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Mobility research tends to focus on physical movement and experiences in later life; however, changes in older adult mobility over time remains underexplored. Furthermore, older adults typically experience many life events, some of which result from cognitive and physical decline, and many of which impact mobility. This article aims to explore how life events affect the mobility of older adults over time. We conducted in-depth interviews with 22 older adults aged 55 years and over from Lancashire, United Kingdom. Of these participants, eight lived with memory problems. The findings show that both anticipated and unexpected life events play a profound role in the participants' mobility over time. Retirement, long-term illness and age-related illness were examples of anticipated life events, while the death of a loved one and developing memory problems were examples of unexpected life events. In both cases, participants' made external adaptations, such as moving home, or internal adaptations, such as self-awareness. The findings also emphasise the layered nature of life events and adaptations playing a role in the participants' mobility. Additionally, life events such as developing memory problems showed a domino effect, triggering further life events and adaptations which impacted the participants' mobility. This article emphasises how transition periods can occur before or after a life event, showing that adaptations can be pre-emptive to a life event. Our article contributes to calls for internal adaptations to be fully incorporated into age-related policy and also for age-related policy to be more inclusive for older adults who experience memory problems and dementia.

Little is known about how teachers’ personal sexual experiences influence their motivations and practices when teaching sexuality education. Cultural schema theory was used to explore teachers’ personal experience of the onset of sexual activity and explain how sexuality education teaching is influenced by such experiences. In-depth interviews were conducted with 40 secondary school teachers in Kampala, Uganda. The interviews were transcribed verbatim and analysed using principles of grounded theory. Findings show that while teachers’ personal experience of sexual initiation did not directly align with the content of their messages, due to the centrality and evocative function of these schemas these experiences strengthened teachers’ motivation to teach sexuality education because they enabled them to empathise with students. The study concludes that teachers’ personal experiences of sexual initiation provide intrinsic motivation for teaching sexuality education. The inclusion of dialogues and activities which encourage self-reflexivity in teacher education and training may improve the delivery of sex, sexuality and relationships education.

School-based sexuality education makes teachers important gatekeepers of students’ access to information about sexual and reproductive health and rights. The school setting has the potential to reach large numbers of students. However, teachers’ professional identities may go beyond, differ from or even conflict with the qualities required of sexuality educators. To gain a better understanding of the role of professional identity in the delivery of school-based sexuality education, this study used cultural schema theory to study teachers’ professional identities, and how these motivate them to provide sexuality education. In-depth interviews were conducted with 40 sexuality education teachers at secondary schools in Kampala, the capital of Uganda. Sexuality education lessons were observed to validate the findings from the interviews. Results identified five cultural schemas of professional identity: (i) upholder of ethics and regulations; (ii) authority figure; (iii) counsellor and guide; (iv) role model; and (v) guardian. The study concludes that teachers’ cultural schemas of professional identity motivate them to adhere to moral discourses of abstinence and sexual innocence. To support teachers in taking more comprehensive approaches to sexuality education, it is important that they receive adequate teacher training and support from the Ugandan government, the school administration and the wider community.

The Ugandan government has been criticised on several grounds for its abstinence-only policies on sexuality education directed towards young people. These grounds include the failure to recognise the multiple realities faced by young people, some of whom may already be sexually active. In the study reported on this paper, students’ perceptions of relationships and sexual practices were analysed to obtain an understanding of how young people construct and negotiate their sexual agency in the context of abstinence-only messages provided in Ugandan secondary schools and at the wider community level. Ten in-depth interviews and six focus group discussions were conducted with students aged 15–19 years (N = 55) at an urban co-educational secondary school. Data were transcribed verbatim and analysed using grounded theory. Findings show that students engage in sexual activity despite their belief that contraception is ineffective and their fears for the consequences. Students’ age, gender, financial capital and perceived sexual desire further increase risk and vulnerability. To improve their effectiveness, school-based sexuality education programmes should support students to challenge and negotiate structural factors such as gender roles and sociocultural norms that influence sexual practices and increase vulnerability and risk.

