Review of reviews of school-based interventions to improve sexual health and reduce alcohol misuse

Abstract

Objective: To systematically review existing reviews of school-based sexual health education and alcohol misuse education, to summarise evidence relating to effectiveness, and to identify program elements that are effective in reducing risky behaviour. Methods: Electronic bibliographies were searched systematically. Results were pooled using a narrative synthesis. Findings: Twenty nine systematic reviews were included in the analysis. Six categories of programs were identified. Those focusing on abstinence-only are not effective in changing behaviour; however, programs that are comprehensive, promote sexual risk reduction, or target HIV can have positive impacts on knowledge, behaviour and health. We present a list of 28 factors that may increase the effectiveness of such programs. Discussion: There are very few studies of the effectiveness of programs focusing on alcohol and risky sexual behaviour. However, programs targeting risky sexual behaviour can be effective. We suggest that certain types of program can lead to changes in behaviour, and we present a list of characteristics that may facilitate this. We encourage intervention developers to consider this list when developing programs.