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A comprehensive review of reviews of school-based interventions to improve sexual-health

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)33-52
Number of pages20
JournalHealth Psychology Review
Issue number1
Early online date7 Nov 2016
DateAccepted/In press - 11 Sep 2016
DateE-pub ahead of print - 7 Nov 2016
DatePublished (current) - Jan 2017


OBJECTIVE: To systematically review systematic reviews of school-based sexual-health and relationship Education (SHRE) programmes and, thereby, identify interventions and intervention components that promote reductions in risky sexual behaviour among young people.

METHODS: Electronic bibliographies were searched systematically to identify systematic reviews of school-based interventions targeting sexual-health. Results were summarised using a narrative synthesis.

RESULTS: Thirty-seven systematic reviews (summarising 224 primary randomised controlled trials) met our inclusion and quality assessment criteria. In general, these reviews analysed distinct sets of primary studies, and no comprehensive review of available primary studies was identified. Interventions were categorised into five types that segment this review literature. Unfortunately, many reviews reported weak and inconsistent evidence of behaviour change. Nonetheless, integration of review findings generated a list of 32 design, content and implementation characteristics that may enhance effectiveness of school-based, sexual-health interventions. Abstinence-only interventions were found to be ineffective in promoting positive changes in sexual behaviour. By contrast, comprehensive interventions, those specifically targeting HIV prevention, and school-based clinics were found to be effective in improving knowledge and changing attitudes, behaviours and health-relevant outcomes.

CONCLUSIONS: School-based interventions targeting risky sexual behaviour can be effective. Particular design, content and implementation characteristics appear to be associated with greater effectiveness. We recommend consideration of these characteristics by designers of school-based sexual-health interventions.

    Research areas

  • Systematic review, behaviour change, sexual-health, school-based

    Structured keywords


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    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Taylor & Francis at Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 560 KB, PDF document


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