An online sexual and reproductive health educational program significantly improved knowledge, attitudes, and behaviours among senior primary school students in China, with improvements sustained at 16-week follow-up.
The online sexual and reproductive health education program demonstrated good adherence and content comprehension among intervention group students.
The intervention group showed significantly higher sexual and reproductive health knowledge scores compared to the control group at both post-intervention and 16-week follow-up.
The intervention group demonstrated significantly improved sexual and reproductive health attitudes compared to the control group at both time points.
The intervention group showed significantly improved sexual and reproductive health behaviours compared to the control group at both post-intervention and 16-week follow-up.
The study used a cluster randomized controlled trial design with eight classes from two primary schools in Shangqiu, Henan Province, China.
Online sexual and reproductive health education faces implementation barriers in China including untrained educators, cultural taboos, and lack of materials.
This research suggests that an online program teaching sexual and reproductive health topics to fifth and sixth grade students (around age 11) in China can meaningfully improve what students know, how they think, and how they behave regarding sexual and reproductive health. The study tested this by randomly assigning eight school classes to either receive a 9-week online program or not receive it, then measuring outcomes right after the program ended and again 16 weeks later. Students who went through the program scored significantly better on knowledge, attitudes, and behaviors related to sexual and reproductive health compared to students who did not receive the program. Importantly, the benefits did not fade quickly — improvements were still evident at the 16-week follow-up assessment. Most students (about 71%) completed the full program and scored an average of nearly 87% on comprehension tests, suggesting the program was both feasible and understandable for this age group. The study was conducted in Shangqiu, Henan Province, a setting representative of resource-constrained areas where in-person sex education is often hampered by a lack of trained teachers, cultural discomfort around the topic, and limited teaching materials. This research suggests that online delivery could be a practical way to bring standardized sexual and reproductive health education to students in areas where traditional classroom-based programs face barriers. The findings may be particularly relevant for school health nurses and administrators looking for scalable approaches to adolescent health education in similar contexts across China and potentially other low- and middle-income settings.
Guo R, Pan W, Zhao W, Zhao M, Wang J. (2025). Effectiveness of an online sexual and reproductive health educational program on knowledge, attitudes, and behaviours among senior primary school students: a cluster randomized controlled trial.. Reproductive health. https://doi.org/10.1186/s12978-025-02071-5