Teachers can feel uncomfortable teaching sexuality education when the content conflicts with their cultural values and beliefs. However, more research is required to understand how to resolve conflicts between teachers’ values and beliefs and those implicit in comprehensive approaches to sexuality education. This study uses cultural schema theory to identify teachers’ cultural schemas of teaching sexuality education and the internal conflicts arising between them. In-depth interviews were conducted with 40 secondary school teachers in Kampala, the capital city of Uganda. Embedded in a context of morality, conflicting cultural schemas of sexuality education and young people’s sexual citizenship in traditional and present-day Ugandan society were found: young people are both innocent and sexually active; sexuality education both encourages and prevents sexual activity; and teachers need to teach sexuality education, but it is considered immoral for them to do so. In countries such as Uganda, supportive school regulations and a mandate from society could help teachers feel more comfortable adopting comprehensive approaches to sexuality education.

Background Increasingly, the health and rights of adolescents are being recognized and prioritized on the global agenda. This presents us with a “never-before” opportunity to address adolescent contraception. This is timely, as there are enormous numbers of adolescents who are currently unable to obtain and use contraceptives. From research evidence and programmatic experience, it is clear that we need to do things differently to meet their needs/fulfil their rights. Main body In this commentary, we call for action in several key areas to address adolescents’ persistent inability to obtain and use contraceptives. We must move away from one-size-fits-all approaches, from a ‘condoms-only’ mind set, from separate services for adolescents, from ignoring the appeal of pharmacies and shops, and from one-off-training to make health workers adolescent friendly. Our efforts to expand access to quality contraceptive services to adolescents must be combined with efforts to build their desire and ability to use them, and to do so consistently. In order for these changes to be made, action must be taken on several levels. This includes the formulation of sound national policies and strategies, robust programme implementation with monitoring, regular programmatic reviews, and implementation research. Further, high-quality collection, analysis, and dissemination of data must underlie all of our efforts. As we move ahead, we must also recognize and draw lessons from positive examples of large scale and sustained programmes in countries that have led the way in increasing contraceptive use by adolescents. Conclusion This unprecedented moment in history gives us a real opportunity to bring about transformational change, particularly when there is so much at stake.

This paper explores adolescents’ perceptions of contraceptives and how these perceptions relate to their intention to engage in safe sexual behaviour. Ten in-depth interviews and six focus group discussions were conducted with adolescents aged 15-19 at a mixed secondary school in the capital Kampala in April-May 2008. The findings show that most participants aim to abstain because of the high perceived risk of pregnancy and contracting HIV, the high perceived unreliability of condoms, and the severe perceived side effects of other modern contraceptives. However, in situations where adolescents will have sex, these perceptions may contribute to a preference of using less reliable traditional methods or even no methods. It is recommended to include comprehensive teaching of contraceptives in sexuality education programmes for adolescents and in the training for sexuality educators.

Background This paper evaluates the effect of the World Starts With Me (WSWM), a comprehensive sex education programme in secondary schools in Uganda. The aim of the present study was to assess the effects of WSWM on socio-cognitive determinants of safe sex behaviour (delay; condom use and non-coercive sex). Methods A survey was conducted both before and immediately after the intervention among students in intervention (N = 853) and comparison (N = 1011) groups. A mixed model repeated measures analysis was performed to assess the effectiveness of the WSWM programme on the main socio-cognitive determinants of safe sex behaviour at post-test. A similar post-hoc comparison was made between schools based on completeness and fidelity of implementation of WSWM. Results Significant positive effects of WSMW were found on beliefs regarding what could or could not prevent pregnancy, the perceived social norm towards delaying sexual intercourse, and the intention to delay sexual intercourse. Furthermore, significant positive effects of WSWM were found on attitudes, self-efficacy and intention towards condom use and on self-efficacy in dealing with sexual violence (pressure and force for unwanted sex). A reversed effect of intervention was found on knowledge scores relating to non-causes of HIV (petting, fondling and deep kissing). A follow-up comparison between intervention schools based on completeness of the programme implementation revealed that almost all significant positive effects disappeared for those schools that only implemented up to 7 out of 14 lessons. Another follow-up analysis on the basis of implementation fidelity showed that schools with a "partial" fidelity score yielded more significant positive effects than schools with a "full" fidelity of implementation score. Conclusions The study showed an intervention effect on a number of socio-cognitive determinants. However, the effectiveness of WSWM could be improved by giving more systematic attention to the context in which such a programme is to be implemented. Implications for the systematic development and implementation of school-based safe sex interventions in Uganda will be discussed.