儿童性教育外文翻译文献

文献信息：

文献标题：The Existing Approaches to Sexuality Education Targeting Children: A Review Article（针对儿童的性教育的现有方法：综述文章）国外作者：Ganji J, Emamian M H, Maasoumi R, et al

文献出处：《Iranian Journal of Public Health》,2017 , 46 (7) :890-898 字数统计：英文2177单词，12737字符；中文3949汉字

外文文献：

The Existing Approaches to Sexuality Education Targeting

Children: A Review Article

Abstract

Background:We aimed to assess what is already known about sexuality education (SE)-related policy or practical issues using review methods to search and critically appraise the existing SE approaches targeting children under age 12 yr.

Methods: We completed the data collection by an extensive search of the English and Persian published and unpublished literature, evidence from experts in the topic, and by searching citations. The MeSH-terms were sexuality and training, sexuality education and programs or approaches, sexuality and children, sexuality education and parents, sex or sexuality education, sex education and parents or caregivers. A systematic search of medical and health-related databases, the Cochrane Library and Web of Science was undertaken for the years 1970–2015 together with citation searching, reference list checking and recommendations from stakeholders to identify evidence for SE.

Results: According to the inclusion criteria, 20 documents were identified. They were synthesized into three main categories as sexuality-related knowledge, attitudes, and parents' skills to manage children's sexual behavior and related education. Employed approaches to children's sexuality were reported to be effective in

developing healthy sexual behavior in children. Education was identified as the primary focus of the included packages and guidelines. Parents were recognized as first line educators in SE. However, interventions aiming to improve parents' skills in SE for children were limited. In other words, developing skills in parents, and their competency in children's sexual behavior management were not specified in the existing programs.

Conclusion: Parents' skill-building must be the focus of SE programs in order to address children' sexual development goals.

Keywords: Sexuality education, Children, Parents, Review

Introduction

Sexuality has physical, social, cultural and psychological dimensions and sexual development is part of human being's life. This dimension, as the other aspects of human development, begins at birth reflected in one's sexual behaviors. Sexual behavior is the result of a deeper and more complex process called ―sexual socialization. In other words, sexual behaviors are not only influenced by biological factors, but they also become complicated through sexual socialization.

Children's sexual behaviors are strongly influenced by children's age and by how they have been socialized. Children's sexual socialization is affected by the family and society's belief and their function with respect to sexual matters.

Sexual socialization is a process through which children acquire the essential beliefs, attitudes, values, cultural symbols, concepts and meanings on sexuality. In fact, identity formation, role of sex, sexual skills and knowledge acquisition, and development of sexual attitudes are achieved in this process. Family, as the first social group those children belong to from the early years of their lives; is considered the first and the most important factor effective in children's sexual socialization. Children acquire their knowledge, skills, and behavior from home, school and society, and the skills they gain can change their future. Therefore, SE by parents, as one of the main components of sexual socialization, is one of the best strategies for children's sexual health promotion.

Sexual behaviors are common in children and more than 50% of children get involved in different types of sexual behaviors before the age of 13. Like other age groups, children need good care, supervision, and education during their sexual development, and their main caregivers are their first line educators.

Parents are children's first and foremost teachers in the field of sexuality. Most parents have not received such education and when it comes to SE, they tend to assign to schools what they themselves are not willing to do.

In Iran, the majority of parents are not well educated with regard to sexuality-related issues. In addition, there is no school-based sexual health education. As a result, it's hard and fearful for parents to engage their children in conversations about sexuality.

Despite the importance of parents' role in SE, they are not adequately prepared to communicate about sexual issues. They are mainly unable to manage properly their children's sexual behaviors. Parents lack the adequate skills in empowering their young children to protect themselves against sexuality-related risks, enjoy sex in adulthood, and get prepared for a healthy and intimate interpersonal interaction.

Using comprehensive programs and appropriate strategies for educating children on sexuality seems to be essential. Cultural influences may alter the efficiency of any educational programs. This review aimed to assess what is already known about SE-related policy or practice issue, by using systematic review methods to search and critically appraise the existing SE approaches targeting children under age 12.

