https://s3.amazonaws.com/moodyprofiles/uploads/profile/attachment/3/1126_5LoveLa nguagesChildren_Quiz_revised2-1.pdf

Tell the students to answer honestly, as there are no right or wrong answers. Have students tally their scores so they can identify their own personal Love Language. Give students 10-15 minutes to fill out the quiz.

Have students record their results on a separate piece of paper so they can reference it during the next part of the activity.

Next, write the five Love Languages on the board and briefly explain each:

 Words of Affirmation : using words to express love, appreciation, encouragement and praise  Quality Time : giving someone your undivided attention  Receiving Gifts : giving and receiving gifts  Acts of Service : doing something for the person you know they would like  Physical Touch : using positive and appropriate physical contact to show love

Explain to students that the skill of interpersonal communication is key to expressing and receiving love. Along with Love Languages, students will learn communication skills that they can use, not only in romantic relationships, but with friends, family, and others, as well. A good way to think about interpersonal communication is with the SLIDE acronym 1:

S – State what you want/need

L – Listen and clarify

I – Identify with other perspectives

D – Determine common ground

E – Elicit agreement

STEP 2 : Divide the room into five areas and ask students to go to the area that represents their primary Love Language. (Be sure to give students an “opt out” if they feel uncomfortable sharing this information). For students who have two languages with an equal score, have them gather around you. Once the room is divided, ask students to pair with someone else who shares their primary Love Language. Once the students are in pairs (for those with tied scores, find out if they have ties in the same Love Languages and pair them up, or alternatively pair up those students with the same Love Languages).

Tell students that the goal of this one-on-one sharing is to practice using SLIDE to effectively use verbal communication techniques to express their primary Love Language to another person. Additionally, tell students to talk with their partner about how they could use their Love Language in a positive way in a relationship, or what it means to them.

To demonstrate effective communication using SLIDE , ask for a volunteer. For the sake of the demonstration, say that your primary Love Language is quality time. Tell your partner that having a date each week is important to you, however receiving a gift is not. Ask what their primary Love Language is and listen to what is important to them.

1 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL.

Let students know that you will now determine common ground with your partner and elicit agreement about what would be acceptable for both of you.

Spend 5-10 minutes having students practice communicating what their Love Languages are using SLIDE to guide the conversation. Once students are done practicing, if they are comfortable, have students share what they talked about with their partner with the large group.

STEP 3 : Remind students that the purpose of this lesson is to be able to describe and communicate about a range of ways to express affection within healthy relationships by identifying the characteristic of the various Love Languages.

Go back to the five Love Languages that are written on the board. Reinforce that being able to communicate effectively means being able to express your needs and wants. Developing a healthy relationship means being able to give and receive love and affection in healthy ways.

Ask students to take out a piece of paper and create a personal profile using their Love Language. Have them write out what they feel their preferences might be based on their Love Language and how they would communicate their needs/wants to a friend or partner using SLIDE . Use the assessment included at the end of this chapter to assess student learning as demonstrated in their personal profiles.

Optional Homework : Pass out extra copies of the Love Languages Profile. Tell students they should leave class and give the profile to a friend, a romantic partner, or even a family member. Encourage students to apply their own personal Love Language in a social or dating situation.

Activity 2.2: Assessment Rubric

Use this rubric to assess student mastery of lesson objectives based on observation in class.

Student name: Learning Outcome Not Present Developing On Target Student participation Student participation and work reflects Student participation and work reflects minimal to no and work reflects thorough Identify their own Love understanding of the some understanding understanding of the Language objective. of the objective. objective. Student participation Student participation and work reflects Student participation and work reflects minimal to no and work reflects thorough Explore other Love understanding of the some understanding understanding of the Languages objective. of the objective. objective. Student participation Student participation Examine how they can and work reflects Student participation and work reflects express affection by using minimal to no and work reflects thorough their own personal Love understanding of the some understanding understanding of the Language in a relationship. objective. of the objective. objective. Communicate effectively using verbal and nonverbal Student participation Student participation communication techniques and work reflects Student participation and work reflects to express your primary minimal to no and work reflects thorough Love Language to another understanding of the some understanding understanding of the person. objective. of the objective. objective. Teacher comments:

LESSON INTRODUCTION:

The purpose of this lesson is for students to practice clear communication around consent for sexual activity.

OBJECTIVES: GRADE: High School Students will be able to… LENGTH OF LESSON: 50 min • Define consent as it applies to a sexual SEQUENCE: 3 situation. • Demonstrate how to use “I” statements when communicating consent. • Demonstrate effective ways to ACTIVITIES: communicate personal boundaries as they relate to intimacy and sexual behavior. 3.1 Anonymous Question Box • Analyze factors, including alcohol and other substances, that can affect the ability 3.2 Video: “Consent: It’s Simple as Tea” to give or perceive the provision of consent to sexual activity. 3.3 Consent Scenarios • Demonstrate respect for the boundaries of others as they relate to intimacy and 3.4 I Statement Challenge sexual behavior.

VOCABULARY: • Consent • “I” Statements MATERIALS/TECHNOLOGY: • Video “Consent: It’s Simple as Tea” https://vimeo.com/128105683 • Handout: “I” Statement Challenge • Worksheet: “I” Statement Response

• Large notecards

© 2018 Health Care Education & Training. All Rights Reserved STANDARDS: Wisconsin Standard for Health Education • Students will demonstrate the ability to use interpersonal communication skills to enhance health and reduce or avoid health risks.

National Sexuality Education Standards • HR.12.IC.2 Demonstrate effective ways to communicate personal boundaries as they relate to intimacy and sexual behavior • HR.12.INF.2 Analyze factors, including alcohol and other substances, that can affect the ability to give or perceive the provision of consent to sexual activity • HR.12.SM.1 Demonstrate respect for the boundaries of others as they relate to intimacy and sexual behavior • HR.12.CC.3 Define sexual consent and explain its implications for sexual health decision-making. Activity 3.1: Anonymous Question Box (5 minutes)

Explain that today’s lesson is about clear communication with others, particularly when it comes to sexual activity or sexual touch. Ask students what they think consent is when it applies to sex and write ideas down on the board. Examples may include: asking someone to have sex with you, giving someone permission to touch you, moving forward with a sexual act, making sure the other person knows you want to have sex with them, etc.

Post the following definition of consent on the board: “Affirmative , unambiguous , and conscious decision by each participant to engage in mutually agreed-upon sexual activity.”

Lead students in a discussion to break down what the definition means:

 Affirmative : saying yes (the absence of “no” is not affirmative)  Unambiguous : clear cut, unmistakable, definite  Conscious : comprehensible, informed, understood, not impaired by drugs or alcohol

Tell the students you are going to play a video entitled Consent: It’s Simple as Tea . Tell the students that “tea” is an analogy for the concept of consent. Play the short video. After watching it, lead students in a discussion of the video using the following to prompt dialogue:

• If someone does not want to drink tea, what should you do? How does this apply to asking someone to have sex? • Should you ever make someone drink tea even if they do not want to? How does this apply to asking someone to have sex? • In the video someone said they wanted tea and then changed their mind. Imagine this in a sexual situation. How could that play out? Give an example. • This video also talks about a person being unconscious or passing out when drinking tea. What does the video say about this? Instead of tea what could cause someone to have a lapse in judgement or pass out? • Who might influence a person to have sex or not have sex and how might they be influenced? What examples do you see in the media of getting consent or not getting consent for sex? • At the end of the video the narrator talks about how a person may want tea once, but then may refuse it in the future. How does this apply to sexual encounters?

Tell the students that you are going to read some scenarios to them about consent. Ask them to use a “thumbs up” if you think that consent is being used in the scenario. Ask them to use a “thumbs down” if consent is not being used.

Scenarios

a. Taylor and Brandy have previously hung out together with mutual friends, but lately they have been spending more time alone. When they were at Taylor’s house watching a movie, Brandy put an arm around Taylor and started kissing Taylor’s neck. Taylor kept watching the movie and didn’t say anything. (NOT CONSENT) b. Lu and Sky are dating. They have just kissed a lot, and both are enjoying it. While they are kissing, Lu asks Sky if Lu can go further. Lu nods yes and kisses Sky again. (CONSENT) c. Tory and Jean are at a party together. Tory has been really interested in Jean. They both have been drinking and Tory decides to approach Jean. Jean is much drunker than Tory and says, “Hey, take me out of here…” Tory has to hold Jean up to keep Jean from falling as they weave through the crowd. When they are outside, Tory starts kissing Jean. Jean passes out after they have been kissing for a while. Tory runs a hand over Jean’s body. What could it hurt? (NOT CONSENT) d. Lamar and Freddie are hanging out in the parking lot after school. They are just starting to realize they like each other a lot. Lamar reaches out to hold Freddie’s hand, and Freddie reaches back. While they’re holding hands, Lamar says, “Freddie, would it be okay if I kissed your cheek?” Freddie smiles and says, “Yes!” Lamar gives Freddie a kiss on the cheek. (CONSENT)

The class may want to take some time to discuss Example C. Pose the question, “Can anyone under the influence truly consent? Why or why not?” If there is sexual contact and no consent, that is sexual assault. It does not matter if the people involved know each other or even if they are in a relationship together. Reiterate that in Example B, the consent was non-verbal, but it was still clear.

Let students know in the next part of the lesson they’ll spend time thinking about and practicing the verbal communication technique covered in the last lesson, with the acronym SLIDE 1. Post SLIDE on the board:

S – State what you want/need

L – Listen and clarify

I – Identify with other perspectives

D – Determine common ground

E – Elicit agreement

Additionally, tell students this time you’ll focus on “I” Statements. Post the following acronym on the board, as well:

Effective Verbal Communication: I TELL YOU 2 I Identify feelings (thoughts, ideas) T Tell feelings (thoughts, ideas) E Express using I-statements L Look at the person you’re speaking to L Listen to the response Y Your body language is appropriate O Open mind U Use assertive communication style

1 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL. 2 Ibid.

Tell students that now they are going to demonstrate effective ways to communicate personal boundaries as it relates to intimacy and sexual behavior using scenarios, SLIDE and I TELL YOU .

Ask two volunteers to read Scenario 1 (give them the “I” Statement Challenge Handout ):

A couple is sitting at the school football game.

Scenario 1: Student A : We never do what I want to do. We only do what you want. Student B : That’s because it’s my car and you don’t have any money. Student A : You only care about you. Maybe we are not meant for each other after all.

Ask for another two volunteers and have them read Scenario 2:

Scenario 2: Student A : I am not really that into football. I wish we could spend our Friday nights doing something else sometimes. Student B : We have friends on the team and football doesn’t last forever…but what else did you have in mind? Student A : I’d love to get something to eat and maybe take a walk together…just us. Actually, I could make us dinner so we don’t have to spend money. When the team has an away game, could we do that? Student B : Yeah, that sounds really nice.

Discussion Questions :

• What was the same about the two scenarios? • What was different? • How easy or difficult do you think it would be to shift from the communication in Scenario 1 to something more like Scenario 2?

Explain that Student A was using an “I” Statement approach in Scenario 2. Talk about how when communicating, staying focused on what you need or feel is easier for another person to hear than attacks or assumptions about how another person is feeling. To get used to this kind of communicating, the “I” Statement formula is often (write this on the board):

When you , I feel . I would like ______.

Take a moment to connect consent and “I” Statements. Ask students how they think these two things relate to each other. Restate the definition of consent as “clear and unambiguous communication.” Restate the definition of an “I” Statement as a clear and unambiguous way to state what a person likes or dislikes.

Pass out the “I” Statement Response Worksheet . Tell students they are going to get in pairs and create an “I” Statement to respond to the statements found on the worksheet. Use the assessment at the end of this lesson to evaluate student learning based on their worksheets.

A couple is sitting at the school football game.

Student Names:

The purpose of this exercise is for you and your partner to practice and demonstrate using effective verbal communication, including “I” Statements. Review the communication tools SLIDE and I TELL YOU :

S – State what you want/need L – Listen and clarify I – Identify with other perspectives D – Determine common ground E – Elicit agreement

Effective Verbal Communication: I TELL YOU 3 I Identify feelings (thoughts, ideas) T Tell feelings (thoughts, ideas) E Express using I-statements L Look at the person you’re speaking to L Listen to the response Y Your body language is appropriate O Open mind U Use assertive communication style

Keeping in mind SLIDE and I TELL YOU , rewrite the following situations using “I” Statements. One way to construct the statements is as follows:

When you , I feel . I would like ______.

Try to come to a resolution or action step with just a few lines of dialogue. If possible and applicable, focus the content of your “I” Statement on giving or not giving consent. Consider how this is similar or different from how you might usually respond in this type of situation.

3 Ibid.

Scenario 1 : Tony and Theresa have been dating for one month. Tony likes walking with his arm around Theresa. Theresa does not like it and feels like Tony is always hanging on her. Theresa : “Why do you always have to be hanging on me?” Tony : (mopes and gives her the silent treatment) INSTEAD:

Scenario 2 : Calvin always kisses Chris on the neck and it makes Chris feel ticklish. Chris pushes Calvin away. Calvin keeps doing it and then it starts to seem like a wrestling match. Calvin : Why won’t you let me kiss you? Chris : Why do you always have to go for my neck? INSTEAD:

Scenario 3 : Tia is best friends with May. They are always together, even when Tia goes on dates with her romantic partner. Partner : Why can’t we ever be alone? Tia : What do you have against May? She is my best friend! INSTEAD:

Assessment Rubric

Use the following rubric to assess student mastery of learning objectives based on classroom observation.

Student name: Learning Outcome Not Present Developing On Target Student participation Student participation and Student participation and work reflects Define consent as it work reflects minimal to and work reflects thorough applies to a sexual no understanding of the some understanding understanding of the situation objective. of the objective. objective. Student participation Demonstrate how to Student participation and Student participation and work reflects use I statements work reflects minimal to and work reflects thorough when communicating no understanding of the some understanding understanding of the consent objective. of the objective. objective. Demonstrate effective ways to communicate Student participation personal boundaries Student participation and Student participation and work reflects as they relate to work reflects minimal to and work reflects thorough intimacy and sexual no understanding of the some understanding understanding of the behavior objective. of the objective. objective. Analyze factors, including alcohol and other substances, that can affect the Student participation ability to give or Student participation and Student participation and work reflects perceive the work reflects minimal to and work reflects thorough provision of consent no understanding of the some understanding understanding of the to sexual activity objective. of the objective. objective. Demonstrate respect Student participation for the boundaries of Student participation and Student participation and work reflects others as they relate work reflects minimal to and work reflects thorough to intimacy and no understanding of the some understanding understanding of the sexual behavior objective. of the objective. objective. Teacher comments:

Homework

In preparation for Lesson 4 on reproductive anatomy, ask students to view one of the videos before the next class. Hand out the links to the videos below.

