Gaining ethical approvals to undertake sexual health research with young people in the UK: Applying a 'Children's Rights Based Approach'

This paper (co-written with Dr Maria Lohan, Dr Carmel Kelly & Professor Laura Lundy) will describe the ethical review process to undertake health research in the UK, and explain an approach that can help researchers deal with ethical and methodological dilemmas in their research. Ethical review is necessary to ensure researchers and participants are protected, yet the requirement to ‘pass’ numerous committees may be challenging particularly for health researchers who work with vulnerable groups and sensitive topics. The inclusion of these groups/topics is crucial if health researchers are to understand health disparities and implement appropriate interventions with health benefits for vulnerable populations. It is proposed that to overcome ethical and methodological challenges and pitfalls, researchers must implement strategies that advocate for, and increase the participation of, vulnerable populations in health research. A ‘children’s rights based approach’ using participatory methodology will be described that draws on the jurisprudence of international law, (United Nations Convention on the Rights of the Child, 1989) and provides a framework that may empower ethics committees to carry out their function confidently. The role of the researcher, framed within the context of doctoral level study, will be reviewed in terms of the investment required and benefits of utilising this approach. It will be argued that adopting this approach with vulnerable groups, not only guarantees their meaningful participation in the research process and permits their voices to be heard, but also offers ethics committees an internationally agreed upon legal framework, ratified by their governing States, from which to fulfil their obligations and resolve their ethical dilemmas. Increasing the representation and participation of vulnerable groups in health research can inform the development of health policy and practice based on ‘insider knowledge’ that better engages with and more adequately reflects their specific needs. This is likely to yield numerous health, social and economic benefits for all of society through the delivery of more equitable, effective and sustainable services.

The perceived impact of interprofessional information sharing on young people about their sexual health care

This article presents the results from an analysis of data from service providers and young adults who were formerly in state care about how information about the sexual health of young people in state care is managed. In particular, the analysis focuses on the perceived impact of information sharing between professionals on young people. Twenty-two service providers from a range of professions including social work, nursing and psychology, and 19 young people aged 18–22 years who were formerly in state care participated in the study. A qualitative approach was employed in which participants were interviewed in depth and data were analysed using modified analytical induction (Bogdan & Biklen, 2007). Findings suggest that within the care system in which service provider participants worked it was standard practice that sensitive information about a young person’s sexual health would be shared across team members, even where there appeared to be no child protection issues. However, the accounts of the young people indicated that they experienced the sharing of information in this way as an invasion of their privacy. An unintended outcome of a high level of information sharing within teams is that the privacy of the young person in care is compromised in a way that is not likely to arise in the case of young people who are not in care. This may deter young people from availing themselves of the sexual health services.

‘Disability and HIV in Africa: Breaking the barriers to sexual health care’

Three decades in to the HIV pandemic, the issues affecting people with disabilities remains less known. Increasing attention has been given to this overlooked population when it comes to HIV prevention, treatment and care. This is related to the significant unmet sexual and reproductive health care needs facing people with disabilities worldwide. This article discusses the barriers to sexual health for people with disabilities in Africa, and presents an argument about how mainstream HIV prevention work and research does not adequately attend to the sorts of systemic barriers that exclude people with disabilities, which a more targeted, and critical approach could.

Participation factors in optional high school health and physical education

Student enrolment rates in optional health and physical education (HPE) classes have been steadily declining, to the point where most Ontario students stop taking HPE after completion of their one required credit, typically taken in grade nine. This study looked at factors that could contribute to HPE enrolment, sampling 227 grade ten students from five schools. These factors included selfefficacy (SE), perceived autonomy support (PAS), task value (TV), motivational regulation (autonomous, AR; controlled, CR), HPE grade average and body size discrepancy (BSD). Qualitative information was also gathered from students regarding likes and dislikes ofHPE, as well as reasons for their HPE enrolment choice. Cronbach Alpha values of each scale fell within acceptable values. ANOVA analysis revealed differences between enrolment groups in SE, TV, AR, HPE grade average, and BSD (p < .05). Reasons students reported for not taking HPE included a dislike of health classes, scheduling challenges, not needing HPE for future endeavors, concerns about social self-presentation, and a dislike of sports and/or competition. This research shows important differences between students and their HPE class choices and calls for a re-evaluation of how HPE classes are structured, advertised and scheduled by high school practitioners. Future works should look toward what other factors could be at play in students' decisions for or against optional HPE and how those factors interact with the constructs that were found to be of significance in this study. Keywords: Health and physical education, high school students, participation.

A needs assessment of public health professionals: supporting the implementation of Ontario 2010 revised elementary health and physical education curriculum

Based on the Comprehensive School Health framework, Ontario's Foundations for a Healthy School (2009) outlines an integrated approach to school health promotion. In this approach the school, community and partners (including public health) are fully engaged With a common goal of youth health. With the recent introductions of the Ontario Public Health Standards (2009) and the revised elementary health and physical education curriculum (2010), the timing for a greater integration of public health with schools is ideal. A needs assessment was conducted to identify the perceived support required by public health professionals to implement the mandates of both policy documents in Ontario. Data was collected for the needs assessment through facilitated discussions at a provincial roundtable event, regional focus groups and individual interviews with public health professionals representing Ontario's 36 public health units. Findings suggest that public health professionals perceive that they require increased resources, greater communication, a clear vision of public health and a suitable understanding of the professional cultures in which they are surrounded in order to effectively support schools. This study expands upon these four categories and the corresponding seventeen themes that were uncovered during the research process.

Understanding the Integration of Living Skills Through the Context of Health and Physical Education: A Case Study of Educators’ Experiences

The research presented is a qualitative case study of educators’ experiences in integrating living skills in the context of health and physical education (HPE). In using semi-structured interviews the study investigated HPE educators’ experiences and revealed their insights relative to three major themes; professional practice, challenges and support systems. Professional practice experiences detailed the use of progressive lesson planning, reflective and engaging activities, explicit student centered pedagogy as well as holistic teaching philosophies. Even further, the limited knowledge and awareness of living skills, conflicting teaching philosophies, competitive environments between subject areas and lack of time and accessibility were four major challenges that emerged throughout the data. Major supportive roles for HPE educators in the integration process included other educators, consultants, school administration, public health, parents, community programs and professional organizations. The study provides valuable discussion and suggestions for improvement of pedagogical practices in teaching living skills in the HPE setting.

“The Ministry of Obligation warns”: it is necessary to protect the sexual offender adolescents

This text deals with a part of the research-action “Multifamiliar groups with sexual offender adolescents” and emphasizes the written production of the adolescents during the process. two texts were involved: the first one was a letter addressed to the parents and the second was an evaluation of the multifamiliar group. Seven adolescents between 14 and 17 years old wrote the texts. About the first text we discussed: the adolescent as responsible for the domestic work; the adolescent and his need to receive support and protection and the adolescent and the recognition of his growth phase. about the second text: the feelings of the adolescent regarding sexual abuse; the relation with the institution that carries out the intervention; the symbols that identify his ambivalence. We comment about the sexual abuse practiced by these adolescents as from two main points: the adolescence seen as a development phase and the role played by the family in the conduction of this phase.