Extended trial of My Vital Cycles: A whole school program to address ovulatory menstrual health literacy and mental wellbeing amongst 13–19-year-old females in Western Australia

BRIEF NAME My Vital Cycles WHY My Vital Cycles is a holistic strengths-based ovulatory menstrual health literacy program of menstrual health education and care. It is delivered as a whole school approach by school staff including teachers and school healthcare providers. There is a high prevalence of menstrual health challenges (e.g., period pain, mood swings, heavy or irregular bleeding) amongst female adolescents who constitute at least 50% of the future reproductively mature population. Therefore, an intervention to empower their capacity to self-care and self-advocate is necessary and timely. WHAT The materials were developed specifically for this trial. References in the "Public Notes" and on the program website https://myvitalcycles.com provide evidence of content and face validation, and researcher-led delivery in single sex and co-educational schools. Materials include guidebooks for teachers and school healthcare professionals | Lesson plans | Student workbooks | Videos | Posters | Charts for cycle tracking | Screening self-tests for Ferritin and Vitamin D are purchased from 2San Pty Ltd Training is provided online and at the convenience of school staff (see details below). Teaching and training materials are accessed through registration on the website portal. Physical resources will be delivered directly to each school. WHO PROVIDED There are two categories of intervention providers who will be drawn from the 10-12 participating schools: 1. The teachers are experienced in delivering either the Science and/or Health curricula - each receives online training of three 90-minute sessions covering cycle science and cycle management 2. The school healthcare providers include registered nurses and psychologists with experience in their healthcare field - each receives online training of four 90-minute sessions covering cycle science, cycle management and cycle care. HOW 1. The teachers deliver menstrual health education as formal face-to-face lessons through the Science (biology) and Health & Physical Education curricula. 2. The school healthcare professionals deliver menstrual health care face-to-face consisting of one initial consultation (history-taking, iron + Vitamin D screening and initiating cycle-tracking) and two follow-up consultations. WHERE 1. The teachers deliver the menstrual health education lessons in their classrooms during normal school hours at each school. 2. The healthcare professionals deliver menstrual health care during normal school hours in their designated rooms or clinics provided by the school. WHEN and HOW MUCH Menstrual health education is delivered once through the Science and Health curricula according to each school's schedule of lesson provision. Topics include: 1. A Whole Person context 2. Understanding how the cycle works 3. Common cycle difficulties 4. Managing common cycle difficulties 5. Critical reasoning and cycle analysis 6. Communicating to health care professionals The typical duration and frequency of the educational elements of the intervention are one-hour weekly classes for 10 weeks. Menstrual health care is delivered on an as-needed basis using a uniform protocol of care which includes cycle tracking, screening finger-prick self-test kits of Ferritin + Vitamin D, and recommendation to parents for follow-through with their preferred healthcare provider. For the purposes of this trial, each school healthcare professional will be requested to provide three anonymised case studies (see below). TAILORING There are 10-12 schools drawn from the Independent, Catholic and public school sectors. Both single-sex and co-educational schools are represented, including schools located regionally. The intervention will be adapted to fit into each school's own context in accordance with the principles laid down by the World Health Organization's Health Promoting School framework. MODIFICATIONS The principal at each school will determine the modifications to the MVC intervention according to the school’s context. For example, small schools may only have a first-aid officer and no nurse or psychologist. Therefore, delivery of MVC’s menstrual health care elements will be recorded as omitted. The exact form in which the intervention My Vital Cycles is delivered by each school will be documented. HOW WELL The planned adherence to intervention includes: 1. Observing teachers for selected lessons using a checklist developed for this trial, and inviting teachers at the end of the trial to attend a one-on-one interview for 20 minutes at a time and place of their convenience. 2. Inviting the school healthcare professionals to select three anonymous case studies from girls seeking menstrual health care using a care protocol developed for this study. At the end of the trial, the school healthcare professionals will be invited to attend a one-on-one interview for 20 minutes at a time and place of their convenience.