1. Female Sexual Response ( animated )

https://www.youtube.com/watch?v=iMHq_WuT6g0&oref=https%3A%2F%2F

2. Porn Sex versus Real Sex

https://www.youtube.com/watch?v=CGsa1CGmlzc

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Activity 4.1: Anonymous Question Box and Assessment of Lesson 3 (5 minutes)

Take a moment to check in on the ground rules for the Human Growth and Development unit. If there are questions in the anonymous question box, answer them using the Answering Difficult Questions Protocol . Remind students that the box will be available throughout the Human Growth and Development unit. Then ask students for examples of “I” Statements that they either used or thought about in retrospect after a difficult conversation. Assess the quality of “I” Statements based on the structure offered during Lesson 3.

Activity 4.2: Reproductive Anatomy “Gonads to Gonads” Game (20 minutes)

In Lesson 3 , students were given the assignment to watch at least one short video on reproductive anatomy to watch online. The videos were:

1. Female Sexual Response (animated)

https://www.youtube.com/watch?v=iMHq_WuT6g0&oref=https%3A%2F%2F

2. Porn Sex versus Real Sex

https://www.youtube.com/watch?v=CGsa1CGmlzc

Check to see that most students watched a video.

Based on the information they learned from the videos, ask the students if they can name any corresponding male to female parts. For example: a man has testes and a woman has ovaries, both produce sex hormones. Or the clitoris in a female is like the penis in a male, both external and highly sensitive.

Let them know that they will be playing a game to review what they learned.

Break the class up into three teams and assign them Internal , External , and Brain .

Ask the students why the brain is a part of the reproductive anatomy (Answer : because the brain has structures that produce sex hormones and the brain is where humans process emotions relating to sex such as love and arousal). Ask students what physical parts of the brain interact with the internal and external organs (Answer : hypothalamus, pituitary gland).

Once the students are in three teams, distribute the Gonads to Gonads Term Cards based on group assignments. Give teams time to go through their term cards and make sure everyone knows what the terms are.

If there is confusion, this is the time to talk about it. During puberty the body changes physically (menstruation, body hair, growing body parts), but hormones are changing as well. Hormones signal your brain and body to want to have sexual intercourse.

Post around the room the following handouts: Brain Diagram , External Female Genitalia , Male Genitalia , and Internal Female Genitalia . Explain that the game is like “Apples to Apples.” To play, a team will play a card, then all the other teams will also

play a card and explain how the cards are related. The first team to get rid of all their cards will win.

Choose a team to put down the first card. Allow teams to refer to the diagrams as they explain how their cards relate to the first card that was put down. If the class agrees on the relatedness of the cards, move on to the next team, asking them to put a card down. If there is a card played that does not seem to relate, ask that team to pick their card back up. Once the cards are all played, and you have a clear winning team, issue a prize of your choosing.

Activity 4.2: Gonads to Gonads Term Cards Brain: Brain: Puberty Progesterone Brain: Brain: Hypothalamus Attraction Brain: Brain: Hormone Feelings Brain: Brain: Testosterone Thoughts Brain: Brain: Estrogen Pituitary gland Brain: Internal: Uterus

© 2018 Health Care Education & Training . All Rights Reserved Frontal lobe higher level thinking Internal: Internal: Gonads – Fallopian ovaries tubes Internal: Internal: Spermatogenesis Endometrium Internal: Internal: Menstruation Cervix Internal: Internal: Ovulation Gamete – ova, sperm

Internal: Internal: Vagina Urethra External: External: Labia – majora, Clitoris minora External: External: Secondary sex Perineum characteristics External: External: Vulva Scrotum External: External: Gonads Menstruation – testes External: Penis

Activity 4.2: Brain Diagram Handout

Activity 4.3: Menstruation and the Path of the Egg (10 minutes)

Utilize the Internal Female Genitalia Handout . Refer to the Menstrual Cycle Fact Sheet . Ask students when an egg is released during a 28-day cycle. Talk about that the egg will travel down the fallopian tube towards the uterus during ovulation. Emphasize that during this phase the sperm can fertilize the egg. Ask what happens if the egg is not fertilized. Then discuss that menstruation or a “period” is when the lining of the uterus, called the endometrium, breaks down and sheds from the body.

Be sure to explain the following Functional Health Knowledge related to the menstrual cycle to the students:

 Explain the average 28-day menstrual cycle  Describe the different phases of the menstrual cycle  If an egg is not fertilized…  A “period” is when the endometrial lining of the uterus breaks down and is shed from the body

Activity 4.4: Human Sexual Response and Reproduction (20 minutes)

Explain that the biological urge to reproduce is built into every species. Although current understanding is that humans are one of the only species to engage in sex for reasons other than reproduction, human bodies are still wired to assist reproduction during sexual activity.

Let the class know that after the review of anatomy and physiology they had during the “Gonads to Gonads” game, you are now going to talk about sexual response and how the changes the body goes through during sexual activity exist to aid in fertilization (regardless of who the partners are or their genders).

If you have not talked about it in the past, remind students that in the male reproductive system, the testicles produce and store sperm cells. When sperm are released into a female reproductive system that is ovulating, this can cause pregnancy.

Pass out the Human Sexual Response Cycle Worksheet . The worksheet is divided into sections based on the research of Masters and Johnson 1.

As you talk through sexual response using the worksheet as a guide, have students fill in the grids. Like the “Gonads to Gonads” game, ask students to pay attention to the processes that are the same. Refer to the Teacher Worksheet for notes and the correct answers to fill in the charts.

1 Masters, W. H., Johnson, V. E., & Reproductive Biology Research Foundation (U.S.). (1966). Human sexual response [by] William H. Masters, research director [and] Virginia E. Johnson, research associate, the Reproductive Biology Research Foundation, St. Louis, Missouri. Boston: Little, Brown.

What is the sexual response cycle?

The sexual response cycle refers to the sequence of physical and emotional changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities, including intercourse and masturbation. Knowing how your body responds during each phase of the cycle can enhance your relationship. This was originally researched by Masters and Johnson. It is not the only model of a sexual response cycle, but it is the best known one.

What are the phases of the sexual response cycle?

The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. All people experience these phases, although the timing usually is different. In addition, the intensity of the response and the time spent in each phase varies from person to person. Understanding these differences may help partners better understand one another’s bodies and responses to enhance the sexual experience.

Phase 1: Excitement

General characteristics of this phase, which can last from a few minutes to several hours, include the following: Characteristic Male Female Role in fertilization? Increase in muscle tension Heart rate and breathing quicken Skin may become flushed Nipples hard or erect Increase blood flow to genitals; swelling of the clitoris and labia minora (inner lips), and erection of the penis Vaginal lubrication Breasts fuller, vagina swells and walls turn a dark purple Testicles swell, scrotum tightens, begins secreting lubricating liquid

During this phase, the changes that occur during excitement are intensified. General characteristics of this phase, which extends to the brink of orgasm, include the following:

Characteristic Male Female Role in fertilization? The clitoris becomes highly sensitive (may even be painful to touch) and retracts under the clitoral hood. Vagina elongates, uterus draws up and back in the body. The testicles are withdrawn up into the scrotum. Muscle spasms may begin in the feet, face, and hands.

Phase 3: Orgasm

This phase is the climax of the sexual response cycle. It is the shortest of the phases and generally lasts only a few seconds. General characteristics of this phase include the following:

Characteristic Male Female Role in fertilization? Involuntary muscle contractions begin. Blood pressure, heart rate, and breathing are at their highest rates, with a rapid intake of oxygen. There is a sudden, forceful release of sexual tension. Muscles of the vagina contract. The uterus also undergoes rhythmic contractions. Rhythmic contractions of the muscles at the base of the penis result in the ejaculation of semen. A rash or sex flush may appear over entire body.

Phase 4: Resolution

During this phase, the body slowly returns to its normal level of functioning. Swelled and erect body parts return to their previous size and color. This phase is marked by a general sense of well-being, enhanced intimacy and, often, fatigue. Female structures are capable of a rapid return to the orgasm phase with further sexual stimulation and may experience multiple orgasms. After male ejaculation, the recovery time is called a refractory period, during which it is not possible to reach orgasm again. The duration of the refractory period varies and changes with age.

What is the sexual response cycle? The sexual response cycle refers to the sequence of physical and emotional changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities, including intercourse and masturbation. Knowing how your body responds during each phase of the cycle can enhance your relationship. This was originally researched by Masters and Johnson. It is not the only model of a sexual response cycle, but it is the best known one.

What are the phases of the sexual response cycle? The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. All people experience these phases, although the timing usually is different. In addition, the intensity of the response and the time spent in each phase varies from person to person. Understanding these differences may help partners better understand one another’s bodies and responses to enhance the sexual experience.

Phase 1: Excitement General characteristics of this phase, which can last from a few minutes to several hours, include the following: Characteristic Male Female Role in fertilization? Increase in muscle tension X X Heart rate and breathing quicken X X Skin may become flushed X X Nipples hard or erect X X Increase blood flow to genitals; X X External structures prepare swelling of the clitoris and labia minora for penetration and (inner lips), and erection of the penis stimulation of external sex organs Vaginal lubrication X Vagina prepares for penetration. Becomes less acidic and friendlier for sperm Breasts fuller, vagina swells, and walls turn a X External structures prepare dark purple for penetration and stimulation of external sex organs Testicles swell, scrotum tightens, begins X Penis lubricating liquid will secreting lubricating liquid make penetration more pleasurable

© 2018 Health Care Education & Training . All Rights Reserved Phase 2: Plateau During this phase, the changes that occur during excitement are intensified. General characteristics of this phase, which extends to the brink of orgasm, include the following:

Characteristic Male Female Role in fertilization? The clitoris becomes highly sensitive (may X Clitoris position enables even be painful to touch) and retracts under pleasurable sensations the clitoral hood. to maintain arousal and response of internal structures Vagina elongates, uterus draws up and back X The cervix drops into a pool in the body. of vaginal secretions to make it easier for sperm to enter cervix and uterus The testicles are withdrawn up into the X Body temperature rather scrotum. than external temperature regulates sperm Muscle spasms may begin in the feet, face X X Spasms precede and hands. contractions of the muscular structures of the reproductive system Phase 3: Orgasm This phase is the climax of the sexual response cycle. It is the shortest of the phases and generally lasts only a few seconds. General characteristics of this phase include the following:

Characteristic Male Female Role in fertilization? Involuntary muscle contractions begin. X X Blood pressure, heart rate and breathing are X X at their highest rates, with a rapid intake of oxygen. There is a sudden, forceful release of sexual X X tension. Muscles of the vagina contract. The uterus X Contractions draw the sperm also undergoes rhythmic contractions. up deeper into the uterus toward the ovum (egg) Rhythmic contractions of the muscles at the X Allows for the release of the base of the penis result in the ejaculation of sperm semen. A rash or sex flush may appear over X X entire body.

Phase 4: Resolution During this phase, the body slowly returns to its normal level of functioning. Swelled and erect body parts return to their previous size and color. This phase is marked by a general sense of well-being, enhanced intimacy and, often, fatigue. Female structures are capable of a rapid return to the orgasm phase with further sexual stimulation and may experience multiple orgasms. After male ejaculation, the recovery time is called a refractory period, during which it is not possible to reach orgasm again. The duration of the refractory period varies and changes with age.

Activity 4.5: Assessment (5 minutes)

Collect student worksheets. Ask students what benefits there are to understanding sexual response. Possible answers might include:

 The link to sexual response and increased risk of pregnancy for heterosexual intercourse without protection  Sexual response is complex  See sexual response as a specific biological process with phases that can be impacted by thoughts, emotions, and controlled by the brain. A reminder can be made that just because a person feels a certain way or has certain thoughts, no action is required.

Use the following rubric to assess student learning based on class discussion and the handout.

Student name: Learning Outcome Not Present Developing On Target Identify the key structures that make Student participation Student participation up reproductive system and work reflects Student participation and work reflects anatomy for males and minimal to no and work reflects some thorough females. understanding of the understanding of the understanding of the objective. objective. objective. An alyze the Student participation Student part icipation relationship between and work reflects Student participation and work reflects human sexual minimal to no and work reflects some thorough response, hormones understanding of the understanding of the understanding of the and reproduction. objective. objective. objective. Teacher comments:

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• Activity 5.1: Anonymous Question Box (5 minutes)

Define an STI/STD as an infection or disease that is passed through sexual contact that could involve vaginal, oral or anal sex. State that most STIs/STDs do not show symptoms immediately. Explain that one of the responsibilities of becoming sexually active is keeping yourself and partner safe and healthy. Preventing STIs/STDs is part of this responsibility. Another responsibility is communicating about your sexual health status honestly. Tell the class that most STIs/STDs are found among people ages 15-24. Let them know that 25%, or 1 in 4, teens in the U.S. will get an STI/STD during their teenage years. 1 Remind students that the best form of prevention is abstinence.

Ask students to identify those STIs/STDs they have heard about and list them on the board. The most common ones are:

• Bacterial Vaginosis • Chlamydia • Gonorrhea • Hepatitis • Herpes • HIV (human immunodeficiency virus) • Genital warts/HPV (human papillomavirus) • Pubic lice • Syphilis • Trichomoniasis (Trich)

Explain that today’s lesson explores basic information about the most common STIs/STDs, and more importantly, they will identify resources for STI/STD testing and treatment in or near their community. Let them know that some of the important facts about STIs/STDs to know are:

• How do you get it? • How do you know if you have it? • Can it be cured? • Where can you get tested and treated? • What can happen if you don’t get treated? • How can you prevent it or lower your risk?

1 Cates JR, Herndon NL, Schulz S L, Darroch JE. (2004). Our voices, our lives, our futures: Youth and sexually transmitted diseases. Chapel Hill, NC: University of North Carolina at Chapel Hill School of Journalism and Mass Communication.

Ask the students if they know any symptoms of the listed STIs/STDs or how they are treated. Add that information to the board. Reference the CDC STD Fact Sheets for Complete Functional Health Information.

Explain that when searching the internet, you need to make sure you are using a valid, reliable resource for information. One can’t just type a term into a search engine and then click on the first website that is listed.

Talk about how reliable, valid resources list references for their information, come from a published journal, or a government source. Encourage students to look outside of the CDC website to find information if they get their assignment done. Use the following acronym 2 to teach students how to identify reliable sources of information:

A - Is it accurate ?

C - Is it credible ?

C - Is it current ?

E - Is it easy to use and access?

S – What situations is it best used in?

S - Are claims or information supported by scientific evidence?

As a demonstration, ask students to go to the Centers for Disease Control Website (www.cdc.gov). Ask them where they think they could go on the CDC website to find the information they need regarding STIs/STDs (diseases and conditions). Tell them you had them go to this website because it is a reliable source.

Divide the class into even groups. Give each group an even amount of term STD cards (left column of STD Matrix Sheet ) without the definitions on them.

2 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL.

