Effects of Interventions Addressing School Environments or Educational Assets on Adolescent Sexual Health: Systematic Review and Meta-analysis

Abstract

School-based interventions that aim to modify sexual health knowledge, attitudes and behaviors have mixed and often unsustained effects on adolescent sexual health outcomes. However, observational evidence suggests that broader school-related factors, such as school climate and academic attainment, can influence outcomes. METHODS: Nine databases were searched in July 2017 for randomized and quasi-experimental evaluations of interventions addressing school-level environment or student-level educational assets, to examine whether such interventions can promote young people's sexual health. Searches were limited to studies published since 1990 but were not restricted by language. Studies were assessed for risk of bias and synthesized narratively and meta-analytically. RESULTS: Searches yielded 11 evaluations, published from 1999 to 2016, of interventions related to school-level environment or student-level educational assets. Because of inconsistent reporting, the risk of bias was not clear for most studies, and meta-analysis was possible for only one outcome. The meta-analysis of three randomized trials provided some evidence that school-environment interventions may delay sexual debut (pooled odds ratio, 0.5). Narrative synthesis of the remaining outcomes found mixed results, but suggests that interventions addressing school-level environment may delay sexual debut and that those addressing student-level educational assets may reduce risk of pregnancy and STDs.

Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

“…The prevalence of HIV in this cohort (about 5%) reflects gaps in preventive services and care needs in KwaZulu-Natal and Mpumalanga. Our incidence and prevalence results from the biomarkers are comparable to results from high-school students in rural KwaZulu-Natal undertaken by Abdool Karim and colleagues [ 27 ]. In their sample of female students with a mean age of 16 years, HIV prevalence was 6.4% and HSV-2 prevalence was 10.7%.…”

Talking about sex and sexual behaviour of young people in Ireland

“…Reviews of best practice in school sex education have highlighted the importance of a life-skills approach (for example, focusing on decision-making and risk assessment) phased in an age-appropriate way and embedded in a whole-school perspective (Pound et al, 2017). Findings on the impact of specific programmes (either within or outside school) to delay sexual activity and/or reduce risky behaviours have, however, been mixed (Jackson et al, 2012a;Peterson et al, 2019;Lopez et al, 2016aLopez et al, , 2016b. In the UK, a study found that young people who had discussed emergency contraception in school or had been taught about local family planning were more likely to have used contraception at first intercourse.…”

The Role of School Social Support and School Social Climate in Dating Violence Prevention among Adolescents in Europe

“…The results of previous studies also show that a good school climate protects students from premature sexual activity, reduces the risk of unwanted pregnancy and sexually transmitted diseases [26]. A safe climate at school is probably conducive to conversations on any topic, also related to sex education in a broad sense, including the topic of sexual abuse.…”

“…The analyzes in this text concern student -with dating experience (n=993) (57.2% of girls and 66.5% of boys). A statistical power analysis was performed for sample size estimation, based on data from a previously published random-effects meta-analysis of 23 studies about school-based interventions aimed to prevent violence and negative attitudes in teen dating relationships [26].…”