Evaluation of holistic sexuality education: A European expert group consensus agreement


Objectives Holistic sexuality education (HSE) is a new concept in sexuality education
(SE). Since it differs from other types of SE in a number of important respects, strategies
developed for the evaluation of the latter are not necessarily applicable to HSE. In this paper
the authors provide a basis for discussion on how to evaluate HSE.
Methods First, the international literature on evaluation of SE in general was reviewed
in terms of its applicability to HSE. Second, the European Expert Group on Sexuality Education
extensively discussed the requirements of its evaluation and suggested appropriate
indicators and methods for evaluating HSE.
Results The European experience in SE is scarcely represented in the general evaluation
literature. The majority of the literature focuses on impact and neglects programme and
implementation evaluations. Furthermore, the current literature demonstrates that evaluation
criteria predominantly focus on the public health impact, while there is not yet a consensus
on sexual well-being criteria and aspects of positive sexuality, which are crucial parts of HSE.
Finally, experimental designs are still considered the gold standard, yet several of the conditions
for their use are not fulfi lled in HSE. Realising that a new evaluation framework for
HSE is needed, the European expert group initiated its development and agreed upon a
number of indicators that provide a starting point for further discussion.
Conclusions Aside from the health impact, the quality of SE programmes and their implementation
also deserve attention and should be evaluated. To be applicable to HSE, the
evaluation criteria need to cover more than the typical public health aspects. Since they do
not register long-term and multi-component characteristics, evaluation methods such as
randomised controlled trials are not suffi ciently suitable for HSE. The evaluation design
should rely on a number of different information sources from mixed methods that are
complemented and triangulated to build a plausible case for the effectiveness of SE in general
and HSE in particular.

Authors & affiliation: 
Evert Ketting * , Minou Friele † and Kristien Michielsen ‡ ; O n behalf of the European Expert Group on Sexuality Education * University Medical Centre, Radboud University, Nijmegen, the Netherlands, † Federal Centre for Health Education (BZgA), Cologne, Germany, and ‡ International Centre for Reproductive Health, Ghent University, Ghent, Belgium
Staff Members: 
Published In: 
The European Journal of Contraception and Reproductive Health Care, 2015; Early Online: 1–13
Publication date: 
Friday, May 29, 2015