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PE Sector: Health Education in United States

Sex education in the United States

School health education

https://en.wikipedia.org/wiki/School_Health_Education_Study

PE Area: Funding for schools

https://en.wikipedia.org/wiki/Peer_Health_Exchange

Health education

Updated PE Sector: Comprehensive Sex Education

Comprehensive sex education
 * 1) Make the structure flow better by adding more sections
 * 2) Provide more health statistics in the benefits section
 * 3) Add hyperlink to "consent"
 * 4) Add more history into the human rights section
 * 5) Under the criticism and CSE as a human right, add cases the support/ go against it
 * 6) Under CSE curricula add US schools that currently have CSE
 * 7) Below CSE add a regulation section as to what can be taught or needs to be included
 * 8) Below CSE curricula and a section for funding: government? non-profit?
 * 9) Add a history tab about how CSE has evolved highlighting important movements/cases
 * 10) Add how medica has influenced sex norms/education/perception

Updated PE Area: Peer Health Exchange

Peer Health Exchange
 * 1) reorganize the way the article is structured: make the paragraphs align, add sections of colleges to make it flow better
 * 2) add a hyperlink to comprehensive sex education and define what it means in terms of PHE's standards and how teaches it
 * 3) correct the hyperlink for the University of Chicago
 * 4) In the see also section provide more links to pages related to health such as mental health, contraceptives, abusive relationships
 * 5) Make the tone more neutral: add a section of challenges right above or below the the "success section"
 * 6) Elaborate on old information: go more into depth about each college and its own unique PHE culture, the schools they serve, and how they teach
 * 7) Add new updated information: PHE logo, health statistics
 * 8) New information not present: add 4 sections of main teaching areas, add section of relationship centered model, add future goals of the HealthyliPHE app, add section of qualifications to join/teach with PHE and what being a member consists of above the college section,

Evaluating two articles
Peer Health Exchange Sex education in the United States
 * Everything in the article is relevant, but the format of the paragraphs is a bit distracting.
 * I find that I can learn a lot more about each college that implements PHE, because every college culture is different and teach PHE differently. I can also learn more of the funding portion of PHE. In addition, I want to lean about the statistics of PHE, success rate/failure rate.
 * The viewpoints that are underrepresented are those of the colleges, some are mentioned, others are not, some go into depth of the college while others do not
 * Should add a college sections to have a better flow and structure
 * Can create the four major teaching sections of PHE and go more into depth
 * There are two logos, one is missing
 * The citations check out and support the claims made
 * References are reliable, but may be biased b/c gets information from PHE site, so does not address the pitfalls in the org
 * The tone is positive in favor of PHE, should be more neutral
 * Talk page is completely empty and the last update was in 2016, so needs to be updated
 * Does not address the new relationship centered model nor the more comprehensive model
 * Does not include future goals such as the HealthyLiPHE app
 * Does not address anything about the raining educators go through, skills evolution test nor the professional development side
 * Statistics may have changed as well as the goal
 * See also section can include many more links related to the content that we teach such as mental link
 * One of the hyperlinks "University of Chicago campus does not exist"
 * Define what comprehensive health education is and provide a hyperlink for it
 * very developed article, has several wiki projects
 * Can learn more about the federal funding and regulations in teaching health education
 * rated as a B class article
 * neutral tone: talks about sex culture in high schools, abstinence, and LGBTQIA+ sex education: covers wide range
 * add more links between sex education and overall health education: ex how a comprehensive sexual education contributes to better mental health
 * citations link work, except for one
 * overall sources support claims
 * references are very reliable
 * talk page is active: talks about including state by state policies, being more inclusive of gender, naming sexual education as a bigger issue of socioenomic status
 * Interesting how this page encompass the political economy approach stated by Katz, but also touches on resources such as federal funding
 * I would add how there are three forms, one abstinence, one comprehensive, and one in between
 * I would also add more in the sex education debates, what were monumental court rulings that changed the course of sexual education
 * In regards to me, I would focus more on the comprehensive sex education and try to add statistics to it because that is what my PE does

Introduction
Comprehensive sex education as "including education about abstinence, but extending instruction to include contraception, sexuality, and other topics related to sexual activity."

