{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:41:37Z","timestamp":1792377697482,"version":"4.4.0"},"reference-count":82,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual health is critical to academic success and adolescent well\u2010being. This paper expands Basch's 2011 analysis of sexual health disparities to a comprehensive definition of positive adolescent health, including teen births, sexually transmitted infections (STI), dating violence, and sexual identity discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Contributions to Theory<\/jats:title>\n                    <jats:p>Over the last two decades, as teen birth rates fall and sexually transmitted infection (STI) rates rise, patterns of disparities stay relatively constant. Driven by systemic factors like institutionalized racism and poverty, Fundamental Cause Theory posits that these social factors restrict access to resources. These disparities, which disproportionately affect youth of color, low\u2010income students, and LGBTQ+ youth, impact academic outcomes through documented causal pathways of chronic absenteeism, trauma\u2010related cognitive disruption, and school disengagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice, and Equity<\/jats:title>\n                    <jats:p>Schools should adopt multicomponent, evidence\u2010based strategies including inclusive Comprehensive Sexual Health Education, access to sexual health services through School\u2010based Health Centers and community linkages, and safe environments and protective policies. Engaging stakeholders is essential for program sustainability and cultural responsiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sexual health disparities are educationally relevant health disparities. Addressing these is fundamental to schools' mission of closing achievement gaps. Prioritizing sexual health and safety ensures all students reach their full potential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.70262","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:44:53Z","timestamp":1791931493000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Promoting Access to Positive Sexual Health in Schools to Support Equitable Academic Outcomes"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8525-2420","authenticated-orcid":false,"given":"Beth D.","family":"Marshall","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3254-059X","authenticated-orcid":false,"given":"Terrinieka W.","family":"Powell","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization \u201cDefining Sexual Health\u2014Report of a Technical Consultation on Sexual Health 28\u201331 January 2002 Geneva \u201d2006 https:\/\/www.who.int\/publications\/m\/item\/defining\u2010sexual\u2010health."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746-1561.2011.00632.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746\u20101561.2011.00635.x"},{"key":"e_1_2_11_5_1","unstructured":"A.Wood SaA \u201cAccess to Comprehensive Reproductive Health Care Is an Adolescent Health Issue \u201d2022 https:\/\/www.guttmacher.org\/article\/2022\/11\/access\u2010comprehensive\u2010reproductive\u2010health\u2010care\u2010adolescent\u2010health\u2010issue."},{"key":"e_1_2_11_6_1","unstructured":"A. K.MicklerandJ.Tollestrup \u201cTeen Births in the United States: Overview And Recent Trends \u201d2025 https:\/\/www.congress.gov\/crs_external_products\/R\/PDF\/R45184\/R45184.11.pdf."},{"key":"e_1_2_11_7_1","unstructured":"Centers for Disease Control and Prevention \u201cSexually Transmitted Infections Surveillance 2023 \u201d2024 https:\/\/www.cdc.gov\/sti\u2010statistics\/media\/pdfs\/2025\/09\/2023_STI_Surveillance_Report_FINAL_508.pdf."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2022.106480"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2017.0045"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.13084"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2626958"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0025430"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2021.11.013"},{"key":"e_1_2_11_14_1","first-page":"1","volume-title":"Youth Risk Behavior Surveillance\u2014United States","author":"Underwood J. M.","year":"2019"},{"key":"e_1_2_11_15_1","unstructured":"CDC \u201cYouth Risk Behavior Survey Data Summary and Trend Report 2013\u20132023 \u201d2013 https:\/\/www.cdc.gov\/yrbs\/dstr\/pdf\/YRBS\u20102023\u2010Data\u2010Summary\u2010Trend\u2010Report.pdf."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0040194"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12817"},{"key":"e_1_2_11_18_1","volume-title":"The Experiences of LGBTQ+ Youth in Our Nation's Schools. A Report From GLSEN","author":"Kosciw J. G.","year":"2022"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2018.0109"},{"key":"e_1_2_11_20_1","volume-title":"The 2019 National School Climate Survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation's schools","author":"Kosciw J. G.","year":"2020"},{"key":"e_1_2_11_21_1","volume-title":"Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy","author":"Hoffman S. D.","year":"2008"},{"key":"e_1_2_11_22_1","unstructured":"H.Manlove JaL \u201cData Point: Half of 20\u2010 to 29\u2010Year\u2010Old Women Who Gave Birth in Their Teens Have a High School Diploma \u201d2018 https:\/\/www.childtrends.org\/publications\/half\u201020\u201029\u2010year\u2010old\u2010women\u2010gave\u2010birth\u2010teens\u2010high\u2010school\u2010diploma."