In the following sections we report the findings from consultations with school staff, students and other youth and policy stakeholders and how these informed intervention design. These are also summarised in Table 1.
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Consultation with schools
Eight staff and nine students (five girls, four boys) from year 8 (age 12-13) participated in the Positive Choices consultations. Fourteen staff and 66 students (34 girls, 32 boys) from years 9-10 (age 13-15) participated in the Project Respect consultations (Table 1).
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For both Positive Choices and Project Respect, staff and students generally confirmed the acceptability of intervention aims, approaches and components. DRV, sexual harassment and unintended teenage pregnancy were recognised as salient issues for schools to address.
With Positive Choices, the tailoring of the intervention to student needs and the student-centred approach was particularly welcomed. Several school staff, nevertheless, raised concerns about student responses being used to inform curriculum content because they felt students might be unable to foresee what they needed to learn about relationships and sex. This feedback resonated with our planned approach to ensure a core recommended set of RSE topics were covered by all schools while maintaining a level of student choice by demarcating ‘essential’ lessons, which all schools would deliver, and ‘add on’ lessons, the selection of which would be informed by student data.
Staff and students were positive about Project Respect components. Parent engagement, a classroom curriculum, hotspot-mapping and the Circle of Six app were perceived as appropriate and useful. Project Respect proposed that NSPCC would train key staff who would then cascade training to other staff. Teachers supported this approach as a means of capacity development and limiting need for training cover. However, they also highlighted that it could be difficult for schools to release even these key staff for training and that this needed to be well planned out with each participating school. The scheduling of hour-long curriculum lessons was also highlighted as a potential issue and staff suggested that there was a need for curriculum lessons to be adaptable for split delivery over shorter (usually around thirty minute) tutor-time slots or longer ‘off-timetable’ days. An element of flexibility was built into both interventions, to enable delivery in shorter lessons. However, SEF advised against recommending delivery through single ‘off timetable’ (or ‘drop-down’) days in Positive Choices, even if this might cover the full number of specified curriculum hours or be convenient for schools. Such an approach was considered inconsistent with best practice in RSE delivery where skills, competence and knowledge should be developed and revisited across time (See [55, 56], for example).
With regard to intervention materials, staff in both Positive Choices and Project Respect consultations reported that, because there was so little time for planning for RSE, manuals needed to be comprehensive, containing everything they needed to know but concise, ‘sticking to the essentials’ necessary for delivery. Similarly, teaching staff in Project Respect reported a preference for ‘plug-and-play’ curriculum materials that provided detailed lesson plans, scripts to help guide classroom discussion and PowerPoint slides, so staff with limited confidence, experience or time could deliver an effective lesson. These recommendations posed some dilemmas in Positive Choices, however, they did not align with what is recognised within the sector as best practice for delivery of quality RSE in schools (in which highly trained, competent and confident professionals develop their own curriculum and / or tailor available resources to their context and students). After some discussion, however, researchers and SEF agreed that in order to ensure quality and fidelity of delivery it was a priority that the materials fitted with what was likely to be the current reality of teaching RSE in many English secondary schools, where the subject is afforded little priority, time for preparation is limited and less experienced teachers may be required to deliver.
In contrast some staff, nevertheless, requested flexibility in the curriculum design to allow more experienced staff to adapt activities including where topics had already been covered in earlier RSE provision. Options for adaption were, therefore, built in via suggestions for additional or extension activities beyond what was specified as essential. Excluding core content on the basis it had been previously covered was to be discussed with researchers and the specialist provider and agreed on a case by case basis.
Staff reported they favoured materials provided electronically, and interactive PDF documents where they could easily locate relevant resources from live links. Both interventions were therefore designed with this in mind. A handful of participants, nevertheless, suggested that they still liked hard copies and these were made available at staff trainings.
Although for both Project Respect and Positive Choices, students suggested that RSE should be introduced before year 9 we could not reflect this in our design as this, based on earlier consultation with teachers in the initial design phase, had already become embedded in our agreed study protocols.
Students were adamant that the intervention should reflect the reality of their experiences and recognise their emerging sexuality and involvement in intimate relationships. In terms of curriculum format for Project Respect, they supported proposed pedagogical approaches including the use of role-play and small-group activities particularly for discussing sensitive topics and recreating real life scenarios. Students also indicated that it would be important to cover what might be considered ‘subtler’ or less obvious forms of abuse, such as controlling and coercive behaviours, and emotional abuse. They also highlighted the need for training on how to respond if friends disclose DRV as well as the importance of ensuring that lessons covered the role of social media in DRV and sexual harassment. Staff and students also offered a range of terms to describe DRV and relationships, and suggested that terms should be introduced and defined early in lessons. These suggestions were reflected on and incorporated into the design of curriculum materials as described in Table 2.