This includes discussions surrounding contraceptives and promoting safe behaviors, such as communicating with partners and seeking testing for sexually transmitted infections. Additionally, " Some comprehensive sex education curricula also discuss pregnancy outcomes, including parenting, adoption, and abortion.

Benefits of CSE
Studies have found that comprehensive sex education is more effective than receiving no instruction and/or those who receive abstinence-only instruction.

CSE is very beneficial in regards to teen pregnancy because studies show that, "teen pregnancy and childbearing have a significant negative impact on high school success and completion, as well as future job prospects."

CSE also reduces the frequency of sex and the number of partners which in turn also reduces the rates of sexually transmitted infections.

For example, programs funded under AEGP are reviewed for compliance with the 8 standards (listed below in "Abstinence Education Grant Program (AGEP) Requirements), but are not screened for medical accuracy. Therefore, critics believe that students under these educational programs are put at a disadvantage because it prevents them from making informed choices about their sexual health. Additionally, under these AEGP programs, health educators have referred to those that engage in sex, especially females, as "dirty" and "used." They have also used phrases such as "stay like a new toothbrush, wrapped up and unused" and "chewed-up gum" to teach abstinence. Under a CSE model, language would be more sensitive.

LGBTQIA+ community not included in CSE
The term "comprehensive" is also often misleading because some comprehensive programs do not show the holistic picture of human sexuality.

A cross sectional study done in New York City analyzed the sexual behaviors of high school girls. Studies found that, "high school girls who identified as LGBTQIA+ were more likely to report substance use such as: alcohol, marijuana, cocaine, heroin, meth, ecstasy and prescription drugs. They also had higher rates of contemplating and/or attempting suicide." Another study found that "the LGBTQIA+ youth accesses health information online five times more than the heterosexual population, and these rates are even higher for LGBTQIA+ youth that identify as a person of color which stems from the fact that they lack health resources.

In fact, as of May 2018, only 12 states require discussion of sexual orientation and of these, only 9 states require that discussion of sexual orientation be inclusive. Additionally, several states have passed legislation that bans teachers from discussing gay and transgender issues, such as sexual health and HIV/AIDS awareness, in a positive light. Furthermore, three states require that teachers only portray LGBTQIA+ people in a negative light.

In a Canada, a federal report showed that LGBTQIA+ community has less access to health services and faces more comprehensive health challenges compared to the general population. As a result of lack of support for the LGBTQIA+ population, the Comprehensive Health Education Workers (CHEW) Project emerged in October 2014. Their goal is to educate the LGBTQIA+ community about topics such  sexual and gender identity, sexually transmitted infections (STIs), healthy social relationships, and depression. They do this though workshops, arts‐based projects, and one‐on‐one meetings.

Who's role is it to deliver sexual education
Many people regard health education as a moral or religious issue," and therefore should be taught not in schools. "Before the late 1800s, delivering sex education in the United States and Canada was primarily seen as a parent’s responsibility." Today, programs under the Sexuality Information and Education Council of the United States (SIECUS) begin comprehensive sex education in pre-kindergarten, which many people believe is not age appropriate. Many of those in favor of abstinence only education, usually fear any type of sexual education that encourages sexual behavior at a young age.

Is it necessary
Although CSE is seen as the polar opposite of abstinence only education, some critics believe that they are very similar. They both aim at preventing STIs and teen pregnancy. The way in which they differ is through their primary goal. Abstinence only education aims at reducing premarital sex while comprehensive sex education acknowledges that premarital sex may happen and therefore seeks to reduce the unintended consequences of premarital sex through education. Studies in developing counties surrounding sex education have also shown that comprehensive sex education is not needed. General education, such as literacy skills, was seen to delay sexual initiation and reduced the likelihood of pregnancy. Therefore, some people believe general education is of more importance.

