Changed attitudes towards unintended pregnancy: young men and the Relationship and Sexuality Education curriculum
Submitting InstitutionQueen's University Belfast
Unit of AssessmentAllied Health Professions, Dentistry, Nursing and Pharmacy
Summary Impact TypeSocietal
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Studies In Human Society: Policy and Administration, Sociology
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.
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
- 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
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
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 &
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)
C. Corkindale & Prof. J. Condon, Flinders University, Prof. A. Hyde,
University College Dublin.
References to the research
1. Lohan M. (2007) How Might We Understand Men's Health Better?
Integrating Explanations From Critical Studies On Men And Inequalities In
Health. Social Science & Medicine, 65: 493-504. [Abstract]
Re-publication in a special virtual issue of the journal on Gender and
Featured in the top 25 most downloaded articles of journal in 2007
2. Lohan, M., Cruise, S., O'Halloran, P., Alderdice, F., and Hyde, A.
(2011) Adolescent men's attitudes and decision-making in relation to an
unplanned pregnancy. Responses to an interactive video drama, Social
Science & Medicine, 72, 1507-1514. [Abstract]
Social Science & Medicine is a world leading journal and the world's
most highly cited social science journal. Impact Factor (5yr) 3.404.
Ranked 5/33 Social Sciences Biomedical; 10/95 Public health.
3. Lohan, M., Cruise, S., O'Halloran, P., Alderdice, F., and Hyde, A.
(2010) Adolescent men's attitudes in relation to pregnancy and pregnancy
outcomes: A systematic review of the literature from 1980-2009. Journal
of Adolescent Health 47 (4), 327-345. [Abstract]
Impact Factor (5yr) 3.404. Ranked 5/33 Social Sciences Biomedical; 10/95
4. Lohan, M., Olivari, M.G., Corkindale, C., Milani, L., Confalonieri, E.
et al., (2013) Adolescent men's pregnancy resolution choices in relation
to an unintended pregnancy: A comparative analysis of adolescent males in
three countries. Journal of Family Issues
Impact Factor 1.068. Ranked 11/33 in Family Studies.
5. Hyde, A. Carney, M., Drennan, J. Butler, M., Lohan, M. and Howlett, E
(2010) The silent treatment: parents' narratives on sexuality education
with their adolescent children. Culture Health and Sexuality 14,
Impact Factor 1.068. Ranked 8/33 in Family Studies. Leading social
science journal on sexuality.
6. Hyde, A. Drennan, J. Howlett, E., Carney, M. and Lohan, M. (2012)
Parents' Constructions of the Sexual Self-presentation and Sexual Conduct
of Adolescents: Discourses of Gendering and Protecting. Culture Health
and Sexuality 14, 895-909
Impact Factor (as above).
The research was funded 2007-2012 by five grants from the ESRC, Health
Services Executive Ireland, Dept. of Health (NI) and Public Health Agency
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
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
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
- 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
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
- Sexual Health Promotion Strategy & Action Plan 2008-2013.Progress
Report (see Ref 6. below).
- I'm all right, Jack. Every Child Journal, 3(5): 38-43.
- 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.
- They need to know.... A report on teachers' use of the South
Australian Relationships and Sexual Health Curriculum. University of
- 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 15th
Contact details to corroborate contribution, impact or benefit.
- Public Health Consultant, Public Health Agency
- Programme Manager, Council for the Curriculum Education and Assessment
- Acting Director, The Crisis Pregnancy Programme (CPP), Health Services
- National Co-ordinator for Personal Social and Health Education,
Department of Education and Skills (IRL)
- Coordinator of Teacher Education Workforce Development and Resources
Team, Shine, South Australia