Methods

In order to complete this review within a very short time-frame, rapid review methods were used to ensure the efficient identification and synthesis of the most relevant evidence. The following keywords were used for search: sexuality training, sexuality education, sex education, sexual health, skill building, guidelines, packages, and children. Medical Subject Headings (MeSH) were also used. The terms included sexuality education and program or approach, sexuality and children, sexuality education and parents, sex or sexuality education, sex education and parents or

caregivers. A systematic search of medical and healthrelated databases MEDLINE, EMBASE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library and Web of Science, Scopus, Google scholar, SID, Magiran, and Iranmedex was undertaken for the years 1970–2015 together with citation searching, reference list checking and recommendations from stakeholders to identify evidence for SE. The rationale for limiting the review to 1970–2015 was that sex education for children was originated from the Western societies. Many American kindergartens started to implement sexuality education curriculum since 1960s, and Sweden implemented sex education for all children and adolescents since 1970.

We also searched key organizations and associations including WHO, UNICEF UNAIDS and Ministry of Health in countries such as Canada, Australia, the U.S., and Iran as well as active associations in the field of sexual health for children. In cases where the reported results were incomplete, the authors were contacted and asked for further details. The articles and gray documents were assessed based on the inclusion and exclusion criteria.

Inclusion criteria were studied design (articles, gray documents, packages and guidelines introduced in the field of SE); outcomes; and population (children aged 0-12); and interventions (designed to improve child sexual development through the provision of relevant knowledge, attitude, and skills of parents). Studies published in English and Persian was included in the study. We excluded programs targeted at the adolescent and the elderly. Duplicate publications of the same study and articles available only in abstract form were also excluded. Studies that met the inclusion criteria were critically appraised to assess their quality. Guideline Evaluation Tool was used to assess study quality. This tool assesses concepts and topics covered (human development, relationships, personal skills, sexual behavior, sexual health, society and culture), accuracy and relevance (information is scientifically accurate; information is up-to-date; information is presented in a way that appeals to young people; information, graphics, and materials represent target populations).

Two reviewers separately screened the search results for inclusion using a

predefined inclusion criteria form. The guidelines and packages contents were evaluated based on their applications in improving parents' knowledge, attitudes and skills in SE and sexual behavior management for children under 12 yr of age.

Ethics Committee of Shahroud University of Medical Sciences approved this review with the ethical code of IR.SHMU.REC.2015.48.

Results

Of 1243 studies initially identified, after some exclusion, 20 studies from different regions of the world were included in our as study shown in (Fig. 1). The packages and guidelines were classified into three main categories based on sexuality-related knowledge, attitude, and skill (Table 1). Employed approaches to children's sexuality were reported to be effective in developing healthy sexual behavior in children. Education was identified as the primary focus of the included packages and guidelines. Parents were recognized as first line educators in SEs. However, approaches regarding improving parents' skills in SE for children were limited in number. In other words, skill-building approaches targeting parents, and parents' competency in children's sexual behavior management were not specified in the existing programs.

-Knowledge: provides accurate information about human sexuality, including growth and development, reproductive system, normal sexual behavior, childbirth.

-Attitude: offers opportunities for identification of values, beliefs and culture (personal, family, friends, and community).

-Skill: promotes the acquisition of skills in relation to competency in children's sexual behavior management, impact on children's moral growth and development, the ability to make healthy decisions, self-confidence, and sense of comfort with oneself and one's body, understanding of children's normal sexual behaviors, appropriate response to children's sexual questions, identification and reporting of child sexual abuse.

Discussion

Although valuable and effective packages and guidelines in relation to SE for children were found in this review, feasibility, and possibility of their usage in accordance with the Iranian culture was in question.

Although cultural influences may alter the efficiency of any given educational program, the majority of the included packages and guidelines agree on 1) parents' role in SE; 2) education as the primary focus of SE; 3) parents as the primary sexuality educators; 4) attention to the values and culture of every society in SE for children; 5) effectiveness of the educational programs in children's sexuality.

However, approaches to improving parents' practical skills in SE for children were limited. In other words, parents' competency in their children's sexual behavior management in day-to-day practice was not the focus of attention in these programs.

Some packages and guidelines were designed for parents. There is widespread agreement that parents are children's first and foremost educators and that they play a central role in the development, growth, and management of children's sexual behaviors .