If you have access to a computer lab, tell students they are going to research the STIs/STDs named on the cards they received. Their task is to use a reliable source, such as the CDC, to describe the STI/STD they were assigned, and to answer at least two of the following questions:

• How common is this STI/STD in adolescents? • What are the symptoms of this STI/STD? • How serious? Can it be cured? • How is this STI/STD spread? • How can this STI/STD be prevented?

Students should write their information on the back of the cards.

Get the group back together and discuss what the students found.

Ask the students the following questions to further the discussion if there is time:

 What did you notice about various STI/STD symptoms? (That many of the symptoms are the same….)  What STIs/STDs are not curable? (Herpes, HIV) What does that tell you about those STIs/STDs? (That they are caused by a virus rather than bacteria)  What is the greatest risk of not seeking treatment for an STI/STD? (In the case of HIV, it could turn into AIDS and the risk is death. Syphilis carries the risk of brain damage/death in advanced stages or blindness in ocular syphilis. The most common STIs/STDs for teens carry the risk of infertility.)

Review that the best and most common way to prevent STIs/STDs is abstinence, but if you want to have sexual intercourse a latex barrier (condoms, dental dams) will help prevent STIs/STDs when used correctly.

Now give students the informational STD cards (right column of the STD Matrix Sheet ). Allow students to staple the information together for future use.

What is it? A sexually transmitted infection that

occurs in males and females.

How common? It is very common, particularly in

sexually active young people ages 15-24.

Symptoms? Often people do not have

symptoms. But if they do they can include

abnormal discharge, burning sensation when

urinating. How serious? Can it be cured? If untreated, it can spread to the female reproductive organs Chlamydia and lead to inability to get pregnant or a greater risk for a pregnancy in the fallopian tubes (ectopic pregnancy). Having this may also raise the risk of getting other STIs/STDs like HIV. How is it spread? Is spread through anal, oral, or vaginal sex with an infected person. A baby can get it via an infected mother during childbirth. How can it be prevented? Abstinence, or being in a long term, monogamous relationship where both people have been tested and are negative for STIs/STDs, and using latex condoms correctly every time during oral, anal, or vaginal sex.

What is it? A sexually transmitted infection that occurs in males and females. How common? Is more common in young people ages 15-24. Symptoms? Symptoms include a burning sensation when urinating, and white, yellow or green discharge from the penis or vagina. Females often do not have symptoms but may also have bleeding between periods. How serious? Can it be cured? Can be cured with antibiotics, but in some areas, there are strains that are resistant to antibiotics. If left Gonorrhea untreated, it can create scar tissue in the reproductive organs for both males and females, leading to pain and possibly infertility. How is it spread? Having oral, anal or vaginal sex with someone that has the STI/STD. How can it be prevented? Abstinence, or being in a long term, monogamous relationship where both people have been tested and are negative for STIs/STDs, and using latex condoms correctly every time during oral, anal, or vaginal sex.

© 2018 Health Care Education & Training . All Rights Reserved What is it? An ST D that can cause long term complications if not treated. How common? Is more common in some populations. Males who have sex with other males and people who are HIV positive may be more susceptible. Symptoms? There are three stages. The early stages involve a sore called at the site of infection, usually on the genitals, anus, or inside the mouth. After this goes away, the second stage usually involves a skin rash and/or sores in the mouth, anus, or vagina. How serious? Can it be cured? This STD can be Syphilis passed to a fetus, resulting in low birth weight or death. This STD occurs 10-30 years after infection and can result in death. This can be cured with the right antibiotics, but any damage caused by the disease cannot be undone. How is it spread? Is spread through direct contact with the sores of an infected person or during pregnancy to the fetus. How can it be prevented? Abstinence is best, or being in a long term, monogamous relationship where both people have been tested and are negative for STIs/STDs, and using condoms correctly every time during oral, anal, or vaginal sex.

What is it? An STD that can cause genital warts. How common? Very common. Cervical cancer is caused by this STD. Symptoms? Most people have no symptoms or are unaware until they have genital warts. How serious? Can it be cured? In most cases it Human goes away on its own, but when it doesn’t, it can cause genital warts and cancer. There is no cure. How is it spread? Having oral, anal, or vaginal Papilloma sex with someone who is infected. It can be passed even if the person with the STD has no symptoms. Virus How can it be prevented? This STD can be prevented by getting a vaccine.

(HPV)

What is it? Parasitic insects found primarily in the pubic or genital area of humans. Symptoms? Itching and bumps in the genital area or the presence of bugs or their eggs. They are usually found in the genital area on pubic hair, but they may occasionally be found on other coarse body hair, such as hair on the legs, armpits, mustache, beard, eyebrows, or eyelashes. Pubic How serious ? Can it be cured? Difficult to get rid of but they will not cause other disease or more serious conditions. How is it spread? Is spread through sexual contact with an infected person or through close contact with bedding, towels, or clothing of an Lice infected person. How can it be prevented? Abstinence is best, or being in a long term, monogamous relationship where both people have been tested and are negative for STIs/STDs. Condoms will not protect against this.

What is it? An STD caused by two types of viruses. How common? In the United States, about one out of every six people aged 14 to 49 years have Herpes this STD. Symptoms? Most people who have this have very mild symptoms. Simplex How serious? Can it be cured? This STD is a virus that stays in the body forever. There is no cure, but drugs are available that can prevent Virus outbreaks or shorten them. Over time, most people have fewer outbreaks. How is it spread? By having vaginal, anal, or oral sex with someone who has the disease. Fluids (HSV) found in a herpes sore carry the virus and contact with those fluids can cause infection. How can it be prevented? Abstinence, or being 1 and 2 in a long term, monogamous relationship where both people have been tested and are negative for the STD, and using latex condoms correctly every time during oral, anal, or vaginal sex.

What is it? A virus that is in the blood, breast milk, semen and vaginal fluids of infected people. The virus attacks the body’s immune system. How common? Currently 1.2 million people are living with it in the United States and nearly one in seven of them do not know they are infected. Symptoms? When first infected, people report flu like symptoms. Eventually those symptoms go Human away but this is when a person is at very high risk of transmitting the virus to others. How serious? Can it be cured? If left untreated, Immunodeficiency this will eventually progress to AIDS. There is no cure for it, but with new drug treatment (taken Virus consistently) people are living with HIV. How is it spread? Is spread through contact with blood, semen, or vaginal fluids of an infected (HIV) person. Pregnancy and breastfeeding can also transmit it to a fetus or baby. How can it be prevented? Abstinence, or being in a long term, monogamous relationship where both people have been tested and are negative for HIV, and using latex condoms correctly every time during oral, anal, or vaginal sex. What is it? An inflammation of the liver. How common? The most common types of are entitled A, B, C. Symptoms? Many people do not experience symptoms and do not know they are infected. How serious? Can it be cured? Most people will develop a chronic lifelong infection with serious complications. However, there is now a treatment that can cure, but it is extremely expensive. How is it spread? Is spread through contact with an infected person’s blood, even in small Hepatitis amounts. Most often this occurs when sharing needles or even personal items like razors, toothbrushes, or nail clippers. How can it be prevented? Take universal precautions to not be exposed to the blood of others. Never share needles, personal items that may have small amounts of blood on them, and only get tattoos or piercing in licensed shops that sterilize their equipment. What is it? An infection caused when too much of certain bacteria change the normal balance of bacteria in the vagina. How common? Most common in females (ages 15-24). Symptoms? Many females do not have symptoms. If they do have symptoms, it is usually a thin white or gray vaginal discharge, odor, pain, itching, or burning in the vagina. Bacterial Some women have a strong fish-like odor, especially after sex. They may also have burning when urinating, itching vaginal opening, or both. How serious? Can it be cured? Can cause some serious health risks, including: increasing the Vaginosis chance of getting HIV from unprotected sex with an HIV positive person; making it more likely for a premature birth if pregnant; increasing the chance of getting other STIs/STDs, such as chlamydia and gonorrhea. Can lead to pelvic inflammatory disease (PID), which can result in fertility problems. It can be cured with antibiotics. How is it spread? Doctors are not sure. Can be spread during sexual activity. How can it be prevented? Abstinence, limiting the number of sex partners, not douching. What is it? A sexually transmitted infection that occurs in males and females. How common? The most common. Symptoms? Itching or irritation in the genitals, discharge from the genitals, discomfort/burning during or after urination or ejaculation. About Trichomoniasis 30% of people infected experience symptoms. How serious? Can it be cured? It is curable. Because of genital inflammation, it can increase (Trich) the risk of contracting or transmitting other STIs/STDs. How is it spread? The parasite passes from an infected person to an uninfected person during sex. In females, the lower genital tract (vulva, vagina, cervix, or urethra) is most commonly infected; in males, the penis. How can it be prevented? Abstinence, or being in a long term, monogamous relationship where both people have been tested and are negative for the STI/STD, and using latex condoms correctly every time during oral, anal, or vaginal sex. Activity 5.3: Graffiti Sheets: Get Yourself Tested (15 minutes)

Let students know that since they now know some information about common STIs/STDs they need to know what to do if they suspect they have one. Ask if students know where to go to get tested for an STI/STD.

If the internet is available, have students go to https://gettested.cdc.gov/ . If not, let them know they can search that database to find a place to get tested near them. Next ask students to think about why it is important to get tested and what they think some of the challenges are that come with STI/STD testing.

Post flip chart paper around the room with the following headings:

• It is important to get tested for STIs/STDs because… (Answers: If you don’t, you could have effects from it forever. Some STIs/STDs are linked to cancer. You could give a partner one without even knowing it or get one from a partner without knowing it.) • It is important to talk with sexual partners about STI/STD status because… (Answers: It may be on their mind too. You do not want to get an STI/STD. You may not want to be with a person if they don’t want to get tested or haven’t. You could go together.) • Some reasons why people do get tested are… (Answers: They are scared. They want to know their status. They don’t want to think about it. They know where to go.) • If a sexual partner did not tell me they had an STI/STD I would feel… (Answers: Sad, angry, scared, upset, offended.) • Some reasons people do not get tested are… (Answers: You may feel you will offend your partner or make them feel uncomfortable by asking if they have ever been tested. Or it could be that you and your partner are so quick to want to get intimate that you don’t want to bother with getting tested before you start hooking up. The testing place doesn’t seem friendly to me because – I am male. I am gay. I am transgender. I know someone who works there.)

Tell students to get up and write responses to the sheets on the wall. Because there are multiple sheets, and this will be a very active few minutes, this method allows for some anonymity in answers.

Remind students a big responsibility that comes with being sexually active is knowing your sexual health status. Young people are disproportionately affected by STIs/STDs, so with the right advocacy skills, young people can help their peers to stay informed about their sexual health status and get tested. Advocacy means to support a cause – in this case, to support the cause of getting tested and knowing your sexual health status. Students can learn the skill of advocacy with the I CARE acronym 3:

I - Identify and research a relevant and meaningful health issue.

C - Create a health-enhancing position or message that is supported by facts and evidence and is geared toward the audience.

A - Act passionately and with conviction

R - Relay your health-enhancing message to your audience

E - Evaluate the effectiveness of your advocacy effort

Using the responses from the large sheet headed with “Some reasons people do not get tested are…” . Have each of the groups create a scenario around one of the reasons that involves either a friend or potential sexual partner advocating for STI/STD testing. As a demonstration, recruit a student volunteer and act out how you would advocate testing to someone who is afraid they have an STI/STD and doesn’t want to deal with it. Have students work in pairs to create a dialogue involving a friend trying to convince a peer to get tested, knowing the reason why is feelings of reluctance. Let students know they will demonstrate their role plays at the beginning of the Lesson 6.

Additionally, let students know there will be a take home worksheet to hand in at the next class.

Homework : Ask students to complete the STI/STD Demonstration of Understanding Worksheet to demonstrate their level of understanding of lesson objectives.

3 Ibid.

Student Name

Descr ibe 5 STIs/STDs and their common early symptoms.

Explain why it is imp ortant for young people who are sexually active to be aware of their sexual health status.

Describe where a young person can go to obtain STI/STD testing and treatment.

Describe the steps for identifying valid health information using ACCESS .

Name three reliable sources of health information online.

Student name: Learning Outcome Not Present Developing On Target Student participation and work reflects Student participation Student participation and minimal to no and work reflects work reflects thorough Identify common STIs/STDs understanding of the some understanding understanding of the and their characteristics objective. of the objective. objective. Student participation Explore local and national and work reflects Student participation Student participation and resources for STI/STD minimal to no and work reflects work reflects thorough treatment understanding of the some understanding understanding of the objective. of the objective. objective. Student partici pation and work reflects Student participation Student participation and Analyze why it is important minimal to no and work reflects work reflects thorough to get yourself tested for understanding of the some understanding understanding of the STIs/STDs objective. of the objective. objective. Student participation Demonstrate skill of and work reflects Student participation Student participation and accessing valid health info minimal to no and work reflects work reflects thorough using the ACCESS method understanding of the some understanding understanding of the objective. of the objective. objective. Student participation Demonstrate skill of and work reflects Student participation Student participation and advocacy skill using the I minimal to no and work reflects work reflects thorough CARE method understanding of the some understanding understanding of the objective. of the objective. objective. Teache r comments:

LESSON INTRODUCTION:

The purpose of this lesson is to explore the role of stigma associated with getting tested for HIV and STIs/STDs. A condom demonstration is included with this lesson to highlight an important means of preventing HIV transmission.

OBJECTIVES: GRADE: High School 45-60 min Students will be able to… LENGTH OF LESSON: 6 • Describe the role of stigma in relationship SEQUENCE: to getting tested and treated for HIV and STIs/STDs ACTIVITIES: • Demonstrate healthy self-management by understanding the importance of condom 6.1 Revisit classroom ground rules use as a health enhancing behavior and the Anonymous Question Box • Demonstrate the steps of using a condom 6.2 STD Role Plays 6.3 HIV Video VOCABULARY: • AIDS (Acquired Immunodeficiency 6.4 Healthy Self-Management and Using a Condom Syndrome) • Stigma 6.5 Anytown: Stigma, STDs and HIV

STANDARDS: MATERIALS/TECHNOLOGY: • HIV Video: http://bit.ly/2CLG9QO Wisconsin Standard for Health Education • How to Use a Condom Video: • Students will demonstrate the ability to http://bit.ly/2P1mVN1 practice health-enhancing behaviors and avoid or reduce health risks. • Anytown Cards (cut into individual cards) • Students will demonstrate the ability to • Assessment Rubric advocate for personal, family and • Homework Videos: (1) http://bit.ly/2Ek- community health. SNYE (2) http://bit.ly/2EkdnIY National Sexuality Education Standards • Condom(s) • SH.12.CC.2 Evaluate the effectiveness of • Scissors abstinence, condoms, and other safer sex • Penis model or banana (if applicable, methods in preventing the spread of STDs, provide enough condoms and including HIV. bananas for students to work in small groups/pairs) • SH.12.ADV.1 Advocate for sexually active youth to get STD/HIV testing and • Seven Steps to Using a Condom treatment. Handout - one for each student

Activity 6.1: Revisit classroom ground rules and the Anonymous Question Box (5 minutes)

Take a moment to check in on the ground rules for the class. Do a quick review of the homework from lesson five and ask if there are any outstanding questions or observations. Remind students of the anonymous question box. Refer to the Answering Difficult Questions Protocol referenced in the introduction of this Human Growth and Development Unit. Remind students that the box will continue to be available throughout the Human Growth and Development unit.

