Moms Weigh In On Abstinence Education

A new study shows when teaching teenagers about sex education abstinence works better than showing them safe methods of contraception. According the study, published in the Archives of Pediatrics and Adolescent Medicine, 67 percent of the teens who received some form of abstinence-only education delayed having sex for two years, compared with 48 percent of teens who received no sex education. Host Michel Martin talks with regular parenting contributors Dannette Tucker and Mary Kate Carey. They are joined by Loretta Jemmott, co-lead author of the study, and a professor with the School of Nursing at the University of Pennsylvania.

MICHEL MARTIN, Host:

I'm Michel Martin and this is TELL ME MORE from NPR News.

They say it takes a village to raise a child, but maybe you just need a few moms in your corner. We visit with a diverse group of parents each week for their common sense and savvy parenting advice. Today, we talk about that famous advice from back in the day, just say no. That was the mantra of the anti-drug movement - and let's be honest, a lot of people laughed about that. Critics said it was unrealistic and simplistic, just to tell kids no, stop, and don't. But now a new study says that teaching younger teens to say no to sex just may work.

According to a new study published in the Archives of Pediatrics and Adolescent Medicine, the majority of the young teens, 67 percent, who received a type of abstinence-only education delayed having sex for two years, compared with 48 percent of the teens who received no sex education. The study was done with 600 African-American middle school students in one city in the Northeast. The findings have caught the attention of those from across the political spectrum because it's the first study that showed that abstinence education might be effective.

Abstinence programs were a favorite of the Bush administration, but the Obama administration has eliminated over $170 million in federal funding for abstinence programs after previous studies showed that they did not work. We wanted to talk more about this, so we're joining by Loretta Jemmott. She's the co-lead author of the study and a professor with the School of Nursing at the University of Pennsylvania. She is with us from their studios. Also joining us our TELL ME MORE parenting regulars Danette Tucker and Mary Kate Carey. They're both snowed in here in Washington. So they're joining us by phone from their homes. Welcome ladies, moms. Thanks for joining us.

MARY KATE CAREY: Thank you.

LORETTA JEMMOTT: Thanking for having me.

DANETTE TUCKER: Thank you.

MARTIN: Professor, let's clarify one thing. This study was not abstinence until marriage. What's the difference?

JEMMOTT: Well, the message is different. What happens is that a lot of the programs in the past focused on the message of abstinence until marriage. And when you have a message like that, it really is confounding because it gives the children the message that they can't do this thing called sex until they are married. Our program didn't focus on the moralistic issue of waiting until marriage. It focused on waiting until you're responsible to be able to handle the consequences of sex.

MARTIN: How did you impart that message?

JEMMOTT: In the way that the kids can hear it. So when we designed this study, we did a thing called elicitation. We started this like a lot of focus groups, hanging out with the young people, trying to hear their voices, trying to understand their attitudes and their beliefs around abstinence. And what we learned a lot from them is that they helped us to be able to use their voices in our program. We were able to integrate all their thoughts about their attitudes, their beliefs. What were the skills that they needed to be safe in abstaining? What are the messages that would work best for them and their code or their street? So we were very excited to be able to integrate that into the program.

MARTIN: And the kids who were getting these abstinence-only messages were compared with kids who got no sex education, but were there also kids who got what some people call comprehensive sex education programs, which is they were said, wait, but if you're not going to wait, do this?

JEMMOTT: Yes. The study had various interventions that we were measuring to see what works best comparing to our control group, but the one that we're focusing on, the one that was the most effective, was the abstinence one.

MARTIN: And why do you think that is?

JEMMOTT: Mind you now, the study focused on 12-year-olds. And what is the message that 12-year-olds should be hearing - is around abstinence. And if you integrate it into the way we did it, we focused on their goals and their dreams. What do they want to be when they finished, when they grew up? What do they wanted to do? How do they get there? So one of the activities was design your goal, okay? To you have your goal, okay? What do you got to do in the next five years to get there? And they started writing it down, very excited. Okay, about the next 10 years - what do you have to do to get there?

And so, what will get in the way of you obtaining your goals and dreams? And they said having sex and drugs, and so we said, now, how do we make sure that they don't get in the way, what are some of the things that you can do to prevent those things from happening to you? And they kept saying, abstaining, abstaining. The words coming out their own mouth was powerful. So you design the intervention in a way that gets to them where they are, the children will follow.

