Abstract / Summary
Sexual harassment is common among healthcare workers and is associated with poor mental health, job dissatisfaction, and workforce attrition. Education and training may help prevent sexual harassment, but their effectiveness in healthcare settings has not been systematically evaluated.
To assess the effectiveness of education and training interventions on knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings.
We searched CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, Scopus, ClinicalTrials.gov, and the WHO ICTRP, together with reference checking and contact with study authors, to identify eligible studies. The latest search date was March 2025.
We included randomised controlled trials (RCTs) involving healthcare workers comparing education or training interventions with control (no intervention, waiting list, placebo, or minimal intervention) or different types of education or training to prevent sexual harassment in healthcare settings.
Our critical outcomes were knowledge and skills in managing sexual harassment and the incidence of all types of sexual harassment perpetrated by patients, visitors, coworkers, and management. Important outcomes were anxiety, depression, burnout, sick leave, staff turnover, disability, and perception of the organisational climate related to harassment.
We used the Cochrane RoB 2 tool to assess risk of bias.
We synthesised results for each outcome using random-effects model meta-analysis. We used GRADE to assess the certainty of evidence for each outcome.
We included two studies from Taiwan with a total of 170 nurses. Most participants were young women with little work experience. The intervention group received education to prevent sexual harassment, and the comparison group received a different type of education to prevent sexual harassment. We found no studies that had a comparison group without any active educational or training components.
Education and training interventions to prevent sexual harassment compared to control (no intervention, waiting list, placebo, or minimal intervention) in healthcare workers No studies addressed this comparison. Education and training interventions to prevent sexual harassment compared to other education and training interventions for healthcare workers We found two studies reporting on education and training interventions to prevent sexual harassment compared to other education and training interventions in healthcare workers. Educational interventions to prevent sexual harassment probably increase sexual harassment prevention knowledge slightly ('sexual harassment prevention', mean difference (MD) 4.74, 95% confidence interval (CI) 1.21 to 8.28; P = 0.71; I2 = 0%; 2 RCTs, 168 participants; moderate-certainty evidence) and may increase management skills slightly ('coping behaviour', MD 6.36, 95% CI -6.84 to 19.56; P = 0.43; I2 = 0%; 2 RCTs, 168 participants; low-certainty evidence) and ('prevention strategy', MD 11.70, 95% CI 2.56 to 20.85; P = 0.22; I2 = 33%; 2 RCTs, 168 participants; low-certainty evidence). No study evaluated the incidence of sexual harassment, anxiety, depression, burnout, sick leave, staff turnover, disability, or perception of the organisational climate related to harassment. Adverse effects were not measured or reported in the included studies. The certainty of the evidence was moderate to low. We judged the overall risk of bias as low, and we identified no inconsistency or publication bias. However, imprecision was more of a concern given the low number of participants and relatively broad CIs around the effect estimates.