HEALTH EDUCATION RESEARCH

Theory & Practice

Vol.17 no.4 2002

Pages 471481

The effectiveness of school-based sex education

programs in the promotion of abstinent behavior: a
meta-analysis
Monica Silva
Abstract
This review presents the findings from controlled school-based sex education interventions
published in the last 15 years in the US. The
effects of the interventions in promoting
abstinent behavior reported in 12 controlled
studies were included in the meta-analysis. The
results of the analysis indicated a very small
overall effect of the interventions in abstinent
behavior. Moderator analysis could only be
pursued partially because of limited information
in primary research studies. Parental participation in the program, age of the participants,
virgin-status of the sample, grade level, percentage of females, scope of the implementation and
year of publication of the study were associated
with variations in effect sizes for abstinent
behavior in univariate tests. However, only
parental participation and percentage of females
were significant in the weighted least-squares
regression analysis. The richness of a metaanalytic approach appears limited by the quality
of the primary research. Unfortunately, most of
the research does not employ designs to provide
conclusive evidence of program effects. Suggestions to address this limitation are provided.

Introduction
Sexually active teenagers are a matter of serious
concern. In the past decades many school-based

Escuela de Administracion, Pontificia Universidad

Catolica de Chile, Vicuna Mackenna 4860, Santiago, Chile

Oxford University Press 2002. All rights reserved

programs have been designed for the sole purpose

of delaying the initiation of sexual activity. There
seems to be a growing consensus that schools can
play an important role in providing youth with a
knowledge base which may allow them to make
informed decisions and help them shape a healthy
lifestyle (St Leger, 1999). The school is the only
institution in regular contact with a sizable proportion of the teenage population (Zabin and Hirsch,
1988), with virtually all youth attending it before
they initiate sexual risk-taking behavior (Kirby and
Coyle, 1997).
Programs that promote abstinence have become
particularly popular with school systems in the US
(Gilbert and Sawyer, 1994) and even with the
federal government (Sexual abstinence program
has a $250 million price tag, 1997). These are
referred to in the literature as abstinence-only
or value-based programs (Repucci and Herman,
1991). Other programsdesignated in the
literature as safer-sex, comprehensive, secular or
abstinence-plus programsadditionally espouse
the goal of increasing usage of effective contraception. Although abstinence-only and safer-sex programs differ in their underlying values and
assumptions regarding the aims of sex education,
both types of programs strive to foster decisionmaking and problem-solving skills in the belief
that through adequate instruction adolescents will
be better equipped to act responsibly in the heat
of the moment (Repucci and Herman, 1991).
Nowadays most safer-sex programs encourage
abstinence as a healthy lifestyle and many
abstinence only programs have evolved into
abstinence-oriented curricula that also include
some information on contraception. For most pro-

471

M. Silva
grams currently implemented in the US, a delay
in the initiation of sexual activity constitutes a
positive and desirable outcome, since the likelihood
of responsible sexual behavior increases with age
(Howard and Mitchell, 1993).
Even though abstinence is a valued outcome of
school-based sex education programs, the effectiveness of such interventions in promoting
abstinent behavior is still far from settled. Most of
the articles published on the effectiveness of sex
education programs follow the literary format of
traditional narrative reviews (Quinn, 1986; Kirby,
1989, 1992; Visser and van Bilsen, 1994; Jacobs
and Wolf, 1995; Kirby and Coyle, 1997). Two
exceptions are the quantitative overviews by Frost
and Forrest (Frost and Forrest, 1995) and Franklin
et al. (Franklin et al., 1997).
In the first review (Frost and Forrest, 1995), the
authors selected only five rigorously evaluated sex
education programs and estimated their impact
on delaying sexual initiation. They used nonstandardized measures of effect sizes, calculated
descriptive statistics to represent the overall effect
of these programs and concluded that those
selected programs delayed the initiation of sexual
activity. In the second review, Franklin et al.
conducted a meta-analysis of the published
research of community-based and school-based
adolescent pregnancy prevention programs and
contrary to the conclusions forwarded by Frost and
Forrest, these authors reported a non-significant
effect of the programs on sexual activity (Franklin
et al., 1997).
The discrepancy between these two quantitative
reviews may result from the decision by Franklin
et al. to include weak designs, which do not allow
for reasonable causal inferences. However, given
that recent evidence indicates that weaker designs
yield higher estimates of intervention effects
(Guyatt et al., 2000), the inclusion of weak designs
should have translated into higher effects for the
Franklin et al. review and not smaller. Given the
discrepant results forwarded in these two recent
quantitative reviews, there is a need to clarify the
extent of the impact of school-based sex education