Activity 6.2: STD Role Plays (15 minutes)

Begin teaching by asking students why it is important that sexually active people get tested for HIV/STDs. Remind students of the key ideas associated with the importance of getting yourself tested for STIs/STDs that were presented in Lesson 5 . Post the I CARE acronym 1 on the board to remind students of the skill of advocacy.

I - Identify and research a relevant and meaningful health issue.

C - Create a health-enhancing position or message that is supported by facts and evidence and is geared toward the audience.

A - Act passionately and with conviction

R - Relay your health-enhancing message to your audience

E - Evaluate the effectiveness of your advocacy effort

Ask a few groups to present their “get yourself tested” role plays from Lesson 5 . After all the groups present, ask the following:

1. What strategies can be used to convince someone to get tested for HIV/STDs (showing concern, using facts, peer pressure, etc.)? 2. Do you think these strategies would be effective (maybe, definitely not, depends on how it is said or who says it)? 3. How easy or difficult is it to come up with a convincing argument to get tested given the reasons people do not get tested (easier if they just don’t know the facts, harder if emotional, etc.)? 4. What are reasons to tell a partner you are getting tested (encourage them to get tested, build trust, get support)? What are advantages and disadvantages to telling a partner your HIV or STI/STD status (advantages: relief, honesty, building trust; disadvantages: fear of loss of relationship, fear of violence)? 5. Given what you know about the places in your community where people can get tested, what might make those places more welcoming for all students? (encourage students to think about race, sex, gender identity, sexual orientation, age, ability, etc.)

1 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL.

Activity 6.3: HIV Video (10 minutes)

Tell students the purpose of this lesson is to learn about two important factors related to HIV:

1. Practicing healthy self-management to prevent HIV transmission with accurate and consistent condom use when one becomes sexually active. 2. The effects of stigma on the HIV epidemic.

Play the short video from CDC (HIV/AIDS 101) using the link (https://www.cdc.gov/cdctv/diseaseandconditions/hiv/hiv-aids-101.html ).

Check for student understanding after the video. Specifically cover:

1. How is HIV transmitted? (Answer: blood, semen, vaginal fluid, rectal fluid, mother to child) 2. Why is it important to get tested? (Answer: prevent the spread to others, initiate treatment to be able to live with HIV) 3. Who is at greatest risk of contracting HIV? (Answer: those who engage in anal intercourse, IV drug users-sharing needles, unprotected sex within populations where HIV is more prevalent)

Activity 6.4: Healthy Self-Management and Using a Condom (20 minutes)

Reiterate the message from the video that abstinence is the best method of protection against HIV and STDs. However, when people do choose to be sexually active, they need to practice healthy self-management by embracing safe practices such as consistently and accurately using condoms. Using a latex barrier can protect against many STIs/STDs, including HIV. Choosing to use a condom if sexually active is a choice that can protect both partners.

To teach the skill of self-management utilize the acronym I APPEAR 2:

I - Identify health behaviors, wants and needs within your context.

A - Access information, products, and services necessary to support health-enhancing behaviors or behavior changes.

P - Practice health-enhancing behaviors.

P - Practice avoiding health risk behaviors.

E – Explain your role in your health.

A – Assess the outcomes of the behavior changes or of current health policies.

R - Reflect on current health practices or changes made.

As a demonstration of how to use I APPEAR , walk students through how to apply the acronym to using condoms to prevent HIV transmission.

Now let students know you will demonstrate (and if school policy permits the students will practice) putting on a condom using a banana or a penis model.

For the demonstration (sample script and steps):

Did you know that there are many steps to using a condom properly? These seven steps will ensure correct condom usage. However, always remember to talk with a partner about safer sex and gain consent before engaging in sexual activity. (Remind students of the key ideas regarding consent that were presented in Lesson 3 ).

2 Ibid.

1. Check the condom type and expiration date. 2. Check for air bubble in package to ensure that the condom is not dried out or punctured. 3. Once the penis is erect, open the condom package carefully with your hands and remove rolled condom from the package (no teeth, sharp nails, or scissors). 4. Be sure the condom is upside right and will unroll easily. Squeeze the tip of the condom with your fingers and place the rolled condom on the head of the penis. 5. Leave a half inch space at the tip of the condom to collect semen. Semen is released at about 28mph! Hold the tip of the condom and roll the condom down the entire length of the penis pushing all the air out as it is rolled down. 6. After ejaculation, hold the rim of the condom and withdraw from partner while the penis is still erect. 7. Dispose of used condom properly by tying it in a knot, wrapping it in a tissue, and throwing it in the trash. Do not ever flush a condom down a toilet.

Remember : Use a NEW condom for every act of vaginal, oral, or anal intercourse!

If time permits, illustrate “How to Use a Condom” at https://www.youtube.com/watch?v=cRUIoelzlPs

If students can practice using condoms, students can work in pairs or small groups, but each student should have the opportunity to put a condom on a banana. When students have their bananas and condoms, model each step and have students complete the steps with you. Scaffold the demonstration by leading the entire demonstration the first time. The second time through have the students volunteer to give you the steps, assisting them if necessary. The third time, have them complete the task independently.

If school policy does not permit students to practice putting condoms on bananas, pass around a few wrapped condoms so students are able to locate the date stamp and feel the air bubble in the sealed packets.

Follow up this activity by asking students which steps were challenging (possible answers include tearing open the package without damaging the condom, knowing which way to place the condom, rolling the condom down the banana, etc.). Provide feedback to students on areas where you saw them struggling and where you saw them problem solve to learn this skill.

Ask students where they can get condoms and what stands in the way of them accessing condoms. Ask students to generate some simple solutions to access issues.

Ask students to take a few seconds to reflect on their personal practices and behaviors related to STD/HIV prevention and how this new skill might increase safety in the future or how the information could be shared with a sexually active friend.

Activity 6.5: Anytown: Stigma, STDs and HIV (15 minutes)

Let students know that they are now going to explore assumptions we make about people as they relate to sexual risk taking. Assumptions about people are often related to stigma. Stigma is extreme disapproval of a person or group based on the perception of what makes them different from others.

Review for students that having unprotected vaginal oral or anal sex with an HIV+ partner puts them at risk of contracting HIV. People should get tested regularly to ensure they know their sexual health status.

Ask for eight volunteers to read Set A of the Anytown Cards in the front of the room. After students read their cards, have the class rank them from “Most at Risk” to “Least at Risk” for getting HIV. After the class puts the cards in order of actual/perceived risk, ask the students the following questions:

• What do you know about the risk of contracting HIV? • What cues were you hearing that caused you to rank each person the way that you did? • Which of the town residents do you feel positive about? Which ones do you feel you may judge more harshly? Why?

Now pass out Set B of the Anytown Cards . Have students read the cards and have the class re-order based on the new information. Discuss the following with the class as a large group:

• Did any of the residents move position? Why? • What surprised you as you learned a bit more about each person? • Had you made incorrect assumptions or judgments based on the cards in set A? • How can making assumptions about sexual health status affect a person’s sexual health? • Who among the town residents is most at risk for a negative health outcome based on your assumptions?

Thank students that came to the front of the room to read the cards. Ask if someone can define stigma. Which of the town residents experienced stigma? Ask for examples of how the stigma is illustrated in that person’s story. What impact is it having, or could it potentially have, on their health? Based on the role plays in advocating for testing, how does stigma influence getting tested for HIV/STDs? Ask students if they can think of ways to combat stigma.

Activity 6.5: Anytown Cards (15 minutes)

Harry: A Harry: B

I am a young police officer in this small town. I Being gay in this town has been challenging. I married my high school sweetheart and I am have been attracted to men my whole life. When monogamous. My wife is the only woman I have Jason moved back, we rekindled our high school ever had sex with. romance. We are having sex and I think I am in love with him. My wife doesn’t know.

Jason: A Jason: B

I am a young gay man who recently I moved back to my hometown because I was moved back to my hometown after traveling sexually assaulted by a friend in New Orleans. I extensively and living in New Orleans and New was afraid to get tested after the assault, so I York. haven’t been tested yet. I moved home because I needed to grieve and get back to my roots.

Amanda: A Amanda: B

I am a six-month-old baby. I have seen my mom My mother is a Type 1 Diabetic. inject herself daily since I was born. I am breastfed.

Dr. Miller: A Dr. Miller: B

I am the only doctor in my small community. I am With access to medication and a past lower back responsible for the health care of all citizens, injury, I have become addicted to opiates. birth to death.

Judy: A Judy: B

I am doing my best to be a responsible adult. I I am HIV+. Last week I had unprotected sex with have had many sexual partners in my life. I have Dr. Miller. also experimented with drugs. But now that I’m in my forties, I’m considering making different choices. I just got a job at the town clinic.

Bill: A Bill: B

I am the star half-back on the high school football Some of my teammates use steroids. Now I do team. I am serious about athletics and academics. too so I can keep up and stay competitive. We I have never had sex. I don’t drink or do drugs. often share needles when we inject steroids in the locker room.

Stacy: A Stacy: B

I am sixteen and know that I’m a lesbian, but I’m I was sexually assaulted by three seniors and I’m afraid to be out in this small town. I get taunted afraid to tell. I don’t even know who I would tell. and bullied a lot.

Natasha: A Natasha: B

I am married to Harry. We started dating in high Sex with Harry was never great, and it hardly school and got married after we graduated. We happens anymore. I am having an affair with a have a little boy who just turned two. woman in my company who lives in a nearby big city. Harry doesn’t know.

Homework

Explain that the Centers for Disease Control (a U.S. health agency) has recognized the impact of stigma in HIV status and the role it plays in people getting tested and then treated. Tell students that for homework, they are going to watch two CDC videos and look for stigma.

http://www.cdc.gov/cdctv/diseaseandconditions/hiv/stop-hiv-together-jamar- rogers.html

http://www.cdc.gov/actagainstaids/campaigns/hivtreatmentworks/resources/videos.h tml

In a brief essay, students should identify which biases or stigma the videos are trying to address based on who is highlighted in the story. Possible biases about people include assumptions based on sex, race, sexual orientation, age, drug use, and gender identity. In their essays, students can address what biases/assumptions are on display in the videos including ones based on sex, race, sexual orientation, age, drug use, gender identity, or other factors they may notice. What messages were they giving? Are they effective messages? Why or why not? Also, have students address in their essays why using condoms or other latex barriers is an effective form of self- management for overall health, and describe the steps involved in using a condom.

Use the Assessment Rubric to assess student learning based on their essays.

Assessment Rubric

Use the following assessment rubric to assess student learning based on their essays.

Student name: Learning Outcome Not Present Developing On Target Student Student participation and participation and Describe the role of stigma work reflects Student participation work reflects in relationship to getting minimal to no and work reflects thorough tested and treated for HIV understanding of some understanding understanding of and STIs/STDs the objective. of the objective. the objective. Demonstrate healthy self - Student Student management by participation and participation and understanding the work reflects Student participation work reflects importance of condom use minimal to no and work reflects thorough as a health enhancing understanding of some understanding understanding of behavior the objective. of the objective. the objective. Student Student participation and participation and work reflects Student participation work reflects minimal to no and work reflects thorough Demonstrate the steps of understanding of some understanding understanding of using a condom the objective. of the objective. the objective. Teacher co mments:

LESSON INTRODUCTION:

The purpose of this lesson is to access medically accurate information and make healthy decisions about prenatal care services, support services, emergency contraception, and pregnancy options.

OBJECTIVES: GRADE: High School Students will be able to… LENGTH OF LESSON: 55 min • Access medically accurate information SEQUENCE: 7 about prenatal care and pregnancy support services • Identify community resources for pregnancy options • Use a decision-making model to make healthy choices about pregnancy ACTIVITIES: VOCABULARY: 7.1 Anonymous Question Box • Birth Defects • Placenta 7.2 Signs of Pregnancy • Dilation • Safe surrender • Labor • Transition 7.3 Accessing Valid Health Information • Phases of labor and Decision-Making for

STANDARDS:

Wisconsin Standard for Health Education

• Students will demonstrate the ability to use decision-making skills to enhance health. • Students will demonstrate the ability to MATERIALS/TECHNOLOGY: access valid information and products and services to enhance health. • 5 Computer Stations (Or Printed Web-page Stations) for Activity 7.3 National Sexuality Education Standards • Labor and Delivery Video: http://bit. • PR.12.CC.3 Identify the laws related to ly/2AbWko8 (includes birth footage reproductive and sexual health care with vulva blurred out; just over 2 services. minutes long.) • PR.12.CC.4 Describe the signs of pregnancy. • Handout: Pregnancy Scenarios • PD.12.DM.1 Apply a decision-making (2 pages) – cut into individual scenarios model to various situations relating to sexual health. • Worksheet: Pregnancy Scenarios • PR.12.AI.4 Access medically accurate (2 pages) information about prenatal care services. • Assessment Rubric • PR.12.AI.2 Access medically accurate information and resources about emergency contraception • PR.12.AI.3 Access medically accurate information about pregnancy and pregnancy options

Let students know that the lesson today will be about health behaviors and laws surrounding pregnancy and pregnancy options.

Begin the lesson by asking students to brainstorm all the signs and symptoms of pregnancy they can think of. Write them down and, after each, pause and ask them how that relates to what is happening in the body to cause that sign. For example, a missed period is the result of a disruption of the hormonal cycle due to hormones produced by the fertilized egg.

If you want to show a video on pregnancy and birth, do that as part of this section. The Labor and Delivery Video listed in the Resources/Materials/Technology section only covers labor and delivery.

Activity 7.3: Accessing Valid Health Information and Decision- Making for Pregnancy (40 minutes)

Part One : Remind students of what they learned in lessons 5 about accessing valid health information online. Post the ACCESS acronym 1 in the room:

A - Is it accurate ?

C - Is it credible ?

C - Is it current ?

E - Is it easy to use and access?

S – What situations is it best used in?

S - Are claims or information supported by scientific evidence?

Let students know that today you’ll review the skill of accessing valid health information, applying it to finding credible information about pregnancy. You’ll also learn the skill of decision-making as it applies to healthy choices around pregnancy.

Split the class into five groups and pass out one scenario from the Pregnancy Scenarios Handout to each group. Have one member of the group read the scenario out loud to the rest of their group. Then, in their groups, students should generate a list of questions and possible actions the people in the scenario might take.

