Speakers
Description
Authors: Rebecca Meiksin, Ruth Ponsford, Veena Muraleetharan, Josephine McAllister, Alison Hadley, GJ Melendez-Torres, Maria Lohan, Catherine Mercer, Honor Young, Rona Campbell, Karin Coyle, Steve Morris, Elizabeth Allen, Chris Bonell
Background: Young people in the UK are at disproportionate risk of STIs and experience high rates of adolescent pregnancy and dating violence. Effects of classroom-only relationships and sex education are inconsistent, but emerging evidence suggests that a ‘whole-school’ approach might be more effective. We conducted the first study of student acceptability and engagement of a whole-school sexual health intervention for secondary schools in England.
Methods: Intervention schools within a fifty-school randomised controlled trial delivered Positive Choices. This two-year intervention comprised year-9 and year-10 lessons, a student-staff School Health Promotion Council and additional whole-school components. Purposively sampling by involvement, gender and ethnicity, we invited intervention-school students focus group discussions (FGDs) each year. We transcribed and thematically analysed FGD data.
Results: We conducted 40 FGDs across 19 schools involving 135-150 per year. Accounts suggest that students found lessons acceptable and thought RSE was important in schools but were dissatisfied where teachers did not seem comfortable with, knowledgeable about or committed to lessons. Classroom discussions were the most valued and enjoyable aspect of the programme. These allowed students to express themselves and learn from others, particularly across genders. Where teachers curtailed discussion, this undermined acceptability and engagement. In some schools, limited space for exploring critical viewpoints could undermine boys’ participation. Boys could also feel targeted or blamed when they felt lessons framed males in a primarily negative light. When well-implemented by staff, whole-school elements were acceptable and valued by students involved. However, overall awareness of these was low.
Discussion: Our study suggests that Positive Choices was acceptable to students and that classroom discussions were particularly engaging. Whole-school elements were acceptable but required strong staff leadership. Lessons should be delivered by expert staff who are committed to sex education, prepared to foster an open and non-judgmental environment and skilled in facilitating sensitive discussions.
| Conflict of interest | The authors declare no conflicts of interest. |
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