Lessons Learned from an Online Sexual Health Education Program: Reflections from Preservice Health and Physical Education Teachers
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| Title: | Lessons Learned from an Online Sexual Health Education Program: Reflections from Preservice Health and Physical Education Teachers |
|---|---|
| Language: | English |
| Authors: | Cathy McKay (ORCID |
| Source: | Quest. 2025 77(2):216-236. |
| Availability: | Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals |
| Peer Reviewed: | Y |
| Page Count: | 21 |
| Publication Date: | 2025 |
| Document Type: | Journal Articles Reports - Research Tests/Questionnaires |
| Education Level: | Higher Education Postsecondary Education |
| Descriptors: | Online Courses, Sex Education, Preservice Teachers, Physical Education Teachers, Teaching Methods, Health Education, Undergraduate Students, Student Attitudes, Reflective Teaching |
| DOI: | 10.1080/00336297.2024.2441772 |
| ISSN: | 0033-6297 1543-2750 |
| Abstract: | The purpose of this qualitative study was to seek to understand and describe the experiences of 18 preservice physical and health education teachers taking part in the published Vision of You (VOY) sexual health program. Data from reflective writing responses were collected and analyzed inductively, revealing three themes: (1) ""I feel better prepared to teach sexual health in my classroom:" Preservice teachers' views on VOY as a training and instruction tool, (2) "It does not have to be some huge, awkward thing:" Preservice teachers' getting comfortable with the uncomfortable, and (3) "VOY changed a bias in my head I didn't know I had:" Preservice teachers' new knowledge and understanding of inclusive sexual health education." Based on these findings, the meaning of the VOY program was evident in the data, supporting its value as a mechanism for learning and engagement, with clear implications for practice in training preservice teachers who will be responsible for teaching sexual health content. |
| Abstractor: | As Provided |
| Entry Date: | 2025 |
| Accession Number: | EJ1471288 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwFT-7r3ct_A0LQ8o_zLlQtVAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDPlzv52cjGe-BAfapgIBEICBmp9EK-FG6-lZXZMQLdvj7blMEdLKpgnPq4gkRtHDhz7oQX2N6ldvjRVIRQM4ymX0TtwkYYwHJuiSRZ1VOBsxv2R6CrnpxMGF3FPleC5KYI7fD9T1gCHBabc5l6WtszfGmWNvvhXgcCyRZmcgeHut9jp0u3mesYCArdLz_Jfhymf63cfkwxnOt1zd7ANibx5ND-QHZG0UpxqUYEg= Text: Availability: 1 Value: <anid>AN0184595407;qus01apr.25;2025Apr22.02:22;v2.2.500</anid> <title id="AN0184595407-1">Lessons Learned from an Online Sexual Health Education Program: Reflections from Preservice Health and Physical Education Teachers </title> <p>The purpose of this qualitative study was to seek to understand and describe the experiences of 18 preservice physical and health education teachers taking part in the published Vision of You (VOY) sexual health program. Data from reflective writing responses were collected and analyzed inductively, revealing three themes: (<reflink idref="bib1" id="ref1">1</reflink>)"I feel better prepared to teach sexual health in my classroom:" Preservice teachers' views on VOY as a training and instruction tool, (<reflink idref="bib2" id="ref2">2</reflink>) "It does not have to be some huge, awkward thing:" Preservice teachers' getting comfortable with the uncomfortable, and (<reflink idref="bib3" id="ref3">3</reflink>)"VOY changed a bias in my head I didn't know I had:" Preservice teachers' new knowledge and understanding of inclusive sexual health education. Based on these findings, the meaning of the VOY program was evident in the data, supporting its value as a mechanism for learning and engagement, with clear implications for practice in training preservice teachers who will be responsible for teaching sexual health content.</p> <p>Keywords: Sexuality education; teacher education; qualitative; health education</p> <hd id="AN0184595407-2">Introduction</hd> <p>Sexual health is defined by the World Health Organization (WHO) as "a state of physical, emotional, mental and social well-being in relation to sexuality" ([<reflink idref="bib76" id="ref4">76</reflink>]). The sexual and reproductive (SRH) health of adolescents is important as negative sexual health outcomes may have consequences well into adulthood. Lindberg and colleagues reported that over half of adolescents aged 15–19 have had some degree of sexual experience and while the proportion of adolescent women reporting use of a contraceptive method at last intercourse has increased over time, consistent use of condoms has decreased (Lindberg et al., [<reflink idref="bib44" id="ref5">44</reflink>]). As a result, almost half of all incident sexually transmitted infections (STIs) occur in adolescents and young adults, ages 15–24 (Centers for Disease Control and Prevention [CDC], [<reflink idref="bib14" id="ref6">14</reflink>]). Though declining over time, unintended pregnancy among adolescent females, ages 15–19, is higher in the United States compared to other high-income countries (Martin et al., [<reflink idref="bib50" id="ref7">50</reflink>]; World Bank, [<reflink idref="bib75" id="ref8">75</reflink>]).</p> <hd id="AN0184595407-3">Health education</hd> <p>Health education has been variously defined over several decades. Common components of these definitions include the development of strategies to improve health knowledge, attitudes, and skills to positively improve the health behaviors of individuals and communities (Catford &amp; Nutbeam, [<reflink idref="bib12" id="ref9">12</reflink>]; National Institutes of Health, [<reflink idref="bib57" id="ref10">57</reflink>]; WHO, [<reflink idref="bib77" id="ref11">77</reflink>]). Health education is situated within the larger context of health promotion, which often considers broader biological, historical, socio-economic, environmental, and cultural factors that impact health behavior and accessing health care (Nutbeam, [<reflink idref="bib58" id="ref12">58</reflink>]). Health education does not occur incidentally, but rather includes systematically planned activities to increase health knowledge and capacity and may occur at home, in community settings, and at school.</p> <hd id="AN0184595407-4">Sexual and reproductive health education</hd> <p>One important context of health education includes SRH. SRH education should provide medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development (CDC, [<reflink idref="bib13" id="ref13">13</reflink>]). Adolescents who participate in evidence-based SRH education are more likely to delay sexual intercourse, have fewer sexual partners when they do, have fewer experiences of unprotected sex, have increased contraceptive use, and have increased academic performance (Coyle et al., [<reflink idref="bib19" id="ref14">19</reflink>]; Denford et al., [<reflink idref="bib23" id="ref15">23</reflink>]; Marseille et al., [<reflink idref="bib49" id="ref16">49</reflink>]). STIs and unintended pregnancy are the main negative health outcomes that SRH education is intended to prevent (National Conferences of State Legislators, [<reflink idref="bib55" id="ref17">55</reflink>]). Thus, these are often the main outcome measures which are focused on in sexuality research. More recently, additional measures are being included in some curricula including the experience of intimate partner violence and sexuality/gender-based bullying and harassment (The American College of Obstetricians and Gynecologists, [<reflink idref="bib2" id="ref18">2</reflink>]; Breuner et al., [<reflink idref="bib10" id="ref19">10</reflink>]). Indeed, adolescents who participate in comprehensive SRH education are also more likely to exhibit greater appreciation of sexual and gender diversity, have fewer experiences of intimate partner and dating violence, and have more skills and self-efficacy associated with healthy relationships (Goldfarb &amp; Lieberman, [<reflink idref="bib32" id="ref20">32</reflink>]). Thus, the content of SRH education may cover any number of topics that directly relate to any of these outcomes, including anatomy and physiology, contraceptives, healthy relationships, communication, boundaries and respect, and mental health (The Sexuality Information and Education Council of the United States, [<reflink idref="bib64" id="ref21">64</reflink>]). However, because sexuality education is a contested topic there is no consensus on what content should or should not be taught. What agreement there is, is that STI and pregnancy prevention should be provided to students, but this can occur through comprehensive sexuality or abstinence-only modalities depending on the locality (National Conferences of State Legislators, [<reflink idref="bib55" id="ref22">55</reflink>]).