This agreement can be found in several studies and guidelines such as Bersamin et al.; Vidourek; Goldman; Sexual Development and Behavior in Children Information for Parents and Caregivers, International Technical Guidance of Sexuality V olume II, Guidelines for Comprehensive Sexuality Education 3RD editor kindergarten through 12th Grade.

In addition to parents' prominent role, some packages and guidelines were found targeting at teachers. For instance, teachers' role in children's sexual health promotion is undeniable, and teachers can play an important role in promoting sexual health and formal school based education can help parents acquire' the related skills and knowledge.

Some packages and guidelines have been designed for parents and professionals . Professionals work in the area of promotion of sexual health and education; in particular, curriculum and program planners, and educators in and out of a school setting, policy-makers, and health care practitioners. For parents who support the implementation of a comprehensive SE program, the quality of SE for their children

will improve. Parents are given information and knowledge in this field by professionals in order to acquire the essential knowledge since parents does not have access to the appropriate resources. Many resources pay attention to parents' role as sexual educators, emphasize education of parents by professionals as the first sexual health promotion strategy for children, and focus on provision of educational materials for enhancing knowledge, so that adults can easily talk to their children and destroy barriers of negative attitude towards SE for children.

In educational packages and guidelines, attention to the values and culture of every society in SE for children has been emphasized, and this has been the strength of these programs. The influence of parents' attitudes has extended well into all stages of life. Sexuality is strongly influenced by family and community norms. As the sexual socialization of children, takes place first at home and then in the society, the role of culture and family values is very substantial and overshadows children's sexuality.

Many of these programs were related to developed countries where SE for children is widely recognized, yet it remains unacceptable in some countries, and Iran is not an exception. There is a lack of agreement on SE for children in Iran like other conservative societies. In developed countries, children receive formal and informal education by parents, school, and professionals; yet despite Iran's progress in sexual and reproduction health and its movement toward healthy communities as defined by WHO (2004), a formal comprehensive SE for children does not exist.

This study has some limitations as most of the packages and guidelines found in this review were stated theoretically. In other words, they were not based on experimental studies.

Conclusion

The findings in this review emphasized the importance of SE for children. All programs focus on children's sexual growth and development. Synthesis of the findings reveals that skill building targeting parents are not practically specified throughout the studies, packages or guidelines. A possible explanation is that SE

needs to be contextualized through a given society. Building skills for parents in management of their children's' sexuality must be the focus of SE programs. Children' sexual development goals will be achieved if their first line educations become skillful.

General principles of these packages and guidelines have generalizability and usability for other countries such as Iran but some details of these packages and guidelines need to be repaired and modified according to the culture of each country. The implications of these findings for intervention design and development and further research are discussed.

中文译文：

针对儿童的性教育的现有方法：综述文章摘要

背景：我们的目的是评估性教育（SE）的相关政策或实际问题，利用综述的方法来搜索和批判性地评价现有的针对12岁以下儿童的性教育方法。

方法：我们通过广泛搜索英文和波斯文发表的和未出版的文献，专家的证据，以及搜索引文，完成了数据收集工作。主题词包括性行为和培训、性教育和方案或方法、性与儿童、性教育和父母、性或性教育、性教育和父母或照顾者。对1970至2015年间的医学和健康相关数据库、Cochrane图书馆和Web of Science 进行了系统的搜索，以及引文检索、参考清单检查和利益相关者的建议，一起确定了性教育的证据。

结果：根据入选标准，确定了20份文件。他们被分为三大类，即与性有关的知识、态度和父母管理儿童性行为和相关教育的技能。据报道，对儿童性行为采用方法可以有效地促进儿童健康的性行为。教育被确定为入选文件和指导方针的主要重点。父母被公认为性教育的一线教育者。然而，旨在提高父母在儿童性教育方面的技能的干预措施有限。换句话说，在现有的计划中没有详细说明父母的技能，以及他们在儿童性行为管理方面的能力。

结论：为了实现儿童的性知识发展目标，父母的技能培养必须成为性教育计

划的重点。

关键词：性教育，儿童，家长，评论

介绍

性具有生理、社会、文化和心理层面，性发展是人类生活的一部分。这一维度与人类发展的其他方面一样，从出生开始就反映在一个人的性行为中。性行为是一个更为复杂的过程，即性社会化的结果。换句话说，性行为不仅受生物因素的影响，而且也因性社会化而变得复杂。

