Mixed Method Evaluation of My Vital Cycles®: A Holistic School-Based Ovulatory Menstrual Health Literacy Program

Application of psycho-educational intervention to reduce menstrual-related distress among adolescent girls: a randomized controlled trial

OBJECTIVES

The objective of the present study was to investigate the effect of psycho-educational intervention on severity of menstrual distress symptoms among adolescents with primary dysmenorrhea.

METHODS

A randomized controlled trial was conducted from August 2019 to April 2020 comprising 120 adolescent girls. The study settings were high schools in Qazvin City. Participants were randomly assigned to intervention (n=60) and control groups (n=60) using a cluster randomization method. The intervention included three 60- to 90-min group psycho-educational sessions based on Leventhal's self-regulatory method. The sessions took place over three consecutive weeks with each group comprising 8-10 individuals. Menstrual distress (as the primary outcome), and illness perception and severity of dysmenorrhea (as the secondary outcomes), were assessed at four time points (pre-intervention, and three post-intervention assessments [one month, two months, and three months]).

RESULTS

A total of 54 individuals from the intervention group and 60 from the control group completed all follow-up measurements. Menstrual distress in the pre-menstruation phase significantly decreased among the intervention group at the three follow-ups (-5.41, -5.45, -4.97; all p<0.001). Menstrual distress in the menstruation phase significantly decreased among the intervention group at the three follow-ups (-11.75, -12.49, -12.38; all p<0.001). Dysmenorrhea pain intensity significantly decreased among the intervention group at the three follow-ups (-2.90, -3.49, -3.30; all p<0.001). Illness perception of dysmenorrhea significantly decreased among the intervention group. Mean differences of between group comparison (intervention vs. control) through follow-ups were -19.74, -22.56, -22.71 (all p<0.001). Based on the result of the RM ANOVA-ANCOVA model, the group effect was significant (p<0.001) with the intervention explaining 36.3 % of variance for change in menstrual distress in the pre-menstruation phase, 75 % of change in mean scores of menstrual distress in the menstruation phase, 78.5 % of variance for change in mean scores of dysmenorrhea, and 74.8 % of variance for change in mean scores of illness perception.

CONCLUSIONS

This intervention improved adolescent girls' menstrual distress, severity of dysmenorrhea, and illness perception regarding dysmenorrhea.

A Scoping Review and Environmental Scan of Health Literacy and Resources Related to Menstrual Health for Aboriginal Women in Australia

ISSUES ADDRESSED

Menstrual health literacy is an important aspect of improved engagement, management and social participation linked to menstrual health and wellbeing. There is stark evidence surrounding culturally appropriate menstrual health literacy for Aboriginal women in Australia.

METHODS

This scoping review sought to explore current menstrual health literacy programmes and resources in Australia with further interrogation of how these relate to Aboriginal women specifically. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map and explore menstrual health literacy programmes and resources in Australia and for Aboriginal women.

CONCLUSIONS

Seven research articles and nine grey literature reports from Australia met the inclusion criteria. The grey literature was insightful in relation to community based and culturally appropriate approaches to improving menstrual health literacy. SO WHAT?: Further research is required to demonstrate how culturally safe menstrual health programmes and health literacy resources that address the psychosocial and cultural needs of Aboriginal women, can be appropriately co-designed, evaluated and adapted to the diverse geographical contexts, in partnership with and for Aboriginal women.

A formative investigation assessing menstrual health literacy in professional women's football

The aim of this study was to assess and compare menstrual health literacy in professional women's football. A three-section questionnaire was completed by professional players (n = 25), development players (n = 22) and staff (n = 19). The mean total knowledge score (out of 19) was lower for development players (5.4 ± 2.9) than professional players (7.8 ± 3.2) and staff (9.1 ± 4.8) (p < 0.001). No group achieved >50% correct answers. For each group, knowledge of the menstrual cycle (MC) was greater than knowledge of hormonal contraceptives (HC) (p < 0.001). Previous MC and HC education did not correspond to higher knowledge scores in professional players (p = 0.823) or development players (p = 0.274). In professional and development players, comfort of communication was influenced by the sex of whom they were communicating with (p < 0.001), with a preference for females. In conclusion, results from the present study suggest refined education strategies and new approaches are required for both players and staff to improve menstrual health literacy in professional women's football.

'Everyone needs to be educated': pupils' voices on menstrual education

BACKGROUND

Physical, affective and behavioural symptoms associated with the menstrual cycle are commonplace. Adolescents with problematic symptoms have reported a negative impact on school attendance, behaviour and participation in physical activity. In the United Kingdom, evidence suggests that menstrual health education delivered by teachers focusses on menstrual cycle biology as opposed to management of menstruation and menstrual cycle related symptoms. Through obtaining the pupil voice, this study aimed to understand young people's perceptions and experiences of menstrual education in schools and their experiences of menstruating whilst at school, including within Physical Education.

METHODS

To address the aims, a qualitative descriptive study was conducted. Nine focus groups with female pupils (n = 48; ages 10-15 years) were completed across six school locations in England and Wales, including primary and secondary schools. A range of elements relating to the menstrual cycle, education at school and PE were discussed by pupils.

RESULTS

Four main themes were developed (a) Education preferences, (b) Period positive environments, (c) Personal experiences and (d) Impact on school. Similarities were reflected across focus groups in terms of current (lacking) education, lesson style and preferences, comfort of conversations, lack of school support and impact on school and PE.

CONCLUSION

The findings highlight the lack of menstrual education received and subsequent impact of menstruation and menstrual-related symptoms in school and PE. The abundance of information requested by pupils highlights the deficit in understanding about how to manage periods in school and remain engaged in physical activity. Schools can utilise information from the current study to; create period positive environments; consider lesson content and format; and explore how to support girls to stay physically active in PE.