472

in abstinent behavior and explore the specific

features of the interventions that are associated to
variability in effect sizes.

Purpose of the study

The present study consisted of a meta-analytic
review of the research literature on the effectiveness of school-based sex education programs in the
promotion of abstinent behavior implemented in the
past 15 years in the US in the wake of the AIDS
epidemic. The goals were to: (1) synthesize the
effects of controlled school-based sex education
interventions on abstinent behavior, (2) examine the
variability in effects among studies and (3) explain
the variability in effects between studies in terms of
selected moderator variables.

Literature search and selection

criteria
The first step was to locate as many studies
conducted in the US as possible that dealt with
the evaluation of sex education programs and
which measured abstinent behavior subsequent to
an intervention.
The primary sources for locating studies were
four reference database systems: ERIC, PsychLIT,
MEDLINE and the Social Science Citation Index.
Branching from the bibliographies and reference
lists in articles located through the original search
provided another source for locating studies.
The process for the selection of studies was
guided by four criteria, some of which have been
employed by other authors as a way to orient and
confine the search to the relevant literature (Kirby
et al., 1994). The criteria to define eligibility of
studies were the following.
(1) Interventions had to be geared to normal
adolescent populations attending public or
private schools in the US and report on some
measure of abstinent behavior: delay in the
onset of intercourse, reduction in the frequency
of intercourse or reduction in the number
of sexual partners. Studies that reported on

The effectiveness of school-based sex education programs

interventions designed for cognitively
handicapped, delinquent, school dropouts,
emotionally disturbed or institutionalized
adolescents were excluded from the present
review since they address a different
population with different needs and
characteristics. Community interventions
which recruited participants from clinical or
out-of-school populations were also eliminated
for the same reasons.
(2) Studies had to be either experimental or quasiexperimental in nature, excluding three designs
that do not permit strong tests of causal
hypothesis: the one group post-test-only
design, the post-test-only design with nonequivalent groups and the one group pre-test
post-test design (Cook and Campbell, 1979).
The presence of an independent and
comparable no intervention control group
in demographic variables and measures of
sexual activity in the baselinewas required
for a study to be included in this review.
(3) Studies had to be published between January
1985 and July 2000. A time period restriction
was imposed because of cultural changes that
occur in societysuch as the AIDS
epidemicwhich might significantly impact
the adolescent cohort and alter patterns of
behavior and consequently the effects of sex
education interventions.
(4) Studies had to be published in a peer-reviewed
journal. The reasons for this criterion are
3-fold. First, there have been many reports
published in newspapers or advocacy
newsletters claiming that specific sex
education programs have a dramatic impact
on one or more outcome variables, yet when
these reports have been investigated, they
often were found lacking in valid empirical
evidence (Kirby et al., 1994; Frost and Forrest,
1995). Second, unpublished studies are hard to
locate and the quality of unpublished research
makes it doubtful whether the cost involved
in undertaking retrieval procedures is worth
investing. This is not to say that all conference
papers are defective or all journal articles are

free of weaknesses. However, regardless of

varying standards of review rigor and
publication criteria between journals,
published articles have at least survived some
form of a refereeing and editing process
(Dunkin, 1996). Finally, an added advantage
of including only published articles is that it
helps reduce the risk of data dependence. The
probability of duplication of studies is likely
to be increased when including dissertation
and papers presented at conferences, which
often constitute previous drafts to published
studies. Even considering only published
studies, it may be difficult to detect duplication.
The same data set, or a subset of it, may be
repeatedly used in several studies, published in
different journals, with different main authors,
and without any reference to the original data
source. Published studies which were known
or suspected to have employed the same
database were only included once.1

