REACHING CONSENSUS: A SCOPING REVIEW ON SCHOOL-BASED COMPREHENSIVE SEXUALITY EDUCATION PROGRAMS (CSE) ALCANZAR EL CONSENSO: UNA REVISIÓN DE ALCANCE SOBRE LOS PROGRAMAS DE EDUCACIÓN INTEGRAL EN SEXUALIDAD (CSE) BASADOS EN LA ESCUELA CHEGAR A UM CONSENSO: UMA REVISÃO DO ESCOPO DOS PROGRAMAS ABRANGENTES DE EDUCAÇÃO EM SEXUALIDADE (CSE) NAS ESCOLAS

Sexuality education in schools is a hot topic in part because it is closely intertwined with social and parental interpretations of right and wrong. This study is a scoping review that was conducted in six steps: (1) identification of the research question, (2) identification of relevant studies, (3) selection of studies, (4) data extraction, (5) summarizing and reporting the results, and (6) consultation with stakeholders. Curricula were assessed by the Curriculum Evaluation Tool (SIECUS) and guidelines were evaluated by the appraisal of guidelines for research & evaluation (AGREE II) tool. After reviewing 24 programs extracted from 50 studies, the majority of which (90%) were designed and utilized in developing countries, 5 questions were answered. Finally, the “Guidelines for the Sexual Health education component of Comprehensive Health Education” guideline, and the “FLEHI, WSWM, Tuko Pamoja” curricula were recommended with modifications. This review shows that CSE programs are not only cost-effective interventions, but also part of adolescents’ sexual rights. At the beginning of


Introduction
The sex education debate worldwide takes on special relevance because sex and its related health outcomes are a reality in the lives of many young people (Collins, Alagiri, Práxis Educacional e-ISSN 2178-2679

Revista
Summers, & Morin, 2002). Most adolescents have been in school for many years before they initiate sex (nearly 95% of all youth aged 5 to 17 years are enrolled in elementary or secondary schools) and when they do, schools have the potential to reduce high risk adolescent sexual behavior (D. Kirby, 2002). Sexuality education in schools is a hot topic in part because it is closely intertwined with social and parental interpretations of right and wrong, and with people's feelings about religion and personal autonomy. Yet, it is also intended to serve a variety of practical public health purposesto reduce STIs, violence, and unwanted pregnancy among young people (Roy, Roy, & Rangari, 2007).
There are many educational approaches in this field, most of which are divided into two categories, including comprehensive sex education (or 'abstinence-plus') and 'abstinence- To achieve the educational goals set by the Iranian government, the curriculum should be strategically formulated into certain programs because the curriculum is important and part of the educational program. Therefore, the assessment and selection of health education programs in any school district should be based on clearly identified goals, health needs, health behavior expectations (cultural and religious norms(, and outcomes for health education ("https://www.cdc.gov/healthyschools/professional_development/e-learning/hecat.html,"; Information & States, 2004). However, there is a paucity of systematic appraisals of the existing programs focused on adolescent sexual health.

Methods
Scoping review is an ideal methodology for mapping key concepts within a research area, identifying the main sources and types of evidence available, and identifying gaps in the existing research (Lima et al., 2017). This scoping review was developed using the scoping

Stage 2: Identifying relevant studies
At this stage, the research team established the inclusion and exclusion criteria, electronic databases.

Inclusion and exclusion criteria
Inclusion criteria: All the accessible articles published in English and Persian on school-based education programs that had evaluated and improved adolescent sexual health were included without a time limit.
Exclusion criteria: Sexual education programs that weren't comprehensive and schoolbased and that did not cover the age of 10-19 years were excluded.

Stage 3: Study selection
The review process consisted of two levels of screening: (1) title and abstract review, Revista concepts section, each concept is graded according to its emphasis. A score of 1 indicates 'major emphasis' and a score of 5 means 'not addressed'. When parts 1, 3, and 6 gain lower scores they indicate a better status (Information & States, 2004) ( Table 1). The domain scores were calculated by adding up the scores of the items in each domain and calculating the total of the maximum possible score obtainable for each domain.
This study was conducted by three separate appraisers for each guideline. The total score of all three appraisers was collected for each individual domain (Obtained score).

Stage 5: Summarizing and reporting the results
In this scoping review, we examined 24 programs out of 50 studies to answer the questions in Step 4. The results of this study have been described in the tables.

Stage 6: A consultation exercise
According to Levac et  Revista context, it is essential to work on changing stakeholders' attitudes, including those of parents, teachers and policy makers before the implementation of the curriculum.

Results
Upon examining the databases a total number of 50 studies were identified, within which 24 programs were found. Ten of these programs met the inclusion criteria. Thereafter, three guidelines and seven curricula were evaluated (see in Table 1, 2). The programs were mostly (80%) intra-curricular and approximately 90% of them had been designed and utilized in developing countries. Eventually, the 'Guidelines for the Sexual Health education component of Comprehensive Health Education' and 'FLEHI, WSWM, Tuko Pamoja' were selected from the guidelines and curricula, respectively, and were recommended with certain modifications.
Finally, based on the similarities of the programs, we answered the following 5 questions:   recommended for developing countries like Iran, due to its cultural discrepancies.

Conclusion
Based on this scoping review and the insights provided by the interviews on sexuality education programs, six key principle steps were identified for their establishment: 1. Clarify the programs' objectives and the roles of different players and ensure local/national ownership/leadership; 2. Choose educational approaches that can be implemented within existing systems; 3. Identify the perceived needs of the target groups and adapt them to existing political systems; 4. Examine the effectiveness and cost-effectiveness of existing training programs; 5. Adapt existing programs to social and cultural norms; 6. Pilot programs before execution.
There are invaluable programs for building professional capacity in the field of adolescent sexual health. These programs are not only cost-effective interventions for adolescents, but also part of their human rights.