儿童的性行为受到儿童年龄和社会化程度的强烈影响。儿童的性社会化受到家庭和社会的信仰及其在性方面的作用的影响。

性社会化是儿童获取基本信仰、态度、价值观、文化符号、性观念和意义的过程。事实上，在这个过程中，身份的形成、性的作用、性技能和知识的获取以及性态度的发展都得到了实现。家庭作为儿童早期生活的第一个社会群体，被认为是儿童性社会化的首要因素和最重要的因素。孩子从家庭、学校和社会获得知识、技能和行为，他们获得的技能可以改变他们的未来。因此，作为性社会化的主要组成部分之一，父母的性教育是促进儿童性健康的最佳策略之一。

性行为在儿童中很常见，超过50％的儿童在13岁之前就会参与不同类型的性行为。与其他年龄组别一样，儿童在性发育过程中需要良好的照顾、监督和教育，他们的主要照顾者是他们的一线教育者。

父母是儿童在性方面的首要和最重要的教师。大多数父母没有接受过这样的教育，当涉及到性教育的时候，他们倾向于将自己不愿意做的事情分配给学校。

在伊朗，大多数父母在与性相关的问题上没有受过良好的教育。另外，还没有学校的性健康教育。因此，对父母来说，和孩子谈论性是非常困难和可怕的。

尽管父母在性教育中的作用很重要，但他们没有充分准备好就性问题进行交流。他们主要无法妥善处理子女的性行为。父母缺乏足够的技能让他们的孩子保护自己免受与性有关的风险，享受成年后的性生活，并为健康和亲密的人际交往做好准备。

使用全面的计划和适当的策略来教育儿童性行为似乎是至关重要的。文化影响可能会改变任何教育计划的成效。本综述旨在通过系统的评估方法，针对12

岁以下的儿童的现有的性教育方法进行搜索和批评性评估，以评估已知的与性教育有关的政策或实践问题。

方法

为了在很短的时间内完成这一综述，我们采用了快速的评审方法，以确保对最相关的证据进行有效的识别和综合。以下关键词用于搜索：性训练，性教育，性教育，性健康，技能培养，指导方针，文件和儿童。医学主题词表（MeSH）也被使用了。这些术语包括性教育，计划或方法，性与儿童，性教育和父母，性或性教育，性教育和父母或照顾者。系统地搜索医学和健康相关数据库EDLINE、EMBASE、PubMed、护理和联合卫生文献累积索引（CINAHL）、Cochrane图书馆、Web of Science、Scopus、谷歌学术搜索，SID，Magiran和Iranmedex的1970至2015年间的文献，以及引文检索、参考清单检查和利益相关者的建议，确定了性教育的证据。将审查限制在1970至2015年的理由是，儿童性教育起源于西方社会。自20世纪60年代以来，美国许多幼儿园开始实施性教育课程，瑞典从1970年起开始对所有儿童和青少年实施性教育。

我们还搜查了包括卫生组织，儿童基金会艾滋病规划署和加拿大、澳大利亚、美国和伊朗等国的卫生部，以及儿童性健康领域的积极协会。在报告结果不完整的情况下，联系了作者并要求提供进一步的细节。根据入选和排除标准对文章和灰色文档进行了评估。

入选标准是研究设计（在性教育领域引入的文章、灰色文档、文件和指南）；结果；人口特征（0-12岁的儿童）；干预措施（旨在通过提供父母的相关知识、态度和技能来改善儿童的性发育）。研究中包括了以英语和波斯语出版的研究。我们排除了针对青少年和老年人的项目。同一项研究的重复出版物和仅以抽象形式提供的文章也被排除在外。对符合入选标准的研究进行了严格评价，以评估其质量。准则评估工具用于评估学习质量。该工具评估涵盖的概念和主题（人类发展、人际关系、个人能力、性行为、性健康、社会和文化），准确性和相关性（信息是科学准确的；信息是最新的；信息是以吸引年轻人的方式提出的；信息、图形和材料代表目标群体）。

两位评阅者分别使用预定义的选入标准表单对包含的搜索结果进行了筛选。