Coding of the studies for exploration

of moderators
The exploration of study characteristics or features
that may be related to variations in the magnitude
of effect sizes across studies is referred to as
moderator analysis. A moderator variable is one
that informs about the circumstances under which
the magnitude of effect sizes vary (Miller and
Pollock, 1994). The information retrieved from the
articles for its potential inclusion as moderators in
the data analysis was categorized in two domains:
demographic characteristics of the participants in
the sex education interventions and characteristics
of the program.
Demographic characteristics included the following variables: the percentages of females, the
percentage of whites, the virginity status of
participants, mean (or median) age and a categorization of the predominant socioeconomic status
of participating subjects (low or middle class) as
reported by the authors of the primary study.
In terms of the characteristics of the programs,
the features coded were: the type of program

473

M. Silva
(whether the intervention was comprehensive/safersex or abstinence-oriented), the type of monitor who
delivered the intervention (teacher/adult monitor or
peer), the length of the program in hours, the scope of
the implementation (large-scale versus small-scale
trial), the time elapsed between the intervention and
the post-intervention outcome measure (expressed
as number of days), and whether parental participation (beyond consent) was a component of the intervention.
The type of sex education intervention was
defined as abstinence-oriented if the explicit aim
was to encourage abstinence as the primary method
of protection against sexually transmitted diseases
and pregnancy, either totally excluding units on contraceptive methods or, if including contraception,
portraying it as a less effective method than abstinence. An intervention was defined as comprehensive
or safer-sex if it included a strong component on
the benefits of use of contraceptives as a legitimate
alternative method to abstinence for avoiding
pregnancy and sexually transmitted diseases.
A study was considered to be a large-scale trial
if the intervention group consisted of more than
500 students.
Finally, year of publication was also analyzed
to assess whether changes in the effectiveness of
programs across time had occurred.
The decision to record information on all the
above-mentioned variables for their potential role
as moderators of effect sizes was based in part
on theoretical considerations and in part on the
empirical evidence of the relevance of such variables
in explaining the effectiveness of educational interventions. A limitation to the coding of these and of
other potentially relevant and interesting moderator
variables was the scantiness of information provided
by the authors of primary research. Not all studies
described the features of interest for this metaanalysis. For parental participation, no missing
values were present because a decision was made to
code all interventions which did not specifically
report that parents had participatedeither through
parentyouth sessions or homework assignments
as non-participation. However, for the rest of the
variables, no similar assumptions seemed appro-

474

priate, and therefore if no pertinent data were

reported for a given variable, it was coded as missing
(see Table I).

Decisions related to the computation of

effect sizes
Once the pool of studies which met the inclusion
criteria was located, studies were examined in an
attempt to retrieve the size of the effect associated
with each intervention. Since most of the studies did
not report any effect size, it had to be estimated
based on the significance level and inferential
statistics with formulae provided by Rosenthal
(Rosenthal, 1991) and Holmes (Holmes; 1984).
When provided, the exact value for the test statistic
or the exact probability was used in the calculation
of the effect size.
In order to avoid data dependence, a conservative
strategy of including only one finding per study was
employed in this review. When multiple variations
of interventions were tested, the effect size was
calculated for the most successful of the treatment
groups. This decision rests on the assumption that
should the program be implemented in the future,
the most effective mode of intervention would be
chosen. Similarly, to ensure the independence of the
data in the case of follow-up studies when multiple
measurements were reported across time a single
estimate of effect size was included.2
Analyses of the effect sizes were conducted
utilizing the D-STAT software (Johnson, 1989). The
sample sizes used for the overall effect size analysis
corresponded to the actual number used to estimate
the effects of interest, which was often less than the
total sample of the study. Occasionally the actual
sample sizes were not provided by the authors of
primary research, but could be estimated from the
degrees of freedom reported for the statistical tests.
The effect sizes were calculated from means and
pooled standard deviations, t-tests, 2, significance
levels or from proportions, depending on the nature
of the information reported by the authors of primary
research. As recommended by Rosenthal, if results
were reported simply as being non-significant a
conservative estimate of the effect size was included,

