The aim of this paper is to analyse the findings from three studies which examined participant involvement in action-oriented projects in different settings, aiming to attain distinct sexual health outcomes, develop action competence and, which strengths and weaknesses emerged throughout their learning process. In these projects, sexual health is understood as the experience of the ongoing process of physical, psychological, and sociocultural wellness and wellbeing related to sexuality (1).  Therefore, it is a more encompassing concept than reproductive health and is an integral component of basic human rights (2). However, reproduction is one of the critical dimensions of human sexuality and may contribute to strengthening relationships and personal fulfillment when desired and planned. Because of this fact, reproductive health promotion must be a broadened lifelong learning process to address the various dimensions of sexuality and sexual health. Therefore, in this paper we have selected three studies which showed the strengths and weaknesses of the IVAC methodology in different educational settings to promote sexual health in different phases of the life cycle.

The first and second studies under analysis, respectively a school-based and a health centre based action-oriented projects, were aimed at: i) increasing links between teen pregnancy prevention programs and community-based health centres (clinical services); ii) reducing the rates of unwanted or unplanned teenage pregnancies. The main goal of the third action-oriented hospital-based project for pregnant women attending childbirth classes was to increase their quality of life by preventing low-back pain in respects to its functional limitations, effects on their quality of life and personal perception of the intensity of the problem.

The IVAC (investigation – vision – action & change) methodological approach (3,4,5) applied in these projects and the didactic material produced to support them, were based on the Danish critical health education theoretical framework (4, 5, 6) and in the democratic health education paradigm (7,8). Insight into their own and the behaviours of others, attitudes, norms and values, the positive and broader concepts associated to the holistic health and sexual health vision, as well as a strong focus on human rights and the empowerment of participants through participation, were the principal guidelines to promote the (re)construction of their action-oriented knowledge and the development of their competencies to act in order to control the determinants of their own sexual health or those of their  community. Therefore, this paper raises the following questions regarding the implementation of the IVAC methodology in different settings:

- What are the differences and similarities in the dimensions of action-oriented knowledge of participants in different educational settings (in particular the characteristics of the main ideas about the consequences and causes of the problem, action strategies and visions)?

- What are the main characteristics of actions undertaken in different educational settings (planning, implementation and evaluation of sexual health outcomes envisioned)?

- What were the strengths and weaknesses that have emerged through the action-oriented learning process in different educational settings?

(1) World Association for Sexual Health, Organización Panamericana de la Salud (2008). Salud Sexual para el Milenio Declaración y documento técnico. Minneapolis, MN, USA: World Association for Sexual Health. (2) UNESCO (2009). International guidelines on sexuality education: an evidence informed approach to effective sex, relationships and HIV/ DTI Education. Paris: UNESCO (3) Jensen, B. B. (2000). Participation, commitment and knowledge as components of pupil’s action competence.In B. B. Jensen, K. Schnack & V. Simovska (Eds.), Critical Environmental and Health Education. Research Issues and Challenges (pp. 219‐237). Copenhagen: Research Centre for Environmental and Health Education. The Danish University of Education. (4) Simovska V., & Jensen, B. B. (2003).Young‐minds.net/lessons learnt: Student participation, action and cross‐cultural collaboration in a virtual classroom. Copenhagen: Danish University of Education Press. (5) Simovska V., & Jensen, B. B. (2008). On‐line learning environments and participatory health education: teachers’ reflections, J. Curriculum Studies, 40 (5), 651‐669. (6) Simovska, V. & Jensen, B. B. (2009). Conceptualizing participation – the health of children and young people. Copenhagen: World Health Organization Regional Office for Europe. (7) Jensen, B. B. (1995). Concepts and models in a democratic health education. In B.B. Jensen (Ed.). Research in environmental and health education (pp.151-169). Copenhagen: Research Centre for Environmental and Health Education. (8) Jensen, B. B. (1997). A case of two paradigms within health education. Health Education Research, 12 (4), 419‐428.