| Name of school | My vital cycles – Research case study |
| Motto | Empowering tomorrow’s women |
| Number of students | Unlimited |
| Name and role of contact person | Dr Felicity Roux
Chief Investigator |
| www.myvitalcycles.com | |
OverviewThere is no denying it; the ovulatory menstrual cycle is complex. Even up-to-date resources can give contradictory content, and few align with the protocols recommended by Restorative Reproductive Medicine. On top of this, teachers are inadequately supported in their professional learning on a subject that personally affects more than 70% of their workforce. The learning outcomes reveal this state of teacher support: about 60% of 15 year old female students in Western Australia do not know vaginas from vulvas, about 50% when the cycle starts, and less than 9% can say when ovulation happens. On top of this, about 70% of female students report period pain and mood swings, and more than 40% have heavy bleeding. Not surprisingly, their school attendance and academic performance are impacted. As teachers do care about their students, external guest speakers are invited to talk about all things menstrual; and it helps having others who can speak about this stigmatised and misunderstood subject. They come from a good place, offering a variety of programs. Some focus on problems, like period pain. Others give colourful one-size-fits-all descriptions of a mature cycle, which disregards the paediatric rule that girls are not miniature women. A research project was established at Curtin University to address these issues by developing and trialling a holistic ovulatory menstrual health literacy program. Experts from education and medicine were consulted in developing content. This was critiqued by teachers and school healthcare professionals, including nurses and psychologists. The resources for students were examined by adolescent girls and their mothers, who named the program My vital cycles. The final refined program was trialled in 2021 with year 9 girls at one single-sex school in Perth. In 2022, a shortened version was trialled in 5 co-educational schools, including regional and CARE schools. In all trials, the ovulatory menstrual health literacy of participating students significantly improved. Teachers were surprised by new information and clear explanations. One teacher even achieved a long-desired pregnancy. This research has been running for nearly a decade. As an ongoing project, it welcomes any who wishes to address menstrual health education and care in their schools. |
|
Project planning
The decision to use the HPSF was made at the start of the program’s development. Deciding on key content was informed by a panel of 35 experts in education (curriculum developers, health teachers, wellbeing coaches, school nurses and psychologists) and medicine (gynaecologists, GPs, fertility educators, and public health practitioners). Their recommendation to base the project on the HPSF was unanimous.
After all, the cycle is a biopsychosocial phenomenon. Its biology is best taught to both male and female students in Science. Armed with this foundational knowledge, actions and strategies to enhance menstrual wellbeing are then covered in Health Education. Menstrual health care is delivered to female students through the school’s Health Services.
The motto Empowering tomorrow’s women reflects the HPS philosophy by merging menstrual health education and care within the school and with the community to enhance both student and staff wellbeing. |
|
Major activities based on 2021 WHO Global standards for HPS (see diagram below)Government policies and resources – WA Women’s Health & Wellbeing Policy
Application of the global standards for health promoting schools to My vital cycles
1. School policies and resources
Professional learning is tailored to the curricula requirements for teaching Science and HPE. Training extends into clinical care supervision for schools’ nurses, psychologists and counsellors. Professional learning is self-directed and online through the program’s learning management system. The resources across different years and subjects ensure that accuracy and the same strengths-based message are delivered consistently.
2. School governance and leadership
Schools want evidence-based programs so that their students are more likely to achieve better health and academic results. However, it takes years to develop and trial such programs. This research depends on schools and their staff being willing to inconvenience themselves so that others receive better outcomes.
3. School community partnerships
Three community partnerships were developed:
4. School curriculum
In year 8 Science, students learn:
In years 7 and 8 Health Education, students learn:
In year 9 Health Education, students learn:
5. School social emotional environment
The following anecdotes were collected from the schools in the follow-up debrief:
6. School physical environment
Examples of changes made at schools:
7. School health services
Clinical care training enables school wellness staff (e.g. nurses and psychologists) to offer students appropriate and individualised menstrual health care regardless of their year level. Examples of services at schools:
|
|
OutcomesThe ability to use the cycle as a personal health monitor needs ovulatory menstrual health literacy. This is a key measure of ‘empowerment’. Health literacy is learnt sequentially, beginning with basic knowledge (functional); progressing to personal application and communication skills (interactive); and culminating in the capability of appraising information (critical). The health literacy outcome was measured using a questionnaire. Overall improvements were reported with 94 year 9 girls at a single-sex school and 63 year 9–12 girls in co-educational schools. Qualitative results showed that stigma was addressed, new discoveries were made, and medical students’ peer-based teaching was a highlight. After an initial reluctance to engage, a student reported, ‘I think it’s a great program with a great message, and I admire what you’re doing for young women’. |
|
Highlights
The 2021 pre-trial survey results showed that the school staff’s knowledge was lacking and they could not determine cycle patterns. So it was satisfying when teachers admitted, ‘I learned stuff. I did. Definitely’. Similarly, the nurses liked that, ‘You’re not just treating one symptom; you’re looking at the whole person’.
The significant improvement in girls’ mood concerns was a highlight. The program’s strengths-based approach emphasised the cycle as a positive sign of good health, whilst menstrual health challenges were dealt with pragmatically and optimistically. Girls reported the cycle as ‘a big part of our life’. It seems that any wellbeing program that involves girls cannot ignore the cycle.
Awards:
|
|
Challenges
It was obvious that Health and Science work and are taught in silos. Teachers from each discipline assumed the other had taught the cycle. Both pre-program results showed that students fell between the cracks. One Health teacher relayed a colleague’s comment, ‘In Science I’m, like, gobsmacked at how little these girls know!’.
Healthcare professionals were also surprised by girls’ lack of knowledge. ‘It’s like we’re speaking a foreign language to them. Yeah. And we think, ‘oh my gosh, how could they not be learning this?’ Yet their hands were tied. ‘Sometimes we just supply them with analgesia and send them back. I do think that we could possibly be doing more.’
|
|
Lessons learnt
The outcome of students’ improving their ovulatory menstrual health literacy was more than surpassed. The improvement in their mood concerns and their positive change in attitude showed that this program made a difference.
Each school has its unique context. There is no one-size-fits-all. So different approaches are the norm. Realistically, it is important to be attentive to what a school can take on. Being flexible helps ensure that when girls leave school, they possess knowledge, skills and confidence for a long reproductive life.
|
|
Tips for success and sustainability
|
|
