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

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.

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 Research Design

Stage 2. Creating the Intervention Synthesising results from stage 1 into an intervention – the writing and creating stage 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 Stage 3. Implementing the Intervention Implementing the intervention (SPIY Program) in the schools

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)

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

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

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

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” “a mate of mine caught fire…the bike was on flames” “she had a miscarriage” (as a passenger in a stolen car that crashed)

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

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. Youth Risk Taking Workshop Key Feedback

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 based 1 ) Personally, developmentally and culturally relevant Interactive discussions based on scenarios Practical exercises 1 Buckley (2005); Buckley (2006); Sheehan & Chapman (2005); Chapman & Sheehan (2005)

14 Typical lesson structure 5-10 mins Risk taking and injury scenario Brief story of friends’ risk taking and injury to contextualise learning (e.g. getting in car with underage driver) minsFirst aid Practical responses for dealing with injury (e.g. treating fractures/ bleeding; resuscitation) minsPrevention Skills to prevent own and friends’ risk behaviour and injury; increasing protective behaviour

15 Example lesson Lesson 8 summarised 5-10 mins Risk taking and injury scenario: Lift Home Students read story: Lift Home (friends taking a lift home from a party)

16 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? mins First aid: Head, neck & spinal injury treatment Students taken through fact sheets and complete worksheet on head, neck and spinal injury treatment Example lesson Lesson 8 summarised

mins Prevention: Getting help & Helping mates Discussion on importance of getting help when alcohol is involved; Helping mates worksheet I could... Worksheet – Helping mates What could you do if you were Lee that night? What’s good about that option… What’s bad about that option… How good is that decision… Example lesson Lesson 8 summarised

18 Student work