Aine Aventin

Knowledge Translation in Men’s Health Research: Development and Delivery of Content for Use Online

Background Men can be hard to reach with face-to-face health-related information, while increasingly, research shows that they are seeking health information from online sources. Recognizing this trend, there is merit in developing innovative online knowledge translation (KT) strategies capable of translating research on men’s health into engaging health promotion materials. While the concept of KT has become a new mantra for researchers wishing to bridge the gap between research evidence and improved health outcomes, little is written about the process, necessary skills, and best practices by which researchers can develop online knowledge translation. Objective Our aim was to illustrate some of the processes and challenges involved in, and potential value of, developing research knowledge online to promote men’s health. Methods We present experiences of KT across two case studies of men’s health. First, we describe a study that uses interactive Web apps to translate knowledge relating to Canadian men’s depression. Through a range of mechanisms, study findings were repackaged with the explicit aim of raising awareness and reducing the stigma associated with men’s depression and/or help-seeking. Second, we describe an educational resource for teenage men about unintended pregnancy, developed for delivery in the formal Relationship and Sexuality Education school curricula of Ireland, Northern Ireland (United Kingdom), and South Australia. The intervention is based around a Web-based interactive film drama entitled “If I Were Jack”. Results For each case study, we describe the KT process and strategies that aided development of credible and well-received online content focused on men’s health promotion. In both case studies, the original research generated the inspiration for the interactive online content and the core development strategy was working with a multidisciplinary team to develop this material through arts-based approaches. In both cases also, there is an acknowledgment of the need for gender and culturally sensitive information. Both aimed to engage men by disrupting stereotypes about men, while simultaneously addressing men through authentic voices and faces. Finally, in both case studies we draw attention to the need to think beyond placement of content online to delivery to target audiences from the outset. Conclusions The case studies highlight some of the new skills required by academics in the emerging paradigm of translational research and contribute to the nascent literature on KT. Our approach to online KT was to go beyond dissemination and diffusion to actively repackage research knowledge through arts-based approaches (videos and film scripts) as health promotion tools, with optimal appeal, to target male audiences. Our findings highlight the importance of developing a multidisciplinary team to inform the design of content, the importance of adaptation to context, both in terms of the national implementation context and consideration of gender-specific needs, and an integrated implementation and evaluation framework in all KT work.

Recruiting faith- and non-faith-based schools, adolescents and parents to a cluster randomised sexual-health trial: experiences, challenges and lessons from the mixed-methods Jack Feasibility Trial

BackgroundThe move toward evidence-based education has led to increasing numbers of randomised trials in schools. However, the literature on recruitment to non-clinical trials is relatively underdeveloped, when compared to that of clinical trials. Recruitment to school-based randomised trials is, however, challenging, even more so when the focus of the study is a sensitive issue such as sexual health. This article reflects on the challenges of recruiting post-primary schools, adolescent pupils and parents to a cluster randomised feasibility trial of a sexual-health intervention, and the strategies employed to address them.MethodsThe Jack Trial was funded by the UK National Institute for Health Research. It comprised a feasibility study of an interactive film-based sexual-health intervention entitled If I Were Jack, recruiting over 800 adolescents from eight socio-demographically diverse post-primary schools in Northern Ireland. It aimed to determine the facilitators and barriers to recruitment and retention to a school-based sexual-health trial and identify optimal multi-level strategies for an effectiveness study. As part of an embedded process evaluation, we conducted semi-structured interviews and focus groups with principals, vice-principals, teachers, pupils and parents recruited to the study as well as classroom observations and a parents’ survey.ResultsWith reference to social learning theory, we identified a number of individual-, behavioural- and environmental-level factors that influenced recruitment. Commonly identified facilitators included perceptions of the relevance and potential benefit of the intervention to adolescents, the credibility of the organisation and individuals running the study, support offered by trial staff, and financial incentives. Key barriers were prior commitment to other research, lack of time and resources, and perceptions that the intervention was incompatible with pupil or parent needs or the school ethos.ConclusionsReflecting on the methodological challenges of recruiting to a school-based sexual-health feasibility trial, this study highlights pertinent general and trial-specific facilitators and barriers to recruitment, which will prove useful for future trials with schools, adolescent pupils and parents.Trial registrationISRCTN 11632300. Registered on 19 December 2014.

