Engagement with and acceptability of a school-based relationships and sexual health intervention: student perspectives from trial-nested qualitative research in English secondary schools

Meiksin, Rebecca, Ponsford, Ruth, Muraleetharan, Veena, McAllister, Josephine, Lohan, Maria, Tilouche, Nerissa, Melendez-Torres, G. J. ORCID: https://orcid.org/0000-0002-9823-4790, Hadley, Alison, Mercer, Catherine H., Young, Honor ORCID: https://orcid.org/0000-0003-0664-4002, Campbell, Rona, Coyle, Karin, Morris, Stephen, Opondo, Charles, Sturgess, Joanna, Allen, Elizabeth and Bonell, Chris 2026. Engagement with and acceptability of a school-based relationships and sexual health intervention: student perspectives from trial-nested qualitative research in English secondary schools. Sexuality Research and Social Policy 10.1007/s13178-026-01428-0

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Abstract

Introduction Evidence suggests that school-based relationships and sex education plus school-level actions may be effective in promoting sexual health. We conducted a trial of a relationships and sexual-health intervention in English secondary schools. We draw on nested qualitative research to explore student engagement and acceptability. Methods Twenty-four intervention schools participating in a randomised trial delivered a two-year programme aiming to comprise classroom lessons for year 9 and 10 students (aged 13–15 years), alongside school-level actions (e.g. student-led campaigns and reviews of sexual health services), although implementation fidelity of the latter was poor. We conducted 40 student focus groups across 19 intervention schools and analysed these thematically. Results Lesson acceptability was high but undermined when teachers appeared uncomfortable, uncommitted or insufficiently knowledgeable. Students valued that class discussions allowed them to express themselves and learn from others, particularly across genders. This was compromised where teachers curtailed dialogue. Boys could feel targeted where they were positioned as responsible for problem behaviours. Awareness of school-level elements was low, but students involved valued these when well-implemented. Conclusions Although relationships and sex education is now mandatory in schools in England, gaps in provision remain with regard to schools’ capacity to implement good-quality relationships and sex education.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Social Sciences (Includes Criminology and Education) Schools > School of Social and Spatial Sciences Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Publisher:	Springer
ISSN:	1868-9884
Date of First Compliant Deposit:	12 October 2026
Date of Acceptance:	1 October 2026
Last Modified:	12 Oct 2026 15:15
URI:	https://orca.cardiff.ac.uk/id/eprint/190174

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