What is best practice in school sex education?

Sex and relationship education (SRE) is regarded as vital for improving young people’s sexual health but a third of schools in England lacks good SRE and government guidance is outdated.

New research led by SPHR researchers at the University of Bristol has found clear evidence that school-based SRE and school-linked sexual health services can be effective at improving sexual health.

The study, published in BMJ Open, aimed to gather evidence about best practice in SRE and identify what makes SRE programmes effective, acceptable, sustainable and well delivered.   Professionals agreed that good programmes start in primary school, are adaptable and use a spiral curriculum model, which involves returning to the same topics to reinforce learning.

The  research found professionals and young people agreed that good SRE programmes are age-appropriate, interactive, engaging and take place in a safe and confidential 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 also backed a ‘sex-positive’ approach but reported this was currently lacking. Young people and professionals agreed that SRE should discuss risks, but young people indicated that approaches to risk need revising.

Professionals believe that teachers have a key role to play in delivering SRE but many young people disliked having their own teachers deliver SRE and the researchers found that key messages intended by SRE programmes could become lost or more negative when interpreted by teachers.

Dr Pandora Pound, the paper’s lead author and Research Fellow in Public Health Research Methodology in the School of Social and Community Medicine at the University of Bristol, said: “Our findings highlight the importance of focusing on SRE delivery as well as content. We uncovered a difference between the views of young people and professionals on how to deliver SRE, a disagreement that suggests potential conflict between the principles of acceptability and sustainability.

“However, we identified criteria for best practice based on the evidence. These criteria will be of value to those interested in developing high-quality SRE programmes to help safeguard young people and improve their sexual health. We hope that they will help to inform the forthcoming consultations around developing guidance for statutory SRE in English schools.”

The research team carried out primary research and stakeholder consultations in the UK and examined secondary research from worldwide studies. They conducted five pieces of research, several of which have already been published separately, including practitioner interviews, a case study investigation, analyses of the National Survey of Sexual Attitudes and Lifestyles [Natsal-3], a review of systematic reviews and a qualitative synthesis. The team also gained feedback on their research in stakeholder consultations.

‘What is best practice in sex and relationships education? A synthesis of evidence, including stakeholders’ views’ by Pound, P et al. in BMJ Open DOI: 10.1136/bmjopen-2016-014791