Assessing the role of school-based sex education in sexual health behaviours: a systematic review

Abstract

Objective: To identify and synthesise evidence on the role of school-based sex education interventions and to use a Behaviour Change Techniques (BCTs) taxonomy to identify behaviour change techniques on sexual health behaviours. Methods: The systematic review was informed by the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and included the components of PICOS: participant/population, interventions, comparisons, outcomes and study design. Five electronic databases were searched up to February 2023 including PUBMED, Cochrane Central Register of Controlled Trials, ERIC, Web of Science Core Collection and PsycINFO. Methodological quality was assessed using the Effective Public Health Practice Project, Quality Assessment tool. Results were presented as a narrative synthesis. Results: Of the 1387 studies identified, twenty-seven studies met the inclusion criteria. Studies examined sexual health behaviours such as condom usage, frequency of sexual activity, initiation of sexual activity and number of sexual partners. More than half studies (56%) reported a statistically significant change on one or more sexual health behaviour outcomes. Nine (out of 93) BCTs were identified with the most used BCTs being information about health consequences and social and emotional consequences, demonstration of behaviour, behavioural practice/rehearsal and instructions on how to perform the behaviour. Conclusion: School-based sex education interventions can be effective in promoting positive sexual health behaviours. The findings of this review provide understanding of such interventions in shaping sexual health behaviours. These also offer evidence-based knowledge for researchers, educators and policy makers in understanding how they can support future development of school-based sex education programmes.