BackgroundSchools need to collaborate with health network to actualize their important role in promoting sexual health among students. Studies focus on determinants of teacher’s intention to deliver sexuality education (SE), but do not take into consideration the specificity of the action and the context, i.e., the multiple teaching strategies they could choose. Teachers can deliver SE by (a) teaching students alone, (b) co-teaching, (c) inviting a sexual health educator in their classroom. The purpose of this study is to investigate the psychosocial determinants of teachers' intention to deliver SE in any of those roles, using a theory-based approach.MethodsGodin's (2012) health behavior change theoretical framework - an integrated version of Ajzen's planned behavior theoretical framework, Triandis's interpersonal behaviors, and Banduras's social cognitive theory - was used to measure teachers' intentions and determinants to do SE. A 66-minute online questionnaire was sent to teachers at a school service center in Quebec. Hierarchical logistic regression analyses were conducted to assess the relationship between the independent variables (determinants of intention) and the intention to teach alone SE, co-teach, or invite a sexual health educator.ResultsA total of 295 teachers from 51 elementary and 12 secondary schools were selected for analyses. Nearly 40% (39.9%) of the study participants had a favorable intention to teach SE alone to their students, 36.2% by co-teaching and 76.5% by inviting a sexual health educator. The main predictors of intention were respectively: a) for the teaching SE alone model (R2=58%): self-efficacy in sexual health education (OR = 6.07; p < .001), followed by moral norm (OR = 5.35; p < .001), descriptive norm (OR = 3.37; p < .01), comfort teaching the SE curriculum (OR = 3.09; p < .01), and past experience (OR = 2.89; p < .01). Age was also negatively associated with the outcome variable (OR = 0.92; p < .001). b) For the co-teaching model (R2=46%): moral norm (OR = 7.97; p < .001), followed by educational attainment (OR = 3.40; p < .05), teaching multi-age or multi-grade groups (OR = 2.36; p < .05), and self-efficacy with working in partnership (OR = 1.27; p < .05). Further, age (OR = .93; p < .001) and gender (OR = .44; p < .05) were negatively associated with the outcome variable. c) For the inviting sexual health educator model (R2=55%): moral norm (OR = 3.81; p < .001), followed by anticipated regret (OR = 2.45; p < .05), and descriptive norm (OR = 2.38; p < .05). Teachers who reported feeling comfortable teaching the SE curriculum (OR = .45; p < .05) were less likely to intend inviting a sexual health educator.ConclusionsResults indicate that determinants of teacher intention are relatively distinct depending on whether teachers make the decision to teach SE to their students alone, co-teach, or invite a sexual health educator in their classroom. The study further suggests complementary strategies being adopted by schools to optimize implementation of SE program.