The effectiveness of school-based sex education programs

Table I. Description of moderator variables
Categorical predictor

Continuous predictors
Valid n

Socioeconomic status
low
middle
Type of program
comprehensive
abstinence-oriented
Type of monitor
teacher/adult
peer
Virginity status
virgins-only
all (virgins non-virgins)
Parental participation
yes
no
Scope of the implementation
large scale
small scale

8
5
3
12
8
4
11
9
2
12
6
6
12
2
10
12
7
5

Valid n

Mean

SD

Min

Max

percent of females

11

54

40

66

percent of whites

12

39

33

93

14

1.5

12

16

length of the program 12

10

7.4

age

timing of post-test

assuming P 0.50, which corresponds to an effect

size of zero (Rosenthal, 1991). The overall measure
of effect size reported was the corrected d statistic
(Hedges and Olkin, 1985). These authors recommend this measure since it does not overestimate
the population effect size, especially in the case
when sample sizes are small.
The homogeneity of effect sizes was examined to
determine whether the studies shared a common
effect size. Testing for homogeneity required the
calculation of a homogeneity statistic, Q. If all
studies share the same population effect size, Q
follows an asymptotic 2 distribution with k 1
degrees of freedom, where k is the number of effect
sizes. For the purposes of this review the probability
level chosen for significance testing was 0.10, due
to the fact that the relatively small number of effect
sizes available for the analysis limits the power to
detect actual departures from homogeneity. Rejection of the hypothesis of homogeneity signals that
the group of effect sizes is more variable than one
would expect based on sampling variation and that
one or more moderator variables may be present
(Hall et al., 1994).

10

221

218

4.5

30

540

To examine the relationship between the study

characteristics included as potential moderators and
the magnitude of effect sizes, both categorical and
continuous univariate tests were run. Categorical
tests assess differences in effect sizes between subgroups established by dividing studies into classes
based on study characteristics. Hedges and Olkin
presented an extension of the Q statistic to test for
homogeneity of effect sizes between classes (QB)
and within classes (QW) (Hedges and Olkin,
1985). The relationship between the effect sizes
and continuous predictors was assessed using a
procedure described by Rosenthal and Rubin which
tests for linearity between effect sizes and predictors
(Rosenthal and Rubin, 1982).
A weighted least-squares regression analysis was
conducted to test the joint effect of the significant
moderators on the effect sizes. The results of the
univariate analyses were used to select the predictors
to be included in the model. Categorical predictors
were included as dummy variables. All predictors
were entered simultaneously. Significance of each
regression coefficient was tested using a z-test where
the standard errors in the output of SPSS were

475

M. Silva
Table II. Effect sizes of studies
Study

Effect
size (di)

Brown et al. (1991)

0.00
Denny et al. (1999)
0.00
Howard and McCabe (1990)
0.59
Jorgensen (1991)
0.49
Kirby et al. (1991)
0.19
Kirby et al. (1997a)
0.05
Kirby et al. (1997b)
0.0
Main et al. (1994)
0.03
ODonnell et al. (1999)
0.21
Roosa and Christopher (1990) 0.00
Walter and Vaughan (1993) 0.05
Weeks et al. (1995)
0.00
Overall effect size (d)
0.05

