Developing the evidence-base for school sex education programmes: Contributions of an augmented Theory of Planned Behaviour, gender and school year across three contraceptive methods

Abstract

Background Positive adolescent sexual health is supported by effective school based sex education. Methods to promote positive sexual health need to reflect determinants of contraception intention, which must include understanding gender and age (year group) differences. To date, there has been limited theory-based exploration of these determinants in school-age participants, placing limitations on sexual health educators to tailor learning most effectively. MethodsCross sectional survey data was collected from UK school pupils (N = 1378) aged 12-16 years. Measures included Theory of Planned Behaviour, Prototype Willingness, anticipated regret and knowledge items. Linear regression determined significant predictors of intention to use condoms, the oral contraceptive pill and the emergency contraceptive pill. t-tests and ANOVAs were used to assess differences by gender and school year. ResultsThree distinct predictive models emerged for condom, pill and EC, predicting 36%, 18% and 23% variance respectively. Attitude, gender and anticipated regret for unprotected sex significantly predicted intention for all types (p<.001). The influence of other explanatory variables differed by contraceptive. Girls scored higher on all variables except condom intention, and intention scores peaked in year 10. ConclusionCondoms, pill and EC intention have different predictive profiles, with girls more strongly motivated and year 10 a crucial stage for intention. Social comparisons and control beliefs exert differential effects across contraceptive types whilst attitudes and anticipated regret are consistently strong influences. Findings suggest clear scope for supporting sexual health and wellbeing through modified school sex education