Thursday, July 13, 2017

Using Cognitive Science to Teach About Sex


Sex is a wonderful thing that has potentially life-altering consequences—particularly for teens.  Teen pregnancy can derail educational opportunities.  Sexually transmitted diseases from unprotected sex can have lifelong consequences. 
Because sex is so consequential, sex education is a routine part of teen education, though regions vary in the content of that education.  Some areas of the United States focus primarily on “abstinence only” education that asks teens to refrain from having sex at all.  Other regions have a broader base for their sex education that suggests that teens wait to have sex until they are older, but also provides information about contraception and ways to prevent sexually transmitted infections. 
The best possible outcome for sex education programs is for teens to have an appreciation for the desirability of sex and for them to be able to engage in healthy sexual behavior.  The longer that teens wait to initiate having sex and the more that they practice safe sex (like using condoms) the less likely that they will suffer from the potential negative consequences of having sex.
The most effective programs take a broad-based approach to sex education.  They provide facts about sexual function and healthy sexual practices.  They provide information about risks.  They also give teens practice having difficult conversations about saying no and using condoms.  In addition, they give homework to teens to speak to pharmacists about condoms in order to reduce their anxiety about buying them at the store.
A fascinating paper by Valerie Reyna and Britain Mills in the August, 2014 issue of the Journal of Experimental Psychology: General explored whether a sex education curriculum could be improved by using an understanding of differences between the way teens and adults learn about risks. 
Valerie Reyna and her colleagues have developed a comprehensive model of learning they call fuzzy trace theory.  One of the components of this model is that people store information in a number of different ways.  They learn about the surface of what they were told as well as the gist, which is a summary of the broad meaning of what they were told.
An interesting component of this theory is that adults tend to focus on the gist of what they learn, but that teens often focus on the surface details. 
In the case of sex education, this can be a problem, because many of the facts that teens learn about the consequences of unprotected sex are taught as probabilities.  For example, teens may be taught that the chances of getting pregnant after having unprotected sex are about 1 in 12.  That means that heterosexuals who repeatedly have unprotected sex are highly likely to create a pregnancy. 
Adults readily store this gist information, but teens tend to get focused on the details and remember the probability.  Consequently, they judge unprotected sex as less risky than they should.
In order to overcome this bias in teens, Reyna and Mills took an established sex education curriculum (called Reducing the Risk) and modified it to include more focus on gist level information and less focus on details that teens might remember in ways that would reduce their assessment of the severity of the risks of unsafe sex. 
In a randomized experiment, over 700 teens from three states were assigned either to the original Reducing the Risk curriculum, the modified curriculum that included more gist information, or a control condition that focused on communication skills. The classes in each condition involved a total of 16 hours of instructions with some homework.
The teens were given assessments of their sexual behavior and their attitudes and beliefs about sex before the classes and several times afterward with a final assessment a year after taking the class to which they were assigned.
A year after taking the class, teens who took either curriculum felt they were better equipped to say no if they did not want to have sex, were better prepared to use protection during sex, and had a better understanding of the risks unprotected sex than those in the control condition.
In addition, a year after the class, fewer people who took one of the two classes were deciding to become sexually active than those in the control condition.  Those students who took the course that focused on gist level information were least likely of all the groups to become sexually active.   For those students who were sexually active, those who took the course that focused on gist had fewer partners than those who took the standard curriculum or those in the control condition.  
In addition, the students who took the class that focused on gist also had a better understanding of social norms about safe sex than those who took the standard curriculum or those in the control condition.
That said, once students became sexually active, they engaged in about the same number of acts of unprotected sex and expressed about the same degree of intention to engage in safe sex regardless of whether they took one of the sex education classes or not.
Overall, these results suggest that a broad-based sex education curriculum does help reduce the amount of risky sexual behavior that teens engage in.  In particular, it can increase knowledge, decrease the likelihood of becoming sexually active, and potentially reduce the number of sexual partners that teens engage with.  Using an understanding of the way teens learn can improve the effectiveness of sex education, and it can help teens to develop more accurate knowledge about the risks associated with unprotected sex.
This is just another way that research in cognitive science can be used to improve the way people learn.