</p> <hd id="AN0184595407-5">School-based health education</hd> <p>Adolescence is an important developmental stage where abstract thinking begins and where exploration and identity become important (Kar et al., [<reflink idref="bib40" id="ref23">40</reflink>]). School-based health education has been cited as a major source of knowledge about healthcare and health issues in adolescents and young adults (McCuaig et al., [<reflink idref="bib52" id="ref24">52</reflink>]). Through the delivery of health education, schools play a critical role in reducing risk by providing students functional health knowledge, strengthening attitudes and beliefs, and facilitating the practice of health skills and behaviors (Eisen et al., [<reflink idref="bib25" id="ref25">25</reflink>]; Lohrmann &amp; Wooley, [<reflink idref="bib46" id="ref26">46</reflink>]; Nation et al., [<reflink idref="bib54" id="ref27">54</reflink>]). School-based health education may be the first-time students have the opportunity to learn about a wide array of health topics. Physical and health education teachers are tasked with implementing lessons and activities that improve health and well-being among their developing students (Bezeau et al., [<reflink idref="bib7" id="ref28">7</reflink>]), both in the gymnasium and in the health education classroom. While certification and licensure vary from state to state, our approach in this paper, based on our state standards and licensure requirements, partners health and physical education as one certification, where teachers are trained in health and physical education in one licensure track. Despite the inclusion of comprehensive health education into the profession, previous studies have highlighted sport, exercise, and nutrition as the focus of many health and physical educators, rather than as components of a more holistic approach (Alfrey et al., [<reflink idref="bib1" id="ref29">1</reflink>]). As a result, physical and health education teachers may lack the knowledge, skills, and pedagogy to effectively teach other areas of health (Alfrey et al., [<reflink idref="bib1" id="ref30">1</reflink>]; Armour &amp; Harris, [<reflink idref="bib3" id="ref31">3</reflink>]). Armour and Harris ([<reflink idref="bib3" id="ref32">3</reflink>]) note that most health behaviors are complex and current physical education pedagogy may not be adequate to address the needs of diverse and dynamic learners. Further, while inservice teachers (those who have completed their teacher education and certification and are employed in a school division) may value continuing education opportunities to build knowledge and skills, they may be frustrated with the limited content and lack of innovative pedagogies (Makopoulou &amp; Armour, [<reflink idref="bib48" id="ref33">48</reflink>]).</p> <p>Despite discussions within the profession aimed at broadening health education beyond exercise and nutrition (Cale, [<reflink idref="bib11" id="ref34">11</reflink>]), there is very little if almost no focus on SRH education specifically. School-based SRH education may be offered by a variety of instructors including those in the science disciplines, school nurses, and outside community experts, such as those from the local health department (Eisenberg et al., [<reflink idref="bib26" id="ref35">26</reflink>]; Preston, [<reflink idref="bib60" id="ref36">60</reflink>]). However, in many school settings, physical and health education teachers are most often tasked with providing sexuality and healthy relationship content to students. Whereas there is literature regarding the experiences of general education preservice (those enrolled in a teacher preparation program) and inservice teachers in providing sexuality education, we have not been able to identify any studies that focus on the experience of preservice or inservice physical and health education teachers in providing sexuality education (Cohen et al., [<reflink idref="bib17" id="ref37">17</reflink>]; Cummings et al., [<reflink idref="bib20" id="ref38">20</reflink>]; Eisenberg et al., [<reflink idref="bib27" id="ref39">27</reflink>]; O'Brien et al., [<reflink idref="bib59" id="ref40">59</reflink>]; Walker et al., [<reflink idref="bib72" id="ref41">72</reflink>]). Thus, the purpose of this study was to seek to understand and describe the experiences of preservice physical and health education teachers taking part in the published Vision of You (VOY) SRH education program in relation to enhancing confidence and shaping perceptions of teaching SRH related content. An assertion paramount to this research was the belief that the impact of the VOY program would be articulated by the participants through written reflections with depth and intensity, offering insight that can only be expressed in the qualitative realm.</p> <hd id="AN0184595407-6">The vision of you program</hd> <p>SRH education programs should offer an avenue for adolescents to receive evidence-based medically accurate health information to prevent unintended pregnancy and STIs. However, SRH education varies widely across the United States, with differences not only at the state-level, but also from educational district to district (National Conference of State Legislators, [<reflink idref="bib55" id="ref42">55</reflink>]). There are two federal funding streams for SRH education among public schools: Teen Pregnancy Prevention Programs (TPPP) and Personal Responsibility Education Programs (PREP; Gutmacher Institute, [<reflink idref="bib36" id="ref43">36</reflink>]). Both types of programs intend to prevent STIs and unintended pregnancy. One program developed to address both of these goals is Vision of You.</p> <p>Vision of You is a self-paced sexuality education program designed for youth ages 13 – 19, and evaluated with rural youth between the ages of 14 – 17 (Youth.gov, [<reflink idref="bib79" id="ref44">79</reflink>]). According to the SexEdVA website ([<reflink idref="bib63" id="ref45">63</reflink>]), VOY is an interactive, independent, self-paced, online curriculum addressing comprehensive sexuality education, adulthood preparation subjects, healthy life skills, and relationships. Goals of the VOY program include a reduction in the frequency of sexual activity and number of sexual partners, and an increase in contraceptive use. Further, the final program goal focuses on an increase in adulthood preparation subject knowledge and skills, including healthy relationships, healthy life skills, parent-child communication, and adolescent development. VOY includes nine 45-minute units that are delivered in an online, self-paced platform. The nine units include: (<reflink idref="bib1" id="ref46">1</reflink>) Identity, where students explore the concept of identity, including their experiences, their culture, people's perception of them, and how they choose to represent themselves; (<reflink idref="bib2" id="ref47">2</reflink>) Healthy Relationships, where students identify healthy relationships and their green flags, and red flags or unsafe and unhealthy relationships, building skills and practicing having clear and direct conversations with partners and peers; (<reflink idref="bib3" id="ref48">3</reflink>) Talking with Adults, where students identify adults they trust and what makes them a trusted adult, identifying resources and tools to strengthen communication with adults; (<reflink idref="bib4" id="ref49">4</reflink>) Consent, where students define consent, know what is and what is not consent, and know how to ask for and give affirmative consent; (<reflink idref="bib5" id="ref50">5</reflink>) Anatomy, where students accurately identify and explain the functions of the reproductive system and sex organs, noting their standards for health and understanding when medical attention is necessary; (<reflink idref="bib6" id="ref51">6</reflink>) Sexually Transmitted Infections Prevention, where students describe symptoms, effects, and treatments of STIs, as well as ways to prevent them, including identifying where to access medical care for STI screenings and STI treatment; (<reflink idref="bib7" id="ref52">7</reflink>) Methods of Protection, where students identify different methods of protection including abstinence, physical barriers, and hormonal birth control, and know about their cost and how to access them; (<reflink idref="bib8" id="ref53">8</reflink>) Clinic Visit, where students visit a virtual clinic allowing them to become familiar with the layout and routine of a typical clinic, and seeing how a visit flows and what they should expect to help them build self- efficacy; and (<reflink idref="bib9" id="ref54">9</reflink>) Thinking Forward, where students think about goals for the future and how the decisions that they make can help them achieve those goals or create obstacles for accomplishing those goals.