Can An Image Dominant Contraception App Educate, Enable And Empower Young Offenders To Make An Informed Choice To Consent To Treatment. Designing And Developing The Contra-mate Contraception App For Young People.
Gregory and Bryan (2011) report that more than 65% of young offenders have speech, language and communication needs making understanding and processing of contraception advice challenging. This makes them a high risk group for teenage pregnancy. The Public Health Outcomes Framework 2013-2016 includes reducing the under 18 conception rate as a key sexual health indicator (DH 2013a). The Framework for Sexual Health Improvement in England also cites under 18 conceptions as one of its 5 priority areas for improvement. (DH2013b).
Contra-mate contraception App has been developed to support the speech, language and communication needs of young offenders but ultimately all young people .The study sought to explore whether an App could be designed to give young people not only accessible information about contraception but support them through missed pill rules and accessing emergency contraception. It is hoped the App will address the indicators set out in the above Frameworks.
A need was identified within the School Nursing Service during secondment to the Bath and North East Somerset Youth Offending Team. Young people with speech, language and communication needs needed a new way of understanding contraception information in a media they are familiar with enabling them to make an informed choice to consent to treatment
Methodology
The research methodology used followed the Action Research Model. This model also known as Participatory Action is a research method that generates solutions to nursing issues in practice. (Abad-Carpa et al 2010). Action Research model involves a cyclical process of planning, action, observing and reflecting (Koshi et al 2011)
The research protocol used mixed methods which included:
A critical literature review of speech, language and communication needs in Young Offenders was completed to ascertain the extent of the language difficulty in this client group. Quantitative surveys were used to gather data on what Young People wanted in the App and qualitative focus groups to help with the design of the App. Focus groups were also used to gather data on what School Nurses would like in the App. Within this model both quantitative and qualitative data were triangulated and used to shape the content and design of the App.
Findings
The results of the qualitative focus groups of Young People n =3, n=11 and n=3 and School Nurses n=8 identified 3 emerging themes of what Young People and School Nurses would like in the App. The emerging themes were content of the App, design and help offered within the App. The results of the quantitative data collected from surveys n=55 revealed that 89% of young people wanted help in choosing a method of contraception and 91% wanted information about side effects and benefits. 88-91% of those surveyed would like a pill reminder and clinic locator. The surveys also revealed it was not important for them to record their menstrual symptoms or moods so this facility was removed from the App.
The results were used to fine tune the content of the App and designed to include 4 sections
- Information on all methods of contraception in easy to read terminology. For users who have a reading difficulty a slide show Power Point video has been included with a voice over. The colour scheme of the App was designed to reduce visual disturbances for readers with Dyslexia.
- Alarms/notification have been included to alert the user when to take the Pill or when to book an appointment for the 12 week contraceptive injection thereby decreasing user failure
- A Quiz has been included to assist the health professional in assessing the Young Persons understanding and Fraser competence
- The Help section guides the user through the missed pill rules asking them when they last took their pill and what to do. If the Young Person requires emergency contraception the App will alert them to, not only the nearest contraception and sexual health clinic but how far away it is. The final part of the Help section offers advice on pill taking during illness.
Conclusion
Following a review of the literature there appears to be a significant gap in research linking contraception services and socially disadvantaged young people. While Young People with speech, language and communication needs within the Youth Justice Service are well supported with an expanding evidence base, the language difficulties of this high risk group within sexual health needs further study.
The research study although not concluded has resulted in the design and development of a contraception App called Contra-mate.
It had been designed for use by School Nurses initially as part of the role of the School Nurse within the Bath and North East Somerset. However it became apparent that all health professionals working with Young People would benefit for knowing about this App. Any service that has contact with Young People i.e. Midwifery, Health Visiting would benefit. Even though the App will be primarily used during and after a consultation, it will be in the App store so freely available to all young people to gather information prior to seeking advice.
The aim is to launch Contra-mate in early 2016 following a period of user testing and feedback. A period of marketing and promotion will follow.