Meanwhile, have five computer (or printed webpage) stations set up around the room:

 Station 1 : Health behaviors and pregnancy; including legislation on drug use during pregnancy US Department of Health and Human Services: www.womenshealth.gov Laws on drug use and pregnant women: http://www.guttmacher.org/statecenter/spibs/spib_SADP.pdf

 Station 2 : Safe Surrender Legislation http://safeplacefornewborns.org

1 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL.

 Station 3: Pregnancy options; including adoption and termination; all pregnancy options and additional information on the parental consent law in Wisconsin http://www.plannedparenthood.org/learn/abortion/

 Station 4: Cost of a Baby Paying for pregnancy, childbirth, and beyond Information on Badger Care Maternity Benefits: https://www.dhs.wisconsin.gov/publications/p1/p10026.pdf The Bump: A website/blog from “The Knot” magazine http://www.thebump.com/a/advice-for-saving-up-for-a-baby Child support enforcement in Wisconsin https://dcf.wisconsin.gov/cs/home

 Station 5: Accessing contraception and reproductive health care https://www.dhs.wisconsin.gov/fpos/index.htm Information on Plan B Emergency Contraception http://ec.princeton.edu/providers/index.html

Pass out the Pregnancy Scenarios Worksheet (one for each student). Then, with the students in groups, have the groups rotate to the various stations to learn more about pregnancy and parenting in terms of laws, programs, etc. Students should capture on Part 1 of their Pregnancy Scenarios Worksheet any information that would help them access medically accurate prenatal care services and support, as well as information about emergency contraception and pregnancy options for the characters in the scenarios. Once the students have gone through all the stations to access valid health information, the teacher should bring the class back together and lead a brief discussion on the following questions:

• What resources did you find at each station? • How did you judge whether the resources were reliable? • How did you use the resources? • Can you imagine you or someone you know using these sources of information, why or why not? In what ways could this information be useful to you or someone you know?

Part Two : Let the class know now that you have valid information for the scenarios, the class will practice making healthy decisions for the characters. With the class all together, present the following decision-making model to help the students determine what the characters in the scenarios could do to make a healthy choice:

© 2018 Health Care Education & Training . All Rights Reserved  Step 1: Assess the situation: what decisions need to be made?  Step 2: List the options: what are all the positive and negative choices you could make?  Step 3: Weigh the possible outcomes using HELP (healthful, ethical, legal, parent approval)  Step 4: Consider your values: what attitudes, ideas and beliefs are important to you?  Step 5: Decide and act on the healthiest outcome and justify why it is the healthiest option.  Step 6: Evaluate and reflect on the outcome. 2

Write the title of each Pregnancy Scenario on the board. Ask students from each of the groups to describe the situation and key characters. Then have them identify the concerns and choices characters must make, and practice with the students making healthy choices for the characters using the six-step decision making model. You can demonstrate the model for students using one of the Pregnancy Scenarios. After groups report this out, have a broader discussion about resources and options. Students can fill out Part 2 of their Pregnancy Scenario Worksheet during this conversation, or it can be assigned as homework.

2Benes, S. & Alperin, H. (2016) The essentials of teaching health education: Curriculum, instruction, and assessment. Human Kinetics: Champaign, IL.

Activity 7.3: Handout: Pregnancy Scenarios

#1: Tally and Ray

Tally and Ray, both 17-year-old seniors, have been dating since sophomore year. They have discussed wedding plans but are going to wait until Tally graduates from a nursing assistant community college program. Ray works for his father’s plumbing business and has plans to do that full time once he graduates. They both like to go to parties on the weekends and often drink and get high. Ray also smokes cigarettes. Tally and Ray usually rely on Tally’s long acting birth control shot (Depo) for pregnancy prevention and have not used condoms for about a year. Tally missed her last shot appointment. Although she often does not menstruate with the shot, something felt different, so she took a pregnancy test and it was positive.

#2: Sondra

Sondra is 15. Her family is against premarital sex, birth control, and abortion. Sondra is the oldest of four sisters and one brother. Her parents do not let her spend time with friends or go out. She spends her time studying, attending church, and caring for her younger siblings. Her family expects her to earn good enough grades to get a college scholarship. For the last couple of months, Sondra and a 16-year-old boy from her church have been making out every weekend. They had sex once, and they did not use protection. A month has passed since the time they had sex, and Sondra is pretty sure she is pregnant.

#3: Lucy

Lucy is 16 and has a two-year-old son that she is raising on her own with great support from her father. Lucy has recently gotten sober. She is taking high school classes in an alternative program and parenting classes, too. Lucy has a social worker who helps her with finding resources for herself and her son, including job training and applying for jobs. Lucy trusts her social worker. Lucy remembers how hard it was when she got pregnant at 14. Her father kicked her out and she was living on the street. Lucy’s relationship with her father is getting better now that Lucy is sober and working hard in school. Lucy has a couple of friends she has sex with on occasion, but they are just friends without commitments. When Lucy discovered she was pregnant again, she was devastated and told no one. She has hidden her pregnancy under baggy clothes

for the past six months. Lucy does smoke cigarettes, but since she got pregnant again the cigarettes make her feel sick, so she has cut down. As her due date grows closer and she hasn’t seen a doctor, Lucy is starting to panic. She does not want to raise another child. She was just starting to feel like her life was under control.

#4: Merrin

Merrin is 17 years old and bisexual. She came out to her friends and family last year. Merrin struggles with being accepted at school, and at home they tell her it is just a phase. Merrin knows she has a problem with drugs and alcohol, but justifies her use because it helps her deal with life. A couple of months ago Merrin was at a party and drank a lot of alcohol. The last thing Merrin remembers, three boys from her school pulled her into a bedroom and each of them took turns sexually assaulting her. They laughed and said horrible things. Merrin has been really depressed and getting drunk and high every day since it happened but has told no one. Merrin has been vomiting every day on the way to school for almost a month. One of her teachers pulled her aside and expressed concern. Merrin did not want to talk to her teacher. So, the teacher suggested she go see the school nurse. When Merrin saw the nurse, she started to cry and told her everything. The nurse gave her a hug and the phone number to their local sexual assault resource center. The nurse also gave Merrin a pregnancy test and it was positive.

#5: Troy and Mandy

Troy is 16 years old and has been dating 15-year-old Mandy for six months. They recently started having sex. Troy was glad when Mandy said she was on birth control and that he did not need to use a condom. It was cheaper and one less thing to worry about for him! Troy frequently skips school, because he prefers to skateboard and do drugs. Troy is also dealing drugs and just bought a project muscle car with the cash he has available. Mandy is quiet and always happy to do what Troy wants to do. Last night when they were hanging out, Mandy told Troy she is pregnant and that he is the father. Mandy is excited to be pregnant and is disappointed Troy does not feel the same way. She said she is going to have the baby no matter what. Troy was just starting to feel like things were going his way.

Activity 7.3: Worksheet: Pregnancy Scenarios

Student Name:

Part 1: Rotate through the five stations with your group. Each station has information related to pregnancy options/resources, healthy behaviors, and laws. As you explore the information, capture any resources or facts that would inform the characters in your scenario, and answer the following:

Who are the key characters in your scenario?

How far along is the pregnancy?

What are the accurate resources available for prenatal care?

What are the accurate resources available for emergency contraception?

What are the accurate resources available for pregnancy?

What are the accurate resources available for pregnancy options?

Part 2: using the decision-making model, answer the following questions on your own:

 Step 1: Assess the situation: what decisions need to be made?  Step 2: List the options: what are all the positive and negative choices you could make?

 Step 3: Weigh the possible outcomes using HELP (healthful, ethical, legal, parent approval)  Step 4: Consider your values: what attitudes, ideas and beliefs are important to you?  Step 5: Decide and act on the healthiest outcome and justify why it is the healthiest option.  Step 6: Evaluate and reflect on the outcome.

What are some of the challenges the characters face?

What decisions do the characters above need to make?

What choices are available to the characters in the story?

Based on the information you found, what advice would you give them?

Assessment Rubric

In this class (or in the next if worksheets are completed as homework) see the following rubric to assess student mastery of learning objectives.

Student name: Learning Outcome Not Present Developing On Target Access medically St udent participation accurate information Student participation and Student participation and and work reflects about prenatal care and work reflects minimal to work reflects some thorough pregnancy support no understanding of the understanding of the understanding of the services objective. objective. objective. Student participation Student participation and Student participation and and work reflects Identify community work reflects minimal to work reflects some thorough resources for pregnancy no understanding of the understanding of the understanding of the options objective. objective. objective. Student participation Use a decision-making Student participation and Student participation and and work reflects model to make healthy work reflects minimal to work reflects some thorough choices about no understanding of the understanding of the understanding of the pregnancy objective. objective. objective. Teacher co mments:

LESSON INTRODUCTION:

The purpose of this lesson is to understand the commitment necessary to raise a child. Information is also provided about Shaken Baby Syndrome.

OBJECTIVES: GRADE: High School Students will be able to… LENGTH OF LESSON: 45-50 min • Analyzing influence of pregnancy and SEQUENCE: 8 parenting on daily life • Identify one goal they would like to complete by the close of high school • Examine how pregnancy may affect one’s ability to reach a goal ACTIVITIES: • Articulate why someone may shake a baby and identify warning signs of shaken baby 8.1 Anonymous Question Box syndrome 8.2 Analyzing the Influence of Pregnancy VOCABULARY: and Parenting on Daily Life • Financial Wellness 8.3 Shaken Baby Syndrome Slide Show • Emotional Wellness • Physical Wellness • Social Wellness 8.4 Pregnancy Prevention and Goal-Setting & Homework

STANDARDS: Wisconsin Standard for Health Education • Students will demonstrate the ability to use goal-setting skills to enhance health. • Students will analyze the influence of family, peers, culture, media, and MATERIALS/TECHNOLOGY: technology, and other factors of health behaviors. • Shaken Baby Syndrome Slide Show: http://bit.ly/2PzJvtf National Sexuality Education Standards • Worksheet: My Day-to-Day • PR.12.INF.3 Analyze factors that influence decisions about whether and when to • Worksheet: Goal Setting become a parent. • Assessment Rubric • PR.12.DM.2 Assess the skills and resources

Take a moment to check in on the ground rules for the Human Growth and Development unit. If there are questions in the anonymous question box, answer them using the Answering Difficult Questions Protocol found in the introduction of the curriculum. Remind students that the box will be available throughout the remainder of the human growth and development unit.

Tell the students that the purpose of this lesson is to understand the commitment necessary to raise a child. They will also learn information about Shaken Baby Syndrome.

To understand this commitment, they’ll learn about analyzing influences, setting goals, and how becoming a parent could affect the future goals students hope to achieve. List the following four vocabulary words on the board (financial wellness, social wellness, emotional wellness, and physical wellness) and talk about what they mean. Ask students for examples of how having a baby would impact each wellness factor. For example:

Financial Wellness Social Wellness Emotional Physical Wellness Wellness Raising a baby is Raising a baby is Raising a baby can Raising a baby expensive time consuming, be stressful keeps people up – leaving less time new parents can for friends lose a lot of sleep Earnings at an Less time for other Chronic stres s can Pregnancy afterschool job activities like sports lead to other changes your would likely not be and clubs emotional body, and good enough to support challenges like nutrition and raising a baby anger or anxiety exercise is important

Tell students today they are going to look at the commitment involved with becoming a parent. Specifically, they are going to analyze how having a baby as a young person influences daily life, and the four dimensions of wellness.

1. Identify people and things that might influence you (ex. family, culture, peers, media, technology, perceptions of norms, personal values, health risk behaviors [such as alcohol and other drugs], public health policies). 2. Evaluate how the influence might affect your health behavior and decisions. 3. Choose positive influences on health. 4. Protect yourself from negative influences on health.

Ask students where they have seen life with a baby portrayed. Ask for real life and media examples, and to describe them. Do students think these are realistic examples?

Share with students this scenario: Imagine you became pregnant or got someone pregnant, and you decided to raise the baby.

Lead a discussion with students working through the four steps, asking students what influences might be present in their lives in this scenario.

Explain that students will be completing the My Day-to-Day Worksheet . Each student will complete the worksheet twice; once with a baby (“Baby and Me”) and once without a baby (“Just Me”). Pass out the My Day-to-Day Worksheet . Instruct students to fold the paper down the middle line, then complete the “Just Me” side first followed by the “Baby and Me” side.

Questions for Discussion:

 What kind of time adjustments did you make between your “Just Me” wake-up time compared to your “Baby and Me” wake-up time?  What are some strategies to balance the responsibilities, and options for your time after school or work?  How would you feel after bathing, feeding, and putting a baby to sleep at night after working or being in school all day?  How often do babies need to eat at night? How would that disrupt your sleep? Who can you ask for tips on how to manage that?  Who can you think of in your life that would be a positive influence on you and your child? How likely would it be that they would be willing and available to help with care?

Discuss that parenting a baby is hard work and may interfere with life goals.

Directions :  Fold this handout down the middle line.  Step 1 : Fill out the “Just Me” side.  Step 2 : Fill out the “Baby and Me” side  Compare the time difference between the two and reflect on how having a baby will change each day of your life.

PART ONE PART TWO Time Activity – Just Me Time Activity – Baby and Me Wake Up Wake Up Feed Baby

Shower Shower Brush teeth Brush teeth Get dressed Get dressed Change baby Dress baby Pack baby for the day Eat breakfast Eat breakfast Feed the baby Go to school/work Drop off baby at daycare Go to school/work Do something fun after Pick up baby work

Eat dinner Eat dinner Feed baby

Relax Play with baby Household chores Bathe baby Laundry Put baby to bed Relax Household chores Laundry Go to bed Go to bed Sleep Sleep Wake to feed baby every 3-5 hours

Let students know they you’re going to spend some time learning about Shaken Baby Syndrome. Define Shaken Baby Syndrome (also known as abusive head trauma or whiplash shake syndrome) as a serious brain injury resulting from forcefully shaking an infant or toddler.

Explain that knowing about Shaken Baby Syndrome is important to both avoid it and to recognize the signs if you have a baby and leave it with a care provider. Tell students that they have seen how much time and attention babies need to thrive, so they can probably also imagine that caring for a child is often stressful and tiring. Show students the Shaken Baby Syndrome Slide Show .

Field any questions or comments students have about Shaken Baby Syndrome and/or the slide show.

Let students know that to wrap up the class they’re going to learn about setting goals for their lives. Goal setting is an important way for them to think through what they want for their future and make plans for how to achieve it. Students will learn and practice the skill of goal setting using the SMART model 1. SMART stands for: specific, measurable, achievable, realistic, and has a timeline.

Demonstrate how to set a SMART goal for the class. One example could be:

My goal is to apply to at least nine out-of-state colleges or universities. I’ll apply to three reach schools, three schools I think I can get accepted into, and three safety schools. I’ll save money from my afterschool job to pay for the application fees and set aside three hours each week to write essays. I’ll submit all my applications by the posted deadline.

Next give each student a copy of the Goal Setting Worksheet . Explain that students will identify one goal they personally want to complete before the end of high school. They’ll reflect on why that goal is important, and how their ability to achieve it might be affected by a pregnancy.