</p> <p>The SexEdVa ([<reflink idref="bib63" id="ref55">63</reflink>]) website also indicates that those engaged in the program can work at their own pace and save their progress as they go, returning later to continue the units. The program utilizes almost seven hours of programming and includes engaging videos, animation, interactive components, and gamification principles. VOY is intended to be completed in four to six weeks, and can be done in a variety of settings, including school, community-based settings, and at home (Youth.Gov, [<reflink idref="bib79" id="ref56">79</reflink>]). The program was shown to be effective in decreasing the number of recent sexual partners and the occurrence of unprotected sexual activity through a randomized controlled trial across 23 sites (Dainis, [<reflink idref="bib22" id="ref57">22</reflink>]). Information provided on Youth.Gov ([<reflink idref="bib79" id="ref58">79</reflink>]) indicates program structure and timeline, staffing, materials and resources, implementation, fidelity, and allowable adaptations.</p> <p>It is important to note that VOY is not a teacher training curriculum, but rather is an up- to-date, comprehensive sexuality education program, where those engaged in the online lessons can learn, value, understand, and practice content and skills related to sexuality and SRH. In this study, VOY introduced to the participants critical content and skills for comprehensive sexuality education, as well as modeled an innovative online teaching strategy for content delivery.</p> <hd id="AN0184595407-7">Andragogy theory</hd> <p>This study is situated in andragogy theory (adult learning theory; Knowles, [<reflink idref="bib41" id="ref59">41</reflink>]), which concerns the education of adults. Andragogy theory focuses on the needs of the adult learner, and the creation of independent and adaptable learners (Forrest &amp; Peterson, [<reflink idref="bib31" id="ref60">31</reflink>]). Knowles ([<reflink idref="bib41" id="ref61">41</reflink>]) explains that andragogy theory refers to adult learners' independent, self-directed learning to solve real-world professional issues and concerns. The VOY program is an independent, self-paced program that proposes a variety of real-world issues and concerns related to SRH education, creating a seamless link between this study and andragogy theory. Additionally, andragogy theory accounts for the influences of social, historical, and environmental experiences in adult education, and acknowledges that people vary in how they learn (Flannery, [<reflink idref="bib30" id="ref62">30</reflink>]). Participants in this study had a wide variety of SRH education experiences as students in K-12 learning settings, and likely have varying social and environmental exposure to SRH related real-life scenarios. One andragogy theory characteristic indicates that college students are more problem-centered than subject-centered in learning (Knowles, [<reflink idref="bib41" id="ref63">41</reflink>]). In this study, college students are tasked with learning and problem solving related to sexual health and determining how SRH content and learning strategies benefit them as future teachers. Andragogy theory supports the VOY experience, including participant reflections of how they are growing as independent and self-directed learners, applying knowledge to real-world professional issues (Fidishun, [<reflink idref="bib29" id="ref64">29</reflink>]). Thus, in this study we ask 1. What did participants learn from the VOY program, 2. What, if any, content and strategies did participants perceive they might use in teaching, and 3. How did participants perceive that the VOY program would or would not help them to meet their individual goals related to successful health education in the classroom?</p> <hd id="AN0184595407-8">Methods</hd> <p></p> <hd id="AN0184595407-9">Research approach</hd> <p>This study utilized a qualitative descriptive approach, exploring the experiences of preservice teachers after taking part in VOY, with a particular focus on enhancing confidence and shaping perceptions of teaching SRH related content. The goal of qualitative descriptive research is to comprehensively summarize specific events experienced by individuals or groups of individuals (Lambert &amp; Lambert, [<reflink idref="bib43" id="ref65">43</reflink>]). To date, research exploring the efficacy of VOY has not utilized qualitative methods. This research paradigm permits researchers to conduct in-depth explorations of the nature and extent of participant experiences (Brantlinger et al., [<reflink idref="bib9" id="ref66">9</reflink>]; Haegele &amp; Sutherland, [<reflink idref="bib37" id="ref67">37</reflink>]). Utilizing this paradigm, researchers can gain further insight into the perspectives of participants experiencing the VOY program.</p> <p>When engaging in qualitative research, it is necessary to describe researcher positionality, as our motivations, morals, and individual experiences can inform important expositions, procedural decisions, and explanations of the data (Sparkes &amp; Smith, [<reflink idref="bib69" id="ref68">69</reflink>]). Our research team explored individual positionality to consider the influences of our positionality and how it may have impacted the research process. Our research team is composed of four White individuals, three who identify as nondisabled and use she/her pronouns and one who identifies as nondisabled who uses he/his pronouns. All four members of the research team are professionally and personally invested in understanding issues central to health education, with three members of the research team focused specifically on how to train preservice students to be successful and confident in the health education teaching space, and one member of the research team serving as an inservice health and physical educator. Our shared interests in health education are revealed in our teaching, scholarship, and service undertakings. We were cognizant of our past experiences during the processes of data analysis, paying attention to the way those experiences have shaped our perspectives.</p> <hd id="AN0184595407-10">Participants and setting</hd> <p>Participants were recruited from undergraduate health and physical education students (preservice health and physical education teachers) who were enrolled in a health content course designed for students in this program of study at a university in a Mid-Atlantic state. The university is a public institution offering 139 academic programs, with over 21,000 undergraduate students and over 1,500 graduate students. Participants (<emph>N</emph> = 18) were all third-year students (due to the nature of the curricula of this program), and 100% identified as Caucasian with a mean age of 20.88. All (100%) of the participants indicated that they had no (0%) experience teaching SRH education, and all (100%) indicated that they took part in a SRH unit or lesson as a middle or high school student. The health content course is required during the second semester of the health and physical education teacher education program, and covers topics ranging from the National Health Education Standards (National Consensus for School Health Education, [<reflink idref="bib56" id="ref69">56</reflink>]) and skills based health education; to whole school, whole community, whole child (Centers for Disease Control and Prevention, [<reflink idref="bib15" id="ref70">15</reflink>]); to a variety of health content topics including substance use and abuse, communicable and chronic disease, sexuality and sexual health, emotional health, growth and development, and family and social health; plus the manner in which content is developed on these topics for K-12 learning experiences in the health classroom or gymnasium. The VOY curriculum and assignments were graded (for completion) components of the course, including reflection questions about their experience with VOY. After completing the VOY program and assignments, students had the option of having their reflection questions included in this research study. The treatment of participants was in accordance with the ethical standards of the American Psychological Association. Permission to conduct the study was granted by the Institutional Review Board at the primary researcher's university.