Federal Funding for sexual education
Although there is no federal mandate that requires states to teach sexual education, there is federal funding available to assist with sexual education programs.

Abstinence Education Grant Program (AGEP)
Historically, funding for abstinence education has always been favored over CSE. In 1996, during Bill Clinton's presidency, legislation was passed to promote abstinence in education programs. Under Title V Section 510 of the Social Security Act, the Abstinence Education Grant Program (AGEP), was passed. AEGP has always been renewed before its expiration date, and each time funds gradually increase from fifty million dollars per year to seventy-five and as high as $6.75 million per state grant in 2015. The way the funds are disbursed are based on the proportion of low-income children in each state. So far, thirty-six states have been given AEGP funds.

Abstinence Education Grant Program (AGEP) Requirements
Part of Section 510(b) of Title V of the Social Security Act, contains the "A-H guidelines," which are the eight criteria that programs must abide by order to be eligible to receive federal funding. They are as follows:

A. Has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;

B. Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;

C. Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;

D. Teaches that a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity;

E. Teaches that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects;

F. Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child's parents, and society;

G. Teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances; and

H. Teaches the importance of attaining self-sufficiency before engaging in sexual activity;

In addition to abiding by these 8 conditions, AGEP compliant programs cannot discuss contraception, STIs, or methods for protecting against STIs, except only when describing failure rates

Teen Pregnancy Prevention Program (TPP)
More recently legislation has pushed for funding that goes beyond abstinence only education. In 2010, President Obama introduced the Teen Pregnancy Prevention Program (TPP), which provides a total of $114.5 million annually to sex education programs that are "medically accurate and age-appropriate." TPP falls under a subsection of United States Department of Health and Human Services ("HHS") which is overseen by the Office of Adolescent Health. Funding for TPP is dispersed if "they emulate specific evidence-based programs promulgated under TPP."

California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act
In January 2016, the California Healthy Youth Act, amended the California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act to include minority groups and expand health education. Before it authorized schools to provide comprehensive sex education and required that all materials are made accessible to students with a variety of needs. It also focused solely on marital relationships. It now mandates that schools provide comprehensive sex education and states that "materials cannot be biased and must be appropriate for students of all races, genders, sexual orientations, and ethnic and cultural backgrounds, as well as those with disabilities and English language learners." Additionally, education must now include "instruction about forming healthy and respectful committed relationships," regardless if marital status. Furthermore, it is now required to have discussions about all FDA-approved contraceptive methods in preventing pregnancy, including the morning after pill.

In conclusion now requires that all sex education programs promulgated in the state should


 * normalize sexuality as part of human development;
 * ensure people receive integrated, comprehensive, accurate, and unbiased sexual health and HIV prevention and instruction; and
 * provide pupils with the knowledge and skills to have healthy, positive, and safe relationships.

CSE as a human right
Other analysis show that comprehensive sex education is not an international right nor a human right because it not clearly stated in either a treaty nor custom. By international law, states are required to provide access to information and education about reproductive health, but this does not require a sex education curriculum. It may take different forms such as mandating that local school districts create a system for providing information to students, or mandating that health clinics and practitioners dispense information to patients

CSE terminology
Apart from the different teaching methods, termiology also differs. Abortion, homosexuality, abstinence have connotations and definitions that vary state. For example, the word "abstinence" may refer to disengaging from all forms of sexual activities until marriage or may refer to only disengaging from sexual intercourse. Furthermore, the degree of sexual activity that "abstinence" connotates is often unclear, because sexual behavior that is not sexual intercourse may or may not be included in its definition. As a result, students are left confused about what activities are risky and teachers do not know what they can and cannot teach.

''The term "comprehensive," is also falls on spectrum, therefore can be considered an umbrella term. CSE means something radical for some institutions while it can mean something moderate and even conservative for others.''

