Table 2.

Activities for local education agencies to support HIV, other sexually transmitted disease (STD), and pregnancy prevention.

Strategy	Domain	Activity
Sexual health education (SHE)	Strengthening staff capacity	Identify and approve a list of instructional competencies to be demonstrated by those teaching skills-based health and sexual health education in middle and high school.
		Develop and implement a technical assistance plan that incorporates teacher observation, coaching, peer mentoring, and other methods to improve an individual teacher’s sexual health education instruction.
		Provide training at the local education agency once per year to ensure school health and sexual health education teachers have content knowledge, comfort, and instructional competencies to effectively implement approved school health and sexual health education instructional programs.
	Increasing student access to programs and services	Establish, adopt, and implement a skills-based health education course requirement, which includes sexual health education content, for all students attending middle and high schools in the district.
		Develop and approve a health education scope and sequence that delineates sexual health education learning outcomes for all students in middle and high schools in the district.
		Develop, revise, or select a sexual health education instructional program consistent with the approved scope and sequence (referenced above), and inclusive of instructional lessons, student learning activities, resources, and student assessment.
		Develop, revise, or select health education instructional programs for students in elementary grades that align with the priorities for health education and sexual health education established in the health education scope and sequence.
		Incorporate specific changes to existing instructional programs to better meet the needs of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) adolescents.
		Strengthen student assessment instruments to more accurately assess student mastery of health education knowledge and skills.
		Develop, update, and foster use of teaching tools and resources (e.g., lesson pacing guide, specific lesson plans) for teachers to continuously improve delivery of the identified sexual health education instructional program.
	Engaging parents and community partners	Establish and maintain a School Health Advisory Council (SHAC) that regularly provides district-level advice and guidance to improve health and sexual health education programs for students and health and sexual health education instruction for staff.
		Integrate strategies to actively engage parents in sexual health education instructional programs.
Sexual health services (SHS)	Strengthening staff capacity	Provide training and professional development to school and/or health service staff to support SHS activities annually.
	Increasing student access to programs and services	Assess district and priority school capacity to implement activities to increase student access to SHS.
		Incorporate skill-based instruction to students on accessing school-based and community SHS into sexual health education lessons annually.
		Increase student access to and use of SHS through either on-site provision or referral to community-based sexual health providers depending on district/schools’ health services infrastructure. For on-site health services- improve student use and quality of SHS provided by School-Based Health Centers (SBHCs). For referral-based health services- establish or improve use of a referral system to link sexually active students to community providers for SHS by using the referral system toolkit to implement the seven core components of a referral system.
		Implement school-wide, student-planned marketing campaigns that promote recommended health services for teens and selected school SHS programs.
		Conduct school-based STD screening (SBSS) events.
		Implement or improve a condom availability program.
	Engaging parents and community partners	Disseminate SHS-related materials for parents.
Safe and supportive environments (SSE)	Strengthening staff capacity	Provide professional development to teachers on classroom management annually.
		Provide professional development to all school staff on supporting LGBTQ adolescents annually.
	Increasing student access to programs and services	Implement mentoring, service learning, and/or other positive youth development programs for students, and/or connect students to such community-based programs.
		Establish or enhance student-led clubs that support LGBTQ adolescents (often known as Gay-Straight Alliances or Genders and Sexualities Alliances).
	Engaging parents and community partners	Disseminate resources to parents/caregivers on parental monitoring and parent-adolescent communication (generally and specifically about sex).
		Disseminate resources specifically relevant to parents of LGBTQ students.
		Implement and/or connect parents to skill-building parenting programs.