IMPORTANCE Delivery of vaccination to adolescents via a school-based program provides an opportunity to promote their involvement in health decision-making, service provision, and selfefficacy (belief in one's ability to perform a certain behavior).OBJECTIVE To examine the effect of a human papillomavirus (HPV) vaccination education and logistical intervention on adolescent psychosocial outcomes. DESIGN, SETTING, AND PARTICIPANTSIn this cluster randomized trial and process and qualitative evaluation, adolescents aged 12 to 13 years (first year of high school) were recruited at high schools in Western Australia (WA) and South Australia (SA) in 2013 and 2014. Statistical analysis was performed from January 2016 to December 2020. INTERVENTIONSThe complex intervention consisted of an adolescent intervention to promote knowledge and psychosocial outcomes, shared decisional support tool, and logistical strategies. MAIN OUTCOMES AND MEASURESPrespecified secondary outcomes were assessed. The HPV Adolescent Vaccination Intervention Questionnaire (HAVIQ) was used to measure changes in adolescent knowledge (6-item subscale), fear and anxiety (6-item subscale), self-efficacy (5-item subscale), and decision-making (8-item subscale). The hypothesis was that the intervention would improve adolescent involvement in vaccine decision-making (measured before dose 1 only), improve vaccine-related self-efficacy, and reduce vaccine-related fear and anxiety (measured before doses 1, 2, and 3). Mean (SD) scores for each subscale were compared between intervention and control students. In the process evaluation, focus groups were conducted. Analyses of the HAVIQ data were conducted from 2016 to 2020. Qualitative analyses of the focus groups were undertaken from 2017 to 2020. RESULTSThe trial included 40 schools (21 intervention and 19 control) across sectors with 6967 adolescents (mean [SD] age, 13.70 [0.45] years). There were 3805 students (1689 girls and 2116 boys) in the intervention group and 3162 students (1471 girls and 1691 boys) in the control group. The overall response rate for the HAVIQ was 55%. In WA, where parental consent was required, the response rate was 35% (1676 of 4751 students); in SA, where parental consent was not required, it was 97% (2166 of 2216 students). The mean (SD) score for decision-making in the intervention group before dose 1 was 3.50 (0.42) of 5 points and 3.40 (0.40) in the control group, a small but significant difference of 0.11 point (95% CI, 0.06 to 0.16 point; P < .001). There was a small difference in favor of the intervention group in reduced vaccination-related anxiety (pre-dose 1 difference, −0.11 point [95% CI, −0.19 to −0.02 point]; pre-dose 2 difference, −0.18 point [95% CI, −0.26 to −0.10 point]; (continued) Key Points Question Does a human papillomavirus (HPV) vaccination intervention in the school setting improve adolescent psychosocial outcomes? Findings In this analysis of secondary outcomes of a cluster randomized trial and qualitative evaluation of an education and logistical interv...
Following the discursive or poststructuralist turn, accounts of "experience" can no longer be read by those social scientists who have taken that turn, as straightforward descriptions of "an individual's being or consciousness." Nor can readings of accounts of experience produce any final analysis of the meaning of the "real person" who made the account or of "real worlds" that might be acted on as a result of that meaning making. To recuperate "experience" within a poststructuralist framework, the authors analyze multiple accounts of one particular experience produced at different points of time and in different contexts.
This article is a critical reflection on undertaking qualitative research with children and young people about sexuality issues. Framed within a feminist post-structuralist and queer theoretical perspective, the authors understand sexuality as a historically and culturally contingent category of subjectivity, and a complex signifying system founded on individual and institutional relations of power. Based on Australian research that has spanned the past decade, the authors reflect on their experiences of research with children and young people around sexuality, and the issues encountered in gaining approval to undertake this research from institutional human ethics committees. The authors also discuss the use of images from popular culture and media representations as a methodology to engage children, young people and adults in discussions on relationships and sexuality issues within the context of interviews and focus groups. In conclusion, the authors reflect on what it means to be a researcher in this field and offer some thoughts on how best to support researchers to continue engaging in this research.
THIS DISCUSSION ADDS TO the body of literature on young girls and their relationships with each other, through an exploration of the experiences of self-identified ‘tomboys’ and ‘sissy girls’ in early childhood. It does this through the memories of experiences identified by women. It is not our intention to have adult women speaking on behalf of children; rather, their experiences demonstrate how gendered identity is constructed and negotiated in childhood. They represent critical points in the process of gender construction in early childhood for each of these women, and have practical implications for early childhood professionals working with children today. In all cases, the women considered these critical moments as fundamental in shaping their lives. McLeod and Yates (2006) point out that reflexive memory can provide new readings of the past and present. These experiences provide a valuable avenue in which to gain insight to the complexities and contradictions associated with young girls' performances of gender. In addition, they provide some insight to the complexities of girls' relationships with each other, extending understandings of the constitution of girls' desires and friendships. Their earliest memories of being gendered subjects focused on heteronormative regulations to which children were expected to adhere, with each carrying a sense of injustice about these practices throughout their lives.
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