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CDC Task Force Says Sex Ed Better Than Abstinence Ed But Won’t Release Full Data to Public
An independent task force assembled by the CDC to issue recommendations on the best way to teach teens how to avoid pregnancy and sexually transmitted diseases has reported that "comprehensive risk reduction" programs are more effective than abstinence programs. But the CDC will not release the data the task force used to reach its conclusion.
(CNSNews.com) - An independent task force assembled by the Centers for Disease Control and Prevention to issue recommendations on the best way to teach teens how to avoid pregnancy and sexually transmitted diseases has reported that “comprehensive risk reduction” programs are more effective than abstinence programs, even though the CDC will not release the data the task force used to reach its conclusion.
The 15-member Task Force on Community Preventive Services and four other experts made up the team, which analyzed dozens of studies of sex education programs conducted between 1980 and 2007.
A list of the studies is available on the Community Guide portion of the CDC Web site, but the task force’s analysis of the studies is not.
Lack of access to that analysis, critics say, prevents an open review of data they contend shows that abstinence programs were underrepresented in the studies used and that using comprehensive sex education programs in school settings did not reduce teen pregnancy, STDs, or increase the use of condoms.
“The Task Force has made public its recommendation statements without also making available to the public the full set of study findings upon which the recommendations are based – both supporting and otherwise,” Irene Ericksen, a member of the review team and researcher with the Institute for Research and Evaluation, said about the recommendations.
“This prevents the public from scrutinizing the body of evidence underlying the CDC Task Force Recommendations in the same time frame in which the CDC recommendations will influence the decisions of policymakers and public health professionals,” she said.
Danielle Ruedt, the public health program coordinator for the Georgia governor’s Office of Children and Families and a member of the task force, said that when used in school settings, the data do not support the task force’s sweeping recommendations.
“The effectiveness of school-based programs is crucial since the school
classroom is where most teens receive sex education,” Ruedt said. “Yet the report's conclusion that comprehensive sex education programs are generally effective in school settings is contradicted by some of the data upon which the report is based.”
The official task force recommendations support using “comprehensive risk reduction” programs, but do not recommend abstinence education apparently because of “insufficient evidence.”
“The Task Force on Community Preventive Services recommends group-based comprehensive risk reduction (CRR) delivered to adolescents to promote behaviors that prevent or reduce the risk of pregnancy, HIV, and other sexually transmitted infections (STIs),” the recommendations state.
“The recommendation is based on sufficient evidence of effectiveness in: reducing a number of self-reported risk behaviors, including (1) engagement in any sexual activity; (2) frequency of sexual activity; (3) number of partners; and (4) frequency of unprotected sexual activity; (5) increasing the self-reported use of protection against pregnancy and STIs; and (6) reducing the incidence of self-reported or clinically documented sexually transmitted infections,” states the recommendations. “There is limited direct evidence of effectiveness, however, for reducing pregnancy and HIV.”
On abstinence education the task force reported the following:
“The Task Force on Community Preventive Services concludes that there is insufficient evidence to determine the effectiveness of group-based abstinence education delivered to adolescents to prevent pregnancy, HIV, and other sexually transmitted infections (STIs),” the recommendations state. “Evidence was considered insufficient due to inconsistent results across studies.”
The task force analyzed 62 comprehensive sex education studies and 21 abstinence studies before issuing its recommendations.
Ericksen and Ruedt issued a “minority report” to explain their position and why they think transparency about the data is important.
“The Task Force has made public its Recommendation Statements without also making available to the public the full set of study findings upon which the recommendations are based—both supporting and otherwise,” said Erickson and Ruedt. “The reason given for this decision is that the data from the study has not yet been scientifically cleared by the CDC for release to the public.
“However, this policy prevents the public from scrutinizing the body of evidence underlying the CDC Task Force Recommendations in the same time-frame in which the CDC recommendations will influence the decisions of policymakers and public health professionals,” said Erickson and Ruedt in their report.
“(Having the opportunity to examine this evidence is particularly important in the current climate of controversy and politicization that surrounds the public policy debate about sex education in America.),” they added.
A spokeswoman from the CDC told CNSNews.com that it is standard procedure for the agency not to release the complete data used by the task force to make recommendations on a range of issues, including adolescence health.