According to the Sexuality Information and Education Council of the United States (SIECUS), the guidelines for comprehensive sexuality education are as follows:


 * appropriate to the age, developmental level, and cultural background of students;
 * respects the diversity of values and beliefs represented in the community;
 * complements and augments the sexuality education children receive from their families, religious and community groups, and healthcare professionals;
 * teaches not only about abstinence, but also contraception, including emergency contraception and reproductive choice;
 * teaches about lesbian, gay, bisexual, transgender (LGBT) issues and questions issues;
 * teaches anatomy, development, puberty, and relationships;
 * teaches all of the other issues one would expect to be covered in a traditional sexuality education class; and
 * should be science-based and medically accurate

Sexual education exemption
Just as teaching methods and curricula vary by state, excusal from sex education also varies by state. States may have with an opt out or opt in produce. In some states, students can opt out of receiving sexual education without specifying a particular reason. In other states, students can only opt out for religious or moral reasons. In an opt-in provision, parents must actively agree to allow their children to receive sex education prior to the start of the sexual education.

Why we should move towards CSE
Further steps and outcomes of moving towards CSE are listed below

Mandate Sex Education in each state

 * providing guidelines for instruction would improve access to appropriate sex education for the students who need it most;
 * will promote consistency within states; and
 * will promote accountability

Require Medical Accuracy

 * will set a national standard;
 * reduce the amount of inaccurate information being given; and
 * prevent programs from expressing religious bias

Passive Consent with an Opt-Out Provision

 * will be broad enough to allow parents/guardians with religious objections to curricula to shield their children from material they consider objectionable;
 * will be narrow enough that students still receive components of sex education;
 * would respect families' religious beliefs; and
 * ensure that students have access to important materials

Address the Needs of Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual Youth

 * remove discriminatory language and factually incorrect information about LGBTQIA+ people.
 * will increase intersectionality

Sexual content in the media
Since 1997, the amount of sexual content on TV has nearly doubled in the United States. Additionally, a study done in 2008 showed that nearly 40% of popular music lyrics contained sexual references which were often sexually degrading. These lyrics were also often accompanied with mentions of other risk behaviors, such as substance use and violence.

Teens (ages 13-15) in the United States, use entertainment media as their top source for education in regards to sexuality and sexual health. Additionally, a study found that 15-19 year olds in the U.S use media far more than parents or schools to obtain information about birth control. Some studies have found that, "very few teen television shows mention any of the responsibilities or risks (e.g., using contraception, pregnancy, STIs) associated with sex and almost none of the shows with sexual content include precaution, prevention, or negative outcomes as the primary theme." Television shows 16 and Pregnant and its spin-off, Teen Mom, which first aired on MTV in 2009 received major disapproval from some parents as they thought the shows glamorized teen pregnancy and motherhood. However, 16 and Pregnant actually led to a 4.3 percent reduction in teen pregnancy, mostly as a result of increased contraceptive use. In contrast, other data shows that exposure to high levels of sexual content on the television causes adolescents to have twice the risk of becoming pregnant in the following 3 years, compared to those who were exposed to low levels.

The film Mean Girls, directed by Mark Waters shed light on the state sex education in some parts of the United States. In the film the health instructor states, "At your age, you're going to have a lot of urges. You're going to want to take off your clothes and touch each other. But if you do touch each other, you will get chlamydia and die." This line is meant to be satirical, but it illustrates common flaws within sex education in the U.S. It depicts simplistic descriptions of sexual activity and implementation of fear without any legitimate basis.

Not only have films portrayed sex education, but so has social media. Platforms such as YouTube, Facebook, Vine, and others are used as a tool to uplift the narratives of marginalized communities such as persons of color and LGBTQIA+ persons in hopes to "strengthen sexual health equity for all."

As a result of the mass amount of sex content in media, media literacy education (MLE) has emerged. It was created to address the influence of unhealthy media messages on risky health decisions, such as intention to use substances, body image issues, and eating disorders. A study analyzed the effectiveness of a teacher-led MLE program, called Media Aware Sexual Health (MASH), which provides students with accurate health information and teaches them how to apply that information to critical analysis of media messages. This comprehensive sex education resulted in increased intentions to talk to a parent, partner and medical professional prior to sexual activity, and intentions for condom use.

