TeachAIDS Students at the Shirimatunda Primary School in Tanzania use a Swahili version of an online course about AIDS created by a company called TeachAIDS.

Asia Jackson likes to learn at the computer because she can work at her own pace, which is usually faster than her classmates’. Al-Tariq Linton says, “It’s one on one. If I have a question, instead of competing for the teacher’s attention, I can go back and read it on my own.” Wanda Williams says her favorite part of the online course she’s taking is the narrator of the videos it includes. “Rufus made it funny,” she says. “It was fun.”

As interest in online education rages, these 17- and 18-year-old students at Newark, N.J.’s West Side High are guinea pigs in a global experiment to answer a key but surprisingly elusive question: whether and when it actually works.

Evidence is mixed about how well online courses teach core subjects such as science, math or reading, with a recent large-scale Columbia study showing disadvantages to online learning for community college students. (The study was done at Columbia’s Teachers College, which is also home to The Hechinger Report, producer of this story.) But new research shows that, in certain topics—as for these students in Newark — computer-based instruction is not only just as effective as the old-fashioned, in-person kind. It’s more effective.

These topics include sex, drugs and health — subjects in which privacy, personal comfort and customized information are especially important, and embarrassment or cultural taboos can get in the way of classroom teaching.

Simple video- and animation-based interactive courses in these disciplines turn out to be good ways of teaching subjects you may have giggled through in health class. And they’re increasingly being used all over the world with success now confirmed by peer-reviewed, controlled research. The results are important as online education continues to expand faster than its impact and effectiveness can be fully measured.

“We’re seeing significant and large effects on attitudes, knowledge, and also behaviors” from online courses in nontraditional subjects, says Marco Gonzalez-Navarro, an assistant professor at the University of Toronto who coauthored one study of the subject.

Sex in Colombia

Gonzalez-Navarro, working with researchers at Yale and the University of Ottawa, found that Colombian students in an 11-week online course in safer sex created by Profamilia, part of the International Planned Parenthood Federation, knew more about safer sex practices than students who took the conventional, state-mandated health class. And their knowledge was put into practice. For every 68 students who took the online course instead of the traditional course, researchers estimated by reviewing students’ medical records and comparing them to those of peers who didn’t take the course, up to two sexually transmitted infections were prevented. The students were also 10 percentage points more likely than their counterparts to redeem vouchers for free condoms offered six months later.

It’s not just that students often feel embarrassed to talk about sex in conventional classrooms, the researchers found. Teachers don’t like teaching about it, making them less effective — assuming they even broach the topic.

“A lot of teachers are just not comfortable teaching these subjects,” says Gonzalez-Navarro. “The central education ministry might say you have to give this sex-ed course, but it’s not happening.”

Another series of independent research studies has confirmed the effectiveness of online education about alcohol awareness in the United States. In the largest, the researchers found a short-term reduction in harmful behaviors related to drinking among college freshmen at 15 colleges who took an online course called AlcoholEdu. Similar studies at the University of West Florida and Villanova and Roger Williams found similar results.

AlcoholEdu is produced by EverFi, a venture-funded startup backed by a group of high-profile Silicon Valley investors, including Amazon's Jeff Bezos, Google's Eric Schmidt and Twitter's Evan Williams. In addition to alcohol education, EverFi offers animation, video and game-based courses in sexual violence awareness, financial literacy and digital citizenship, reaching 69 of the nation's largest 100 school districts, and 33 percent of the nation's incoming freshmen.

Five and a half million students have already completed EverFi courses, according to CEO Tom Davidson, each of which includes eight to 10 hours of instruction. Some are used as part of for-credit courses while others are woven into freshman orientation.

“You can’t get your dorm key at NYU until you do our sexual violence prevention course,” says Davidson.

The NIH-funded study of the company’s online alcohol-awareness course found that it was most effective when more freshmen took the class at the same time, suggesting that peer pressure plays a role — though the results had dissipated by the spring semester, meaning more follow-up was needed.

Tackling cultural taboos

Other ongoing research supports the use of online courses for sex education. Students in China, India and South Africa who completed an online sex-education program called TeachAIDS were 91 percent more knowledgeable about HIV than before they took the course, compared to an improvement of 73 percent for students who were taught the conventional, state-mandated curriculum.

TeachAIDS became a nonprofit in 2009. It was founded by Piya Sorcar and her husband, Shuman Ghosemajumder, who had spent six years in high-level jobs at Google, along with several others. In her Stanford dissertation, Sorcar had examined the role of cultural taboos in dealing with issues of sexual and reproductive health in India.

“Sex education has been banned in some states in India,” she says. “There have been incidents of teachers burning curricular material in the streets.” In Andhra Pradesh, a state with a population of 85 million, HIV-positive students have been expelled.

Sorcar set out to create a curriculum for HIV/AIDS that would be both culturally acceptable and scientifically rigorous, and that would attack social stigmas by showing what AIDS is, how the virus is transmitted and how to protect against it.

The TeachAIDS course combines a 20- to 25-minute animated video with interactive quizzes. So far, she said, it has been produced in 15 languages and used in 74 countries. For added appeal and to make it more relatable for young people, each country and region features likenesses of and voiceovers by local celebrities. In Botswana, the program stars a hip-hop artist named Scar, who hosts the TV show Idols East Africa; in India, it features Shabana Azmi, an award-winning Hindi actress.

“Our culture doesn’t talk about love or what comes out of it,” says Tristha Ramamurthy, who uses the TeachAIDS curriculum with seventh- through 12th-graders in a network of private schools she oversees in Bangalore, India. “We have arranged marriages — we’re very caste-driven. Sex itself is very uncomfortable to talk about, and in school it’s not taught.”

What makes the TeachAIDS material acceptable to her students, Ramamurthy says, is the use of culturally specific euphemisms. For example, a honeymoon suite and two lovebirds kissing suggests intercourse; images of a woman holding a baby stand in for childbirth.

Digital downsides

There are downsides to using online courses to cover health topics. Both the software and the hardware cost money, and funding is often a problem in schools worldwide. TeachAIDS’ video-based course has been projected on a wall in villages in Nepal and shown on outdoor screens in Rwanda in between World Cup soccer matches, which extends the program’s reach but sacrifices the advantages of interactivity and privacy. Even at West Side High in Newark, Everfi had to provide a version of the course loaded on a jump drive, because the school had problems with its Internet connection.

EverFi licenses its material to colleges for a fee, but public schools like West Side High can get it free with the backing of corporate or local business underwriters, which have included the National Basketball Association and Capital One bank. The sponsorships, which can include prizes and giveaways, are seen by some critics as an unwelcome intrusion of business into the classroom.

Nor do any of these courses constitute a hands-off, digital-only solution. The learning effects are strongest in most cases when the programs are used as part of for-credit courses, with teachers in the room to guide and motivate students, and when students take the courses together. And companies like EverFi need to provide ongoing support and professional development for teachers.

But the need for easy-to-use, compelling resources to cover topics that teenagers are not all that eager to discuss with adults is likely to grow, opening more markets to organizations such as EverFi and TeachAIDS.

EverFi is already expanding its offerings. And TeachAIDS is being adopted as part of the official high-school curriculum in Karnataka, an Indian state with a population of 60 million, and the company plans to grow to 50 countries with 90 percent of the world’s HIV cases by 2018.

“We see such a need for these ‘everything else’ areas outside the core curriculum,” Davidson says of the apparent effectiveness of using online education in this way, and continued research into it. “New mandates are coming down at the state level, and schools are having trouble getting their arms around them. This is a model that we're following with the development of all our courses: develop, test, redevelop.”

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