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      Feasibility trial of a film-based educational intervention for increasing boys’ and girls’ intentions to avoid teenage pregnancy: Study protocol ☆

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          Highlights

          • •

            We report the protocol of a feasibility trial for a school-based sex education intervention.

          • •

            The intervention challenges the gender-bias in sex education by especially targeting boys.

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            The interactive online intervention prompts adolescents to think about teenage pregnancy.

          • •

            The cluster randomised controlled trial includes a process evaluation and health economics analysis.

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            This trial will test the feasibility of a larger trial to test for intervention effectiveness.

          Abstract

          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. This study seeks to fill this gap by determining the feasibility of conducting an effectiveness trial of the If I Were Jack intervention in post-primary schools. This 4-week intervention aims to increase teenagers’ intentions to avoid unintended pregnancy and addresses gender inequalities in sex education by explicitly focusing on young men. A cluster randomised feasibility trial with embedded process evaluation will determine: recruitment, participation and retention rates; quality of implementation; acceptability and feasibility of the intervention and trial procedures; and costs.

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          Most cited references45

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          Interventions using new digital media to improve adolescent sexual health: a systematic review.

          Kylene Guse, Deb Levine, Summer Martins … (2012)
          New digital media (e.g., the Internet, text messaging, and social networking sites [SNS]) have dramatically altered the communication landscape, especially for youth. These communication platforms present new tools for engaging youth in sexual health promotion and risk reduction. We searched eight public databases across multiple disciplines for all peer-reviewed studies published between January 2000 and May 2011 that empirically evaluated the impact of digital media-based interventions on the sexual health knowledge, attitudes, and/or behaviors of adolescents aged 13-24 years. Of 942 abstracts, 10 met inclusion criteria. Seven studies were conducted in the United States. Eight described Web-based interventions, one used mobile phones, and one was conducted on an SNS. Two studies significantly delayed initiation of sex, and one was successful in encouraging users of an SNS to remove sex references from their public profile. Seven interventions significantly influenced psychosocial outcomes such as condom self-efficacy and abstinence attitudes, but at times the results were in directions unexpected by the study authors. Six studies increased knowledge of HIV, sexually transmitted infections, or pregnancy. This area of research is emerging and rapidly changing. More data from controlled studies with longer (>1 year) follow-up and measurement of behavioral outcomes will provide a more robust evidence base from which to judge the effectiveness of new digital media in changing adolescent sexual behavior. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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            Theories of reasoned action and planned behavior as models of condom use: a meta-analysis.

            Jerald B. Johnson, M Fishbein, P Muellerleile … (2000)
            To examine how well the theories of reasoned action and planned behavior predict condom use, the authors synthesized 96 data sets (N = 22,594) containing associations between the models' key variables. Consistent with the theory of reasoned action's predictions, (a) condom use was related to intentions (weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and subjective norms (r. = .39), and (c) attitudes were associated with behavioral beliefs (r. = .56) and norms were associated with normative beliefs (r. = .46). Consistent with the theory of planned behavior's predictions, perceived behavioral control was related to condom use intentions (r. = .45) and condom use (r. = .25), but in contrast to the theory, it did not contribute significantly to condom use. The strength of these associations, however, was influenced by the consideration of past behavior. Implications of these results for HIV prevention efforts are discussed.
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              Interactive computer-based interventions for sexual health promotion.

              Jackie A. Cassell, Greta Rait, Catherine Mercer … (2009)
              Sexual health promotion is a major public health challenge; there is huge potential for health promotion via technology such as the Internet. To determine effects of interactive computer-based interventions (ICBI) for sexual health promotion, considering cognitive, behavioural, biological and economic outcomes. We searched more than thirty databases for randomised controlled trials (RCTs) on ICBI and sexual health, including CENTRAL, DARE, MEDLINE, EMBASE, CINAHL, British Nursing Index, and PsycINFO. We also searched reference lists of published studies and contacted authors. All databases were searched from start date to November 2007, with no language restriction. RCTs of interactive computer-based interventions for sexual health promotion, involving participants of any age, gender, sexual orientation, ethnicity or nationality. 'Interactive' was defined as packages that require contributions from users to produce tailored material and feedback that is personally relevant. Two review authors screened abstracts, applied eligibility and quality criteria and extracted data. Results of RCTs were pooled using a random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios (ORs) for binary outcomes. We assessed heterogeneity using the I(2) statistic. Separate meta-analyses were conducted by type of comparator: 1) minimal intervention such as usual practice or leaflet, 2) face-to-face intervention or 3) a different design of ICBI; and by type of outcome (cognitive, behavioural, biological outcomes). We identified 15 RCTs of ICBI conducted in various settings and populations (3917 participants). Comparing ICBI to 'minimal interventions' such as usual practice, meta-analyses showed statistically significant effects as follows: moderate effect on sexual health knowledge (SMD 0.72, 95% CI 0.27 to 1.18); small effect on safer sex self-efficacy (SMD 0.17, 95% CI 0.05 to 0.29); small effect on safer-sex intentions (SMD 0.16, 95% CI 0.02 to 0.30); and also an effect on sexual behaviour (OR 1.75, 95% CI 1.18 to 2.59). Data were insufficient for meta-analysis of biological outcomes and analysis of cost-effectiveness.In comparison with face-to-face sexual health interventions, meta-analysis was only possible for sexual health knowledge, showing that ICBI were more effective (SMD 0.36, 95% CI 0.13 to 0.58). Two further trials reported no difference in knowledge between ICBI and face-to-face intervention, but data were not available for pooling. There were insufficient data to analyse other types of outcome.No studies measured potential harms (apart from reporting any deterioration in measured outcomes). ICBI are effective tools for learning about sexual health, and they also show positive effects on self-efficacy, intention and sexual behaviour. More research is needed to establish whether ICBI can impact on biological outcomes, to understand how interventions might work, and whether they are cost-effective.
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                Author and article information

                Contributors
                Maria Lohan
                Journal
                Journal ID (nlm-ta): Int J Educ Res
                Journal ID (iso-abbrev): Int J Educ Res
                Title: International Journal of Educational Research
                Publisher: Pergamon Press
                ISSN (Print): 0883-0355
                ISSN (Electronic): 1873-538X
                Publication date PMC-release: 1 January 2014
                Publication date (Print): 2014
                Volume: 68
                Pages: 35-45
                Affiliations
                [a ]School of Nursing and Midwifery, Queen's University Belfast, Northern Ireland/Scotland, United Kingdom
                [b ]Centre for Public Health, Queen's University Belfast, United Kingdom
                [c ]MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
                Author notes
                [* ]Corresponding author at: School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland/Scotland, United Kingdom. Tel.: +44 28 90972839; fax: +44 (0)2890972328. m.lohan@ 123456qub.ac.uk
                Article
                Publisher ID: S0883-0355(14)00079-2
                DOI: 10.1016/j.ijer.2014.08.003
                PMC ID: 4183752
                PubMed ID: 25284956
                SO-VID: feb693c5-1a45-4677-8938-734521163b7e
                Copyright © © 2014 The Authors
                History
                Date received : 4 July 2014
                Date revision received : 13 August 2014
                Date accepted : 16 August 2014
                Categories
                Subject: Article

                Keywords: teenage pregnancy,sex education,sexual health promotion,intervention,feasibility trial
                Data availability:
                Keywords: teenage pregnancy, sex education, sexual health promotion, intervention, feasibility trial

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