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By S.N. Nyeck Marc Epprecht - S.N. Nyeck Marc Epprecht

The PRISMA guidelines are a well-accepted tool for systematic reviews and meta-analyses, they provide a valuable overview on how to structure the research process and help authors to account for transparency, validity and reproducibility. The search string included two components: We used Boolean search operators, parentheses, search fields and asterisk according to the database specifications.

Furthermore, we screened reference lists and citations of included articles to identify additional relevant studies. These documents are also available under Supplementary Materials. We only included studies meeting the following eligibility criteria:. Two independent reviewers CB and GL gradually screened all the titles and abstracts of studies identified for eligibility according to the criteria. Based on given information within the titles and abstracts, we made decisions about inclusion or exclusion.


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For studies that looked as if they would fulfil the inclusion criteria, we screened the full texts. If insufficient information was given in the abstract in order to make a clear exclusion decision, the full text was also screened. Any disagreements between reviewers were resolved by discussion.

Sexual Diversity in Africa S.N. Nyeck Marc Epprecht McGill-Queen's Press - MQUP

Both reviewers carefully documented their results after each step. We contacted the corresponding authors of 30 studies and requested additional information about the intervention and analyses procedures.

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Both reviewers screened the reference lists and citations of included studies listed in Scopus using the same procedure to identify additional relevant studies. For each included study, we extracted data using a piloting form in respect to the required items. When essential information was not available from the full texts, we asked the corresponding authors to provide more information. Options for statistical quantitative analyses, including, risk ratios and standardised mean differences, were limited due to the heterogeneity of study designs, the range of measured outcomes and the overall small number of included studies.

We therefore firstly provide a flow chart on the search and selection process and three tables presenting the main descriptive characteristics as well as the reported main outcomes of the included studies. Secondly, we qualitatively describe the most important outcomes of the studies in a narrative synthesis.


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Thirdly, we present results of the methodological quality assessment of included studies both in tables and narrative text. Two reviewers CB and GL assessed the methodological quality of included studies. Additionally, one more independent reviewer FM had to specifically evaluate one article [ 23 ] which had been included in the review, due to the authorship of GL and UD who are part of the review team.

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Any disagreements between the reviewers were resolved through discussion and by referring to a third reviewer UD. Both tools were used for studies using quantitative, as well as qualitative, methods. For each tool, an overall rating was conducted based on the given assessment criteria. Quantitative studies were rated on 12 questions using a scale: Qualitative studies were rated on 9 questions using a scale: One item was excluded due to inappropriateness within the research field.

For both quantitative and qualitative studies, an overall rating is presented in Appendix A Table A1 and Table A2 with mean values and standard deviations. Based on the mean values, we provide an overall rating regarding the categories low, moderate and high methodological quality. The cut-off values are defined as follows: They are based on theoretical assumptions in relation to methodological quality. Our approach, including the cut-off values based on the mean values, should be seen as a relative rating in relation to our data to provide a comparison of methodological quality.

To our knowledge, no other rating system is available in relation to the applied tools. No studies were excluded from the review based on their methodological quality assessment results to ensure that all the potential valuable results are presented [ 26 ]. Figure 1 shows the selection process in general, numbers for each stage of the selection process and reasons for exclusion after screening the full papers.

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After the exclusion of direct duplicates, the literature search in the various databases yielded potentially relevant publications. After we screened titles and abstracts, we retrieved studies in full-text. Thirteen studies met all the eligibility criteria. We looked at reference lists and citations of included studies listed in Scopus. Both the reference list search and the cited-by-search yielded no additional studies that met all the eligibility criteria.

Finally, we included 13 studies in this systematic review. Table 1 shows the main descriptive characteristics of the 13 included studies. Table 2 shows specific information concerning the interventions and data collections. One study included data from the UK, India and Kenya [ 34 ].

Nine studies are defined as case studies [ 4 , 6 , 7 , 27 , 29 , 31 , 32 , 33 , 34 ], three studies used a quasi-experimental design [ 5 , 28 , 30 ], and one study used a cross-sectional design [ 23 ]. Three publications [ 4 , 6 , 7 ] are based on the same intervention, while all other publications are based on individual interventions.

Six studies collected and analysed data on a solely student level [ 4 , 23 , 27 , 29 , 34 , 35 ], five studies also included data from teachers, staff and parents [ 6 , 30 , 31 , 32 , 33 ] and one study [ 5 ] only included data from parents. Eight studies used interviews [ 6 , 27 , 29 , 30 , 31 , 32 , 33 , 34 ], six studies used questionnaires [ 5 , 7 , 28 , 30 , 31 ], three studies used learning assessments [ 29 , 30 , 31 ], two studies used observations [ 32 , 34 ] and, in each case, one study used a postal survey [ 23 ], written documents [ 29 ], drawings and concept maps [ 34 ], and accelerometry [ 4 ].

The quantity of compulsory educational activities in a natural or cultural environment outside the classroom varied from one school day bi-weekly to a duration of eight weeks [ 27 ], and a six-month full week programme [ 23 ]. The chosen environments also differ between the studies: Descriptive characteristics of studies on regular school- and curriculum-based outdoor education programmes.

Characteristics of intervention and data collection of studies on regular school- and curriculum-based outdoor education programmes. The included studies are very heterogeneous in respect of their study design, used methods and instruments, learning environments and measured outcomes. We categorised measured outcomes and presented the results of each study according to the study design. Seven studies reported outcomes on learning dimensions [ 7 , 27 , 29 , 30 , 31 , 32 , 34 ] and eight studies on social dimensions [ 6 , 7 , 23 , 27 , 28 , 30 , 31 , 34 ].

Main reasons for the low ratings result from insufficient information about the influence of the researcher on the observed or interviewed participants, and vice-versa; insufficient information according to current ethical criteria; and an inappropriate connection between the conclusions and the analyses. We categorised the reported outcomes of studies on regular school and curriculum OEP. Reported outcomes of studies on regular school- and curriculum-based outdoor education programmes. Six case studies [ 7 , 27 , 29 , 31 , 32 , 34 ] analysed datasets concerning learning dimension.

Mygind [ 4 ] conducted a study with primary school children attending a three-year outdoor education project. Students were asked about their perceptions on teaching and learning during indoor and outdoor classes by means of a questionnaire. Significant differences were found in three out of 14 statements: No significant differences were found for the other 11 statements. The authors analysed documents written by students, and interviews conducted by students using a semi-quantitative content analysis.

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