</p> <hd id="AN0184595407-11">Vision of you experience</hd> <p>The VOY experience took place over the course of three weeks, including in class debrief discussions, and out of class online activities. The participants were first introduced to the program during a guest presentation conducted by a staff member representing the VOY program design and development. Students were able to ask questions about the origins of the program, the areas of focus, and the technical aspects of program delivery and support with the online platform. Next, students were assigned components of the program to complete online (independently). During class meetings, students would indicate their progress with the online work and take part in debrief discussions. After completing the nine VOY units online, participants submitted reflection questions about their experience taking part in the program.</p> <hd id="AN0184595407-12">Data collection</hd> <p>Data for this study were collected in the form of reflective writing responses. Utilizing reflective writing responses allowed students to make meaning of personal experiences (Bangert-Drowns et al., [<reflink idref="bib6" id="ref71">6</reflink>]). Writing provides students an avenue to evaluate perceptions, confusions and emotions about a topic, as it is a tool that supports comprehension (Bangert-Drowns et al., [<reflink idref="bib6" id="ref72">6</reflink>]). Writing responses, such as the reflective writing responses used in this study, help students analyze ideas and relationships between ideas, elicit relevant knowledge and experiences, and consolidate and review new experiences (Walshe, [<reflink idref="bib73" id="ref73">73</reflink>]). Reflective writing responses were collected from each participant one week after completion of the VOY program. One week was selected in order to provide participants with enough time to think about the meaning of their experiences with VOY, but not too much time as to burden them in remembering the characteristics of the program. Participants were asked to respond to the following question categories, indicated in Figure 1: (<reflink idref="bib1" id="ref74">1</reflink>) Questions about the program; (<reflink idref="bib2" id="ref75">2</reflink>) Questions about impact on future teaching; (<reflink idref="bib3" id="ref76">3</reflink>) Questions about games and videos; and (<reflink idref="bib4" id="ref77">4</reflink>) Questions adapted from the literature. On average, responses were approximately 1300 words in length.</p> <p>Graph: Figure 1. VOY reflection questions.</p> <hd id="AN0184595407-13">Data analysis</hd> <p>After data were collected, we engaged in a three-step inductive thematic analysis. First, the first author, holding a doctoral degree in teacher education pedagogy, immersed herself into the original data by reading and re-reading the reflective writing responses to develop a broad understanding and closeness with the content (J. A. Smith, [<reflink idref="bib66" id="ref78">66</reflink>]). While reading and re-reading, the author identified and associated passages she judged of importance and documented interpretative narration on the documents (Boeije, [<reflink idref="bib8" id="ref79">8</reflink>]). Second, the author condensed each case into emergent themes that conveyed the substance of each individual's experiences. At this stage, themes reflected both the participants' words as well as the author's interpretation of those words (J. A. Smith et al., [<reflink idref="bib67" id="ref80">67</reflink>]). Lastly, after emergent themes were established at the case level, the final step was to examine patterns and connections across participants through constant comparison (Boeije, [<reflink idref="bib8" id="ref81">8</reflink>]). The identified emergent themes were then presented to the research team, which were critically discussed and then presented as results.</p> <p>To ensure trustworthiness, a number of techniques were utilized during data collection and analysis. Trustworthiness is the extent to which phenomena represent experiences shared by the study participants (Brantlinger et al., [<reflink idref="bib9" id="ref82">9</reflink>]). Rigor (i.e., the completeness of the data collection) was supported by using reflective writing prompts that were inspired by the focus of the study and reviewed by the research team (Yardley, [<reflink idref="bib78" id="ref83">78</reflink>]). Particularizability, the extent to which findings can be applied to others in similar contexts or settings, was enhanced in this study by the researchers describing the school and course setting with thick detail so that readers can determine the degree of transferability to other situations (Brantlinger et al., [<reflink idref="bib9" id="ref84">9</reflink>]). Transparency, how clearly the stages of the research process are described, was achieved through explicitly describing the research processes (e.g., participant recruitment, analytic procedures; Yardley, [<reflink idref="bib78" id="ref85">78</reflink>]). Critical friends (i.e., the process of critical dialogue between people) were used to encourage reflexivity in the data analysis process (B. Smith &amp; McGannon, [<reflink idref="bib65" id="ref86">65</reflink>]). After emergent themes were identified by the first author, the third and fourth authors discussed alternative explanations and interpretations of the themes based on the data with the first author (B. Smith &amp; McGannon, [<reflink idref="bib65" id="ref87">65</reflink>]). Lastly, Yardley ([<reflink idref="bib78" id="ref88">78</reflink>]) explains that the impact and importance of qualitative research lies in the ability of the authors to communicate the content as interesting and useful. In line with this assertion, the impact and importance of this work will ultimately be judged by those consuming this study.</p> <hd id="AN0184595407-14">Findings</hd> <p>Qualitative analysis revealed three themes related to the participants' experiences with the VOY program: (a)"I feel better prepared to teach sexual health in my classroom:" Preservice teachers' views on VOY as a training and instruction tool, (b)"It does not have to be some huge, awkward thing:" Preservice teachers' getting comfortable with the uncomfortable, and (c)"VOY changed a bias in my head I didn't know I had:" Preservice teachers' new knowledge and understanding of inclusive SRH education. Each participant was assigned a number to ensure anonymity, which are referred to when presenting the participant voices. Language within quotes of participants was left uncensored in order to respect each participant's views.</p> <hd id="AN0184595407-15">"I feel better prepared to teach sexual health in my classroom:" preservice teachers' views o...</hd> <p>In the first theme, participants described the use of VOY to enhance training and instruction related to SRH. For example, Participant 3 expressed, "VOY would be a worthwhile tool for teachers because it will enhance the training and instruction they receive about teaching sexual health to teenagers by showing them what developmentally appropriate sexual education looks like with examples of lessons.," and participant 9 noted, "I think the VOY program could be a great tool to enhance training and instruction strategies for preservice teachers. I believe VOY is a great tool for anyone who needs to deeper understand these topics." Also focusing on training and development, participant 6 explained, "Professional Development such as VOY can only enhance learning for the teacher and the student, so I think it is a very good choice to use for those incoming teachers." In addition, Participant 1 echoed:</p> <p>I would highly recommend the Vision of You program to future teachers. Because of this program, I feel better prepared to teach a sexual health unit in my health classroom. Before I began the program, I had little experience in researching developmentally-appropriate sexual health resources for students. After examining the content, videos, and activities provided by the program, I feel as if I now know what information to look for and include in my lesson plans. The Vision of You program is one that all health educators should have the opportunity to experience.