95% CI for di
Lower

Upper

0.11
0.13
0.36
0.07
0.00
0.03
0.10
0.13
0.02
0.23
0.21
0.09
0.01

0.11
0.13
0.82
0.91
0.38
0.14
0.10
0.18
0.40
0.23
0.11
0.09
0.09

adjusted by a factor of the square root of the mean

square error for the regression model (Hedges and
Olkin, 1985). Model specification was tested using
the QE goodness-of-fit statistic.3

Results
The search for school-based sex education interventions resulted in 12 research studies that complied
with the criteria to be included in the review and for
which effect sizes could be estimated.
The overall effect size (d) estimated from these
studies was 0.05 and the 95% confidence interval
about the mean included a lower bound of 0.01
to a high bound of 0.09, indicating a very minimal
overall effect size. Table II presents the effect size
of each study (di) along with its 95% confidence
interval and the overall estimate of the effect size.
Homogeneity testing indicated the presence of variability among effect sizes (Q(11) 35.56; P
0.000).
Among the set of categorical predictors studied,
parental participation in the program, virginity status
of the sample and scope of the implementation were
statistically significant.4
Parental participation appeared to moderate the
effects of sex education on abstinence as indicated
by the significant Q test between groups (QB(1)
5.06; P 0.025), as shown in Table III. Although

476

small in magnitude (d 0.24), the point estimate

for the mean weighted effect size associated with
programs with parental participation appears substantially larger than the mean associated with those
where parents did not participate (d 0.04). The
confidence interval for parent participation does not
include zero, thus indicating a small but positive
effect. Controlling for parental participation appears
to translate into homogeneous classes of effect sizes
for programs that include parents, but not for those
where parents did not participate (QW(9) 28.94;
P 0.001) meaning that the effect sizes were not
homogeneous within this class.
Virginity status of the sample was also a significant predictor of the variability among effect sizes
(QB(1) 3.47; P 0.06). The average effect size
calculated for virgins-only was larger than the one
calculated for virgins and non-virgins (d 0.09 and
d 0.01, respectively). Controlling for virginity
status translated into homogeneous classes for
virgins and non-virgins although not for the virginsonly class (QW(5) 27.09; P 0.000).
The scope of the implementation also appeared
to moderate the effects of the interventions on
abstinent behavior. The average effect size calculated for small-scale intervention was significantly
higher than that for large-scale interventions (d
0.26 and d 0.01, respectively). The effects
corresponding to the large-scale category were
homogeneous but this was not the case for the
small-scale class, where heterogeneity was detected
(QW(4) 14.71; P 0.01)
For all three significant categorical predictors,
deletion of one outlier (Howard and McCabe,
1990) resulted in homogeneity among the effect
sizes within classes.
Univariate tests of continuous predictors
showed significant results in the case of percentage
of females in the sample (z 2.11; P 0.04),
age of participants (z 1.67; P 0.09), grade
(z 1.80; P 0.07) and year of publication
(z 2.76; P 0.006).
All significant predictors in the univariate
analysiswith the exception of grade which had
a very high correlation with age (r 0.97; P
0.000)were entered into a weighted least-squares

The effectiveness of school-based sex education programs

Table III. Tests of categorical moderators for abstinence
Variable and class

Between-classes
effect (QB)

Mean weighted
effect size

95% CI for di
Lower

Parent participation
yes
no
Virginity status
virgins-only
all
Scope of implementation
Small scale
Large scale
*P

Upper

Homogeneity
within each class
(QW)a

5.06**
2
10

0.24
0.04

0.07
0.00

0.42
0.08

1.6
28.9***

6
6

0.09
0.01

0.03
0.04

0.14
0.07

27.09***
5.03

5
7

0.26
0.01

0.16
0.03

0.36
0.05

14.71**
1.73

3.47*

19.16***

0.10;**P 0.05***; P 0.01

indicates rejection of hypothesis of homogeneity.

