P2.079: Content Analysis of Reproductive Health Education Resources for Middle Childhood Using Established Guidelines

Background: Access to comprehensive, accurate reproductive health education is critical for the health and well-being of youth ages 9-12. This demographic often lacks resources tailored to their developmental needs, leaving gaps in knowledge that impede informed decision-making. Current guidelines, such as Washington’s Healthy Youth Act (WHYA), Sexuality Information and Education Council of the United States (SIECUS), and frameworks like the American Academy of Pediatrics (AAP) outline developmentally appropriate topics for children of all ages. Despite established standards, existing children’s literature frequently falls short in addressing these recommendations.

Methods: We utilized content analysis to evaluate the alignment of reproductive health content with established guidelines. We purposively sampled books targeting ages 9-12, published 2004-2024, less than 100 pages in length, and publicly available within the United States. We developed a coding framework based on AAP and SIECUS guidelines. SIECUS guidelines for ages 9-12 outline six themes for comprehensive sex education: Human Development, Relationships, Personal Skills, Sexual Behavior, Sexual Health, and Society and Culture. Each theme was divided into subthemes as outlined by SIECUS. These were consolidated into a thematic matrix and defined explicitly for use in coding, ensuring clarity of content analysis. Three analysts coded each text with discrepancies being resolved through consensus discussion. We calculated quality scores for each subtheme, with a max score of 3 per subtheme. Averages were calculated for each theme based on the total quality score. Those averages were compared to an ideal quality score to reflect the degree of alignment with AAP and SIECUS recommendations. Reflexivity practices, including regular team meetings, journaling, and bracketing were employed to increase trustworthiness.

Results: A total of 24 texts were analyzed. Human Development and Personal Skills had the highest quality scores (6.74 and 6.15, respectively; ideal score of 18). Sexual Behavior and Society and Culture had the lowest quality scores (2.47 and 2.73, respectively; ideal score of 15). Overall, only 16.7% of the books reviewed scored above the 50th percentile in the total thematic quality score. Of note, the book with the highest thematic total was “It’s Perfectly Normal: Changing Bodies, Growing Up, Sex, Gender, and Sexual Health,” with a score of 84.66 out of an ideal score of 105. The book with the lowest thematic total was “Urology for Kids” with a score of 5 out of 105.

Conclusion: Our analysis suggests a substantial disparity between published guidelines and available literature for youth ages 9-12. Addressing these deficiencies could improve early education outcomes. Our primary study limitation is the small purposive sample of texts as it was not possible to analyze all text publicly available that could have met the study criteria. Future steps include collaborating with educators and healthcare professionals to develop inclusive, culturally relevant materials that bridge these gaps.