</p> <p>Three participants shared thoughts related to the foundation that the VOY program provides, connecting the foundation to the positive outcomes of the VOY program. For example, Participant 9 shared, "VOY does a great job of covering every aspect of sexual health education and it can definitely be used as a tool for teachers to relearn the content and gain a foundation to teach to students.," additionally Participant 7 commented, "This training gives a better understanding and foundation of sexual health material." Participant 1 also reflected on the foundation that the program provides, saying:</p> <p>The program allows future teachers to develop a foundation for understanding sexual health topics. The program also allows teachers to see how content in a sexual health unit should be sequenced. For example, understanding that lessons on relationships should covered before lessons on consent.</p> <p>Other thoughts related to instruction included Participant 10 sharing, "The program made me realize that addressing different parts of sexual health is important and does not necessarily mean that you endorse sexual activity.," and Participant 9 describing, "The VOY program made me think of sexual health education as a more important part of the health curriculum than I originally thought."</p> <p>The use of VOY as a training and instruction tool was also brought to life in statements about the interactive videos and games in the VOY platform. For example, Participant 3 noted, "The videos and games help the learning process by showing situations where concepts exist in everyday life. For example, you see what red flags look like in relationships, which will make it easier to point out in real life." Participant 2 shared, "The videos delivered the content in a new and fresh way. The games provided a break from some of the more serious content, and were great tools which helped to check my learning." Finally, Participant 9 recalled, "The games and videos helped in the learning process ... they worked to reinforce learning by giving the student multiple ways to understand and interact with the content. They worked to build the content up and progressively throughout the program."</p> <p>While participant reflections related to this theme were overwhelmingly positive, two participants expressed skepticism about the use of the curriculum as a training and instruction tool. Participant 5 said:</p> <p>I feel like it depends on the teacher, some teachers may find this as a way that they could connect with the students easier, but some teachers may feel like the program is hindering their teaching. They may feel comfortable teaching all this material and see the program as an easy way out of actually teaching. I think that it really just depends on the teacher's personality and how connected they are with their students.</p> <p>Also raising concerns, Participant 4 processed:</p> <p>The VOY program is reliable, beneficial and a unique approach in teaching sexual health. The only thing more I have to say is the importance of understanding that each student does not learn the same. For some teens, this program could work great but for others it may not. I believe it does not hurt to try this program, but should never be looked at as an end all be all. As teachers we must be open and accept different forms of learning.</p> <hd id="AN0184595407-16">"It does not have to be some huge, awkward thing:" preservice teachers' getting comfortable w...</hd> <p>The second theme concerned participants' newfound feelings of comfort with SRH content. Participants reflected both briefly, as well as in detail, related to comfort. Brief comments include Participant 16 saying, "VOY helped me overcome the uncomfortableness by going through a program that helps start conversation on topics that seem uncomfortable.," and Participant 13 adding, "VOY did influence my thoughts. For example, how simple it was. It does not have to be some huge awkward thing. Students could do this and then come to you if they have any questions.," and Participant 14 noting, "I honestly feel less weird now about talking about these sorts of things in class or addressing them privately with students." More detailed thoughts about comfort include Participant 9 describing:</p> <p>VOY did a great job of teaching this topic and other sensitive topics and I think it is important to talk about things that may be uncomfortable. VOY is very interactive and makes uncomfortable conversations feel a little bit less uncomfortable. I think it is important to emphasize the importance of these topics while making sure students feel comfortable talking and learning.</p> <p>Also related to comfort, Participant 6 explained:</p> <p>VOY is an educational experience where students are able to learn health content in a less awkward and beneficial way outside of the classroom. This provides students with more information than most classroom lessons do. It makes topics less awkward to learn about when it's virtual compared to a teacher talking and having every student need to ask questions but being afraid to.</p> <p>Finally, in the last reflection related to comfort, Participant 14 echoed:</p> <p>It shows that it is not that weird to talk about these things within the class, but also know that you are not the only teacher that feels a little weird talking about these things. VOY for me, at least, made me more comfortable when talking about these things.</p> <p>While participants addressed having to get comfortable with the uncomfortable, they also indicted that while they see the value in the program, they were uncomfortable during the experience. For example, Participant 6 recalled, "Some of the videos from learning about STI's made me a little uncomfortable, but I thought the information that it delivered was great.," and Participant 8 echoed, "Some of the videos about consent were a little uncomfortable to watch but nothing too bad." Participant 11 commented, "I believe topics are avoided too often because they are uncomfortable, but these topics are necessary to teach. For example, the consent unit made me feel uncomfortable but they also provided me with more insight on consent.," and Participant 7 said, "VOY may be a little graphic, but it is something that will open the eyes of the students, so that it will create a bigger impact."</p> <p>While a handful of participants reflected on feeling uncomfortable, others shared that they were comfortable. For example, Participant 10 recalled, "What surprised me is that I didn't feel uncomfortable during the program. Usually hearing this kind of information does, but in this format, it made hearing sensitive information easier.," and Participant 1 shared, "I cannot recall any aspect of the program that I found uncomfortable." Similarly, Participant 8 echoed, "Nothing was too uncomfortable.," and Participant 18 said, "It didn't make me feel uncomfortable. It could be a tad bit graphic which I wasn't expecting." The graphic nature of the videos was also reflected on by Participant 13, who described:</p> <p>It surprised me how in detail the consent character thing went into. I think it was good that it was so detailed, so people know what to expect and what to do but at the same time I was like wow! Nothing truly made me feel uncomfortable it was more of a wow that was very straight forward.</p> <p>Similar thoughts came across from Participant 2, who explained:</p> <p>I was surprised by all of the different content that was woven throughout the program. When I think of my sex education class from high school, I don't remember talking about identity, healthy relationships, or what happens at the doctor. Some of the videos were difficult to watch but they didn't make me uncomfortable.</p> <hd id="AN0184595407-17">"VOY changed a bias in my head I didn't know I had:" preservice teachers' new knowledge and u...