Publication Date


Type of Culminating Activity


Degree Title

Master of Science in Nursing



Major Advisor

Leonie Sutherland, Ph.D., R.N.


A needs assessment was conducted in Boise in 2008 to address pregnancy, abortion. and sexually transmitted diseases in teens. Key informants indicated students lacked knowledge about sexuality and agreed that comprehensive sex education was the best strategy for improving teen sexual health (Elliott, 2008). Because the Independent School District of Boise (ISDB) had an abstinence-only policy, the strategy could not be implemented until the policy was changed.

The purpose of this case study was to cultivate an in-depth understanding of the influences on sex education policy decisions at the ISDB and to add to the body of knowledge, which may facilitate the adoption of evidence-based sex education programs. A qualitative case study design was used to collect descriptive information about the ISDB comprehensive health education policy implemented in 2010. The Communities Coping with Change Model was used as the theoretical framework to guide data collection and analysis of the case (Kelly & Steed, 2004).

Unstructured, one-on-one interviews were conducted with two Board of Trustees and five ISDB employees. Archival records and documents were also reviewed. The data analysis revealed four primary categories of influence on sex education policy: conflict from the past, adherence to an abstinence-only sex education policy, the values of the Boise community, and communication getting lost in the bureaucracy. Sex education policy development had been contentious in the past, influencing Trustees and staff to avoid conflict and strictly adhere to an abstinence-only philosophy. The Trustees and staff perceived a strong community value of sexual abstinence until marriage and that superseded providing comprehensive sex education. A bureaucratic organizational structure and competing priorities for education prevented a free flow of information between the ISDB Trustees, staff, and the community. The ISDB Trustees and staff were unaware of the current research on the growing problem of poor teen sexual health in Boise, evidence of effectiveness regarding sex education curricula or current research on parental support for comprehensive sex education. The community was unaware of the procedure for bringing sex education policy issues to ISDB Trustees and the vast majority of parents, teachers, and nurses had not participated in the process since 1986.

The findings of the case study suggested strong community support would be essential to persuading the ISDB Trustees to adopt an evidence-based sex education policy. Nurses, teachers, parents, and other community members must collaborate to present the ISDB Trustees with the full array of information they need to make an informed decision regarding sex education.

Keywords: Sex education, school, school board, decision making, influences, evidence-based, comprehensive sex education, abstinence-only, and policy.

Included in

Health Policy Commons