Summary of the impact

The World Health Organisation, amongst others, recognises that adolescent men have a vital yet neglected role in reducing teenage pregnancies and that there is a pressing need for educational interventions designed especially for them. Research at Queen's has helped to fill that gap. Through work with the Departments of Health and Education in Northern Ireland (NI) and Ireland (IRL), our research led to the introduction of an educational resource into the national curricula of post-primary schools in IRL and NI. The resource that we designed has been demonstrated to improve knowledge and understandings of unintended pregnancy amongst young men. As a result of this impact, the resource is also being delivered in 86% of state schools in South Australia.

Underpinning research

The underpinning research developed a number of key building blocks for this educational resource:

• First, we began with the development of an improved model of understanding men's health behaviours (2007). One indicator of the significance of this theoretical work is evidenced in its selection for re-publication in a special virtual edition of the journal Social Science and Medicine on gender and health, representing the Editor in Chief's selection of the most influential articles on gender and health in the last 20 years (Reference1).
• Second, we conducted novel research on adolescent men and pregnancy. To-date, the overwhelming focus of research on adolescent pregnancy has been on women. Our research (systematic review and new large empirical study) led to improved understandings of I) adolescent men's attitudes to the possibility of an unintended pregnancy in their lives; II) what young men would decide to do in relation to an unintended pregnancy and III) who (e.g. parents and peers) and what (socio-demographic and cultural factors) drive men's attitudes to, and decision-making about, unintended pregnancy. These results were published in world leading ranked journals (2009) (References 2 & 3). A further paper expanded the results in a comparative international context (4).
• In addition to the new knowledge gained in the research, the methodological innovations in our research directly led to the educational resource described here. Together with our collaborators in Flinders University in Australia, we developed an innovative method of data collection based on a computer-based Interactive video drama (IVD) (2009). The IVD, entitled "If I were Jack" is shot from the young man's point of view and is explicitly targeted towards eliciting men's responses. The IVD facilitates participants to role play how they would act and feel in relation to the unintended pregnancy and how they would work through pregnancy resolution choices if an unintended pregnancy were to happen in their lives. An excerpt of "If I were Jack" may be viewed at http://www.qub.ac.uk/IfIWereJack/ While the IVD was highly successful for data collection, its usefulness as an educational resource was highlighted to us by users and policy stakeholders.
• Third, we were awarded an ESRC knowledge exchange grant (April 2012-2013) to re-develop this IVD into a comprehensive educational resource (four week programme) on unintended pregnancy and to work with statutory stakeholders to integrate the educational resource into current Relationship and Sexuality Education (RSE) curricula in NI and IRL. In addition, we worked closely with our international collaborators to develop the resource for schools in South Australia and we are also currently working with researchers at University of British Columbia to develop a similar resource for Canada
  http://www.qub.ac.uk/IfIWereJack
• Of critical importance, we also conducted two studies of parent-child communication. This research allowed us to explicitly build in parent-child communication exercises as part of our resource, which is a further unique contribution to RSE curricula. (References 5 & 6).

School of Nursing and Midwifery Research Team Members

Dr Maria Lohan (SL), Dr Peter O'Halloran (L), Prof. Fiona Alderdice, Dr Sharon Cruise (Research Fellow) 2007-2009, Áine Aventin (Research Fellow) 2012-present.

International Collaborators

C. Corkindale & Prof. J. Condon, Flinders University, Prof. A. Hyde, University College Dublin.

References to the research

The research was funded 2007-2012 by five grants from the ESRC, Health Services Executive Ireland, Dept. of Health (NI) and Public Health Agency (NI).

Details of the impact

Impact on Policy and Educational Practice

A reduction of teenage pregnancies rates is a policy priority of all western developed nations. It is increasingly recognised that educating young men must be part of the solution. Currently, young men are much less likely to receive school-based education on teenage pregnancy and parents are much less likely to speak to their sons than their daughters about teenage pregnancy.

We worked in partnership with government departments to deliver a research informed resource within the state-supported RSE curricula of NI and IRL which also supports parent-child communication. RSE teachers began attending state-supported annual training days (since November 2012) on have been using `If I were Jack' in the classroom during 2013.

This partnership ensures universal access to the resource for all adolescents attending schools (N= 216) in Northern Ireland at Key Stage 4 of the curriculum, (100% of schools and approximately 2,400 pupils) and in Ireland (N= 582 schools who have a transition year programme, 81% of schools and approximately 3,200 pupils) (Corroborators 6 & 9).