</hd> <p>The third theme dealt with the participants' new, more inclusive perceptions of SRH content that rejected binary thinking. For example, Participant 3 said, "VOY shapes my attitude toward inclusivity of LGBTQ+ within a sex ed program by heightening the importance of being inclusive. We have many different kinds of relationships and sexual identities that we need to be aware and supportive of.," and Participant 1 shared, "The program models inclusivity, as various types of relationships are presented throughout the course." Further, Participant 1 elaborated with thoughts about inclusivity:</p> <p>The Vision of You program was effective at utilizing inclusivity in their lessons. The videos and activities showed examples of both heterosexual and LBTQ+ couples, which was encouraging to see. We should never assume our students' sexual orientation. As a future educator, I have recognized the importance of including LGBTQ+ relationships into my sexual health lesson plans, so that no students feel excluded.</p> <p>Also focusing on inclusivity, Participant 14 processed, "VOY made me realize all students have their differences and when discussing sexual health, you have to create an inclusive environment for all students and make them comfortable to ask questions." In addition, Participant 5 expressed:</p> <p>It opened my eyes and helped me see that the LGBTQ+ community needs to be included into the lessons. In the past, it may have been skipped over, but at this time in society I think that it would be doing the students a disservice to not teach them the proper ways to go about people who may not share the same beliefs as they have. I need to make sure that I am behaving in a way in which students see that I am welcoming to anyone who comes through the door, no matter their sexuality.</p> <p>Further thoughts about the LGBTQ+ community were shared by Participant 11, "After completing VOY I now realize how important it is to ensure that LGBTQ+ students are provided with the information necessary for maintaining sexual health.," and Participant 10 noted, "It helped me realize that there are many questions from members of the LGBTQ+ community that often go unanswered because they are not discussed. It is important for ALL students to have the knowledge necessary for healthful choices."</p> <p>Participants also shared their own evolving thoughts, biases, and perceptions when discussing the VOY program. For example, Participant 4 described:</p> <p>I believe the VOY program did an excellent job of providing the audience constantly with all different types and dynamics of a relationship. In one of my responses earlier, I said I was somewhat uncomfortable, however that diminished as I became more accepting as the program continued. I believe anyone can accept and become open to learning about the LGBTQ+ community if their exposure to it was more common. As it pertains to inclusivity in my health classroom, I must take on the challenge to be open, willing to seek and understand their needs/wants, and willing to learn myself.</p> <p>Similarly, Participant 5 reflected on being a bit closed minded, sharing:</p> <p>I think that the lesson on identity was pretty impactful. During my time spent in high school health I don't think I was ever presented the idea of different identities. So, by seeing that it is part of the curriculum now shows a massive step forward for the health education sector. It showed me that I was a little closed minded, if I would have had the chance to be exposed to this in high school it would have opened my mind up to a different style of life that I wasn't familiar with.</p> <p>Also connected to identity, Participant 13 said, "I think the most important topics include identities of all people. I feel as if this is so important because this is the first step in understanding who someone is and how to respect all people.," and Participant 11 observed, "The topic that impacted me the most was the assumptions related to identity, because no matter the person they have different life experience, and everyone has their own biases." Participant 2 also reflected on biases, sharing:</p> <p>VOY changed a bias in my head I didn't know I had. When I think of sex education, I don't think about how all students are included – I'm usually just thinking of the basic content (ex: NHES 1). I now realize that there are a lot of different factors to consider and content to include when teaching sex education.</p> <p>Reflections in this theme also pointed out the traditional binaries that are taught in SRH education, and the manner in which VOY extended knowledge related to gender. For example, Participant 13 explained, "It has helped me better understand the language to use and how sexual health education is just more than female and male and we have to teach to everyone and include everyone even if those students are not in our class in that given time," and Participant 3 described:</p> <p>The VOY made me think about how I need to remind myself to be inclusive during sexual health education in my future classroom. In my experiences of sex ed in middle and high school we only learned about relationships between men and women. The VOY program incorporates examples of men with men and women with women relationships.</p> <p>Final thoughts about new knowledge related to inclusivity include, "Completing VOY shaped my attitudes or actions by knowing that my sexual health education program should be inclusive and relate to all students, not just students of one sexual orientation." (Participant 8), "By completing vision of you it shows us that everyone has different preferences and that we cannot judge people on who/what they like, but accept people for how they are." (Participant 12), and "VOY expanded my knowledge of the LBGTQ+ community. It is extremely important to make sure students feel comfortable with who they are and that starts by educating everyone to be respectful toward all types of people." (Participant 9).</p> <hd id="AN0184595407-18">Discussion</hd> <p>The purpose of this study was to describe and understand the experiences of preservice health and physical education teachers taking part in the published VOY SRH education program. To the authors' knowledge, this is the first study to employ qualitative methodologies to explore the meaning of the VOY experience by examining expressed insights through the voices of the participants. The impact of VOY was evident in all participant passages about the VOY experience, thereby reinforcing the notion of VOY as a valuable and critical learning experience for future health and physical educators. Whereas there is literature regarding the experiences of non-health and physical education teachers with teaching SRH education, there is little if no literature regarding the experiences of preservice and inservice physical and health education teachers teaching SRH education (Cohen et al., [<reflink idref="bib17" id="ref89">17</reflink>]; Cummings et al., [<reflink idref="bib20" id="ref90">20</reflink>]; Eisenberg et al., [<reflink idref="bib27" id="ref91">27</reflink>]; O'Brien et al., [<reflink idref="bib59" id="ref92">59</reflink>]; Walker et al., [<reflink idref="bib72" id="ref93">72</reflink>]).</p> <hd id="AN0184595407-19">Training</hd> <p>After completing the VOY curriculum, our participants felt better prepared to teach subjects related to SRH. It provided them with an example of developmentally appropriate SRH education, which many may not have had previous personal experience with. Interacting with the material not only provided them with example lessons but allowed them to understand what content to include in their own future lesson plans and how it might be structured. Some of the participants noted that their participation allowed them to acquire (or re-learn) a solid foundation of SRH knowledge. Other studies have found that the higher the level of health knowledge and skill that a teacher has beforehand, the more prepared and confident they will feel in the classroom (Vamos &amp; Zhou, [<reflink idref="bib71" id="ref94">71</reflink>]). However, one systematic review found that sexuality education teachers regularly had little formal preparation and were often under-resourced in the classroom (O'Brien et al., [<reflink idref="bib59" id="ref95">59</reflink>]). When there was formal SRH education training prior to being posted in the classroom, it was often through an elective course or research project (Eisenberg et al., [<reflink idref="bib27" id="ref96">27</reflink>]). In addition to factual and medically accurate content, SRH education teachers are often tasked with navigating the controversial and taboo socio-cultural aspects related to the topic. Prior to in-class experiences, teachers do not recognize that they will be assigned with managing a variety of complexities associated with SRH education; from the political to cultural and religious controversies (Eisenberg et al., [<reflink idref="bib27" id="ref97">27</reflink>]). Indeed, the participants of this study in their narratives did not indicate that they recognized this potential future aspect.