What is best practice in sex and relationship education? A synthesis of evidence, including stakeholders’ views

Abstract

ObjectivesSex and relationship education (SRE) is regarded as vital to improving young people’s sexual health, but a third of schools in England lacks good SRE and government guidance is outdated. We aimed to identify what makes SRE programmes effective, acceptable, sustainable and capable of faithful implementation.DesignThis is a synthesis of findings from five research packages that we conducted (practitioner interviews, case study investigation, National Survey of Sexual Attitudes and Lifestyles, review of reviews and qualitative synthesis). We also gained feedback on our research from stakeholder consultations.SettingsPrimary research and stakeholder consultations were conducted in the UK. Secondary research draws on studies worldwide.ResultsOur findings indicate that school-based SRE and school-linked sexual health services can be effective at improving sexual health. We found professional consensus that good programmes start in primary school. Professionals and young people agreed that good programmes are age-appropriate, interactive and take place in a safe environment. Some young women reported preferring single-sex classes, but young men appeared to want mixed classes. Young people and professionals agreed that SRE should take a ‘life skills’ approach and not focus on abstinence. Young people advocated a ‘sex-positive’ approach but reported this was lacking. Young people and professionals agreed that SRE should discuss risks, but young people indicated that approaches to risk need revising. Professionals felt teachers should be involved in SRE delivery, but many young people reported disliking having their teachers deliver SRE and we found that key messages could become lost when interpreted by teachers. The divergence between young people and professionals was echoed by stakeholders. We developed criteria for best practice based on the evidence.ConclusionsWe identified key features of effective and acceptable SRE. Our best practice criteria can be used to evaluate existing programmes, contribute to the development of new programmes and inform consultations around statutory SRE.

Implementing a whole-school relationships and sex education intervention to prevent dating and relationship violence: evidence from a pilot trial in English secondary schools

“…Uncertainty as to what was meant by the term dating and relationship violence was also a barrier to staff's initial 'cognitive engagement' with the intervention. Although delivery of lessons by teachers rather than external specialists offers the most promise for embedding dating and relationship violence interventions in school curricula (Stanley et al 2015;Ollis 2014), it was however also clear that some teachers lacked the skills or interest to deliver high-quality lessons and facilitate participative discussions on challenging topics, consistent with some previous research findings (Pound et al 2017).…”

Sexual health outcomes for young people in state care: Cross-sectional analysis of a national survey and views of social care professionals in Wales

“…Previous research has repeatedly emphasised the importance of learning from and being led by young people, identified concerns for privacy, deficits in supportive networks, and highlighted the need to improve access to appropriate sex education and sexual health advice (Corylon and McGuire 1999;Love et al 2005;Chase et al 2009;James et al 2009;Connolly et al 2012;Svoboda et al 2012;Aparicio et al 2015;Ahrens et al 2016;Hyde et al 2015;Winter et al 2016). Likewise, best practice guidelines have sought to overcome divergent views of young people and professionals in respect to the delivery of sex education (Pound et al 2017) and extending this work with specific reference to the needs of young people in state care would likely be beneficial. The poorer sexual health outcomes highlighted in this paper, combined with the depiction of some young people, consciously or unconsciously, seeking to fulfil unmet relational needs through sexual relationships, early pregnancy and parenthood should not be interpreted as beyond the limits of state care influence.…”

Impact guaranteed? Involving potential recipients, implementers and wider stakeholders in the co-production of two school-based relationships and sex education interventions to prevent teenage pregnancy and dating and relationships violence

“…However, SEF advised against recommending delivery through single 'off timetable' (or 'drop-down') days in Positive Choices, even if this might cover the full number of specified curriculum hours or be convenient for schools. Such an approach was considered inconsistent with best practice in RSE delivery where skills, competence and knowledge should be developed and revisited across time (See [55,56], for example).…”