Leading civil servants in a variety of government departments and agencies in NI have identified the importance of the resource in meeting key government health policy targets (Reference 1 & Corroborators 6-9). For example:

The DHSSPS considers that this project is supportive of the aims and objectives of the Sexual Health Promotion Strategy and Action Plan 2008-2013. The Department is particularly supportive of this research as it is relevant towards delivery of the objective of providing opportunities for young people in school and youth settings to develop the skills they need to appropriately manage their relationships.

Dr Michael McBride, Chief Medical Officer (Northern Ireland), 18/04/2013

An Australian version of the educational resource developed from our joint research is already being used in 86% of State schools (117 schools with approximately 6,300 pupils at age 15 years) in South Australia. This was achieved in 2012 by working alongside research collaborators at Flinders Unversity through whom we developed a partnership with SHINE, the primary provider of RSE education to state schools. (Reference 4 and corroborator 10).

Impact on End-Users (Adolescents)

The results of a research study conducted with a stratified random sample of male adolescent users of the educational resource in Ireland (N= 360) and South Australia (N= 386) demonstrates that the resource is achieving key educational and health promotion effects, especially in achieving greater awareness of unintended pregnancy amongst young men and in increasing young men's intention to avoid an unintended pregnancy (References 2 and 3).

• 79% of the representative sample of male users in Ireland and 70% of the representative sample of male users in Australia agreed or strongly agreed with the statement that it `made me think about issues I hadn't thought about before';
• 79% of users in Ireland and 69% in Australia agreed or strongly agreed that the resource `made me realise that I should never get myself in that situation';
• 85% of users in Ireland and 72% in Australia agreed or strongly agreed with the statement that it `helped me understand the effect an unplanned pregnancy would have on a guy like me';
• 84% of users in Ireland agreed or strongly agreed with the statement that `If I were Jack' `made me aware that I could talk to a counselling service if I were in Jack's situation.'

Impact On End Users (Teachers)

Case-study research of teachers using the resource in the classroom reported the positive impact of the resource on young people especially in gaining a deeper understanding of teenage pregnancy (Reference 2). For example, teachers said:

"I found the interactive DVD engaged with my students in a way that they could relate to. It offered an experience that no book could match. I found they were better able to walk a mile in Jack's shoes and their feedback indicated that not only did they feel empathy for his situation but they could imagine themselves in that same situation and faced with the same choices. The resource was appropriate and realistic and it led to some great discussions in the class."

"Most pupils said the parent survey homework was 'awkward' but they agreed it was not as difficult to talk to their parents about pregnancy as they thought."

Further podcasts of the experiences of teachers using the resource are available on: http://www.qub.ac.uk/IfIWereJack

Secondary Impact

The Department of Education (IRL) and the Council for the Curriculum Education and Assessment (CCEA) NI are, for the first time, working together on RSE curricula alongside the research team. This co-operation which is being sponsored by the researchers' ESRC grant is leading to shared learning between specialists and supporting the implementation of the Belfast Agreement (Corroborators 6-9).

Sources to corroborate the impact

1. Sexual Health Promotion Strategy & Action Plan 2008-2013.Progress Report (see Ref 6. below).
2. I'm all right, Jack. Every Child Journal, 3(5): 38-43.
3. Teenage men and unintended pregnancy: An Educational Intervention developed for Northern Ireland (UK), Ireland and Australia Advancing Excellence in Gender, Sex and Health Research Conference Montréal, Canada, October 29-31, 2012.
4. They need to know.... A report on teachers' use of the South Australian Relationships and Sexual Health Curriculum. University of South Australia.
   http://www.shinesa.org.au/go/workforce-development/teachers
5. How to reduce teenage pregnancy in Northern Ireland? A movie-based educational approach. Policy Briefing Paper presented to Knowledge Exchange Seminar Series Northern Ireland Assembly, Stormont, November 15^th 2012. http://www.niassembly.gov.uk/Assembly-Business/Research-and-Information-Service-RaISe/Knowledge-Exchange/Knowledge-Exchange-Seminars-Series-2/

Contact details to corroborate contribution, impact or benefit.

6. Public Health Consultant, Public Health Agency
7. Programme Manager, Council for the Curriculum Education and Assessment (CCEA) NI
8. Acting Director, The Crisis Pregnancy Programme (CPP), Health Services Executive (IRL)
9. National Co-ordinator for Personal Social and Health Education, Department of Education and Skills (IRL)
10. Coordinator of Teacher Education Workforce Development and Resources Team, Shine, South Australia