Participatory research studies have been conducted in the field of health care and community health promotion (Schulz, Gravlee, Williams & Israel, 2006; Schulz, Israel et al., 2006; Srinivasan, O’Fallon & Dearry, 2003). However, adolescents have been engaged by researchers almost exclusively as subjects and informants (Powers &
Tiffany, 2006), rather than resources and partners, particularly in the development of programmes (Liegghio et al., 2010; O’Donoghue, Kirshner & McLaughlin, 2004).
Trinidad (2009) proposes that effective research incorporates the processes of youth participation, critical consciousness and production of cultural knowledge. Trinidad (2009) also highlights the complementary nature of these processes and the need for their simultaneous use through specific activities, which many conventional youth programmes lack. However, different types of research differ according to the degree of control exerted by the researcher over outcomes and definitions of improvement (see Fern, 2011; Liegghio et al., 2010). Table A6 (see Appendix A) highlights the major school and community participatory studies that surrounded mental health and wellbeing and adhered to most of the key principles of participatory research.
In youth-specific research, there is a strong underlying determination to involve young people from the very earliest stages of intervention development (O’Donoghue, Kirshner & McLaughlin, 2002; Stafford et al., 2003). Distinguishing the current research from true youth participation, involving young people deciding on the agenda itself (National Children’s Advisory Council, 2009), the researcher and the school administration determined the questions to be asked and subsequently decided what to do with the information. However, in the current study the very nature of the research requires that power be biased towards adults (National Children’s Advisory Council, 2009). While this involvement is often within the bounds of an adult agenda, a study conducted in the UK noted that young people saw this form of participation as very valuable (Stafford et al., 2003). Stafford et al. (2003) have further suggested that the process should be motivated by a genuine interest in making use of young people’s views, and have a clear purpose that is well communicated to young people and is respectful of young people’s role as making an important contribution. While making clear its objectives about youth mental health prevention and promotion, the
current study focuses on male adolescents and the reciprocal partnership with the school in the design and evaluation of a mental health and wellbeing programme.
Conversely, some health sector researchers see participatory practice as a threat to the validity of research (Rowling, 2003). Seriously including adolescents as active participants, particularly in the context of education (Tisdall, 2010), has thus remained somewhat elusive (Graham & Fitzgerald, 2010). However, most recently a number of researchers have sought to develop new directions by examining the gap between promise and practice of participation, particularly among adolescents (Fielding, 2007;
Thomas, 2007). Research in which students and the wider school community are encouraged to participate as active stakeholders have been shown to potentially create opportunities for effective promotion among youth (Powers & Tiffany, 2006).
Further, this may allow researchers to more effectively use the knowledge gained to guide and create collective change in organisations, programmes, communities and in research participants themselves (Reason, 2001; Wicks & Reason, 2009). The practice of having participants and the wider school community as active stakeholders is increasingly becoming adopted and adapted in evaluation practice (Rogers &
Williams, 2006). Therefore, the active involvement of young people and school staff in the current project is intended to aid in establishing a youth-specific and tailored intervention programme in a specific school environment. The contributions from major stakeholders guided the design and implementation of the programme, allowing for a more specific and tailored approach for interventions targeting young males.
An Australian study (Monshat et al., 2012), while not in a school context, used a participatory consultation methodology with young people to design an online Mindfulness Training Program. The programme aimed to improve young participants’ psychological distress and emotion regulation. The authors concluded that the contributions by the youth had made a major impact on the design and strategy for recruitment and evaluation of the eventual programme, called Mindful Awareness Training and Education (MATE) (Monshat et al., 2012). Similarly, in keeping with participating research practice, in the dissemination of MindMatters (a national mental health promotion programme for secondary schools in Australia), schools were given back their baseline data (Hazell, Vincent, Waring & Lewin, 2002).
Aspects of the MindMatters programme have been evaluated (Askell-Williams,
Lawson & Murray-Harvey, 2007; Hazell, 2005; Rowling & Mason, 2005). While some health sector research sees a partnership perspective, such as this one, as a threat to the validity of the research (Rowling, 2003), Hazell et al. (2002) highlight the positive aspect and achievement of this approach through the balancing of opportunities to develop student-level evidence, the need for flexibility and cooperatively working with schools, and the expectations of administrators and policy makers. Thus, researchers have proposed that partnerships in the school environment are an essential quality of health promotion practice (Department for Education and Skills, 2001). The purpose of the current research project is to build on this, by establishing an evidence base for the benefits of students and the broader school community participating in the programme design, particular to the Australian school context and mental health promotion among male adolescents.
Along with addressing the determinants of health, health promotion using a participatory approach aims to enable change and to empower people so that they have the capacity to improve their own health as well as the health of the community (Kickbusch, 2003; Powers & Tiffany, 2006). In contrast to traditional disease prevention in schools, the Health Promoting Schools approach similarly addresses determinants of health in the environment (Rowling & Jeffreys, 2006). It aims to empower schools to be active partners in the development and design of health promotion practices instead of being reactive to instructional materials produced by outside bodies (Tjomsland, 2009). In an Australian systematic review of evidence-based health promotion by the Department of Human Services (2000), the authors provide advice on approaches to adolescent health promotion. They strongly propose that recommendations need to be carefully considered against the context of implementation. Rowling (2003) concurs and adds that controlled designs do not contribute to capacity building, limiting the quality of implementations. Moreover, increased effectiveness and sustainability of programmes and participant or community empowerment are among the claimed benefits of collaborative participation among young people (Kickbusch, 2007; Rifkin, Lewando-Hundt &
Draper, 2000; Wallerstein & Duran, 2006).