A Systematic Review of School-based Programs to Improve Adolescent Sexual and Reproductive Health: Considering the Role of Social Connectedness

Abstract

Schools are an important source of information about sexuality, but programs that focus on promoting knowledge alone generally have limited impact on sexual health. Schools also provide a space for relationship and social skill development, which are critical for social connectedness or a sense of belonging. Enhancing social connectedness among adolescents has been associated with improved mental health, but whether this is a beneficial strategy for sexual health is unclear. The aim of this systematic review was to determine the impact of school-based programs that promote social connectedness on adolescent sexual and reproductive health. Following a search of major databases, 18 studies of ten distinct programs were identified. Overall, improved condom use, delayed initiation of sex, and reduced pregnancy rates were demonstrated. Program effectiveness was influenced by ethnicity and gender, for example, greater improvements in condom use were often reported among African American students. Programs that were most effective incorporated multiple constructs of social connectedness, included social skill-building and had a sustained intensity. Future research should examine gender- and culture-sensitive ways to promote social connectedness, and the optimal program intensity. This review provides promising evidence that programs that promote multiple aspects of connectedness can improve adolescent sexual and reproductive health.