“Before CDC releases information to the public, it must go through the CDC’s scientific clearance process to ensure not only that the underlying data are accurate, but also that 1) it is presented in a manner that is clear and not prone to misinterpretation, and 2) any inferences drawn from the data are defensible,” spokeswoman Karen Hunter said.
She also said that all of the data will eventually be released when it is published in a “peer-reviewed journal,” which can take as long as one year.
When asked by CNSNews.com how recommendations can be made before the data are proved to be “accurate” and “defensible,” Dr. Jonathan E. Fielding, chairman of the task force and county director of Public Health, and health officer for the county of Los Angeles Department of Health Services, said he is “very comfortable” with the recommendations.
“We’re using processes that have been very well vetted and accepted,” Fielding said, adding that the meetings held to analyze the studies over the many months that the process took place were open to anyone who wanted to attend. “It’s all public.”
Fielding further said that critics of the study might not understand the methodology and are “cherry picking” the studies to find support for abstinence education.
But Ericksen and Ruedt are, in fact, critical of the methodology.
“We are concerned that the study averaged together the results of [Comprehensive Sex Education] programs that were very different from each other, such as programs in STD
clinics and programs in school classrooms, without identifying which kind of
programs were effective,” Ericksen told CNSNews.com.
“Doing this had the effect of glossing over the lack of results for the CSE programs in the schools, which is the setting where most teens receive sex ed,” Ericksen added.
“These programs did not significantly increase condom use, or reduce teen pregnancy or STDs,” Ericksen said. “To avoid comparing apples and oranges, a more meaningful study would have been a meta-analysis of school-based programs.”
Fielding defended the methodology and said the task force is not analyzing the reports with any sort of bias.
“We look at [the studies] through the same lens,” Fielding said.
But Ericksen further said the study suffered from a fundamental research error by combining widely divergent types of sex ed programs into one single analysis and drawing “across the board” conclusions.
“The resulting internal inconsistency in the results indicates there are many types of CSE programs that don’t work, yet the study concludes that CSE programs are broadly effective,” Ericksen said. “This, along with the lack of evidence for school-based programs, makes the study’s recommendations potentially misleading to policy-makers who want to implement evidence-based programs, especially in schools.
“Unfortunately, the statistical evidence that demonstrates the above discrepancies was not released to the public along with the study’s Recommendation Statement,” Ericksen said.
Post card picture from the 19th Century
The 15-member Task Force on Community Preventive Services and four other experts made up the team, which analyzed dozens of studies of sex education programs conducted between 1980 and 2007.
A list of the studies is available on the Community Guide portion of the CDC Web site, but the task force’s analysis of the studies is not.
Lack of access to that analysis, critics say, prevents an open review of data they contend shows that abstinence programs were underrepresented in the studies used and that using comprehensive sex education programs in school settings did not reduce teen pregnancy, STDs, or increase the use of condoms.
“The Task Force has made public its recommendation statements without also making available to the public the full set of study findings upon which the recommendations are based – both supporting and otherwise,” Irene Ericksen, a member of the review team and researcher with the Institute for Research and Evaluation, said about the recommendations.
“This prevents the public from scrutinizing the body of evidence underlying the CDC Task Force Recommendations in the same time frame in which the CDC recommendations will influence the decisions of policymakers and public health professionals,” she said.
Danielle Ruedt, the public health program coordinator for the Georgia governor’s Office of Children and Families and a member of the task force, said that when used in school settings, the data do not support the task force’s sweeping recommendations.
“The effectiveness of school-based programs is crucial since the school
classroom is where most teens receive sex education,” Ruedt said. “Yet the report's conclusion that comprehensive sex education programs are generally effective in school settings is contradicted by some of the data upon which the report is based.”
The official task force recommendations support using “comprehensive risk reduction” programs, but do not recommend abstinence education apparently because of “insufficient evidence.”
“The Task Force on Community Preventive Services recommends group-based comprehensive risk reduction (CRR) delivered to adolescents to promote behaviors that prevent or reduce the risk of pregnancy, HIV, and other sexually transmitted infections (STIs),” the recommendations state.
