Implementation of sexuality education: a process model

Abstract

Background: Dissemination, adoption, and implementation of interventions is slowly receiving more attention. This is also shown by the new EHPS conference track implementation research. Previously, Paulussen (1994) designed a model for the adoption of aids curricula, and Wiefferink (2005) modelled the implementation of Long Live love. The current work aims to build upon this prior knowledge through a literature review and two qualitative studies. Methods: as part of a PhD dissertation, process evaluations were carried out for two Dutch sexuality education programmes. Long Live Love – upper classes is implemented in secondary schools, and Make a Move in residential youth care. School teachers (16) were interviewed and students (60) participated in focus group discussions. Make a Move trainers (7) kept a diary (10) on implementation and were interviewed after ending programme implementation. Data collecting was followed by thematic analysis. Results: the findings show that the implementers were highly affected by the response of the audience. Positive assessment of exercises was largely shaped by students’ engagement and enthusiasm, whereas negative valuations often stemmed from students’ inability and insecurity to perform certain exercises, such as role plays. Other determinants that shaped curriculum-related beliefs included barriers, values and priorities, and to what extent Long Live Love contributed to require exam knowledge. Discussion: the results from Make a Move and Long Live Love showed similarities and differences. Combined, it has allowed for a new model on implementation, showing the importance of student response and how this determinant contributes to implementation in a feedback loop.