Let students know they should bring their completed worksheets to the next class.

1 Colorado Initiative Goal Setting Module. (2014, October). Retrieved December 6, 2017, from http://www.coloradoedinitiative.org/wp-content/uploads/2014/10/GS-9-12-model.pdf

Identify a SMART goal, that you can complete by the close of senior year of high school.

Goal Checklist ( SMART ) Circle Yes or No:

Is the goal specific ? Yes No

Is the goal measurable ? Yes No

Is the goal achievable ? Yes No

Is the goal realistic ? Yes No

Does the goal have a timeline ? Yes No

Why is this goal important to you?

How will this goal help you in the future?

How might a pregnancy impact your ability to achieve this goal?

What steps can you take to prevent pregnancy?

Assessment Rubric Use the following rubric to assess student mastery of learning objectives.

Student name : Learning Outcome Not Present Developing On Target Student participation Student and work participation Student participation reflects minimal and work and work reflects Analyzing influence of to no reflects some thorough pregnancy and understanding understanding understanding of the parenting on daily life of the objective. of the objective. objective. Student participation Student and work participation Student participation Identify one goal they reflects minimal and work and work reflects would like to to no reflects some thorough complete by the close understanding understanding understanding of the of high school of the objective. of the objective. objective. Student participation Student and work participation Student participation Examine how reflects minimal and work and work reflects pregnancy may affect to no reflects some thorough one’s ability to reach a understanding understanding understanding of the goal of the objective. of the objective. objective. Teacher co mments:

LESSON INTRODUCTION:

The purpose of this lesson is to identify and categorize the various forms of contraception and discuss influences on, and reasons why, students may or may not choose to utilize contraceptive methods.

OBJECTIVES: GRADE: High School Students will be able to… LENGTH OF LESSON: 55 min • Analyze influences on choosing a SEQUENCE: 9 contraceptive method • Understand different forms of contraception • Categorize types of birth control • Examine real life scenarios related to using ACTIVITIES: contraception 9.1 Anonymous Question Box

VOCABULARY: 9.2 Reasons for Contraceptives • Barrier method • Hormonal method 9.3 Contraceptive Speed Sort

9.4 Scenarios and Influences: Which Method? STANDARDS: Wisconsin Standard for Health Education • Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors. MATERIALS/TECHNOLOGY: National Sexuality Education Standards • PR.12.CC.1 Compare and contrast the • “Birth Control Method” Cards advantages and disadvantages of (cut into individual cards, 1 full set for abstinence and other contraceptive each group) methods, including condoms. • Worksheet: Which Method? • PR.12.INF.1 Analyze influences that may have an impact on making choices about • Answer Key: Which Method? contraception including abstinence and condoms. • Assessment Rubric • SH.12.INF.1 Analyze factors that may influences condom use and other safer sex decisions.

Take a moment to check in on the ground rules for the Human Growth and Development unit. If there are questions in the anonymous question box, answer them using the Answering Difficult Questions Protocol found in the introduction of the curriculum. Remind students that the box will be available throughout the remainder of the Human Growth and Development unit.

Get a quick assessment of the class as you start this lesson by asking them to brainstorm “Reasons People Use Birth Control/Contraception” and “Reasons People Choose Not to Use Birth Control/ Contraception.” Answers may include: they are abstinent, not engaging in sexual activity with risk of pregnancy or contracting an STD, they are in a monogamous relationship and both partners have been tested, etc. Ask students to think about these reasons as they go through the activities in the lesson. You should feel free to address these and/or refer to them as you go through the activities as well, particularly if there is conversation around why one would not want to use contraception. Students may feel pressure from other students to not use contraception or do not want their parents to know.

Remind students that high school students in Wisconsin have been increasingly using condoms the last time they had sex – it is the most common method. Use of the birth control pill has remained stable over time. The percentage of students using no method to prevent pregnancy or STIs/STDs has decreased over time.

NOTE TO TEACHER : Because this lesson focuses on contraception, it may be difficult to keep language inclusive. Be aware that many students that identify as gay or lesbian also have penis-in-vagina sex that puts them at risk for unintended pregnancy. This is particularly true in communities where there is still a great deal of stigma or non-acceptance of same-sex relationships.

Let students know now they’re going to learn about contraceptive methods. Teach the contraceptive methods here, using the contraceptive speed sort cards and definitions as a guide:

 Abstinence  Birth control pills  Patch  Vaginal ring (NuvaRing)  Implant (Nexplanon)  Depo-Provera injections  Emergency Contraception  External Condom  Internal Condom  Sponge

Break the class into groups of four. Pass out a set of Birth Control Method Cards to each group. Let students know this is a sorting game with multiple rounds. You’re going to call out and discuss the categories for each round, and the teams should start sorting when you say go and start the timer. Once a team has its cards sorted, a team member should stand up. Once every team has someone standing, have the first team standing read out the cards they placed in the categories for that round. Have the whole class help you check for accuracy.

Round 1: Definitions

Set a timer for three minutes. Instruct students to match the contraceptive method to the proper description. When three minutes is up, or all teams have someone standing, do an informal assessment by looking around the classroom to notice how many matches groups got. If there is a method that most students did not know about, talk about its definition as a group.

Round 2: Hormonal or Barrier

Next tell students that different methods work to prevent pregnancy in different ways. Some methods are hormonal, meaning they change the hormones in a person’s body to prevent pregnancy, and some are barrier methods, meaning they create a barrier to block sperm from reaching an egg.

Examples: The ring releases hormones to stop the releasing of an egg, which means no fertilization and no pregnancy. The external condom wraps around the penis to prevent sperm from entering the vagina.

Set a timer for three minutes. Instruct students to sort the methods into hormonal or barrier categories.

Repeat the game for the following three rounds providing clarification and further teaching as needed.

Round 3: Prescription or Over-the-Counter

Let students know that some of the methods are available by prescription only and some are available over the counter.

Round 4: Long-Acting (weeks, months, years), Daily, or With Each Act of Intercourse

Let students know that some of the methods are long-acting, some must be used daily, and some must be used with each act of intercourse.

Round 5: Protects Against STIs/STDs and Does Not Protect Against STIs/STDs

Let students know that some methods protect against STIs/STDs while others protect against pregnancy only and not STIs/STDs.

© 2018 Health Care Education & Training . All Rights Reserved Activity 9.3: Birth Control Method Cards Choosing not to have vaginal, oral, or anal sex; 100% Abstinence effective; 100% STI/STD protection; cost = free

Birth control pills work by hormones which block the LH Oral surge and prevent an egg from being released. A pill is taken at the same time daily. No STI/STD contraceptives protection. A T-shaped piece of plastic that gets inserted into the uterus Intrauterine that prevents sperm from fertilizing an egg. Offers between three and twelve years of protection, available in Device (IUD) hormonal and nonhormonal forms. No STI/STD protection.

Slowly releases hormones into skin to prevent Patch ovulation. Replaced weekly. No STI/STD protection.

Small rod implanted in upper arm; slowly releases The Implant progesterone to prevent release of the egg. Good for three years. No STI/STD protection. (Nexplanon)

© 2018 Health Care Education & Training . All Rights Reserved Shot given once every four months. Progesterone that Depo-Provera prevents ovulation. No STI/STD protection. Injections Ring inserted vaginally and remains there for three Vaginal ring weeks; releases hormones to inhibit the releasing of the egg; replace monthly; reversible; 99% effective; No (NuvaRing) STI/STD protection

Prevents release of the egg from the ovary and may prevent Emergency fertilization. Should not be used as regular form of birth control—best in the first 24 hours although some now Contraception available that can be used up to 72 hours after unprotected sex. No STI/STD protection.

Latex covering for the penis. Traps sperm and prevents External contact with an egg. STI/STD protection when used properly. Condom Polyurethane liner fitted into the vagina. Blocks Internal sperm from entering the uterus. STI/STD protection when used properly. Condom

Activity 9.4: Scenarios and Influences: Which Method? (20 minutes)

Remind students of the four steps of analyzing influences that they learned in Lesson 8. Let students know they’re going to spend time working in pairs to complete a worksheet. The Which Method? Worksheet will describe scenarios of young people facing influences around sex and needing to make decisions about contraception. Post the four steps to analyzing influences in the room and encourage students to practice using it in completing their worksheets.

1. Identify people and things that might influence you (e.g. family, culture, peers, media, technology, perceptions of norms, personal values, health risk behaviors [such as alcohol and other drugs], public health policies). 2. Evaluate how the influence might affect your health behavior and decisions. 3. Choose positive influences on health. 4. Protect yourself from negative influences on health.

Once students have gone through the scenarios in pairs and written down their answers, discuss each scenario as a large group capturing the influences the students identified and the contraceptive choices that need to be considered with each scenario. Use the Probable Answer Key for Which Methods? Worksheet at the end of the lesson to guide discussion. At the end of this activity, collect the completed worksheets.

The decision to be abstinent, or sexually active and use a contraceptive method, is a very personal one. Read the scenarios below and determine what birth control method you think best fits the situation best. There are no “right” answers, just be sure to think through the questions using the four-step analyzing influences model before you decide.

1. Identify people and things that might influence you (e.g. family, culture, peers, media, technology, perceptions of norms, personal values, health risk behaviors [such as alcohol and other drugs], public health policies). Example : Students deciding how to protect themselves from pregnancy and STDs may be influenced by their sexually active friends, their families, and messaging they see on social media. 2. Evaluate how the influence might affect your health behavior and decisions. Example : Some friends use condoms, some condoms and the pill, and some nothing. Our families have beliefs that people should not have sex until marriage. Messaging on social media aimed at teens make it seem like everyone our age is having sex. 3. Choose positive influences on health. Example : Keep parents’ views in mind and learn from friends who have experience with condoms and with the pill. 4. Protect yourself from negative influences on health. Example : Avoid relying on social media ads for advice on sexual health. Seek out reliable online sources of information specifically for teens. Seek out more friends who have decided not to have sex or to use a barrier method and a hormonal method. Ask about their experiences. Communicate with each other about ways to be physically intimate that would not be against your families’ beliefs.

1. Trista is very religious and committed to her family. Although she is very in love with her boyfriend of eight months, she does not want to disrespect her parents. She is a first-generation American and her family struggles to pay the bills. She doesn’t really have the money to spend on birth control either.

What influences is Trista facing?

Which birth control method may be best for Trista?

2. Dave and Sula are both 17. They just started seeing each other and there was immediate chemistry. They met at their after-school jobs and they are both very focused on the future. Sula wants to be a doctor and Dave is hoping to study international economics and travel abroad. They know marriage and a family would be at least six-to-eight years away.

What influences are Dave and Sula facing?

Which birth control method may be best for Dave and Sula?

3. Sam and Alex are both in chaotic living situations. Sam lives with their sister and sister’s family, which includes two small children. In fact, Sam shares a bedroom with two small children. Alex goes to the alternative school and works full time to help support their family. Alex and Sam have been together for almost two years and have stayed together through some very rough times for their families. They started having sex five months ago, but it is hard to find a place where they can be alone together. Sam sees firsthand how challenging it is to raise children and is not interested in getting pregnant any time soon.

What influences are Sam and Alex facing?

Which birth control method may be best for Sam and Alex?

4. Katie and Trey have been using condoms for the past six months. They both went and got STD tests. They both feel like it would be nice not to have to use condoms. Katie is afraid of hormones because her mother said she gained weight taking the pill when she was younger. Katie has a great relationship with her mom and they have talked about sex openly. She wants to learn more and make her own choice.

What influences are Katie and Trey facing?

Which birth control method may be best for Katie and Trey?

5. Mai Lo and Mike have been going out for a few months and just made the decision to be sexually active. They want to be responsible since they both have plans to leave their small town and go to college next year. They have both had other sexual partners. The family planning clinic near them has closed and neither of them have regular access to a car. There is a pharmacy in town that they can walk to from the high school.

What influences are Mai Lo and Mike facing?

Which method may be best for Mai Lo and Mike?

 Trista What influences? Which method? ( Probable answer : abstinence; committed to family values)

 Dave and Sula What influences? Which method? ( Probable answer : LARC/IUD; long acting and reliable)

 Sam and Alex What influences? Which method? ( Probable answer : shot, implant, LARC-long acting, do not need to take it every day or every time you have sex)

 Katie and Trey What influences? Which method? (Probable answer : the pill; concern about reaction to hormones so could stop taking it at any time, but based on condom use could do a daily method)

 Mai Lo and Mike What influences? Which method? ( Probable answer : condoms; easily accessible in their rural community and protect against STDs)

NOTE : Students may have chosen other influences or methods for these scenarios for valid reasons, which is also acceptable.

Homework (5 minutes)

Have students write a letter to themselves to be opened one year from now. In their letter, they should address if they want to practice abstinence or use contraception. In writing their letter, they should use the four steps of analyzing influences to: identify people and things that might influence them (e.g. family, culture, peers, media, technology, perceptions of norms, personal values, health risk behaviors [such as alcohol and other drugs], public health policies); evaluate how these influences might affect their decision; discuss how they will utilize positive influences that support their decision; and how they will protect themselves from negative influences that could derail their decision. Students do not need to hand this letter in to you but check in during the next class to ensure students completed the assignment and address any lingering questions.

Assessment Rubric Use the following rubric to assess student mastery of learning objectives, based on classroom participation in the contraceptive sorting game and the scenarios and influences worksheet.

Student name : Learning Outcome Not Present Developing On Target Student Student Student Analyze influences on participation and participation and participation and choosing a work reflects work reflects work reflects contraceptive minimal to no some thorough understanding of understanding of understanding of method the objective. the objective. the objective. Student Student Student participation and participation and participation and work reflects work reflects work reflects Understand different minimal to no some thorough types of understanding of understanding of understanding of contraception the objective. the objective. the objective. Student Student Student participation and participation and participation and work reflects work reflects work reflects minimal to no some thorough Categorize types of understanding of understanding of understanding of birth control the objective. the objective. the objective. Student Student Student Choose a participation and participation and participation and contraception option work reflects work reflects work reflects or other healthy minimal to no some thorough decision for real life understanding of understanding of understanding of scenarios the objective. the objective. the objective. Teacher comments:

LESSON INTRODUCTION:

The purpose of this lesson is to engage students in exploring the health consequences of different choices. Working in small groups, students are given an open-ended scenario focused on having to decide about sexual health behavior. Each scenario provides an opportunity for students to analyze possible decision outcomes related to STD/HIV prevention or transmission. The goal of this lesson is to engage students in exploring the health consequences of different choices.