Public Opinion
Successful sex education programs are stated as those that tailor the curricula to students specific needs, address peer pressure and ways to respond to it, and discuss content in a way that is appropriate for students' age groups and level of sexual experience, all while providing accurate information.

Near-Peer Teaching
In a standard classroom, you have a teacher passing on health information to their students. One student recalls sexual health education being taught through, “a book, [a] teacher, and a PowerPoint… and the teacher made it awkward.” The near peer teaching model differs from that of a regular teaching curricula. A near peer teaching model is when a more experienced student acts as the instructor and passes on their knowledge and experience to the students.

Benefits of near-peer teaching
Near-peer model has been deemed effective due to its high levels of effect communication between the peer educators and the students, thus is often used to teach health education and bio-sciences. Additionally, it has been used as tool for peer educators to enhance their teaching and leadership skills Other studies show that there are positive academic outcomes for not only the students receiving the education, but the peers teaching the education. This is due to the fact there is a gain in social constructivism, a theory that states individuals conceptualize material through social interactions. Additionally, educators develop a new understanding of the material they are teaching, because they often create their own explanations, which is found to have the largest academic gains. Research was conducted in 11 different settings which analyzed health behaviors of those that received peer-led health education versus that received adult-led health education. Results showed that 7 out of the 11 trials were more effective with the peer taught model. It also depicted greater positive changes in health behavior with a peer model compared to that of adults. It was seen to reduce smoking, marijuana, and alcohol usage.

Some examples of successful near-peer teaching models are listed below:

Teen Prevention Education Program (Teen PEP)
In North Carolina high schools, the Teen Prevention Education Program (Teen PEP) is implemented. It is one out of 19 programs funded under the Office of Adolescent Health's Teen Pregnancy Prevention (TPP) aimed at reducing teen pregnancy. Unlike other TPP programs, Teen PEP's main focus is implementing the peer education component, 11th and 12th-grade students are peer educators teaching sexual health to ninth grade students in their second semester. Teen PEP focused in 3 broad areas: cognitive and behavioral, connectedness and self-concept, and and changes in information or knowledge. Results shows a positive impact of this model. Due to the fact that peer educators are closer in age to the students, students across all schools felt that they were more approachable and reliable than teachers since they share more common experiences. One student stated, “I liked this. I learn better from younger kids that have been in my situation.” Additionally, 70% of the students noted that Teen Pep has helped them care about graduating form high school, know where to get birth control, and and know when they need to see a health care provider. Furthermore, peer educators were proven to be effective instructors. Over 95% of the students claimed that the peer educators were organized, prepared, gave explicit instructions.

Peer Health Exchange
In 1999, six Yale undergraduate students began teaching health workshops in New Haven public schools to bridge the funding gap in health programs. In 2003 these same six students created Peer Health Exchange (PHE), in which college undergraduate students teach comprehensive health education to 9th grade students in Title I schools. PHE is a 501(c)3 organization and focuses on four main areas: sexual health, mental health, substance abuse, and communication and advocacy over the course of 13 workshops. Since it's emergence PHE has over 2,000 college student volunteers that serve over 17,000 public high school students in the Bay area, Boston, Chicago, Los Angeles, New York City, and Washington, DC. The purpose of having peer health educators is so that conversations with high school students, regarding health, are more honest and real. In research completed by American Institutes for Research (AIR), statistics stated that students were 17% more likely to visit a health center after completion of the 13 workshops compared to those that did not received the PHE workshops. Additionally, students who received the 13 workshops had higher rates of accurately defining consent, knowing how access contraceptives, and identifying signs of poor mental health compared to those who did not.

