Can teenage men be targeted to prevent teenage pregnancy? A feasibility cluster randomised controlled intervention trial in schools

Lohan, M., Aventin, Á., Clarke, M., Curran, R. M., McDowell, C., Agus, A., McDaid, L. , Bonell, C. and Young, H. (2018) Can teenage men be targeted to prevent teenage pregnancy? A feasibility cluster randomised controlled intervention trial in schools. Prevention Science, 19(8), pp. 1079-1090. (doi: 10.1007/s11121-018-0928-z) (PMID:30022356) (PMCID:PMC6208578)

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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.

Item Type:Articles
Additional Information:Intervention design and development were funded by the UK ESRC (RES-189-25-0300). The feasibility trial (ISRCTN99459996) was funded by the NIHR Public Health Research programme (15/181/01). The views expressed are those of the authors and not those of the NHS, the NIHR, or the Department of Health. The Scottish transferability study was funded by the UK MRC (MC_UU_12017/11) and the Scottish Government Chief Scientist Office (SPHSU11). The transferability study in Wales and England was funded by the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University and University College London.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McDaid, Professor Lisa
Authors: Lohan, M., Aventin, Á., Clarke, M., Curran, R. M., McDowell, C., Agus, A., McDaid, L., Bonell, C., and Young, H.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Prevention Science
Publisher:Springer
ISSN:1389-4986
ISSN (Online):1573-6695
Published Online:18 July 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Prevention Science 19(8): 1079-1090
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727631Social Relationships & Health ImprovementLisa McDaidMedical Research Council (MRC)MC_UU_12017/11HW - MRC/CSO Social and Public Health Sciences Unit