Developing and trialling a school-based ovulatory-menstrual health literacy programme for adolescent girls: a quasi-experimental mixed-method protocol

Abstract

IntroductionA review of international and Australian school-based resources suggests that teaching of the ovulatory-menstrual (OM) cycle is predominantly couched in biology. A whole-person framework that integrates spiritual, intellectual, social and emotional dimensions with the physical changes of the OM cycle is needed to facilitate adolescent OM health literacy. This paper describes the protocol for a study that aims to develop and trial an intervention for adolescent girls aged 13–16 years that enhances positive attitudes towards OM health coupled with developing skills to monitor and self-report OM health. These skills aim to foster acceptance of the OM cycle as a ‘vital sign’ and facilitate confident communication of common OM disturbances (namely, dysmenorrhoea, abnormal uterine bleeding and premenstrual syndrome), which are known to impact school and social activities.Methods and analysisPhase I will comprise a Delphi panel of women’s health specialists, public health professionals and curriculum consultants and focus groups with adolescent girls, teachers and school healthcare professionals. This will inform the development of an intervention to facilitate OM health literacy. The Delphi panel will also inform the development of a valid and reliable questionnaire to evaluate OM health literacy. Phase II will trial the intervention with a convenience sample of at least 175 adolescent girls from one single-sex school. The mixed-method evaluation of the intervention will include a pre-intervention and post-intervention questionnaire. One-on-one interviews with teachers and school healthcare professionals will expand the understanding of the barriers, enablers and suitability of implementation of the intervention in a school-based setting. Finally, focus groups with purposively selected trial participants will further refine the intervention.Ethics and disseminationThe study findings will be disseminated through local community seminars, conferences, peer-review articles and media channels where appropriate. The Curtin University of Human Research Ethics Committee has approved this study (approval HRE2018-0101). This project is registered with the ‘Australian and New Zealand Clinical Trials Registry’.Trial registration numberACTRN12619000031167; Pre-results.

The Use of a Two-Phase Online Delphi Panel Methodology to Inform the Concurrent Development of a School-Based Ovulatory Menstrual Health Literacy Intervention and Questionnaire

“…Their recommendations finalised the drafting of the OM health literacy intervention. Face validity was subsequently conducted with adolescent girls, their parents, teachers and school healthcare professionals ( 33 ) and will be reported separately.…”

“…In accordance with accepted practise conventions, the acceptable level of consensus was set before the study began ( 53 , 54 ) at 70% ( 33 ) in order to maintain rigour ( 34 , 36 , 50 ). The statistical analyses to assess consensus were calculating the mean, median ( 37 , 50 ), frequency counts, ranking of Likert scale responses and rate of agreement using the formula [(strongly agree + somewhat agree) less (strongly disagree + somewhat disagree)] divided by [(strongly agree + somewhat agree) plus (strongly agree + somewhat agree) plus neither agree nor disagree] multiplied by one hundred per cent ( 53 , 54 ).…”

“…A protocol to develop and trial a school-based OM health intervention was formulated to address these challenges ( 33 ). This article describes the initiation of this protocol with an online two-phase modified Delphi Panel methodology ( 34 ) to build consensus between the expertise and perspectives of experts within two distinct professions ( 35 ), namely health and education.…”

Teachers' Perceptions and Experiences of Menstrual Cycle Education and Support in UK Schools

“…Furthermore, findings from Bruinvels et al ( 13 ) suggests that eumenorrheic females experience on average 11 menstrual cycle-related symptoms including mood changes, stomach cramps and increased levels of anxiety and fatigue; these symptoms compromise aspects of daily life such as participation in physical activity, work capacity ( 14 ), girls' education and overall wellbeing ( 15 ). Yet research has highlighted menstrual education focuses on biology rather than addressing social and emotional dimensions, factors which may influence education and wellbeing ( 16 ).…”

“…Teachers are currently pivotal in providing both menstrual cycle education and fostering an environment for young people to learn and share experiences relating to the menstrual cycle. However, research has highlighted that in countries such as Australia, many teachers lack training and confidence in providing information and a positive environment to understand the menstrual cycle, beyond a purely biological perspective ( 16 ). In addition, many teachers report feeling embarrassed, potentially because of a lack of training received ( 20 ).…”