It's Okay to Ask Someone (IOTAS)
Peer education has seemed to improve sexual health outcomes by having positive effects on sexual health knowledge, intentions, and attitudes. This study aimed to analyze the effectiveness of peers intervening via text messaging to promote sexual health. Studies showed that 88% of American teens (ages 13–17) had access to a mobile phone of some kind in 2015. The, It's Okay to Ask Someone (IOTAS) app, was created in 2014 with funding form the Forbes Fun and curricula collaboration with the Planned Parenthood of Western Pennsylvania (PPWP) Education Department. The app's main purpose was to serves as a sexual health text line that would reach beyond the classroom, in which peer educators could participate in by responding to students questions with adult oversight. The PPWP Education Department made sure that the peer educators received appropriate training for answering sexual health question and navigating the app; they developed an 8-lesson student curriculum. The app was then launched in four high schools in western Pennsylvania in which peer educators answered student questions. IOTAS was successful and deemed to be time-effective in answering questions all while upholding the confidentiality of sexual health information beyond the classroom. It also allowed the peer educators to be more involved in their communities and expand their own sexual health knowledge, thus is was great for both those who were receiving and getting the information.

Planned Parenthood
Teen Health Source is a program facilitated by Planned Parenthood Toronto, Canada in which a trained youth volunteers ( ages 16-19) answer sexual health questions from teens (age 13-19) via text, email, phone, or their chat website, manages their blog website, and refers teens to local and community resources such as free clinics. It began in 1993 as a sexual health info line where teens could call and get their sexual health questions answered anonymously and confidentially from adults. Since then it has emerged into a near peer model in which youth volunteers are available 5 days a week (Mondays-Thursdays between 4 p.m. and 9 p.m. and Saturdays between 12 and 5 p.m.) to chat online. They cover a wide range of sexual health topics, some of which include: birth control, sexually transmitted infections, healthy relationships, consent, sexual pleasure, orientation, gender, virginity, puberty, and more.

Additionally, Planned Parenthood of Western Pennsylvania (PPWP)'s has a Peer Helpers peer education program which 250 peer students serve 7 middle and high schools to deliver comprehensive health education.It is run by the PPWP Education Department an their main goal is pregnancy prevention. It started to become less effective due to overcrowding and students not wanting to ask their questions in person. Therefore the PPWP Education Department switched to the IOTAS model which is described above.

Criticisms of near-peer teaching
There are also some drawbacks with near-peer teaching.

Time-commitment
It is hard to sustain due to the time commitment it requires of peers. This time commitment requires the peer to become experts in health knowledge which is impractical.

Classroom Management
A study analyzed peer health educators in 12th grade of high school (ages 16/17) who taught a minimum of three sex education classes to about 30 students in the 9th grade. The results showed that 9th grade students did not perceive educators as having the same authority as teachers, therefore it was difficult for peer educators to have control over the classroom. It was also noted that it was more difficult for male peer educators to control the classroom because of tensions flowing from preconceptions and stereotypical views about male behavior and the role of men in managing groups. Furthermore, 27% of peer educators indicted that they had either "a lot" or "quite a lot" of difficulty managing behavior in the classroom such as addressing comments, bullying, and inappropriate questions. They also had difficulty managing noise levels.

Time constraints
In addition, 20% of the peer educators reported they encountered time management issues; there was not enough time in each lesson to deliver the sex education. The timing of the lessons were another problem. Educators reported that when they taught at the end of the day, students were tired and not engaged. Additionally, the constraints of the school schedule also made it difficult. Sometimes lessons would be cancelled, or the delivery of lessons would have long gaps due to the school schedule therefore, the lesson that followed would not be as effective.

Lack of teacher support
Sometimes teachers were not supportive of the work that peer educators were doing. Peer educators stated they would have appreciated some affirmations for their contributions. Other educators stated that they did not receive advice on classroom management for the teachers and/or would have liked help managing the classroom. Others noted that they did not receive help in finding resources such as writing materials.

Recommendations for near-peer teaching programs
Below are 6 six recommendations one should consider in order to have an effect near peer teaching program and avoid common drawbacks.


