Can teenage men be targeted to prevent teenage pregnancy? A feasibility cluster randomised controlled intervention trial in schools: A Feasibility Cluster Randomised Controlled Intervention Trial in Schools

Maria Lohan, Aine Aventin, Michael Clarke, Rhonda Curran, Cliona McDowell, Ashley Agus, Lisa McDaid, Chris Bonell, Honor Young

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)
74 Downloads (Pure)

Abstract

The World Health Organisation advocates a direct focus on adolescent men in reducing adolescent pregnancy; however, no trials have been conducted. This trial (ISRCTN11632300; NCT02092480) determines whether a novel Relationship and Sexuality Educational intervention, If I Were Jack, is acceptable and feasible to implement in mixed sex UK classrooms. The intervention is a teacher-delivered intervention that emphasises male alongside female responsibility in preventing unintended pregnancies and is designed to prevent unprotected sex. The trial was a parallel-group cluster randomised controlled feasibility trial with embedded process and cost evaluation in eight secondary schools (unit of randomisation) among 831 pupils (mean age 14) in Northern Ireland, alongside a qualitative evaluation of transferability in ten schools in Scotland, Wales and England. The sampling strategy was a maximum variation quota sample designed to capture a range of school management types. Four schools were randomised to each arm and the control arm continued with usual practice. Study duration was 12 months (from November 2014), with follow-up 9 months post-baseline. Results demonstrated that the intervention was acceptable to schools, pupils and teachers, and could be feasibly implemented, cost-effectively, with minor enhancements. The between-group difference in incidence of unprotected sex (primary outcome at pupil level) of 1.3% (95% CI 0.5-2.2) by 9 months demonstrated a potential effect size consistent with those reported to have had meaningful impact on teenage pregnancy. The study responds to global health policy for a paradigm shift towards inclusion of men in the achievement of sexual and reproductive health goals in a practical way by demonstrating that a gender-sensitive as well as a gender transformative intervention targeting males to prevent teenage pregnancy is acceptable to adolescent men and women and implementable in formal education structures. If I Were Jack now merits further effectiveness testing.

Original languageEnglish
Pages (from-to)1079-1090
Number of pages12
JournalPrevention Science
Volume19
Issue number8
Early online date18 Jul 2018
DOIs
Publication statusPublished - 01 Nov 2018

Keywords

  • Feasibility trial
  • Gender
  • Intervention
  • Sex education
  • Teenage pregnancy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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