Factors affecting the implementation of a whole-school relationships and sexual health intervention: staff perspectives from trial-nested qualitative research in English secondary schools

Ponsford, Ruth, Meiksin, Rebecca, Muraleetharan, Veena, McAllister, Josephine, Tilouche, Nerissa, Melendez-Torres, G. J. ORCID: https://orcid.org/0000-0002-9823-4790, Sturgess, Jo, Opondo, Charles, Morris, Steve, Hadley, Alison, Lohan, Maria, Mercer, Catherine H., Young, Honor ORCID: https://orcid.org/0000-0003-0664-4002, Campbell, Rona, Coyle, Karin, Allen, Elizabeth and Bonell, Chris 2026. Factors affecting the implementation of a whole-school relationships and sexual health intervention: staff perspectives from trial-nested qualitative research in English secondary schools. Sex Education: Sexuality, Society and Learning 10.1080/14681811.2026.2620092

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Abstract

Whole-school relationships and sexual health interventions represent promising approaches to promoting healthy sexual development. However, data from a randomised controlled trial of the Positive Choices whole-school intervention demonstrate these may be challenging to implement in English secondary schools. We draw on qualitative data to examine staff perspectives on the implementation of the intervention and the factors affecting delivery. Interviews were conducted with 52 staff in 22 schools. Analysis was guided by May’s General Theory of Implementation, focussing on how processes of sense making, cognitive participation, collective action and reflexive monitoring were shaped by intervention capability, school capacity, and staff potential. Quality training, materials and support, alongside a strong commitment to delivery of statutory relationships and sex education promoted curriculum implementation. However, whole-school components were viewed as more challenging to implement and often beyond the ‘core business’ of schools. Successful implementation of whole-school components was facilitated by a supportive school culture, school leads having the authority to enable collective action and close alignment with school priorities and institutional processes. For whole-school interventions to succeed, sufficient time and resources must be allocated. A pragmatic approach might be to develop whole-school approaches that address health more holistically and build effectively on existing provision.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Social Sciences (Includes Criminology and Education)
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Start Date: 2026-01-28
Publisher:	Taylor and Francis Group
ISSN:	1468-1811
Date of First Compliant Deposit:	12 February 2026
Date of Acceptance:	17 January 2026
Last Modified:	12 Feb 2026 11:46
URI:	https://orca.cardiff.ac.uk/id/eprint/184720

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