Nursing ETDs

Publication Date

Winter 12-15-2017


Previous research has shown that comprehensive sexual health education (SHE) can significantly reduce risky sexual behavior and can increase protective behavior in adolescents. While an important component for all adolescents, this is particularly important for adolescents at high risk for adverse health outcomes, such as unplanned adolescent pregnancy and sexually transmitted infections. The aims of this descriptive study were to explore the content and delivery of SHE in New Mexico and to describe influences on decisions pertaining to implementation of state SHE policy. The social ecological model (SEM) was used as a theoretical framework to better understand levels of influence on implementation of SHE policy. Telephone surveys were conducted with 122 school teachers, school nurses, and administrators in public, secondary (middle and high) schools in New Mexico. SHE curriculum was delivered with great local variability in scope and content and with significant barriers such as insufficient resources and time and competition with other educational mandates. Participants also reported little or no evaluation of how effectively policy was implemented or whether educational objectives were met. From the perspective of participants, the SEM community and organizational levels had the greatest influence on implementation of SHE policy. These data can provide an important perspective of the challenges faced by individuals responsible for SHE policy in secondary schools and classrooms.

Degree Name


Level of Degree


Department Name

College of Nursing

First Committee Member (Chair)

Mark B. Parshall

Second Committee Member

Kim J. Cox

Third Committee Member

Dorinda L. Welle

Fourth Committee Member

Claire D. Brindis


comprehensive sexual health education, policy implementation, social ecological model, school nursing, street-level bureaucrat



Document Type


Included in

Nursing Commons