The research pathway to developing a health promotion intervention for the high school curriculum

1. The research pathway to developing a health promotion intervention for the high school curriculum Dr Lisa Buckley, Rebekah Chapman, Prof Mary Sheehan

2. Background • Injury prevention and health promotion are complex processes and there is considerable science in program design • There is a need for considerable planning and formative research required before programs get to the implementation stage.

3. Research Design Stage 1. Conceptual Development of the Intervention Literature review on problem identification & previous programs Local data on injury risk behaviours • Focus groups with adolescents to identifying ecologically valid themes for program goals Large scale workshop with teachers and school administrators Additional focus groups with students and teachers to reflect on draft material/ implementation

4. Stage 2. Creating the Intervention • Synthesising results from stage 1 into an intervention – the writing and creating stage Stage 3. Implementing the Intervention • Implementing the intervention (SPIY Program) in the schools Stage 4. Evaluation Studies Process & implementation evaluation • Impact evaluation – change in underlying program risk and protective factors Outcome evaluation – change in risk-taking behaviour and injury

5. Risk-taking behaviours & injury over 6 months Survey with Year 9s (n=661, mean age=13.6 years, 46% male) • 42.2% injured riding a bike • 18.1% injured riding a motorbike • 13.8% injured as a vehicle passenger • 5.7% injured while driving • 42.8% injured in a fight (Chapman & Sheehan, 2005)

6. Percentage and clustering of risk-taking behaviours in past 3 months for 14 year olds 25% Traffic Alcohol 12% 10% 13% 17% 8% 12% Violence (Buckley & Shope, 2007)

7. Risk and Protective Factors Risk Factors Protective Factors • Individual: • Sensation seeking • Impulsiveness • Low self esteem • Individual: • Religiosity • Attachment to parents • Family: • Parental monitoring • Parental help with school • Parental disapproval of risks • Family: • Poor supervision • Parental modelling • Family conflict Adolescent risk taking • School: • Academic achievement • Perceived school connectedness • School effort/interest • School: • Poor academic performance • School misbehaviour • Truancy • Peers: • Peer encouragement of risk taking • Peer modelling • Peers: • Peer disapproval of risks • Pro-social peers

8. Indepth understanding Identifying the participants’ experiences enables the program design to best reflect ‘real world’ experiences (Perry, 1999). METHOD • 30 high risk youth in non-mainstream schools (23 males) • Semi-structured with open-ended prompts • 4 focus group discussions

9. “a mate of mine caught fire…the bike was on flames” “she had a miscarriage” (as a passenger in a stolen car that crashed) Findings • Motorbike, bicycle, skateboard, car use • Violent Behaviour • Mostly minor injuries, some exceptions “they will find any excuse for drinking and if they don’t have one, they’re excuse is they wanna get drunk” “yeah, he got knocked out, it was quite funny, probably for about half an hour, he was driving up (the track) on his motorbike and he got hit by a rock, he had his open face helmet on”

10. A large scale workshop • Participants were 42 teachers/ school staff and 8 education department administrators • Series of discussions regarding best implementation/ delivery methods for a high school injury prevention program & suggestions for content

11. Youth Risk Taking WorkshopKey Feedback Intervention methods and processes • Intervention needs to be engaging, interactive and non-traditional, employing a variety of stimulus • Must be implemented across the board and integrated into the school curriculum. Some contents should be assessable. • A Professional Development component is considered important. • Program should offer teachers greater support in the classroom context.

12. Comments on Materials • Specific aspects of delivery discussed, e.g. formatting and layout of materials, unrealistic to include audiovisual/ computing components • Some examples could be added, e.g. support services within specific schools

13. How is SPIY taught? • Integrated with the curriculum • Taught by teachers trained in program delivery and connectedness • Year 9 Health Education • 8 x 50 minute lessons (approximately 1 school term) • Formally assessed • Age-appropriate (research based1) • Personally, developmentally and culturally relevant • Interactive discussions based on scenarios • Practical exercises 1Buckley (2005); Buckley (2006); Sheehan & Chapman (2005); Chapman & Sheehan (2005)

14. Typical lesson structure

15. Example lesson Lesson 8 summarised

16. Example lesson Lesson 8 summarised Worksheet – Head, Neck & Spinal Injuries Use the Facts Sheet – Head injuries and Spinal injuries to answer the questions below. 1. If you’re first on the scene what’s the first thing you should check? 2. Shannon’s checked the scene for any danger and thinks it’s safe, what should Shannon check next? 3. Lee responds and is breathing, how still should Shannon keep the head and neck? 4. Should 000 or 112 (mobile) be called urgently?

17. Example lesson Lesson 8 summarised I could... What’s good about that option… Worksheet – Helping mates What could you do if you were Lee that night? How good is that decision… What’s bad about that option…

18. Student work