Impacts of a theoretically-based teacher-delivered sex education programme (SHARE) on NHS-registered conceptions and terminations up to 5 years post intervention: an RCT in Scotland.
M Henderson1, D Wight1, G Raab2 & G Hart1
1Medical Research Council Social & Public Health Sciences Unit, Glasgow, Scotland,
2Napier University, Edinburgh, Scotland
Objectives: Despite widespread support for school sex education, there are very few large scale, long-term trials of its effects on behaviour, and hardly any that use service-based, rather than self-reported, outcomes. This paper presents the final outcomes from a RCT of a theoretically-based teacher-delivered sex education programme for 13-15 year olds in Scotland. The SHARE programme (20 session pack and five day teacher training course) was developed and carefully piloted over two years. Interim outcomes at 6 mths post intervention, average age 16.1 yrs, showed no impact on behaviour, but at this age only 1/3 of the sample reported sexual intercourse and there was 32% attrition. This paper describes the impact of the intervention on conceptions and terminations up to age 20, 4.5 yrs post intervention, as recorded by the National Health Service. The outcomes are not subject to reporting bias or attrition.
Design & Methods: Twenty-five schools in eastern Scotland were assigned by a balanced randomisation either to deliver SHARE or to continue with their existing sex education. All third year pupils in two successive years were invited to participate in the study (N=8,430). Participants were followed-up at 6 mths (N=5,854) and 2.5 yrs (N=2,864) post-intervention with self-complete questionnaires. The Information and Statistics Division of the National Health Service provided data on conception, miscarriage and termination in aggregated form for all females in the sample (N=4,196) up to the age of 20.
Results: At baseline predictors of sexual experience (parenting and socio-economic) were balanced between the arms of the trial. The achieved sample was representative of all Scottish 14 year olds in terms of social class and family composition (1991 Census). By age 20, 22% of young women had conceived, 58% of all their conceptions (1205 conceptions to 922 women) resulting in a live birth/miscarriage, and 42% a termination. Conceptions rose from 23:1000 at age 15 to 70:1000 at age 19, while the proportion of all conceptions terminated fell from 50% at 15 to 39% at 19. This paper will present analyses of outcomes by arm of the trial and by school, both ‘intention-to-treat’ and ‘on-treatment’ analyses.
Conclusions: These analyses will allow us to report (at conference) on the effect of the SHARE programme on conceptions and terminations at 4.5 yrs post-intervention. The findings will be discussed in terms of the efficacy of the programme, the extent and quality of its delivery, and possible limitations in evaluation design.