In Project Respect consultations students had mixed views about the acceptability of teacher-delivered RSE proposed in both interventions. Some saw benefits to delivery by staff with whom they already had trusting relationships, suggesting this could promote reporting of safeguarding issues. However, students also associated teacher-led delivery with risk of breaching student confidentiality. Lessons led by teachers with whom students had more negative relationships were perceived potentially to compromise learning. Some suggested that an external provider might allow more honest conversations and increase confidentiality. Students suggested that, most importantly, whoever taught lessons should be non-judgmental, able to respect confidentiality and engage with the ‘reality of young peoples’ lives’. Staff explained that in practice the selection of which teachers taught the lessons would largely depend on timetabling and availability.
Across both interventions, teachers proposed that involving outside specialists could usefully cover topics teachers felt ill-equipped to teach, such as sexual violence and female genital cutting/mutilation. Based on these responses for both interventions we opted to continue with teacher delivery as a potentially acceptable model to students, but with clear instruction on the selection criteria for teachers to deliver the curriculum. However, budget constraints meant that we were unable to include an option for specialist external educators to deliver parts of the curriculum in either intervention.
In consultations for both interventions, some students and staff commented that lessons discussing sensitive issues should be taught in single-sex groups. One teacher’s preference for single-sex teaching was rooted in an explicitly feminist desire to provide female students with a supportive environment for active participation, where they would not be marginalised by boys. A suggestion from some staff and students was to teach some content in single-sex classes, but bring groups together at the end of a lesson to share learning. Ultimately, in general single-sex teaching in co-educational settings was not recommended as both interventions were intended to be universal, covering the same topics for all students. Discussion of different views and perspectives across genders was also perceived to be an important part of the learning and to be more reflective of real-life encounters. Preferences to deliver in single-sex classes because of cultural or religious sensitivities were, however, to be discussed with individual schools on a case-by-case basis.
Consultation with students and staff on the most appropriate models of engaging with parents revealed that schools already had a variety of approaches, such as: sending letters home with students; communicating via email, text or social media; posts on school websites; and parent events. While it was agreed adaptable templates to send information home would be useful, participants suggested the content of parent materials should be sensitive to different home cultures and that schools were best placed to tailor these themselves. Templates for parent communication were therefore included in both interventions but precise content and mode of delivery was left to the discretion of the school.
Consultation with the ALPHA group
A total of 12 males and 10 females participated across three ALPHA consultations (Table 3).
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ALPHA members were generally supportive of the student-led social-marketing element of Positive Choices, on the grounds that student-led campaigns could ensure messaging was relevant to young people, complementing teacher-led lessons. Participants raised the importance, however, of ensuring campaigns were genuinely student-led and that messages were consistent with the programme aims. This informed our decision to ensure student-led social-marketing groups were accountable to the joint staff-student School Health Promotion Councils (SHPCs).
Participants broadly supported the parent component of the Positive Choices intervention, recognising the value of informing parents about the RSE being taught in school and involving them in supporting their children’s learning at home. Some participants, however, were more sceptical about resources (like homework assignments or newsletters) aiming to prompt conversations at home and felt that many students would avoid carrying out homework activities due to the risk of embarrassment or breaching existing child/parent boundaries. In line with SEF’s intended plan, homework activities were selected with these considerations in mind and aimed to ease into parent/child discussions at home, focussing initially on the universal, relatively less sensitive topic of ‘rites of passage’ progressing to focus on ‘abusive and healthy relationships’ in a later assignment.
In the Project Respect ALPHA consultations, participants supported the use of small group and scenario-based learning activities that enabled students to reflect on ‘real-life’ situations, and the inclusion of same-sex relationships in these. As with the student consultations, ALPHA also raised some concerns about the sensitivity of some of the Project Respect lesson plans and ensuring appropriate support for students who have experienced or witnessed DRV or other abuse. They suggested that, across lessons, greater attention to the use of online and social media in the conduct of young people’s relationships was important. These suggestions were reflected on and incorporated into the curriculum.
Consultation with practitioners and policy-makers
Twenty-three practitioner and policy-maker stakeholders from governmental and non-governmental organisations in the field of education and health attended the consultation event.
Stakeholders anticipated that one of the major challenges to implementation would be ensuring schools prioritised the interventions, given other pressures, and made suggestions to address this. These included: increased engagement with head teachers and/or senior leadership teams; dissemination of programme information to all school staff; seeking ‘buy-in’ from school governors and parents; involving local partners with long-standing relationships with schools, such as those in public-health departments or school networks; and maintaining regular contact with a named strategic lead with enough seniority to drive implementation.
Participants recommended that to ensure school commitment, the researchers should highlight what schools might gain from the interventions: free staff training to support continued professional development; specialist-designed curriculum materials; improved safeguarding procedures; meeting statutory obligations to support students’ social and emotional wellbeing; contributing to meeting national school-inspectorate criteria; and potential for improved pupil attendance and attainment.
Stakeholders also suggested signing service-level agreements with schools, highlighting expectations for intervention providers, schools and researchers. These strategies were incorporated in to the design of Positive Choices, but due to the time at which the stakeholder meeting took place, they were unable to inform Project Respect in the same way prior to piloting.