Prior to implementing this lesson, the teacher will need to determine which of the GRADE: High School seven stories the class will examine. Perhaps LENGTH OF LESSON: 55 min your class will analyze all the stories or just a SEQUENCE: 10 few. This decision may be influenced by several factors (e.g., your school district’s values; how quickly the class will be able to analyze the stories; how thoroughly the class might discuss the story analyses; and/or ACTIVITIES: perhaps specific stories are more appropriate for your class to analyze than 10.1 Anonymous Question Box others). 10.2 Review a Decision-Making Model with the Class OBJECTIVES: 10.3 Decision-Making Stories Students will be able to… 10.4 Presentation of Decisions and • Analyze decision outcomes for possible Discussion short- and long-term health consequences. 10.5 Assessment • Identify barriers that might hinder making a health-enhancing decision. • Describe realistic ways to deal with barriers that prevent people from making healthy decisions about STI/HIV prevention. MATERIALS/TECHNOLOGY: • Handout: Decision-Making Stories VOCABULARY: • Worksheet: Decision-Making Stories • Beliefs • Worksheet: Peer Feedback Form • Hindering beliefs • Short-term outcomes • Assessment Rubric • Long-term outcomes

National Sexuality Education Standards • PD.12.DM.1 Apply a decision-making model to various situations relating to sexual health. • SH.12.CC.2 Evaluate the effectiveness of abstinence, condoms and other safer sex methods in preventing the spread of STDs, including HIV. • SH.12.DM.1 Apply a decision-making model to choices about safer sex practices, including abstinence and condoms. • SH.12.SM.2 Analyze individual responsibility about testing for and informing partners about STDs and HIV status.

Activity 10.2: Review a Decision-Making Model with the Class (10 minutes)

Let students know that they make decisions every day. Some things are habits (hopefully healthy ones), while others they maybe must think about. Ask students to give you examples of choices they make automatically or with very little thought. (e.g. brush teeth, get dressed, pick out lunch items, etc.).

Ask students to think about how they make decisions.

NOTE : If you have already covered decision making with a decision-making model, please use the model students have learned for the remaining lesson. The one from Lesson 7 of this unit is the six-step model below:

Explain that students will likely be confronted with difficult situations throughout their lives. In the moment it is often difficult to make a healthy decision unless you have already thought about what you would do in a certain situation. Let students know that today’s class will give them an opportunity to think ahead about potential sexual health decisions they may make in their lives.

Thinking clearly in a situation that could be challenging or risky is important. We often know what the “right” decision is, but it is still difficult to do. Remind the students of the six steps of decision-making:

Step 1: Assess the situation: what decisions need to be made?

Step 2: List the options: explain all the positive and negative choices you could make?

Step 3: Weigh the possible outcomes using HELP (healthful, ethical, legal, parent approval)

Step 4: Consider your values: what attitudes, ideas and beliefs are important to you?

Step 5: Decide (act on the healthiest option) and justify why this is the healthiest option.

Step 6: Evaluate and reflect on the outcome. 1

1 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL.

Split students into groups. Assign each group to read one story from the Decision- Making Stories Handout and discuss the accompanying set of questions. Each group will complete the Decision-Making Stories Worksheet (one worksheet per student to be completed with their group).

Activity 10.3: Handout: Decision-Making Stories

NOTE TO INSTRUCTOR: Choose the stories that are most relevant to your students and your community.

Evan and Emily’s Story

Evan and Emily haven’t had sexual intercourse. They have been dating for five months. Lately, they have been spending more time alone together and it is increasingly difficult to stop before having intercourse.

Answer the following questions as you consider the possible consequences for Evan and Emily if they have sex”

• What might happen if Evan and Emily decide to have unprotected sex? • What might happen to Evan and Emily if they decide have sex and use a condom? • Which is the healthiest decision Evan and Emily could make? Why? • What are some barriers that might prevent them from making the healthiest decision? • How might Evan and Emily’s beliefs about this situation support or hinder their ability to make a healthy decision? • How could Evan and Emily effectively deal with any barriers that might prevent them from making the healthiest decision?

Jenna and Joe’s Story

Jenna and Joe are dating each other. Jenna knows she’s not Joe’s first girlfriend. She is currently on the pill, but worried about STIs/STDs. Joe doesn’t like to wear condoms, and he tells her they don’t need to worry about anything because she is on the pill and that he loves her.

Consider the possible consequences for Jenna if Joe has a STI/STD and doesn’t know it:

• What might happen to Jenna if she decides to have unprotected sex with Joe? • What might happen to Jenna if she decides to have sex with Joe and use a condom? • Which is the healthiest decision Jenna could make? Why?

• What are some barriers that might prevent her from making the healthiest decision? • How might Jenna’s beliefs about this situation support or hinder her ability to make a healthy decision? • How could Jenna effectively deal with any barriers that might prevent her from making the healthiest decision in this story?

Zach’s Story

Zach has been sexually active for over a year. Recently he noticed a couple of blisters on his penis. Now he has a couple of painful sores where the blisters broke open.

• What might happen to Zach if he decides to do nothing about the blisters? • What might happen to Zach if he decides to get medical attention? • What might happen to Zach’s partner(s) if he decides to do nothing about the blisters? • What might happen to Zach’s partner(s) if he decides to get medical attention? • Which is the healthiest decision Zach could make? Why? • What are some barriers that might prevent him from making the healthiest decision? • How might Zach’s beliefs about this situation support or hinder his ability to make a healthy decision? • How could Zach effectively deal with any barriers that might prevent him from making the healthiest decision in this story?

Penny & Leonard’s Story

Penny has been in a steady relationship with Leonard. The last couple of days, Penny has been having unusual vaginal discharge and sometimes it burns when she urinates.

• What might happen to Penny if she decides to do nothing about the discharge and burning sensation? • What might happen to Penny if she decides to get medical attention? • What might happen to Leonard if Penny decides to do nothing about the discharge and burning sensation?

• What might happen to Leonard if Penny decides to get medical attention? • Which is the healthiest decision Penny could make? Why? • What are some barriers that might prevent Penny from making the healthiest decision? • How might Penny’s beliefs about this situation support or hinder her ability to make a healthy decision? • How could Penny effectively deal with any barriers that might prevent her from making the healthiest decision in this story?

Maria & Tony’s Story

Maria and Tony have been dating on and off for several months. They fool around a lot but are careful to never have vaginal intercourse because Maria wants to wait until she is married to “have sex.” So, they frequently engage in oral/anal sex. This way, they can respect Maria’s desire to wait and they don’t have to worry about getting pregnant.

Consider the possible health consequences for Maria and Tony:

• What might happen if Maria and Tony continue to have unprotected sex? • What might happen to Maria and Tony if they decide NOT to have unprotected sex? • Which is the healthiest decision Maria and Tony could make? Why? • What are some barriers that might prevent them from making the healthiest decision? • How might Maria and Tony’s beliefs about this situation support or hinder their ability to make a healthy decision? • How could Maria and Tony effectively deal with any barriers that might prevent them from making the healthiest decision in this story?

Cody & Dalton’s Story

Cody and Dalton are attracted to each other. They’ve been hanging out a lot lately and have many things in common. Cody has had several sexual partners. Dalton has not. They have talked about having sex and about their sexual histories.

Consider the possible consequences for Cody and Dalton if they have sex:

• What might happen if Cody and Dalton decide to have unprotected sex? • What might happen to Cody and Dalton if they decide NOT to have unprotected sex? • Which is the healthiest decision Cody and Dalton could make? Why? • What are some barriers that might prevent them from making the healthiest decision? • How might Cody’s and Dalton’s beliefs about this situation support or hinder their ability to make a healthy decision? • How could Cody and Dalton effectively deal with any barriers that might prevent them from making the healthiest decision in this story?

Willow & Wonder’s Story

Willow and Wonder have been together for over a year. They have committed to dating only each other and no one else. They have been having sex and are not at all worried about STIs/STDs because they are girls.

Consider the possible consequences for Willow and Wonder if they have sex:

• What might happen if Willow and Wonder continue to have unprotected sex? • What might happen to Willow and Wonder if they decide NOT to have unprotected sex? • Which is the healthiest decision Willow and Wonder could make? Why? • What are some barriers that might prevent them from making the healthiest decision? • How might Willow and Wonder’s beliefs about this situation support or hinder their ability to make a healthy decision? • How could Willow and Wonder effectively deal with any barriers that might prevent them from making the healthiest decision in this story? • How can healthy decision-making prevent STIs/STDs or HIV?

Directions : Working with the members of your group, complete the tables below and then answer the questions after analyzing your story.

Group members :

Story :

Table 1. Comparing Possible Short-Term Decision Outcomes

Short -Term Physical Health Mental/Emotional Social Health Outcomes Health Decision A

Decisi on B

Table 2. Comparing Possible Long-Term Decision Outcomes

Long -Term Physical Health Mental/Emotional Social Health Outcomes Health Decision A

Decision B

Which is the healthiest decision? Why?

What are some barriers that might prevent people from making the healthiest decision?

How might peoples’ beliefs about this situation support or hinder their ability to make a healthy decision?

How could people effectively deal with any barriers that might prevent them from making the healthiest decision in this story?

After each group has completed analyzing their story, they will share their findings with the entire class.

The class members will provide feedback to each group using the Peer Feedback Worksheet while listening to the various story analyses.

Next, large class discussion occurs about the story analysis. Use the Peer Feedback Worksheet to help guide this discussion. If groups are unable to identify the healthiest decision and/or have an honest discussion about the barriers and challenges of making the healthiest decision, elicit the entire class to assist in problem-solving for the specific story being shared.

Bring the discussion back to the decision-making model. Have students imagine going through the decision-making process “in the moment” taking one of the scenarios as an example. If you have time, ask students to act out the scene AND the decision-making process to arrive at the healthiest decision. Here is the six-step model as an example of discussion questions…

Step 1: Assess the situation: what decisions need to be made?

Step 2: List the options: explain all the positive and negative choices you could make?

Step 3: Weigh the possible outcomes using HELP (healthful, ethical, legal, parent approval)

Step 4: Consider your values: what attitudes, ideas and beliefs are important to you?

Step 5: Decide (act on the healthiest option) and justify why this is the healthiest option.

Step 6: Evaluate and reflect on the outcome. 2

2 Benes, S. & Alperin, H. (2016). The essentials of teaching health education: Curriculum, Instruction, and assessment. Human Kinetics: Champaign, IL.

Directions : Use the scoring guide below to give your peers feedback on the quality of their responses to their story.

Your Name :

Group Members :

Scenario : Yes No Unsure Was the healthiest decision identified?

Were potential barriers to achieving the healthiest decision identified? Were supporting and/or hindering beliefs identified? Were realistic struggles identified for helping people effectively deal with barriers to making the healthiest decision?

Comments :

During the class discussions the teacher should listen to how students process each story.

Ask students to write down their group members’ names on the Decision-Making Stories Worksheet and collect them. Review the completed worksheets to assess students’ perspectives about STD/HIV prevention and sexual health.

Peer Feedback Worksheet – after student groups have presented their analysis of their story, class members will give them feedback using this form. This form may be collected and reviewed by the teacher as further evidence of formative assessment.

Use the following rubric to assess student mastery of learning objectives.

Student name : Learning Outcome Not Present Developing On Target Student Student Analyze decision participation and Student participation and outcomes for work reflects participation and work reflects possible short- and minimal to no work reflects some thorough long-term health understanding of understanding of understanding of consequences. the objective. the objective. the objective. Student Student Identify barriers participation and Student participation and that might hinder work reflects participation and work reflects making a health- minimal to no work reflects some thorough enhancing understanding of understanding of understanding of decision. the objective. the objective. the objective. Describe realistic ways to deal with barriers that Student Student prevent people participation and Student participation and from making work reflects participation and work reflects healthy decisions minimal to no work reflects some thorough about STI/HIV understanding of understanding of understanding of prevention. the objective. the objective. the objective. Teacher co mments:

LESSON INTRODUCTION:

The purpose of this lesson is to provide a review of the entire Human Growth and Development unit of instruction focusing on the skills, emphasizing the importance of using these skills as students move into adulthood.

OBJECTIVES: GRADE: High School Students will be able to… LENGTH OF LESSON: 60 min • Articulate issues and situations that SEQUENCE: 11 (optional review of unit) demonstrate the need for sexual health throughout the lifespan. • Demonstrate at least one of the skills related to sexual health taught in the unit.

VOCABULARY: • Financial Wellness ACTIVITIES: • Social Wellness • Emotional Wellness 11.1 Anonymous Question Box: Last Call • Physical Wellness for Questions!

11.2 Unit in Review STANDARDS: Wisconsin Standard for Health Education 11.3 Assessment of Learning for the • Advocacy Sexual Lifespan: Improvisational • Accessing valid health information Scenarios • Analyzing influences • Decision-making • Goal setting • Interpersonal communication • Self-management

National Sexuality Education Standards • Advocacy • Accessing valid health information MATERIALS/TECHNOLOGY: • Analyzing influences • Handout: Scenario Spinners • Decision-making • Assessment Rubric • Goal setting • Interpersonal communication • Self-management

Activity 11.1: Anonymous Question Box: Last Call for Questions! (5 minutes)

Let students know that this is the last class period devoted to Human Growth and Development. Answer any remaining questions in the anonymous question box. But also let students know that you are available as a resource if they have any further questions about sexual health. Reassure them that they also have the skills to make informed decisions about their sexual health because of the skills and functional health knowledge they have learned throughout the unit.

Ask students what they remember about the last couple of weeks of class. List the main subjects on the board as they mention them. Add any they have forgotten. Topics included:  Advocacy • Accessing valid health information • Analyzing influences • Decision-making • Goal-setting • Interpersonal communication • Self-management • Reproductive anatomy • Sexual consent • STIs, HIV, and prevention • Love Languages • Contraception • Pregnancy and childbirth • Parenting

Prompt them further to think about what skills were practiced within each lesson. Skills within each lesson were:

 Love Languages and interpersonal communication  Sexual consent and interpersonal communication  Reproductive anatomy and accessing valid health information  STI prevention, accessing valid health information and advocacy  HIV and stigma, advocacy and self-management  Pregnancy, childbirth, and decision-making  Parenting and goal setting  Contraception and analyzing influences on healthy behavior  Healthy decision-making for sexual health

Ask students when they think sexual decision-making ends in a person’s life (the answer is never). Let them know that this class period they will have the opportunity to think about some of these topics.

Activity 11.3: Assessment of Learning for the Sexual Lifespan: Improvisational Scenarios (45 minutes)

Let the class know that as young people they probably have not thought about how sexual health and sexuality exists throughout the lifespan. Some of these scenarios may be a challenge. Give the example of STI/STD outbreaks in senior communities when seniors may not realize they should be using a condom because they are no longer at risk of unintended pregnancy.

Divide the class into groups of two to six students per group. Students will participate in role plays. With larger groups, emphasize that everyone has a role to play, even if they are not reading lines within the actual role play. The teacher will bring out the Scenario Spinners . There are three spinner categories: one for an age, one for an age- determined situation, and one for the skills students have learned in the unit.

With the Scenario Spinners , each group will choose an age, an age-determined situation, and a skill. Groups will first spin the age spinner, then the appropriate situation spinner, then the skill spinner to learn what their role plays entail.