</p> <hd id="AN0184595407-20">Confidence</hd> <p>The participants in this study found that participating in VOY made them feel more comfortable in discussing such a complicated and often taboo subject such as sexuality. Numerous studies have found that comfort with the subject was one of the most important factors impacting the delivery of SRH education (Cohen et al., [<reflink idref="bib17" id="ref98">17</reflink>]; Cummings et al., [<reflink idref="bib20" id="ref99">20</reflink>]; Lodge et al., [<reflink idref="bib45" id="ref100">45</reflink>]). Teachers who were confident had greater teaching experience/training in sexuality education, had educational materials and programs provided to them, worked in a supportive school environment, and had a strong sense of their personal role and responsibility in educating about sexuality (Walker et al., [<reflink idref="bib72" id="ref101">72</reflink>]). Our participants noted that teaching sexuality should be normalized, and that the instruction did not have to be "awkward." This outlook is reflected in studies that have explored student perceptions of SRH education. When teachers are relatable and normalize SRH discussions, students feel more comfortable, especially if instructors emphasize the healthy growth and developmental aspects of SRH education (Rose et al., [<reflink idref="bib62" id="ref102">62</reflink>]). Our participants also recognized that SRH education should be an important component of holistic health curricula. This is reflected in the growing acceptance of sexuality education within a wider well-being and socio-ecological perspective (O'Brien et al., [<reflink idref="bib59" id="ref103">59</reflink>]). Though our participants felt more comfortable with SRH education in general, there were some topics that they indicated less comfort with: sexually transmitted infections (STIs), consent, and sexual abuse. However, participants did not specifically detail <emph>what</emph> about these subjects or their presentation made them less comfortable. It is important to note that our participants were young and may be sexually inexperienced. As a result, they may not be used to frank discussions of sex and its potentially negative health outcomes.</p> <p>Our participants found that the VOY curriculum highlighted the importance of inclusive teaching and learning in SRH education. Historically, SRH education has done so from a heteronormative perspective (Elia &amp; Eliason, [<reflink idref="bib28" id="ref104">28</reflink>]). According to the Gay, Lesbian, and Straight Education Network (GLSEN)'s 2021 National School Climate Survey, the proportion of students who report that their school has any curricula containing LGBTQ±related topics is increasing, but most (71.6%) have none (Kosciw et al., [<reflink idref="bib42" id="ref105">42</reflink>]). Only 16.3% of students are taught positive representations of LGBTQ+ people, history, and events, and only 7.4% received LGBTQ+ inclusive sex education. Students having access to inclusive curricula is important. LGBTQ+ students in schools with inclusive curriculum were less likely to hear homophobic and transphobic remarks, were less likely to feel unsafe and experience violence, were more likely to feel greater belonging in their school community, and reported fewer negative psychological outcomes, including suicidal ideation (Kosciw et al., [<reflink idref="bib42" id="ref106">42</reflink>]; Snapp et al., [<reflink idref="bib68" id="ref107">68</reflink>]). Students who experience exclusive SRH education report an absence of LGBTQ+ discourse, a focus on unintended pregnancy through heterosexual intercourse, or negative portrayals of LGBTQ+ persons through pathologizing STI transmission (Gowen &amp; Winges-Yanez, [<reflink idref="bib33" id="ref108">33</reflink>]; Roberts et al., [<reflink idref="bib61" id="ref109">61</reflink>]). Further, students today may request or expect LGBTQ inclusive sexuality education (Dickson et al., [<reflink idref="bib24" id="ref110">24</reflink>]; Jarpe-Ratner, [<reflink idref="bib39" id="ref111">39</reflink>]).</p> <p>Our participants highlighted that they had previously not considered the assumed heterosexuality of typical SRH education, but at the end of the VOY program came to appreciate its inclusive nature. Other studies have found that inservice teachers also value inclusive SRH education, but often lack the training to feel self-efficacy in providing it (Greenan, [<reflink idref="bib35" id="ref112">35</reflink>]). When preservice teachers received LGBTQ+ training and learning experiences (though not specifically related to SRH), they had improved knowledge, attitudes, self-efficacy, and skills for serving LGBTQ+ identifying students (Coulter et al., [<reflink idref="bib18" id="ref113">18</reflink>]). Participants in our study shared an openness to be self-reflective in learning about LGBTQ+ experiences, and being open and willing to learn as an educator. Other studies have shown that some teachers have a similar level of self-awareness of their own ideas and implicit biases but continue to identify needs for additional support (Jarpe-Ratner, [<reflink idref="bib39" id="ref114">39</reflink>]). Thus, training and education related to the experiences of LGBTQ students and best practices in inclusive educational practices may allow teachers to reflect on their current perspectives and teach with a growth-mind-set (Cutler et al., [<reflink idref="bib21" id="ref115">21</reflink>]).</p> <hd id="AN0184595407-21">Interactive videos and games</hd> <p>Finally, our participants found great utility in the modality that the online VOY program offered. First, the videogame like nature of the VOY program provided interactive ways of learning for our participants. As one participant noted, it allowed the content to "come to life." Video games have increasingly been found to be an effective learning strategy, including for improving problem-solving skills (Granic et al., [<reflink idref="bib34" id="ref116">34</reflink>]). The video games allowed participants to immediately check their comprehension. Previous research into the effectiveness of video games as a learning tool has shown similar improvements in comprehension in reading, language, and mathematical computation (Clark et al., [<reflink idref="bib16" id="ref117">16</reflink>]; Martinez et al., [<reflink idref="bib51" id="ref118">51</reflink>]; Morris et al., [<reflink idref="bib53" id="ref119">53</reflink>]). In addition, our participants found that the video vignettes were relatable and allowed them to become invested in the characters. Previous successful health interventions that have incorporated compelling storytelling create an emotional connection between the audience and characters, allowing viewers to trust in the health information they are being shown (Heilemann et al., [<reflink idref="bib38" id="ref120">38</reflink>]; Wang &amp; Singhal, [<reflink idref="bib74" id="ref121">74</reflink>]). For example, one participant reported that they appreciated the videos that showed "red flags" within a romantic relationship. This type of learning fits with establish research surrounding modeling behaviors within the social cognitive (Bandura, [<reflink idref="bib5" id="ref122">5</reflink>]) and inoculation theories (Banas &amp; Rains, [<reflink idref="bib4" id="ref123">4</reflink>]). Finally, our participants found that the online, gamified format of the VOY provided a fun and enjoyable way to learn. The role of fun in learning has been well documented as it can encourage concentration and the absorption of new material as well as provides motivation for continued learning (Lucardie, [<reflink idref="bib47" id="ref124">47</reflink>]; Tews et al., [<reflink idref="bib70" id="ref125">70</reflink>])).