MARTIN: Hmm. Mary Kate and Dani, we are going to get in your business now.

(SOUNDBITE OF LAUGHTER)

MARTIN: Because both of you have 12-year-olds.

TUCKER: Hmm.

MARTIN: So, I want to ask, how are you talking about this? Mary Kate, how are you talking about these issues?

KATE CAREY: Well, I have to say in a very different way than my parents talked to me about it.

(SOUNDBITE OF LAUGHTER)

KATE CAREY: In 1975, I was in fifth grade and my parents talked to me once about this subject and it was a very abstinence-oriented discussion. And I will say one thing, Dr. Jemmott, about this study is it sounds like you use very young kids who were, you know, fifth, sixth, seventh grade - is that right?

JEMMOTT: It was sixth graders.

KATE CAREY: Mm-hmm. Great. And...

JEMMOTT: Sixth and seventh - sixth and seventh graders.

KATE CAREY: And I do think that times have changed since I was in fifth grade and it's not a one-time conversation with your kids.

MARTIN: Mm-hmm.

KATE CAREY: Where most people I know it's a continuing conversation. And I do think at sixth grade it is appropriate to talk about abstinence as really the only thing because I'm not interested in getting into a conversation with a sixth grader on how to put a condom on.

MARTIN: Hmm.

KATE CAREY: I just don't think that's developmentally appropriate. But I think the initial conversations, you know, you sort of start at the top of the iceberg and work down.

MARTIN: Hmm.

KATE CAREY: And I think that one of the things that I liked about this. The other thing is that this was kids talking to each other about that. And I think that's probably a little more effective than adults lecturing.

MARTIN: Dani, what about you? How do you talk to your daughter about these issues?

TUCKER: Much the same way that the study does. I (unintelligible) many kids I love it because it puts responsibility back on them. That wasn't done to us when we were younger. It was don't do it or else.

(SOUNDBITE OF LAUGHTER)

TUCKER: You know, nobody said why you don't do and it's like with anything that you tell a child not to do, well that's what they want to do simply because you don't want me to do it. So, I like this because I have a 12-year old, I have a seventh grader, 12-year-old, who, you know, had friends who have become sexually active.

MARTIN: Hmm.

TUCKER: I feel way too early. But you sit down and have this conversation with them like our parents did with us like, you know, they are ignorant to sex doesn't work. And the study says that and I think that's the way we are approaching - look, I know you may know a lot more about sex - you probably could teach me some things.

(SOUNDBITE OF LAUGHTER)

TUCKER: That, you know, but today look to what happens to those of your friends who are having sex, those who are already pregnant, do you want that? You know, and me and Imani had that conversation all the time. You know, what are your goals? My goal is to go to college and be a doctor. Well how do you think sex will play into that? It will distract me. So, you have to have almost a grown-up conversation with them.

MARTIN: Well, I think a lot of parents are in denial about the degree to which a lot of kids are sexually active even at a younger age that's in - a lot of people would like. So, for kids who you think are already for whatever reason exposed to sexual activity, do you think that this could be effective? Dani?

TUCKER: Oh, I think it can be totally effective because like you hit it on the nose, that abstinence till marriage it doesn't work in 2010. Because most of their parents are not married, most of them come, especially kids of my neighborhood they come from homes where they have more siblings and, you know, the different baby daddies or the different baby mamas. So, the traditional family is not there in a lot of these kids home.

So, abstinence till marriage means nothing to them. Nobody gets married around here any way. And maybe it's abstinence you shack up for 20 years but you have to speak their language. And I like this study because it not only speaks their language but it helps them talk - talk to each other and realize they feel the same way and if we say no to it this is why. Because this is going to stop my dreams, this is going to stop my goals, this is going to keep me from, you know, you getting to where I want to get to.

MARTIN: Professor Jemmott, you wanted to say something?

JEMMOTT: Yes, I was going to say that I completely agree that waiting till marriage syndrome really confuses them. So, I can agree wholeheartedly in what you're saying about the waiting until marriage piece.

MARTIN: What about the idea of teaching kids contraception because the argument has been that at 12 you really want to be all about delaying sexual involvement period but the argument has been that you want to teach comprehensive sex education because you want to catch the kids who might not be abstinent. And you want to be sure that they are kind of covered. Professor Jemmott, what do you say to that?