aSignificance

Table IV. Weighted least-squares regression and test of model

specification
Predictor

SE

Parent participationa
Percent females
Constant
R2
QEb

0.22**
0.02**
0.89
0.28
18.8**

0.09
0.01
0.47

0.10; **P 0.05; ***P 0.01.

participation: yes coded as 1; no coded 0.
bSignificance signals incorrect model specification.
*P

aParent

regression analysis. In general, the remaining set

of predictors had a moderate degree of intercorrelation, although none of the coefficients
were statistically significant.
In the weighted least-squares regression analysis,
only parental participation and the percentage of
females in the study were significant. The twopredictor model explained 28% of the variance in
effect sizes. The test of model specification yielded
a significant QE statistic suggesting that the twopredictor model cannot be regarded as correctly
specified (see Table IV).

Discussion
This review synthesized the findings from controlled sex education interventions reporting on

abstinent behavior. The overall mean effect size

for abstinent behavior was very small, close to
zero. No significant effect was associated to the
type of intervention: whether the program was
abstinence-oriented or comprehensivethe source
of a major controversy in sex educationwas not
found to be associated to abstinent behavior. Only
two moderatorsparental participation and percentage of femalesappeared to be significant in
both univariate tests and the multivariable model.
Although parental participation in interventions
appeared to be associated with higher effect sizes
in abstinent behavior, the link should be explored
further since it is based on a very small number
of studies. To date, too few studies have reported
success in involving parents in sex education
programs. Furthermore, the primary articles
reported very limited information about the
characteristics of the parents who took part in
the programs. Parents who were willing to participate might differ in important demographic or
lifestyle characteristics from those who did not
participate. For instance, it is possible that the
studies that reported success in achieving parental
involvement may have been dealing with a larger
percentage of intact families or with parents that
espoused conservative sexual values. Therefore, at
this point it is not possible to affirm that parental
participation per se exerts a direct influence in the
outcomes of sex education programs, although
clearly this is a variable that merits further study.

477

M. Silva
Interventions appeared to be more effective
when geared to groups composed of younger
students, predominantly females and those who
had not yet initiated sexual activity. The association
between gender and effect sizeswhich appeared
significant both in the univariate and multivariable
analysesshould be explored to understand why
females seem to be more receptive to the abstinence
messages of sex education interventions.
Smaller-scale interventions appeared to be more
effective than large-scale programs. The larger
effects associated to small-scale trials seems worth
exploring. It may be the case that in large-scale
studies it becomes harder to control for confounding variables that may have an adverse impact
on the outcomes. For example, large-scale studies
often require external agencies or contractors to
deliver the program and the quality of the delivery
of the contents may turn out to be less than optimal
(Cagampang et al., 1997).
Interestingly there was a significant change in
effect sizes across time, with effect sizes appearing
to wane across the years. It is not likely that this
represents a decline in the quality of sex education
interventions. A possible explanation for this trend
may be the expansion of mandatory sex education in the US which makes it increasingly difficult
to find comparison groups that are relatively
unexposed to sex education. Another possible line
of explanation refers to changes in cultural mores
regarding sexuality that may have occurred in
the past decadescharacterized by an increasing
acceptance of premarital sexual intercourse, a proliferation of sexualized messages from the media
and increasing opportunities for sexual contact in
adolescencewhich may be eroding the attainment
of the goal of abstinence sought by educational
interventions.
In terms of the design and implementation of
sex education interventions, it is worth noting
that the length of the programs was unrelated to
the magnitude in effect sizes for the range of 4.5
30 h represented in these studies. Program length
which has been singled out as a potential explanation for the absence of significant behavioral effects
in a large-scale evaluation of a sex education