“The recommendation is based on sufficient evidence of effectiveness in: reducing a number of self-reported risk behaviors, including (1) engagement in any sexual activity; (2) frequency of sexual activity; (3) number of partners; and (4) frequency of unprotected sexual activity; (5) increasing the self-reported use of protection against pregnancy and STIs; and (6) reducing the incidence of self-reported or clinically documented sexually transmitted infections,” states the recommendations. “There is limited direct evidence of effectiveness, however, for reducing pregnancy and HIV.”
On abstinence education the task force reported the following:
“The Task Force on Community Preventive Services concludes that there is insufficient evidence to determine the effectiveness of group-based abstinence education delivered to adolescents to prevent pregnancy, HIV, and other sexually transmitted infections (STIs),” the recommendations state. “Evidence was considered insufficient due to inconsistent results across studies.”
The task force analyzed 62 comprehensive sex education studies and 21 abstinence studies before issuing its recommendations.
Ericksen and Ruedt issued a “minority report” to explain their position and why they think transparency about the data is important.
“The Task Force has made public its Recommendation Statements without also making available to the public the full set of study findings upon which the recommendations are based—both supporting and otherwise,” said Erickson and Ruedt. “The reason given for this decision is that the data from the study has not yet been scientifically cleared by the CDC for release to the public.
“However, this policy prevents the public from scrutinizing the body of evidence underlying the CDC Task Force Recommendations in the same time-frame in which the CDC recommendations will influence the decisions of policymakers and public health professionals,” said Erickson and Ruedt in their report.
“(Having the opportunity to examine this evidence is particularly important in the current climate of controversy and politicization that surrounds the public policy debate about sex education in America.),” they added.
A spokeswoman from the CDC told CNSNews.com that it is standard procedure for the agency not to release the complete data used by the task force to make recommendations on a range of issues, including adolescence health.
“Before CDC releases information to the public, it must go through the CDC’s scientific clearance process to ensure not only that the underlying data are accurate, but also that 1) it is presented in a manner that is clear and not prone to misinterpretation, and 2) any inferences drawn from the data are defensible,” spokeswoman Karen Hunter said.
She also said that all of the data will eventually be released when it is published in a “peer-reviewed journal,” which can take as long as one year.
When asked by CNSNews.com how recommendations can be made before the data are proved to be “accurate” and “defensible,” Dr. Jonathan E. Fielding, chairman of the task force and county director of Public Health, and health officer for the county of Los Angeles Department of Health Services, said he is “very comfortable” with the recommendations.
“We’re using processes that have been very well vetted and accepted,” Fielding said, adding that the meetings held to analyze the studies over the many months that the process took place were open to anyone who wanted to attend. “It’s all public.”
Fielding further said that critics of the study might not understand the methodology and are “cherry picking” the studies to find support for abstinence education.
But Ericksen and Ruedt are, in fact, critical of the methodology.
“We are concerned that the study averaged together the results of [Comprehensive Sex Education] programs that were very different from each other, such as programs in STD
clinics and programs in school classrooms, without identifying which kind of
programs were effective,” Ericksen told CNSNews.com.
“Doing this had the effect of glossing over the lack of results for the CSE programs in the schools, which is the setting where most teens receive sex ed,” Ericksen added.
“These programs did not significantly increase condom use, or reduce teen pregnancy or STDs,” Ericksen said. “To avoid comparing apples and oranges, a more meaningful study would have been a meta-analysis of school-based programs.”
Fielding defended the methodology and said the task force is not analyzing the reports with any sort of bias.
“We look at [the studies] through the same lens,” Fielding said.
But Ericksen further said the study suffered from a fundamental research error by combining widely divergent types of sex ed programs into one single analysis and drawing “across the board” conclusions.
“The resulting internal inconsistency in the results indicates there are many types of CSE programs that don’t work, yet the study concludes that CSE programs are broadly effective,” Ericksen said. “This, along with the lack of evidence for school-based programs, makes the study’s recommendations potentially misleading to policy-makers who want to implement evidence-based programs, especially in schools.
“Unfortunately, the statistical evidence that demonstrates the above discrepancies was not released to the public along with the study’s Recommendation Statement,” Ericksen said.
