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The Effects of Sexual Education on Sexual Behaviors of Adolescents in Rural Jamaica

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The Effects of Sexual Education on Sexual Behaviors of Adolescents in Rural Jamaica Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2019 The ffecE ts of Sexual Education on Sexual Behaviors of Adolescents in Rural Jamaica Deborah Simmonds Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Deborah I. Simmonds has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Jennifer Oliphant, Committee Chairperson, Public Health Faculty Dr. Susan Cardenas, Committee Member, Public Health Faculty Dr. Ronald Hudak, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2019 Abstract The Effects of Sexual Education on Sexual Behaviors of Adolescents in Rural Jamaica by Deborah I. Simmonds MBA, Keller Graduate School of Management, 2013 BS, DeVry University, 2012 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2019 Abstract Adolescent pregnancy and the sexual behaviors of adolescents continue to be robust public health and social problems in Caribbean countries such as Jamaica. Numerous researchers have conducted studies on the impact of sex education on sexual behaviors and pregnancy patterns among adolescents with mixed results (i.e., a lack of knowledge) especially in rural communities. The purpose of this study was to ascertain the impact of school- or home-based sex education on sexual behavior and pregnancy patterns of adolescents aged 15–19 years in the rural community of St. Thomas, Jamaica. The parental expansion of the theory of planned behavior and cognitive behavior theory constituted the theoretical foundation for this quantitative descriptive cross-sectional study. Secondary data from the 2008 Jamaica Reproductive Health Survey (N = 8,200) were analyzed. Descriptive statistics, chi-square, and Cramer’s V were computed to determine the relationship and strength between the independent variables (school- and home-based sex education) and the dependent variables (pregnancy and sexual behaviors of adolescents). The results indicate a weak negative inverse relationship that was not statistically significant between sex education in school and sex education at home on adolescent pregnancy. There is a weak positive relationship between sex education in school on condom use and a positive measure of association between sex education at home on condom use. This study may be significant to local community health departments seeking inventive techniques for improving and enhancing existing programs. The results of this study also contribute new data on the impact of sex education on adolescent pregnancy and the sexual behavior of adolescents. The Effects of Sexual Education on Sexual Behaviors of Adolescents in Rural Jamaica by Deborah I. Simmonds MBA, Keller Graduate School of Management, 2013 BS, DeVry University, 2012 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2019 Dedication This dissertation is dedicated to adolescents across the globe, especially those residing in rural communities. Psalm 18:29 - With my God, I can scale a wall. Acknowledgements First and foremost I would like to thank the Almighty God who is my strength, my help, my everything, and who has shown me that with him I can scale a wall. I would like to express my undying gratitude to my Committee Chair Dr. Jennifer Oliphant, my 2nd Committee Member Dr. Susan Cardenas, and my URR Dr. Hudak. I would like to thank my family for their continued support during this process. A special appreciation goes out to my husband who was there to push me when I felt like giving up, who was up many late nights keeping my company, and for putting up with me throughout this period. Table of Contents List of Tables .......................................................................................................................v List of Figures ................................................................................................................... vii Chapter 1: Introduction to the Study ....................................................................................1 Introduction ..............................................................................................................1 Background ..............................................................................................................3 Problem Statement ...................................................................................................5 Purpose of the Study ................................................................................................7 Research Questions and Hypotheses .......................................................................8 Theoretical Framework ..........................................................................................10 Nature of the Study ................................................................................................11 Definitions..............................................................................................................12 Assumptions ...........................................................................................................14 Scope of Delimitations ...........................................................................................14 Limitations .............................................................................................................15 Significance............................................................................................................15 Summary ................................................................................................................17 Chapter 2: Literature Review .............................................................................................19 Introduction ............................................................................................................19 Literature Search Strategy......................................................................................22 Theoretical Framework ..........................................................................................24 Parental Expansion of the Theory of Planned Behavior ........................... 24 Cognitive Behavioral Therapy .................................................................. 28 Literature Review Related to Key Variables and/or Concepts ..............................30 i Descriptive Cross-Sectional Design ......................................................... 30 Adolescents ............................................................................................... 31 Sex Education ........................................................................................... 33 School-Based Sex Education .................................................................... 34 Home-Based Sex Education ..................................................................... 36 Adolescent Pregnancy ............................................................................... 36 Sexual Behavior of Adolescents ............................................................... 37 Factors Contributing to Adolescent Pregnancy ........................................ 39 Sexual Violence and Early Sexual Debut ................................................. 40 Factors Contributing to the Sexual Behaviors of Adolescents ................. 40 Summary ................................................................................................................42 Chapter 3: Research Method .............................................................................................43 Introduction ............................................................................................................43 Research Design and Rationale .............................................................................43 Rationale ................................................................................................... 45 Methodology ..........................................................................................................45 Population ................................................................................................. 45 Sampling and Sampling Procedures ......................................................... 46 Procedures for Recruitment, Participation, and Data Collection .............. 50 Instrumentation and Operationalization of Constructs ............................. 51 Data Analysis Plan .................................................................................... 55 Threats to Validity .................................................................................................57 Internal Threats ......................................................................................... 57 External
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