JEMMOTT: I think that that's an important message - but the message is for what child? As a parent of a 12-year old who just turned 13 last month and my little 11-year old my message at home that I'm teaching them is clearly abstinence. But you have to know your own child and know your child environment and their peer group because one of the things one of the mothers was saying is that girl's friends are pregnant. And so, you're in a mix with a lot of young people who might be doing something different than what your child is doing. And so, you're to tell you message to your child and then when their friends come over you can talk to them too.

MARTIN: If you're just joining us, you're listening to TELL ME MORE from NPR News. We're speaking with the moms and we're talking about new information about a type of abstinence education that a new study demonstrates as effective. Previous studies have shown that abstinence programs have not been effective and we're trying to talk about why this particular method may be.

Mary Kate, I know that anecdotes are dangerous and that's why you need comprehensive studies but just from talking to the mothers I know from all different backgrounds - the parents I know from all different backgrounds, they generally seem to approach it this way. They generally say to their younger children, you're too young and this is why and you need to wait until you're old enough to handle the consequences. This seems to be the approach that parents takes. So why is it that this issue is so fraught with politics about how this issue should be taught?

KATE CAREY: I think part of it has to do with the fact that everyone can agree that the ideal is nobody ever has sex, you know, before their married. That's an ideal for everybody. Yes, wouldn't that be great, you know. And then they start working backwards and that's where all the fighting starts and the federal funding and all that. And so, I think that was sort of a lowest common denominator for a while.

But times have changed and you look now in the District of Columbia the rate of sexually transmitted diseases and the HIV rate is I think one of the highest in country and rivals a third world nation. So, here where my kids go to school - and we're in a private school here at Washington - they show these girls these sexually transmitted disease information and HIV information and it scares the daylights out of them. And that is, you know, actually kind of helpful, I think, in terms of painting the risk picture of why would you want to do this in the first place.

MARTIN: One of the criticisms that some people have about this don't have sex you'll get sick argument is that you're setting people up for later on because at some point, you know, that message is going to change?

KATE CAREY: Well, that...

MARTIN: Do you see what I'm saying? I mean...

KATE CAREY: Well, let me give you an example.

MARTIN: Go ahead, Mary Kate?

KATE CAREY: Speaking of anecdotes, here is an example. My daughter who is 14 got diagnosed with type 1 diabetes when she was five. And one of the first things they told us is, don't let her think that you're in charge and you're going to tell her exactly how it's going to be. She needs to figure out what are your hopes and dreams. What's the best way you can get there? Stay healthy. How do you want to stay healthy? And put the child in charge of the health.

And I was at first horrified because they were saying to me you got to get her giving herself shots of insulin as soon as you possibly can. And I was like what? You know, a six-year-old giving herself shots, you know, and they said believe us in the long run the kids who are in charge of their own health are the ones who succeed the best with this disease. And that has proven itself true in spades. And I think that...

MARTIN: Well, I'm still hearing is the more positive message. What I don't hear you saying is them saying, if you don't do this you're going to be sick and you know, I - what I hear is more...

KATE CAREY: No, no, no it's in a positive way. She is in charge of her future. She knows all the options now sexually and in some ways her diabetes management has had a lot to do with that in terms of educating herself about health and that goes to all parts of her life.

MARTIN: I'm still though interested in this whole question of the focus on abstinence programs that some people have pushed in the past have been focusing on you'll get an STD. You'll be like a cookie that everybody has handled and it will only crumble - that kind of thing. I mean, and I'm just wondering about how effective is that.

JEMMOTT: This is Professor Jemmott.

MARTIN: Yes.

JEMMOTT: Yes, this is Professor Jemmott. And that used to be the fear technique that people started out with in the beginning of the epidemic for HIV and AIDS is that if you have sex you're going to die. And that message really doesn't work for young people. You know, the powerful message that works for young people is teaching them how to be proud of themselves and how to be responsible and make responsible decisions for their health.

Abstinence is a very positive message that goes right in with that. You're not going to have all these other health problems because you're choosing to be safe and you're choosing to be healthy.

MARTIN: Dani, what about you? What's your take on this? Because I know that, Dani, you're not opposed to fear.

