New study finds limits to what sex education can achieve
posted on: Jan 8, 2007
The final results of one of the largest and most thorough evaluations of sex education in the world were recently published in the British Medical Journal. An enhanced sex education programme known as SHARE has been found to have a positive impact on sexual health knowledge and quality of relationships, and was preferred to conventional sex education by both pupils and teachers. However, these final results show that it was no more effective than conventional sex education in reducing the number of pregnancies or abortions.
The UK has the highest level of teenage pregnancy in Western Europe, despite relatively high levels of self-reported contraceptive use. Research has shown that young people in the UK also have high rates of sexually transmitted infections and often regret their early sexual experiences.
The teacher delivered SHARE programme was designed through a collaboration between researchers at the Medical Research Council's Social and Public Health Sciences Unit and the Health Education Board for Scotland (now NHS Health Scotland). It was developed for 13-15 year olds between 1993 and 1996, and evaluated between 1996 and 2006 in a randomised controlled trial.
SHARE involved 5 days teacher training and combines active learning (e.g. small-group work and games), sexual health information leaflets and the development of skills to negotiate sexual encounters, handle condoms and access services, primarily through the use of interactive video but also role playing. The main contrast with conventional sex education was the intensive teacher training and the focus on developing skills, rather than simply providing information and discussing values.
Dr Marion Henderson, the lead MRC researcher said, "Until now, evaluations of sex education have had to rely on young people reporting their sexual behaviour, and have only followed them up for a short period. This is one of the first studies in the world that has used objective data, in this case NHS data on young women's pregnancies and abortions. It also followed-up the young women for five years after their sex education. Unfortunately, it shows that pregnancy and abortion rates in the girls who were taught using the enhanced programme were no different from rates in the control group who were given conventional school sex education."
Dr Daniel Wight, who led the overall study at the Glasgow-based MRC unit, said: "There were also positive results from the evaluation. In addition to increasing practical sexual health knowledge, the SHARE programme improved reported quality of relationships, and it had a positive influence on beliefs about alternatives to sexual intercourse."
Dr Henderson added "I think it was difficult for the SHARE programme to reduce conceptions or abortions as these are so strongly influenced by socio-economic factors. It is clear that economic circumstances still largely determine the likelihood of teenage pregnancy. To have a stronger impact on the sexual health of young people, alternative interventions should be considered. Effective sex education programmes would need to address fundamental socio-economic divisions and would also benefit from involving parents."
‘Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trial' M Henderson, D Wight, G M Raab, C Abraham, A Parkes, S Scott, G Hart is published online on the British Medical Journal website - www.bmj.com