Health Educ. Res.
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Health Education Research Advance Access published online on September 22, 2004

Health Education Research, doi:10.1093/her/cyg120
2004 by Oxford University Press
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Articles by Wiefferink, C. H.
Articles by Paulussen, T. G. W.
Received March 4, 2004
Accepted August 12, 2004

Original article

Outcomes of a systematically designed strategy for the implementation of sex education in Dutch secondary schools

C. H. Wiefferink 1*, J. Poelman 2, M. Linthorst 3, I. Vanwesenbeeck 4, J. C. M. van Wijngaarden 5, and T. G. W. Paulussen 1

1 TNO Prevention and Health, 2301 CE Leiden, The Netherlands
2 Netherlands Foundation for STI Control, 3503 RD Utrecht, The Netherlands
3 Netherlands Institute for Health Promotion and Disease Prevention, 3440 AM Woerden, The Netherlands
4 Rutger Nisso Group, 3513 EV Utrecht, The Netherlands
5 Netherlands Association for Community Health Services, 3508 AH Utrecht, The Netherlands

* To whom correspondence should be addressed. E-mail:


This study examines the effects of a systematically designed innovation strategy on teachers' implementation of a sex education curriculum and its related determinants. A quasi-experimental group design was used to assess the effectiveness of the innovation strategy. Teachers filled in questionnaires on the determinants of curriculum implementation and kept a record of their actual use of the curriculum. We measured several determinants, including teachers' curriculum-related beliefs, characteristics of the interactive context and characteristics of the innovation strategy. Participating teachers (n = 109) carried out most of the activities they were supposed to (81%). Multiple linear regression indicated that their outcome beliefs and perceived instrumentality of the curriculum best predicted extent of use of the curriculum (R2 = 0.23). The innovation strategy had a positive impact not only on extent of use (18.4 activities versus 15.8 activities; t = 2.3, P < 0.05), but also on teachers' curriculum-related beliefs. It can be concluded that a systematically designed innovation strategy has the potential to produce significant changes in classroom-based sex-education practices. Not only did teachers exposed to the innovation strategy implement more of the curriculum than teachers in the control group, also teachers' beliefs and expectations about student learning constituting their classroom behavior changed accordingly.

Copyright 2004 by Oxford University Press.