Once groups know the age, situation, and skill to demonstrate, they should begin planning their role plays. Role plays should be at least five lines long. Someone in the group can introduce the situation to the whole class when the role play is presented. Groups should determine the following and be prepared to talk about these ideas after their role play:

 Who are the main characters (age, circumstance, background)? What is the problem?  How was it resolved?  What was it like imagining characters that are older than yourself?

The students should focus their effort on portraying the specific skill cues associated with each of the various health skills (advocacy, analyzing influences, accessing valid health information, interpersonal communication, decision-making, goal setting, self- management, and advocacy).

As each group presents their role plays, have the class discuss what skills were being portrayed. Reiterate the importance of using health education skills throughout the lifetime.

40s

Age

Use the following rubric to assess student learning of functional health knowledge and skills taught throughout the unit.

Student name s:

Learning Outcome Not Present Developing On Target Functional health knowledge displayed: Reproductive anatomy Sexual consent STIs/STDs, HIV, and prevention Student Student Love Languages participation and Student participation and Contraception work reflects participation and work reflects Pregnancy and minimal to no work reflects some thorough childbirth understanding of understanding of understanding of Parenting the objective. the objective. the objective. Skill(s) displayed: Advocacy Accessing valid health information Analyzing influences Student Student Decision-making participation and Student participation and Goal-setting work reflects participation and work reflects Interpersonal minimal to no work reflects some thorough communication understanding of understanding of understanding of Self-Management the objective. the objective. the objective. Teacher comments:

• • •

(c) Develop cooperative programs between school State Statutes districts and institutions of higher education whereby the appropriate health personnel of such institutions would be available to guide the continuing Statute 115.35 professional preparation of teachers and the devel- 115.35 Health problems education program. (1) opment of curricula for local programs. A critical health problems education program (d) Assist in the development of plans and is established in the department [emphasis procedures for the evaluation of health education added]. The program shall be a systematic and curricula. integrated program designed to provide (3) The department may appoint a council appropriate learning experiences based on consisting of representatives from universities and scientific knowledge of the human organism as it colleges, law enforcement, the various fields of functions within its environment and designed to education, the voluntary health agencies, the favorably influence the health, understanding, department of health and family services, the attitudes and practices of the individual child professional health associations and other groups or which will enable him or her to adapt to agencies it deems appropriate to advise it on the changing health problems of our society. The implementation of this section, including teachers, program shall be designed to educate youth with administrators and local school boards. regard to critical health problems and shall (4) The department shall cooperate with agencies include, but not be limited to, the following of the federal government and receive and use topics as the basis for comprehensive education federal funds for the purposes of this section. curricula in all elementary and secondary (5) In each report under s. 15.04(1)(d), the state schools: controlled substances, as defined in superintendent shall include information: s. 961.01(4); controlled substance analogs, as (a) As to the scope and nature of programs defined in s. 961.01(4m); alcohol; tobacco; undertaken under this section. mental health; sexually transmitted diseases, (b) As to the degree and nature of cooperation including acquired immunodeficiency syn- being maintained with other state and local agencies. drome; human growth and development [emphasis added]; and related health and safety (c) As to the state superintendent's topics. Participation in the human growth and recommendations to improve such programs and development topic of the curricula shall be cooperation.

entirely voluntary. The department may not History: 1971 c. 219; 1977 c. 196 s. 131; 1977 c. 418; 1981 c. 291; require a school board to use a specific human 1985 a 56; 1989 a.203; 1993.492;1995 a. 27 as. 3873, 9126 (19), 9145 (1); growth and development curriculum. 1995 a. Mt 1997 a. 27.

(2) In carrying out this section, the state superintendent may, without limitation because of enumeration: (a) Establish guidelines to help school districts develop comprehensive health education programs. (b) Establish special inservice programs to provide professional preparation in health education for teachers throughout the state.

Chapter 2: State Statutes (Resource 2.1) 15 Statute 118.01 The skills and attitudes that will further lifelong 118.01 Educational goals and expectations. intellectual activity and learning. (1) Purpose. Public education is a fundamental 4. Knowledge in computer science, including responsibility of the state. The constitution vests problem solving, computer applications and the in the state superintendent the supervision of social impact of computers. public instruction and directs the legislature to (b) Vocational skills. Each school board shall provide for the establishment of district schools. provide an instructional program designed to The effective operation of the public schools is give pupils: dependent upon a common understanding of 1. An understanding of the range and nature what public schools should be and do. of available occupations and the required skills Establishing such goals and expectations is a and abilities. necessary and proper complement to the state's 2. Preparation to compete for entry level jobs financial contribution to education. Each school not requiring postsecondary school education. board should provide curriculum, course 3. Preparation to enter job-specific vocational requirements and instruction consistent with the training programs. goals and expectations established under sub. 4. Positive work attitudes and habits. (2). Parents and guardians of pupils enrolled in (c) Citizenship. Each school board shall provide the school district share with the state and school an instructional program designed to give board the responsibility for pupils meeting the pupils: goals and expectations under sub. (2). 1. An understanding of the basic workings of (2) EDUCATIONAL GOALS. (a) Academic all levels of government, including the duties skills and knowledge. Since the development of and responsibilities of citizenship. academic skills and knowledge is the most 2. A commitment to the basic values of our important goal for schools, each school board government, including by appropriate instruction shall provide an instructional program designed and ceremony the proper reverence and respect for to give pupils: and the history and meaning of the American flag, 1. Basic skills, including the ability to read, the Declaration of Independence, the U.S. write, spell, perform basic arithmetical constitution and the constitution and laws of this calculations, learn by reading and listening and state. communicate by writing and speaking. 3. The skills to participate in political life. 2. Analytical skills, including the ability to 4. An understanding of the function of think rationally, solve problems, use various organizations in society. learning methods, gather and analyze 5. Knowledge of the role and importance of information, make critical and independent biological and physical resources. judgments and argue persuasively. 6. Knowledge of state, national and world 3. A basic body of knowledge that includes history. information and concepts in literature, fine arts, 7. An appreciation and understanding of mathematics, natural sciences, including different value systems and cultures. knowledge of the elements of agriculture and the 8. At all grade levels, an understanding of conservation of natural resources, and social human relations, particularly with regard to sciences, including knowledge of the rights and American Indians, Black Americans and Hispanics. responsibilities of the family as a consumer, (d) Personal development. Each school board cooperative marketing and consumers' shall provide an instructional program designed to cooperatives. give pupils:

16 Human Growth and Development: A Resource Guide (5th Edition) 2014 1. The skills needed to cope with social change. value of frugality and other basic qualities and 2. Knowledge of the human body and the means principles referred to in article I, section 22, of the to maintain lifelong health, including: constitution insofar as such qualities and principles a. Knowledge of the theory and practice of affect family and consumer education. physical education, including the development and 6. Knowledge of the prevention of accidents maintenance of physical fitness; and promotion of safety on the public highways, b. Knowledge of the true and comparative including instruction on the relationship between vitamin content of food and food and health values highway safety and the use of alcohol and of dairy products and their importance for the controlled substances under ch. 961. human diet; and 7. The skills needed to make sound decisions, c. Knowledge of physiology and hygiene knowledge of the conditions which may cause and [emphasis added], sanitation, the effects of the signs of suicidal tendencies, knowledge of the controlled substances under ch. 961 and alcohol relationship between youth suicide and the use of upon the human system, symptoms of disease and alcohol and controlled substances under ch. 961 and the proper care of the body. No pupil may be knowledge of the available community youth required to take instruction in these subjects if his suicide prevention and intervention services. or her parent files with the teacher a written Instruction shall be designed to help prevent objection thereto. If a pupil does not take suicides by pupils by promoting the positive instruction in these subjects as a result of parental emotional development of pupils. objection, the pupil may not be required to be 8. Knowledge of effective means by which examined in the subjects and may not be penalized pupils may recognize, avoid, prevent and halt in any way for not taking such instruction, but if physically or psychologically intrusive or abusive the subjects receive credit toward graduation, the situations which may be harmful to pupils, includ- school board may require the pupil to complete an ing child abuse, sexual abuse and child enticement. alternative assignment that is similar to the subjects Instruction shall be designed to help pupils develop in the length of time necessary to complete. positive psychological, emotional and problem– Instruction in physiology and hygiene shall include solving responses to such situations and avoid instruction on sexually transmitted diseases and relying on negative, fearful or solely reactive shall be offered in every high school. [Emphasis methods of dealing with such situations. Instruction added.] shall include information on available school and 3. An appreciation of artistic and creative community prevention and intervention assistance expression and the capacity for self–expression. or services and shall be provided to pupils in 4. The ability to construct personal ethics and elementary schools. goals. 5. Knowledge of morality and the individual's History: 1983 a. 412; 1985 a. 29, 213; 1989 a. 31; 1995 a. responsibility as a social being, including the 27, 229, 448; 1997 a. 27,35. responsibility and morality of family living and the

Chapter 2: State Statutes (Resource 2.2) 17 Statute 118.019 decisions, communicating, and managing stress. 8. How alcohol and drug use affect 118.019 Human growth and development responsible decision making. instruction. (1) PURPOSE. The purpose of this 9. The impact of media and one’s peers on section is to foster a partnership between parents thoughts, feelings, and behaviors related to of pupils attending schools in the school district sexuality. and the schools in the school district to promote 10. Adoption resources, prenatal care, and the optimal health and well-being of the pupils. postnatal supports. The provisions of this section are in addition to, 11. The nature and treatment of sexually and do not supplant, the requirements under ss. transmitted infections. 118.01 (2) (d) 2. c. and 8. and 118.13 (1), which (c) Address self-esteem and personal are critical to maintaining the physical and responsibility, positive interpersonal skills, and psychological health of each pupil. healthy relationships. (1m) DEFINITIONS. In this section: (d) Identify counseling, medical, and legal (a) “Age-appropriate” means suitable to a resources for survivors of sexual abuse and particular age group o pupils based on their assault, including resources for escaping violent developing cognitive and emotional capacity and relationships. consistent with adolescent development and (e) Address the positive connection between community standards. marriage and parenting. (b) “Medically accurate information” means (f) Present information about avoiding information that is scientifically-based and stereotyping and bullying, including how to refrain published, where appropriate, in peer-reviewed from making inappropriate remarks, avoiding journals and textbooks. engaging in inappropriate physical or sexual (2) SUBJECTS. A school board may provide behaviors, and how to recognize, rebuff, and an instructional program in human growth and report any unwanted or inappropriate remarks or development in grades kindergarten to 12. If the physical or sexual behaviors. school board elects to provide an instructional (2d) NONDISCRIMINATION. An instructional program under this section, when the school board program under this section shall use instructional establishes the curriculum for the instructional methods and materials that, consistent with s. program, the school board shall make 118.13 (1), do not discriminate against a pupil determinations as to whether and, if so, for what based upon the pupil’s race, gender, religion, subjects covered in the curriculum the pupils shall sexual orientation, or ethnic or cultural be separated by gender. If an instructional program background or against sexually active pupils or is provided, the following instructional program is children with disabilities. Nothing in this recommended: subsection shall be construed to prohibit a school (a) Present medically accurate information to board from approving an instructional program pupils and, when age-appropriate, address the under this section that includes instruction on following topics: abstinence from sexual activity or that is 1. The importance of communication about abstinence-centered. sexuality between the pupil and the pupil’s parents (2m) REQUIRED SUBJECTS. If a school board or guardians. provides instruction in any of the areas under sub. 2. Reproductive and sexual anatomy and (2) (a), the school board shall ensure that physiology, including biological, psychosocial, instruction conforms to s. 118.13 (1) and that the emotional, and intellectual changes that following is provided, when age appropriate, in accompany maturation. the same course and during the same year: 5. The benefits of and reasons for abstaining (c) Presents abstinence from sexual activity as from sexual activity. Instruction under this the preferred choice of behavior for unmarried subdivision shall stress the value of abstinence as pupils. the only reliable way to prevent pregnancy and (d) Emphasizes that abstinence from sexual sexually transmitted infections, and shall identify activity before marriage is the only reliable way to the skills necessary to remain abstinent. prevent pregnancy and sexually transmitted 7. Methods for developing healthy life skills, diseases, including human immunodeficiency including setting goals, making responsible

18 Human Growth and Development: A Resource Guide (5th Edition) 2014 virus and acquired immunodeficiency syndrome. (5) ADVISORY COMMITTEE. In any school (e) Provides instruction in parental district that offers a human growth and responsibility and the socioeconomic benefits of development curriculum, the school board shall marriage for adults and their children. appoint an ad hoc advisory committee whose role (f) Explains pregnancy, prenatal development, is to advise the school board on the design and and childbirth. implementation of the human growth and (g) Explains the criminal penalties under ch. development curriculum and to review the 948 for engaging in sexual activities involving a curriculum. Parents, teachers, school child. administrators, pupils, health care professionals, (h) Explains the sex offender registration members of the clergy, and other residents of the requirements under s. 301.45. Instruction under school district shall comprise the committee. No this paragraph shall include who is required to one category of member shall constitute more than report under s. 301.45, what information must be one-fifth of the membership of the committee, reported, who has access to the information except that parents may comprise more than one- reported, and the implications of being registered fifth of the membership of the committee. No under s. 301.45. more than one-quarter of the members of the (i) Provides medically accurate information committee may be made up of employees of the about the human papilloma virus and the human school district or their spouses or members of the immunodeficiency virus and acquired school board or their spouses. immunodeficiency syndrome. (2s) PROVISION OF INSTRUCTION. Subject to History: 1985 a. 56; 1987 a. 399; 1989 a. 203; 1995 a. 27; 1997 a. 27; 2001 a. 16; 2005 a. 341, 445; 2009 a. 134; 2011 a. s. 120.13 (37m), nothing in this section prohibits a 216. school district from providing instruction under this section, in whole or in part, to pupils while the pupils are separated from members of the opposite sex. (3) DISTRIBUTION OF CURRICULUM TO PARENTS; NOTICE. Each school board that provides an instructional program in human growth and development shall annually provide the parents or guardians of each pupil enrolled in the school district with an outline of the human growth and development curriculum used in the pupil’s grade level, information regarding how the parent or guardian may inspect the complete curriculum and instructional materials, an explanation of the exemption under sub. (4), and a statement that pupils exempted from instruction under this section will still receive instruction in the subjects under s. 118.01(2)(d)2. c., unless exempted, and s. 118.01(2)(d)8. The school board shall make the complete human growth and development curriculum and all instructional materials available for inspection by a parent or guardian upon his or her request at any time, including prior to their use in the classroom. (4) EXEMPTION FOR INDIVIDUAL PUPILS. No pupil may be required to take instruction in human growth and development or in the specific subjects under subs. (2) and (2m) if the pupil’s parent or guardian files with the teacher or school principal a written request that the pupil be exempted.

Chapter 2: State Statutes (Resource 2.3) 19