Effectiveness of two school sexuality education intervention approaches following health promoting school model in Taiwan

Health Promoting School (HPS hereafter) is a whole school approach, including six dimensions of policy setting, environment building, community partnership, and skill development. However, many schools ignored the importance of health education curriculum and emphasized on holding various activities instead. The purpose of the study was to investigate the effectiveness of two approaches of elementary school sexuality education interventions based on the HPS model. One implied the HPS model to develop and carry out health promotion actions without class meetings (Exp B); another had an additional component of class meetings (Exp A). Both happened at the same school settings. Nearby schools were selected for the purpose of comparison (Comp). Two experimental schools and two comparison schools, totaled 605 sixth and fifth graders participated in the study. There were 244 (56.5% boys) students in the Exp A, 208 (53.4%boys) students in the Exp B, and 153 (53.6% boys,) students in the Comp. Pre-test of sex knowledge, attitude, and intention happened in 2009. The post-test was administered three months later. Experimental schools applied HPS model to carry out various activities, including partnership with parents and NGOs. GEE analyses indicated that the improvement of total knowledge and total attitude scores from baseline was significantly higher for Exp A than for Comp (p=.000, p=.039 respectively). Exp A outscored Comp on 3 sub-knowledge and 2 sub-attitude scales. In terms of behavior intention, no significant difference was found among groups. With sufficient class meetings, the HPS model could improve students' sex knowledge as well as sex attitude effectively.