a Psychology Applied to Health Group, Institute of Health Research , University of Exeter Medical School , Exeter , UK.
b School of Social and Community Medicine , University of Bristol , Bristol , UK.
Health Psychol Rev. 2017 Mar;11(1):33-52. doi: 10.1080/17437199.2016.1240625. Epub 2016 Nov 7.
To systematically review systematic reviews of school-based sexual-health and relationship Education (SHRE) programmes and, thereby, identify interventions and intervention components that promote reductions in risky sexual behaviour among young people.
Electronic bibliographies were searched systematically to identify systematic reviews of school-based interventions targeting sexual-health. Results were summarised using a narrative synthesis.
Thirty-seven systematic reviews (summarising 224 primary randomised controlled trials) met our inclusion and quality assessment criteria. In general, these reviews analysed distinct sets of primary studies, and no comprehensive review of available primary studies was identified. Interventions were categorised into five types that segment this review literature. Unfortunately, many reviews reported weak and inconsistent evidence of behaviour change. Nonetheless, integration of review findings generated a list of 32 design, content and implementation characteristics that may enhance effectiveness of school-based, sexual-health interventions. Abstinence-only interventions were found to be ineffective in promoting positive changes in sexual behaviour. By contrast, comprehensive interventions, those specifically targeting HIV prevention, and school-based clinics were found to be effective in improving knowledge and changing attitudes, behaviours and health-relevant outcomes.
School-based interventions targeting risky sexual behaviour can be effective. Particular design, content and implementation characteristics appear to be associated with greater effectiveness. We recommend consideration of these characteristics by designers of school-based sexual-health interventions.
系统综述基于学校的性健康和关系教育（SHRE）计划的系统评价，从而确定可促进减少年轻人危险性行为的干预措施和干预组成部分。
系统搜索电子文献目录，以确定针对性健康的基于学校的干预措施的系统评价。使用叙述性综合法总结结果。
有 37 项系统评价（总结了 224 项初级随机对照试验）符合我们的纳入和质量评估标准。总体而言，这些综述分析了不同的初级研究集，并未确定对现有初级研究的综合综述。干预措施分为五类，对本综述文献进行分类。不幸的是，许多综述报告了行为改变的证据薄弱且不一致。尽管如此，综合审查结果生成了一份可能增强基于学校的性健康干预措施有效性的 32 项设计、内容和实施特征的清单。仅禁欲干预被发现不能促进性行为的积极改变。相比之下，综合干预措施、专门针对 HIV 预防的干预措施以及基于学校的诊所被发现可有效提高知识水平并改变态度、行为和与健康相关的结果。
针对危险性行为的基于学校的干预措施可能有效。特定的设计、内容和实施特征似乎与更大的效果相关。我们建议设计者考虑这些特征在基于学校的性健康干预措施中的应用。