Recruiting schools, adolescents and parents to a sexual-health trial: experiences, challenges and lessons learned from the Jack Trial (NCT02092480)

Method The Jack Trial is an NIHR-funded feasibility study of a film-based sexual health intervention, recruiting over 800 adolescents from 8 post-primary schools in Northern Ireland. In order to examine the feasibility of piloted recruitment and retention methods and assess acceptability of participation across the range of schools and individuals approached, we analysed qualitative data from triangulated sources including a parents’ survey and semi-structured interviews with principals, viceprincipals, teachers and parents recruited to the study.

JACK trial protocol: a phase III multicentre cluster randomised controlled trial of a school-based relationship and sexuality education intervention focusing on young male perspectives

Introduction Teenage pregnancy remains a worldwide health concern which is an outcome of, and contributor to, health inequalities. The need for gender-aware interventions with a focus on males in addressing teenage pregnancy has been highlighted as a global health need by WHO and identified in systematic reviews of (relationship and sexuality education (RSE)). This study aims to test the effectiveness of an interactive film-based RSE intervention, which draws explicit attention to the role of males in preventing an unintended pregnancy by reducing unprotected heterosexual teenage sex among males and females under age 16 years. Methods and analysis A phase III cluster randomised trial with embedded process and economic evaluations. If I Were Jack encompasses a culturally sensitive interactive film, classroom materials, a teacher-trainer session and parent animations and will be delivered to replace some of the usual RSE for the target age group in schools in the intervention group. Schools in the control group will not receive the intervention and will continue with usual RSE. Participants will not be blinded to allocation. Schools are the unit of randomisation stratified per country and socioeconomic status. We aim to recruit 66 UK schools (24 in Northern Ireland; 14 in each of England, Scotland and Wales), including approximately 7900 pupils. A questionnaire will be administered at baseline and at 12–14 months postintervention. The primary outcome is reported unprotected sex, a surrogate measure associated with unintended teenage pregnancy. Secondary outcomes include knowledge, attitudes, skills and intentions relating to avoiding teenage pregnancy in addition to frequency of engagement in sexual intercourse, contraception use and diagnosis of sexually transmitted infections. Ethics and dissemination Ethical approval was obtained from Queen’s University Belfast. Results will be published in peer-reviewed journals and disseminated to stakeholders. Funding is from the National Institute for Health Research. Trial registration number ISRCTN99459996

What do young people really understand when completing questionnaires? Lessons learnt from developing a questionnaire to measure behavioural outcomes in a sexual health trial

It cannot be taken for granted that young people will understand and interpret questions in the way we expect. This is true even when using validated measures, developed and used with the appropriate age group. It can cause problems for trials that need to minimise “noise” when measuring outcomes. We will describe our observations and lessons learnt from developing a questionnaire for young people in a sexual health trial. The Jack feasibility trial, funded by the NIHR evaluates a film-based educational intervention aimed at increasing boys’ and girls’ intentions to avoid teenage pregnancy (ISRCTN11632300). The trial is ongoing and has recruited eight post-primary schools and 831 young people. As part of the trial, we compiled validated and non-validated instruments to measure sexual behavior data including engagement in sexual intercourse, contraception use, drugs and alcohol usage, diagnosis of STIs; data regarding knowledge, attitudes, skills and intentions relating to avoiding teenage pregnancy; and socio-economic status. The questionnaire was piloted and appropriately modified after pupils took part in focus groups to identify procedural challenges in completing the questionnaire. We discovered difficulties in questionnaire completion due to understanding of terminology and ensuring privacy in different classroom layouts. We will also discuss the issues young people raised when completing the questionnaire, for example by examining the challenges encountered with specific questions such as ‘Have you ever drunk alcohol?’ and present a qualitative description of issues surrounding understanding. We will highlight the importance of feasibility and pilot work for school-based trials in sexual health.

Collecting sensitive information for a sexual health trial with young people: experiences of using electronic data collection and traditional paper methods

Electronic data collection for randomised trials is attractive as it can, in theory, provide great financial advantages by reducing fieldwork costs and data inputting time, as well as increasing the accuracy of responses over and above paper based methods. For trials involving young people, electronic methods provide other advantages such as the ability to adapt questions to meet the needs of young people of differing ages and abilities. Researchers have also suggested that young people prefer electronic methods over traditional ones and have found equal validity across both methods. This presentation will discuss issues relating to the collection of sensitive information from young people in Northern Ireland, using electronic and paper formats. We will draw on experience gained across several research studies that have collected data on sexual risks and behaviours, particularly in school-based research; including a recent trial on adolescent pregnancy. We will examine the feasibility, reliability and validity of data collected along with an evaluation of the cost implications and ease of using both methods (including the merging of the resulting datasets if both methods are offered). The views of the researchers and participants will also be reflected upon.