 * 1) Identify what type of interaction you wish your peer educators and students have. Then develop a training for peer educators that include classroom management skills such as how to deal with bullring and how to address comments.
 * 2) The peer educator's training and student lessons should have clear objectives, be engaging and fun, have relevance to the students, be practical, and should involve learning something new.
 * 3) Reassure peer educators that even the most difficult students are able to engage well with peers. This can be done through creating relationships by using humor.
 * 4) Do not let more than a few weeks elapse between lessons nor the period between the peer educator's training and delivery of lessons.
 * 5) Make sure there is an adequate amount of space to teach the lesson and that the lessons are not taught at the end of the day. Emphasize working in small groups and if feasible have peer educators give multiple lessons to the same group of students.
 * 6) Teachers should be actively engaged by supporting peer educators. Teachers should show appreciation to peer educators, provide them with resources, and make sure to work around the school schedule for lessons.

General policies
update ALL Stats, they are outdated. Used same site as they used.

Feedback: Irvina Yu

 * Extremely interesting topic. I did not know there was an effort to encourage abstinence or that there were even abstinence education programs. I also really appreciate the rich history you provide in regards to the different requirements the state/country must meet for these programs.
 * The overall flow and transitions between sentences/paragraphs is great. I would suggest when you are citing specific quotes from the passage, you should have a citation after even if the citation is at the end of a big paragraph. It becomes easier to distinguish what specific source the quote is from.
 * We talked about this in class, but there seems to have been an error with your citations because it shows the same source for all of your citations in the sector section.
 * "Although it is seen as the polar opposite of abstinence only education, some critics also believe that they are very similar. "
 * For this quote, I'm not sure where it goes in the actual article, but by itself, it's not really clear what "they" are. I think it would be helpful to provide an introduction on this if wherever on the actual article you put it it does not have an introduction.
 * Overall, it seems very developed, informational, and interesting!

Introduction
Added two sentences to the introduction. Made the definition of CSE more inclusive by adding other services/education they provide other than just sexual education.

Benefits of CSE
Added 4 facts/statistics on the benefits of CSE. These included comparisons of CSE to the abstinence only model and no education.Additionally I made it more holistic by adding statistics that are not related to sex, but vital to one's future.

Criticisms of CSE
Moved this section from being the last section to the 2nd, right below "Benefits of CSE." I did this to make the overall tone more neutral, I want to show a balanced argument. Additionally I expanded this section to have four subsections: "How comprehensive is CSE," "LGBTQIA+ community not included in CSE," "Who's role is it to deliver sexual education," and "Is it necessary." For the subsection "How comprehensive is CSE," I kept what was already written and put it under this section as I thought it would fit better for organization and flow better. I expanded upon the issue with the LGBTQIA+ community and decided to make it its own subsection with 7 additional statistics/facts. I also created a hyperlink to LGBTQIA+. For "Who's role is it to deliver sexual education," I created it from scratch and added 3 facts that show the progression of people's perception on who should be teaching sexual education. For the subsection, " "Is it necessary" I also created it from scratch and added two statistics which really bring in a more neutral argument. One builds upon the argument that abstinence only and CSE are completely different, in which I refuted by stating that they are not. Additionally I build upon the fact that general education is vital, they are not mutually exclusive. Therefore someone else can build upon this fact if they wish to and dive deeper into the need for general education.

Federal funding for sexual education
I created this whole section because I felt like it was important to understand what funding had been made available for sex education. With this section I made it a progression of history with the earliest funding made available to the most recent. This timeline also shows a shift toward more CSE funding made available. I focused on three subsections, "Abstinence Education Grant Program (AGEP)," "Teen Pregnancy Prevention Program (TPP)", and "California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act." For the "Abstinence Education Grant Program (AGEP)," subection I added a few sentences which layout its history and purpose. I then created a subsection within this subsection titled "Abstinence Education Grant Program (AGEP) Requirements," which layout the 8 requirements that must be met in order to get funding, I made this a smaller subsection because it would flow better and if one is in a rush they can automatically click on it and read it. For the "Teen Pregnancy Prevention Program (TPP)" subsection I added a few sentences in relation to it's history. For the "California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act" subsection I added sentences which focused on the shift of this act. Therefore I provided some background on the original act and compared that to the changes made. I also listed the new requirements for funding.