(SOUNDBITE OF LAUGHTER)

TUCKER: Yeah.

(SOUNDBITE OF LAUGHTER)

MARTIN: As an organizing principle but...

TUCKER: I like the message but at the same time I am one of those that we must not abandon, we must turn up the volume on the STDs, on the you're getting sick because a lot of our young people especially in this area are so stuck in this mentality, which I see in my 16-year old and others that it will not happen to me.

JEMMOTT: This is Professor Jemmott. I want to add to that. I think you're right on target. You got to give them the facts about STDs, you got to give them the facts about pregnancy, you got to give them the facts about HIV because if you have sex, you're putting yourself at risk for all these other things that happen. And so, I'm not mad - it's just that I agree with you.

(SOUNDBITE OF LAUGHTER)

MARTIN: Well, finally a final thought from each of you and then Professor Jemmott, I'm going to give you the last word. I am interested to hear what kind of reaction you're getting to this study. So, Mary Kate, your anecdote about the diabetes was very helpful I think in kind of framing a way to think about this. And you're right at first you think that's pretty shocking to say...

KATE CAREY: Yeah.

MARTIN: ...kids you're in charge, but that's helpful. So, does this study that sounds to me that this study is in line with your thinking anyway. Does it change anything about the way you think about this issue?

KATE CAREY: No, it falls in the same line - what we were talking about is we never have talked to her about the horrible things that can happen from not taking care of yourself diabetes-wise. And so, we've kept it positive on her hopes and dreams. And I think all the studies in the world, you know, that take place in these schools are interesting and good and they're doing what they can but the bottom line really is whether it's a kid with special needs or sex education or whatever the best place, you know, for all this to be happening is in the home with the parents.

MARTIN: Dani, what about you? And again it sounds as though this is consonant with your view of how to talk about this anyway? But does this report change anything about the way you think you will talk about these issues at home?

TUCKER: Not at all, this just, you know, reinforces, like you said, the way I approach it anyway. I mean, one thing I liked about what the doctor said was getting to know your kids. Their own stance on sex and the mommy's stance on it is two different things. So, you have to get to know your kids. And I like the way this study - because to me this media study makes you interact with them, makes them interact with each other and when you get to talking about it to me you can't go wrong.

MARTIN: Professor Jemmott, final thought from you and I would love to know what reaction you're getting to the study? I know that it has gotten quite a lot of attention?

JEMMOTT: Yeah, the study has gotten a lot of attention, a lot of news media, a lots of news coverage but what I want to add is that when we think about talking to your kids - and I like with the parents on this show have already said that getting to you know your kid is so important but why did this program work? It worked because it focused on the attitudes and beliefs of the young people. But it also gave the young people skills in how to negotiate abstinence.

You can't just tell the kid go say no. You got to teach him how to say no. So we have a whole routine of how to say no, how to negotiate abstinence and how to walk away and be okay. It's a skill building intervention that helps the young person still be safe and abstain from sex.

MARTIN: As we continue to have the conversations with our children, use teachable moments. Every moment is a moment. You daughter or your son is watching TV, listening to music, you can be sitting right there and interject - ask them questions about what they are seeing and join right in with them.

My little daughter - I have their friends in the car and I sit there quietly as they about their day and their friends. And so, you can learn a lot by listening. And one more point is always have these thing - we call them door openers versus door closer conversations. A door opener conversation is the opportunity to really sit down with your children and really have this wonderful conversation.

And instead of using door closers because if you use door closers your child will not come back to you again. So you want to build this relationship with your child so that your child sees as an okay mom to come talk to about anything. And that's what we want to do with our children is to create this relationship with our children so that we can be the person that they want to talk to about these issues as they come up.

MARTIN: Loretta Jemmott is the co-lead author of the study that we've been talking about in the archives of Pediatrics and Adolescent Medicine. She is a professor with the School of Nursing at the University of Pennsylvania. We'll have a link to this study on our Web site, so, if you want to, you can read it for yourself. We were also joined by Danette Tucker. She joined us by phone from home. And Mary Kate Carey from her home office as well where - still snowed in here in the Washington, D.C. area. So, ladies, moms thank you so much for speaking with us.

TUCKER: Thank you.

KATE CAREY: Thank you.

JEMMOTT: Thank you.

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