Development of the concept of impact literacy through applying theory vs. intervention led approaches to adolescent sexual health intervention design

  • Julie Bayley

    Student thesis: Doctoral ThesisDoctor of Philosophy


    Despite an overall reduction in UK teenage conception rates since the 1999 Teenage Pregnancy strategy, rates remain high and sexually transmitted infections remain a public health issue. School sex education remains a primary source of sex and relationships information for young people, but there is varied quality in provision and limited opportunity to accommodate individual differences (such as gender and age). Young people can benefit from parental support in learning about sex and relationships, but parents can feel embarrassed and underequipped to talk with their children. There is clear scope to integrate socio-cognitive theory into provision to improve education and support to ultimately improve contraception use. Approaches to intervention development can be characterised as being rooted in a singular or expanded theory (‘theory led’), or focused on the problem and allowing the application of multiple theories (‘intervention led’). This portfolio presents seven outputs within the theme of sex education, each offering insights into how to improve adolescent sexual health. Two articles are presented within the ‘theory-led’ strand. The first article (Bayley, Brown, & Wallace, 2009) explores under 16s attitudes to emergency contraception within a Theory of Planned Behaviour (Ajzen, 1991) framework. Focus groups with 13-16 year olds (n=48) suggest that practical factors and attitudes may be more significant barriers for teenagers ambivalent about pregnancy, and that confidentiality is a concern for all young people. The second article (Bayley, Baines, & Brown, 2017) integrates these findings into an extended TPB survey (n=1378) on under 16 attitudes to condoms, the contraceptive pill and emergency contraception. Findings suggest three distinct predictive models of intention (36%, 18% and 23% respectively), with attitude, gender and anticipated regret common to each. Girls appear more strongly motivated and year 10 is a crucial stage for intention. Four outputs are presented under the ‘intervention-led’ strand. Output 3 (Newby, Bayley, & Wallace, 2011a) describes the process of using an Intervention Mapping (Eldredge, Markham, Kok, Ruiter, & Parcel, 2016) approach to develop a parents’ sex and relationships communication programme (“What Should We Tell the Children?”). In reflection of the challenge of recruiting fathers to this programme, Output 4 (Bayley, Wallace, & Choudhry, 2009) explores how to improve fathers’ engagement in parenting support. Results of focus groups, questionnaires and interviews (n=38) suggest practical difficulties, female oriented services and lack of organisational support present barriers to fathers’ access. In reflection of difficulties attending a group programme and the need to improve access, Output 5 (Bayley, Baines, & Brown, 2015) demonstrates the process of converting the group based “What Should We Tell the Children?” programme into an online Serious Game. Drawing this learning back into school based provision, Output 6 (Brown, Bayley, & Newby, 2012) applies Intervention Mapping to the development of a serious game for use in the classroom to prevent sexual coercion. Each of these outputs highlights a range of challenges and opportunities for generating real world benefit or ‘impact’. The final output (Bayley & Phipps, 2017a) draws together this learning into a new concept of ‘impact literacy’, emphasising the need to understand the how, what and who of impact to drive research into practice. The learning is also synthesised into two new models of impact literate health psychology interventions, combining best practice across theory, intervention and impact models to guide subsequent development and implementation.
    Date of Award2017
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorKatherine Brown (Supervisor)


    • Adolescents
    • Behaviour change
    • Contraception
    • Knowledge mobilisation
    • Knowledge transfer
    • Knowledge translation
    • Health Psychology
    • Interventions
    • Intervention Development
    • Intervention Mapping
    • Impact
    • Impact literacy
    • Impact research
    • Implementation research
    • Research impact
    • School
    • Sex education
    • Sexual health
    • Teenage pregnancy
    • Theory of Planned Behaviour
    • Under 16s

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