CSE as a human right
I built upon the information that was already there. This section was very biased towards CSE, so I made it more neutral by adding a statistic which proves that CSE is not a human right by law.

CSE in curricula
I built upon information that was already stated. I also made it flow better by creating this into 3 separate subsections, "CSE teaching methods," "CSE terminology," and "Sexual education exemption." For the "CSE teaching methods," subsection, I simply put the existing information under this category because it made the most sense and flowed better. For the "CSE terminology," subsection I created it from scratch and discussed the problem with CSE not having a national standard of teaching, everyone uses different terminology which causes issues. I also then stated some guidelines that must CSE must follow according to SIECUS. These two sentences showed a more balance position. Additionally, I took an existing sentence and added it in between two of my statistics. This made it flow a lot better. Finally for the "Sexual education exemption" subsection I created it it from scratch and showed the exemption varies by state. I did this by providing two statistics.

How to move towards CSE
I created this whole section because I felt like it is vital, if this article is all about "CSE," then one should have an understanding on how to achieve that. I made this section into 5 subsections, "Why we should move towards CSE," "Mandate Sex Education in each state," "Require Medical Accuracy," "Passive Consent with an Opt-Out Provision," and "Address the Needs of LGBTQIA+ Youth." I first began by taking existing information listed under a different section and moving it under the "Why we should move towards CSE," for better organization. I used the existing information as an introduction about the need for CSE. The four subsections, "Mandate Sex Education in each state," "Require Medical Accuracy," "Passive Consent with an Opt-Out Provision," and "Address the Needs of LGBTQIA+ Youth" were then each a main point on how to move toward CSE. This created a great segway into the "How" portion on this section. Each subsection had bullet points which served as instructions on how to complete these tasks and/or showed the importance of these. I also added a hyperlink to "intersectionality" in this section.

Sexual content in the media
I renamed this section from "CSE in the media," to "Sexual content in the media" to make the information more broad, and also because the information that was here previously was not geared towards CSE. I added 10 statistics that were both in favor of sexual media content and against sexual media content. I provided some history of the role of media, which showed how media has become so influential in our lives.I also provided some examples of media platforms that are being used. Furthermore I touched upon a newly emerging program that focuses on media literacy education. I also added hyperlinks to "social media," YouTube," Facebook," "Vine," and "persons of color."

Public Opinion
I added one sentence that adds to the public opinion argument.

Near-Peer Teaching
I added this entire new section because it is the basis of my PE and is relevant to sex education in the US. I created hyperlinks to "Peer Health Exchange," "Title I," "501(c)3 organization," "Planned Parenthood," as it is also relevant. I created two subsections: "Benefits of near-peer teaching," "Criticisms of near-peer teaching," and "Recommendations for near peer teaching programs." For the "Benefits of near-peer teaching," I added 8 sentences from 3 different sources.I decided to add both benefits and criticisms to provide a more balanced view and neutral tone. "Teen Prevention Education Program (Teen PEP)," Peer Health Exchange," "It's Okay to Ask Someone (IOTAS), and "Planned Parenthood" were all smaller subsections within "Benefits of near-peer teaching" to show how successful they can be and to further point out the benefits gained for this model. They are all real life examples. I gave a summary for each subsection and explained their history, purpose, and outcomes/findings. I used a mixture both grey literature (2 sources) and academic literature (3) to support these claims which gave a good balance. For "Criticisms of near-peer teaching," I added small subsections: "Time-commitment," "Classroom Management," "Time Constraints," and "Lack of teach support." Each of these subsections explained common drawbacks and gave facts/stats. "Recommendations for near peer teaching programs." listed 6 recommendations one can take to avoid these common drawbacks.

General Policies
I updated all stats from July 1, 2016 to May 1, 2018. under this section and all of its subsections: "Abstinence education, "Parental role," "Teaching healthy sexuality," and "HIV education. I did this by changing statistical numbers and added state names to stats listed. I got the information from the same website where the original information was taken from.