SEXUAL HEALTH-EDUCATION INTERVENTIONS FOR YOUNG-PEOPLE - A METHODOLOGICAL REVIEW

Objectives-To locate reports of sexual health education interventions for young people, assess the methodological quality of evaluations, id entify the subgroup with a methodologically sound design, and assess t he evidence with respect to the effectiveness of different approaches to promoting young people's sexual health. Design-Survey of reports in English by means of electronic databases and hand searches for releva nt studies conducted in the developed world since 1982. Papers were re viewed for eight methodological qualities. The evidence on effectivene ss generated by studies meeting four core criteria was assessed. Judgm ents on effectiveness by reviewers and authors were compared. Papers-2 70 papers reporting sexual health interventions. Main outcome measure- The methodological quality of evaluations. Results-73 reports of evalu ations of sexual health interventions examining the effectiveness of t hese interventions in changing knowledge, attitudes, or behavioural ou tcomes were identified, of which 65 were separate outcome evaluations. Of these studies, 45 (69%) lacked random control groups, 44 (68%) fai led to present preintervention and 38 (59%) postintervention data, and 26 (40%) omitted to discuss the relevance of loss of data caused by d rop outs. Only 12 (18%) of the 65 outcome evaluations were judged to b e methodologically sound. Academic reviewers were more likely than aut hors to judge studies as unclear because of design faults. Only two of the sound evaluations recorded interventions which were effective in showing an impact on young people's sexual behaviour.Conclusions-The d esign of evaluations in sexual health intervention needs to be improve d so that reliable evidence of the effectiveness of different approach es to promoting young people's sexual health may be generated.