title: Evaluation of holistic sexuality education: A European expert group consensus agreement.
abstract: OBJECTIVE
  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 fulfilled 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 sufficiently 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: a * University Medical Centre, Radboud University , Nijmegen , the Netherlands.
authors.forename: Evert
authors.initials: E
authors.lastname: Ketting
authors.affiliation: b Federal Centre for Health Education (BZgA) , Cologne , Germany.
authors.forename: Minou
authors.initials: M
authors.lastname: Friele
authors.affiliation: c International Centre for Reproductive Health, Ghent University , Ghent , Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Michielsen
mesh_terms: D005060:Europe; D005069:Evaluation Studies as Topic; D005260:Female; D006694:Holistic Health / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards*; D012736:Sex Education / Q000379:methods / Q000592:standards*; D019529:Sexuality / Q000706:statistics & numerical data*
keywords: Europe; Evaluation; Indicators; Sexuality education