My Vital Cycles™: An Ovulatory-Menstrual Health Literacy Program for the Whole Person

Abstract

Background: A high prevalence of adolescent girls experience ovulatory-menstrual (OM) health difficulties such as painful periods, premenstrual symptoms, irregular cycles and abnormal bleeding patterns. These difficulties are associated with school absenteeism and reduced concentration in class. In addition, there is also an association with mental health challenges such as a negative body image, the onset of eating disorders and non-suicidal self-injury. A review of school-based resources suggests that this stigmatized subject is not only couched in biology, but it can be presented negatively. Aim: This research project aimed to develop and trial a school-based OM health literacy program that positively addresses the biopsychosocial aspects of the OM cycle. Method: A Delphi Panel was convened with experts in medicine, education, and public health. Together with a systematic literature review of OM health programs, they informed a draft program to teach adolescent girls and a draft questionnaire to test their OM health literacy. These drafts were reviewed by adolescent girls, parents, teachers and school healthcare professionals in focus groups and one-on-one interviews. The draft questionnaire was then test-retested to establish its validity. Results: The Delphi Panel validated the content of the draft program. Based on the principles of Positive Education, the program was mapped to the Western Australian curriculum, Nutbeam’s Health Literacy Model and the WHO’s Health Promoting School framework. The focus groups and one-one-one interviews face validated the program and questionnaire, and suggested additional refinements (e.g. website, animations, videos, and the name My Vital Cycles™). Conclusion: My Vital Cycles™ recognizes the OM cycle as a biopsychosocial phenomenon. It practically addresses common OM health difficulties with the aim of improving OM health literacy using Positive Education principles. The program has been registered for clinical trial.