478

program (Kirby et al., 1997a)does not appear to

be consistently associated with abstinent behavior.
The impact of lengthening currently existing programs should be evaluated in future studies.
As it has been stated, the exploration of moderator variables could be performed only partially
due to lack of information on the primary research
literature. This has been a problem too for other
reviewers in the field (Franklin et al., 1997). The
authors of primary research did not appear to
control for nor report on the potentially confounding influence of numerous variables that have
been indicated in the literature as influencing sexual
decision making or being associated with the
initiation of sexual activity in adolescence such as
academic performance, career orientation, religious
affiliation, romantic involvement, number of
friends who are currently having sex, peer norms
about sexual activity and drinking habits, among
others (Herold and Goodwin, 1981; Christopher
and Cate, 1984; Billy and Udry, 1985; Roche,
1986; Coker et al., 1994; Kinsman et al., 1998;
Holder et al., 2000; Thomas et al., 2000). Even
though randomization should take care of differences in these and other potentially confounding
variables, given that studies can rarely assign
students to conditions and instead assign
classrooms or schools to conditions, it is advisable
that more information on baseline characteristics
of the sample be utilized to establish and substantiate the equivalence between the intervention and
control groups in relevant demographic and lifestyle characteristics.
In terms of the communication of research
findings, the richness of a meta-analytic approach
will always be limited by the quality of the primary
research. Unfortunately, most of the research in
the area of sex education do not employ experimental or quasi-experimental designs and thus fall
short of providing conclusive evidence of program
effects. The limitations in the quality of research
in sex education have been highlighted by several
authors in the past two decades (Kirby and
Baxter, 1981; Card and Reagan, 1989; Kirby, 1989;
Peersman et al., 1996). Due to these deficits in the
quality of researchwhich resulted in a reduced

The effectiveness of school-based sex education programs

number of studies that met the criteria for inclusion
and the limitations that ensued for conducting a
thorough analysis of moderatorsthe findings of
the present synthesis have to be considered merely
tentative. Substantial variability in effect sizes
remained unexplained by the present synthesis,
indicating the need to include more information
on a variety of potential moderating conditions
that might affect the outcomes of sex education
interventions.
Finally, although it is rarely the case that a metaanalysis will constitute an endpoint or final step in
the investigation of a research topic, by indicating
the weaknesses as well as the strengths of the
existing research a meta-analysis can be a helpful
aid for channeling future primary research in a
direction that might improve the quality of
empirical evidence and expand the theoretical
understanding in a given field (Eagly and Wood,
1994). Research in sex education could be greatly
improved if more efforts were directed to test
interventions utilizing randomized controlled trials,
measuring intervening variables and by a more
careful and detailed reporting of the results. Unless
efforts are made to improve on the quality of the
research that is being conducted, decisions about
future interventions will continue to be based on
a common sense and intuitive approach as to
what might work rather than on solid empirical
evidence.

Notes
1. Five pairs of publications were detected which may have
used the same database (or two databases which were likely
to contain non-independent cases) (Levy et al., 1995/Weeks
et al., 1995; Barth et al., 1992/Kirby et al., 1991/Christoper
and Roosa, 1990/Roosa and Christopher, 1990 and
Jorgensen, 1991/Jorgensen et al., 1993). Only one effect
size from each pair of articles was included to avoid the
possibility of data dependence.
2. Alternative methods to deal with non-independent effect
sizes were not employed since these are more complex and
require estimates of the covariance structure among the
correlated effect sizes. According to Matt and Cook such
estimates may be difficultif not impossibleto obtain
due to missing information in primary studies (Matt and
Cook, 1994).
3. QE provides the test for model specification, when the
number of studies is larger than the number of predictors.

Under those conditions, QE follows an approximate 2

distribution with k p 1 degrees of freedom, where k is
the number of effect sizes and p is the number of regressors
(Hedges and Olkin, 1985).
4. An assessment of interaction effects among significant
moderators could not be explored since it would have
required partitioning of the studies according to a first
variable and testing of the second within the partitioned
categories. The limited number of effect sizes precluded
such analysis.

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Received on April 24, 2001; accepted on July 3, 2001

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