Suchergebnisse

Proponents of animal research claim that the benefits to humans are self evident.1 However, writing in The BMJ 10 years ago we argued that such uncorroborated claims were inadequate in an era of evidence based medicine.2 At that time over two thirds of UK government and charitable investment was going into basic research,3 perhaps creating an expectation that such research was highly productive of clinical benefits. However, when we searched for systematic evidence to support claims about the clinical benefits of animal research we identified only 25 systematic reviews of animal experiments, and these raised serious doubts about the design, quality, and relevance of the included studies. As our colleagues had done earlier,4 we argued the case that systematic reviews should be extensively adopted within animal research to synthesise and appraise findings, just as they are in clinical research.

Objectives: Although sex and relationship education (SRE) represents a key strand in policies to safeguard young people and improve their sexual health it currently lacks statutory status, government guidance is outdated and a third of UK schools has poor quality SRE. We aimed to investigate whether current provision meets young people's needs. Design: Synthesis of qualitative studies of young people's views of their school-based SRE. Setting: Eligible studies originated from the UK, Ireland, USA, Australia, New Zealand, Canada, Japan,Iran, Brazil and Sweden. Participants Studies of students aged 4-19 in full-time education, young adults ≤ 19 (not necessarily in full-time education), or adults ≤ 25 if recalling their experiences of school-based SRE. Results: Sixty nine publications were identified, with 55 remaining after quality appraisal (representing 48 studies). The synthesis found that although sex is a potent and potentially embarrassing topic, schools appear reluctant to acknowledge this and attempt to teach SRE in the same way as other subjects. Young people report feeling vulnerable in SRE, with young men anxious to conceal sexual ignorance and young women risking sexual harassment if they participate. Schools appear to have difficulty accepting that some young people are sexually active, leading to SRE that is out of touch with many young people's lives. Young people report that SRE can be negative, gendered and heterosexist. They expressed dislike of their own teachers delivering SRE due to blurred boundaries, lack of anonymity, embarrassment and poor training. Conclusions: SRE should be 'sex-positive' and delivered by experts who maintain clear boundaries with students. Schools should acknowledge that sex is a special subject with unique challenges, as well as the fact and range of young people's sexual activity, otherwise young people will continue to disengage from SRE and opportunities for safeguarding and improving their sexual health will be reduced.

Objectives Sex and relationship education (SRE) is regarded as vital for improving young people's sexual health but a third of schools in England lacks good SRE and government guidance is outdated. We aimed to identify what makes SRE programmes effective, acceptable, sustainable and capable of faithful implementation. Design Synthesis of findings from five research packages that we conducted (practitioner interviews; case study investigation; National Survey of Sexual Attitudes and Lifestyles [Natsal-3]; review of reviews; qualitative synthesis). We also gained feedback on our research from stakeholder consultations. Settings Primary research and stakeholder consultations were conducted in the UK. Secondary research draws on studies worldwide. Results Our findings indicate that school-based SRE and school-linked sexual health services can be effective at improving sexual health. We found professional consensus that good programmes start in primary school. Professionals and young people agreed that good programmes are age-appropriate, interactive and take place in a safe environment. Some young women reported preferring single-sex classes but young men appeared to want mixed classes. Young people and professionals agreed that SRE should take a 'life skills' approach and not focus on abstinence. Young people advocated a 'sex-positive' approach but reported this was lacking. Young people and professionals agreed that SRE should discuss risks, but young people indicated that approaches to risk need revising. Professionals felt teachers should be involved in SRE delivery but many young people reported disliking having their teachers deliver SRE and key messages could become lost when interpreted by teachers. The divergence between young people and professionals was echoed by stakeholders. We developed criteria for best practice based on the evidence. Conclusions We identified key features of effective and acceptable SRE. Our best practice criteria can be used to evaluate existing programmes, contribute to the development of new programmes and inform consultations around statutory SRE.

OBJECTIVES: Sex and relationship education (SRE) is regarded as vital to improving young people's sexual health, but a third of schools in England lacks good SRE and government guidance is outdated. We aimed to identify what makes SRE programmes effective, acceptable, sustainable and capable of faithful implementation. DESIGN: This is a synthesis of findings from five research packages that we conducted (practitioner interviews, case study investigation, National Survey of Sexual Attitudes and Lifestyles, review of reviews and qualitative synthesis). We also gained feedback on our research from stakeholder consultations. SETTINGS: Primary research and stakeholder consultations were conducted in the UK. Secondary research draws on studies worldwide. RESULTS: Our findings indicate that school-based SRE and school-linked sexual health services can be effective at improving sexual health. We found professional consensus that good programmes start in primary school. Professionals and young people agreed that good programmes are age-appropriate, interactive and take place in a safe environment. Some young women reported preferring single-sex classes, but young men appeared to want mixed classes. Young people and professionals agreed that SRE should take a 'life skills' approach and not focus on abstinence. Young people advocated a 'sex-positive' approach but reported this was lacking. Young people and professionals agreed that SRE should discuss risks, but young people indicated that approaches to risk need revising. Professionals felt teachers should be involved in SRE delivery, but many young people reported disliking having their teachers deliver SRE and we found that key messages could become lost when interpreted by teachers. The divergence between young people and professionals was echoed by stakeholders. We developed criteria for best practice based on the evidence. CONCLUSIONS: We identified key features of effective and acceptable SRE. Our best practice criteria can be used to evaluate existing programmes, contribute to the development of new programmes and inform consultations around statutory SRE.