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.78.5.334"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.4284\/0038\u20104038\u20102012.195"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.3577"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012\u20101029"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010clinpsy\u2010021815\u2010093153"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301069"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10888691.2017.1398650"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/175204"},{"issue":"19","key":"e_1_2_11_31_1","first-page":"532","article-title":"Physical Dating Violence Among High School Students\u2014United States, 2003","volume":"55","author":"Black M. C.","year":"2006","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_11_32_1","doi-asserted-by":"crossref","unstructured":"R.Nath D. D.Matthews S.Hobaica et al. \u201c2025 U.S. National Survey on the Mental Health of LGBTQ+ Young People \u201d2026 https:\/\/doi.org\/10.70226\/EKGT3197.","DOI":"10.70226\/EKGT3197"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2015.12.017"},{"key":"e_1_2_11_34_1","unstructured":"SHAPE America \u201cNational Health Education Standards \u201d2024 https:\/\/www.shapeamerica.org\/MemberPortal\/standards\/health\/default.aspx."},{"key":"e_1_2_11_35_1","volume-title":"National Sex Education Standards: Core Content and Skills, K\u201012","author":"Future of Sex Education Initiative","year":"2020"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2113144119"},{"key":"e_1_2_11_37_1","unstructured":"D.Kirby \u201cEmerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases \u201d2007. National Campaign to Prevent Teen and Unplanned Pregnancy."},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.11.006"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.54675\/UQRM6395"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2020.07.036"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121\u2010025\u201001805\u2010y"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2016.10.024"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2018.11.012"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/10665684.2015.1025614"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121\u2010023\u201001517\u20101"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avb.2020.101546"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2023.10.031"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.04.007"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180250"},{"key":"e_1_2_11_50_1","unstructured":"Centers for Disease Control and Prevention \u201cSchool Health Profiles 2024 \u201dhttps:\/\/profiles\u2010explorer.cdc.gov\/."},{"key":"e_1_2_11_51_1","unstructured":"SIECUS: Sex Ed for Social Change \u201cUnited States Sex Education State Report Card \u201d2025 https:\/\/siecus.org\/siecus\u2010state\u2010profiles\/#highlights."},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12374"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cppeds.2012.03.002"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1054\u2010139X(02)00491\u20106"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2008.153247"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12450"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2021.05.017"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12414"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.03.019"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013\u20102821"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2010.12.011"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010010\u20109812\u2010y"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.70046"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.evalprogplan.2025.102671"},{"key":"e_1_2_11_65_1","doi-asserted-by":"crossref","unstructured":"J. S.Leichliter C.Copen P. J.Dittus et al. \u201cConfidentiality Issues and Use of Sexually Transmitted Disease Services Among Sexually Experienced Persons Aged 15\u201325\u2009Years\u2014United States 2013\u20132015 \u201d2017.","DOI":"10.15585\/mmwr.mm6609a1"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.13297"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1080\/19361653.2024.2335522"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/jora.12487"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.3390\/socsci4030563"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajcp.12406"},{"key":"e_1_2_11_71_1","unstructured":"N. J.Wilkins K. H.Krause J. V.Verlenden et al. \u201cSchool Connectedness and Risk Behaviors and Experiences Among High School Students\u2014Youth Risk Behavior Survey United States \u201d2021."},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/0002716203260102"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-010-9578-6"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018\u20103766"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.2731"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0027197"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2020.07.014"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12642"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2023.12.012"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.13431"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.12.029"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2021.05.015"},{"key":"e_1_2_11_83_1","unstructured":"Congress.gov \u201cEvery Student Succeeds Act \u201dhttps:\/\/www.congress.gov\/bill\/114th\u2010congress\/senate\u2010bill\/1177."}],"container-title":["Journal of School Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/josh.70262","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/josh.70262","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/josh.70262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:37:01Z","timestamp":1792377421000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/josh.70262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":82,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/josh.70262"],"URL":"https:\/\/doi.org\/10.1111\/josh.70262","archive":["Portico"],"relation":{},"ISSN":["0022-4391","1746-1561"],"issn-type":[{"value":"0022-4391","type":"print"},{"value":"1746-1561","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70262"}}