Title: Increasing boys’ and girls’ intention to avoid teenage pregnancy: feasibility trial of an interactive video drama based intervention in post-primary schools in Northern Ireland
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Rationale: The If I Were Jack intervention aims to increase the intention of both boys and girls to avoid teenage pregnancy and addresses gender inequalities in RSE provision by explicitly focusing on young men and teenage pregnancy. The need for gender-sensitive interventions to address teenage pregnancy has been highlighted as a global health need by the World Health Organisation [4142] and recommended in systematic reviews [144344]. The intervention has been designed specifically for use across the range of schools in NI but it is based on international research regarding effective RSE interventions. This study will begin a process of robust evaluation which may lead to the roll-out of the intervention across the UK and international applications of the intervention. The research and policy community will benefit because the proposed research process provides a model for an inclusive collaborative approach to the development of research-based resources that is potentially transferable to other areas of policy and curriculum. Study Aim: To determine the feasibility of conducting an effectiveness trial of the If I were Jack RSE intervention in post-primary schools.Study Objectives: The study will 1) assess the acceptability of the intervention to schools (principals and RSE teachers) pupils and parents; 2) identify optimal delivery structures and systems for the delivery of the resource in the classroom; 3) establish intervention participation rates and reach including equality of engagement across schools of different socio-economic and religious types; 4) assess trial recruitment and retention rates; 5) ascertain variation in normal RSE practice across the participating schools; 6) develop and refine survey instruments for use in a phase III trial; 7) assess differences in outcomes for male and female pupils; 8) identify potential effect sizes that might be detected in an effectiveness trial and estimate appropriate sample size; and 9) identify the costs of delivering If I were Jack and pilot the methods for economic analysis in a phase III trial.The Intervention: The intervention is a classroom-based RSE resource designed to be delivered by teachers over four weeks which also involves parents in the RSE process. The development of the intervention was informed by baseline data on adolescent men’s attitudes to unintended pregnancy and the best available evidence regarding the components of effective RSE interventions. It was designed to fit with the RSE curriculum by a team of researchers working with experts from the Department of Health Social Services and Public Safety the Public Health Agency and the Council for the Curriculum Examinations and Assessment as well as teacher trainers teachers parents and young people. Although produced in Northern Ireland the intervention would have strong cultural resonance for the UK as a whole. It uses an innovative combination of intervention components to address identified deficits in existing RSE interventions: 1) uses a culturally sensitive interactive video drama to immerse young people in a case scenario of an unintended pregnancy; 2) develops this case scenario of an unintended pregnancy from a teenage mans point of view; 3) targets a number of behavioural and sexual psychosocial variables including knowledge; attitudes; perceptions of risk peer norms and gender norms; self-efficacy in communication; and intention to avoid sexual risk-taking behaviour in order to help boys as well as girls build skills to avoid teenage pregnancy; 4) provides comprehensive training and information about teenage pregnancy for teachers/RSE facilitators; and 5) incorporates communication about teenage pregnancy within the classroom as well as with parents/guardians. It is composed of a number of components: I/ The If I Were Jack interactive video drama (IVD) which asks pupils to put themselves in Jack’s shoes and consider how they would feel and what they would do if they were Jack; II/ Classroom materials for teachers containing four detailed lesson plans with specific classroom-based and homework activities which include group discussions role-plays worksheets and a parent-pupil exercise; III/ 60-minute training session for teachers wishing to implement the intervention; IV/ 60-minute information and discussion session for parents/guardians delivered by RSE teachers; andV/ Detailed information brochures and factsheets about the intervention and unintended teenage pregnancy in general for schools teachers teacher trainers young people and parents. Further details on the If I Were Jack resource including excerpts from the IVD and feedback from end-users regarding the acceptability of the IVD are available from: www.qub.ac.uk/IfIWereJackStudy Design: This is a phase II feasibility trial with schools as the unit of randomisation with an embedded process evaluation. Seven schools will participate. Each participating pupil will be in the study for approximately nine months and will be asked to complete a questionnaire three times – at baseline and five and nine months later. The process evaluation will include semi-structured interviews and focus group discussions with a sample of pupils teachers and parents regarding the acceptability and feasibility of the questionnaire the intervention and participation in the trial. It will also include observations of a sample of lessons and parents’ information sessions.Study Outcomes: In this feasibility study key outcomes will be the quality of intervention implementation and recruitment and retention of research participants. The study will also pilot the feasibility and acceptability of collecting demographic information and other sexual-psychosocial data relating to measuring the proposed primary and secondary outcomes in a future phase III trial so that potential response rates can be determined optimal data collection identified and the costs of these data collection methods assessed.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH;INFECTION