</p> <hd id="AN0184595407-22">Limitations</hd> <p>There were several limitations to this study. First, this study was conducted at a single institution, using a single class of preservice teachers as participants. In addition, participants in this study may not be a representative sample of the preservice health and physical education teacher population at other institutions. Therefore, the detail provided about the university setting utilized in this study should be used for readers to determine the degree of transferability these findings can have to other teacher education preparation settings (Brantlinger et al., [<reflink idref="bib9" id="ref126">9</reflink>]). Second, baseline examinations of participants' experiences with SRH education were not conducted, other than inquiring if participants had SRH education in middle or high school. Because we did not inquire about the content or quality of the SRH education that participants personally experienced, and because there is likely great variability among participant experiences with SRH education in secondary schools, it is unknown the degree to which these potential prior experiences influenced the reflections in this study. Results of this study could be biased based on the participants' exposure (or lack of exposure) to SRH content prior to their experience with this study. Third, program implementation indicates four to six weeks for VOY, however, this study utilized a three-week period from introduction to reflection submission for the program. While this timing was adequate for the preservice health and physical education teacher population and the course syllabi schedule, it is one week less than the suggested implementation. Finally, though VOY has been shown effective in an evaluation study conducted by an outside evaluator, these findings have not been disseminated in peer-reviewed literature nor has it been included in the list of evidence-based sexuality education curricula.</p> <hd id="AN0184595407-23">Conclusion</hd> <p>The results of this study provide in-depth qualitative data indicating the experiences of undergraduate preservice health and physical education teachers taking part in the published VOY program. This study is not meant to be an evaluation of VOY, but rather an exploration of the perspectives of preservice teachers in how such a program may provide needed SRH education, confidence, and comfort for those who may find SRH education as a component of their future careers. Findings showed that students were able to enhance their confidence and shape perceptions of teaching SRH related content in their future careers. Results of this study have significant implications for future practice. Many preservice physical and health education teachers may not realize that they might be tasked with SRH education. Most will never receive any SRH training prior to being posted in the classroom. However, successful SRH education relies on competent health educators who are not only knowledgeable about the subject but are comfortable teaching often uncomfortable yet vitally important topics. Thus, sexuality education training should be included in preparation standards for preservice physical and health and education teachers, and further investigation is needed into this promising modality of teaching SRH content.</p> <hd id="AN0184595407-24">Disclosure statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <ref id="AN0184595407-25"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Alfrey, L., Cale, L., &amp; Webb, L. A. (2012). Physical education teachers' continuing professional development in health-related exercise. Physical Education &amp; Sport Pedagogy, 17 (5), 477 – 491. https://doi.org/10.1080/17408989.2011.594429</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> The American College of Obstetricians and Gynecologists. (2016). Comprehensive sexuality education. 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| Items | – Name: Title Label: Title Group: Ti Data: Lessons Learned from an Online Sexual Health Education Program: Reflections from Preservice Health and Physical Education Teachers – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Cathy+McKay%22">Cathy McKay</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-1802-2641">0000-0002-1802-2641</externalLink>)<br /><searchLink fieldCode="AR" term="%22Laura+Merrell%22">Laura Merrell</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-0226-6454">0000-0003-0226-6454</externalLink>)<br /><searchLink fieldCode="AR" term="%22Hayden+Bartley%22">Hayden Bartley</searchLink><br /><searchLink fieldCode="AR" term="%22Kim+Hartzler-Weakley%22">Kim Hartzler-Weakley</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-5750-4662">0000-0001-5750-4662</externalLink>) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Quest%22"><i>Quest</i></searchLink>. 2025 77(2):216-236. – Name: Avail Label: Availability Group: Avail Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 21 – Name: DatePubCY Label: Publication Date Group: Date Data: 2025 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research<br />Tests/Questionnaires – Name: Audience Label: Education Level Group: Audnce Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink> – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Online+Courses%22">Online Courses</searchLink><br /><searchLink fieldCode="DE" term="%22Sex+Education%22">Sex Education</searchLink><br /><searchLink fieldCode="DE" term="%22Preservice+Teachers%22">Preservice Teachers</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Education+Teachers%22">Physical Education Teachers</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+Methods%22">Teaching Methods</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Education%22">Health Education</searchLink><br /><searchLink fieldCode="DE" term="%22Undergraduate+Students%22">Undergraduate Students</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Reflective+Teaching%22">Reflective Teaching</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1080/00336297.2024.2441772 – Name: ISSN Label: ISSN Group: ISSN Data: 0033-6297<br />1543-2750 – Name: Abstract Label: Abstract Group: Ab Data: The purpose of this qualitative study was to seek to understand and describe the experiences of 18 preservice physical and health education teachers taking part in the published Vision of You (VOY) sexual health program. Data from reflective writing responses were collected and analyzed inductively, revealing three themes: (1) ""I feel better prepared to teach sexual health in my classroom:" Preservice teachers' views on VOY as a training and instruction tool, (2) "It does not have to be some huge, awkward thing:" Preservice teachers' getting comfortable with the uncomfortable, and (3) "VOY changed a bias in my head I didn't know I had:" Preservice teachers' new knowledge and understanding of inclusive sexual health education." Based on these findings, the meaning of the VOY program was evident in the data, supporting its value as a mechanism for learning and engagement, with clear implications for practice in training preservice teachers who will be responsible for teaching sexual health content. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2025 – Name: AN Label: Accession Number Group: ID Data: EJ1471288 |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/00336297.2024.2441772 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 21 StartPage: 216 Subjects: – SubjectFull: Online Courses Type: general – SubjectFull: Sex Education Type: general – SubjectFull: Preservice Teachers Type: general – SubjectFull: Physical Education Teachers Type: general – SubjectFull: Teaching Methods Type: general – SubjectFull: Health Education Type: general – SubjectFull: Undergraduate Students Type: general – SubjectFull: Student Attitudes Type: general – SubjectFull: Reflective Teaching Type: general Titles: – TitleFull: Lessons Learned from an Online Sexual Health Education Program: Reflections from Preservice Health and Physical Education Teachers Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Cathy McKay – PersonEntity: Name: NameFull: Laura Merrell – PersonEntity: Name: NameFull: Hayden Bartley – PersonEntity: Name: NameFull: Kim Hartzler-Weakley IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 0033-6297 – Type: issn-electronic Value: 1543-2750 Numbering: – Type: volume Value: 77 – Type: issue Value: 2 Titles: – TitleFull: Quest Type: main |
| ResultId | 1 |
