Research Projects: 3[iv] Qualitative research with early school leavers

Research Brief 3[iv]

Qualitative research with early school leavers

This study aims to explore issues relating to sexual health and behaviour of early school-leavers, and to identify key areas of relevance to this vulnerable group.

Background to research
It is widely recognised that young people are now, more than ever, less sheltered from the realities of the adult world (Teenage Pregnancy Unit Report, 1999). This may be particularly true for those young people who leave school early, leaving behind the relative shelter of the school community. A report carried out by the National Economic and Social Forum (1997) 'Early School-leavers and Youth Unemployment', showed that for the period 1993-1995 up to 1000 young people did not progress to second-level school, while 3000 left second-level school with no qualifications. Boldt and Devine (1998) reported that nearly 13,000 young people leave school immediately after the junior cycle. Early school-leaving is often associated with disadvantaged circumstances. The National Youth Council of Ireland (NYCI) defines disadvantage as 'an inability to avail of choices or opportunities'. Causes include socio-economic conditions such as poverty, unemployment, geographic isolation, fragmentation of traditional domestic and community support structures and social alienation. 'Symptoms' of disadvantage among young people include low school achievement, aggressive/ anti-social behaviour, being in trouble with the law, poor self esteem and low expectations, being unemployed, feeling powerless or isolated. Bloomer (1997), in a study on early school leaving in Athlone, found that the majority of early school leavers were from working class backgrounds, hampered by social, educational and economic disadvantage.

The Report of the National Consultative Committee on Health Promotion, North Western Health Board, 'Promoting the Health of Young People at Risk' (1999); emphasises the effect of lack of education on young people's vulnerability in relation to their health: "Early school leaving has now been well documented as a crucial factor for young people who become long term unemployed, become involved in illegal activities, and engage in high risk health behaviours. On the other hand, educational attainment has been shown to be a major protective factor."

Most previous research on sexual health of young people has been carried out within schools or college settings (e.g. Bonner, 1996; McHale & Newell, 1997). However, several regional studies with disadvantaged/ marginalised youth have been carried out in Ireland. A study of the sexual health of young people in Cork (AIDS Alliance, 1996) accessed young people in a range of settings outside schools. This study provides practical guidance in developing inclusive research to identify the sexual knowledge, attitudes and behaviour of young people outside education settings such as through Youthreach centres and youth settings Sheerin (1998) carried out focus groups and individual interviews with marginalised youth in the Midland region. The sample was recruited through community training centres, Youthreach centres, a drop-in centre and schools. The majority of respondents were living in disadvantaged areas, had left school early and were attending Community Training workshops or Youthreach. The study results showed a major lack of awareness among respondents regarding contraception and STD's, and sexual health services, and the majority had received little or no formal sex education, with the media identified as the main information source. Focus groups carried out with young people at risk in the North Western Health Board (1999) identified key issues for this group, including the need for 'young people friendly' sexual health services and identification of links between poverty and poor health status. The young people also reported that were usually not asked for their opinion or consulted on key issues. This study aims to fill this reported gap by talking directly to early school leavers about their sexual health, knowledge and behaviour. The study will build on previous work carried out with disadvantaged youth and early school leavers in Ireland, and will also compliment qualitative and quantitative research which will be carried out with young people in schools as part of the broader research programme.

Several pertinent issues will be explored in the present study. Knowledge levels regarding sexual health issues will be explored, and the main sources of information identified. Poor knowledge has been associated with poor sex education in school or lack of comprehensive sex education in school. Poor sex education has been found in some studies to be associated with earlier onset of first sexual intercourse (Wellings et al.1994). Early school leavers pose a challenge to sexual health promotion as they do not normally access services, and can not be reached with sexual health promotion campaigns through school settings (Layte, Fullerton & McGee (2003). Without formal sex education in schools it is likely that early-school leavers rely on informal sources of information, such as parents, peers, media. Parental attitudes and parental norms often militate against the use of contraception. HSBC data in Northern Ireland suggested that poor family communication was associated with increased risk taking behaviour. Research has also shown that where there is a strained or discontinued relationship with parents there is greater sexual activity, greater non-use of contraception and higher levels of unplanned pregnancies Sheerin (1998) found that a minority of marginalised young people in her study talked to their parents about sex, the majority of these discussions were a warning rather than an explanation, and most reported feeling uncomfortable talking to their parents about sex.

Research in the UK suggests that the media is the main source of information on sex and relationships for boys (Todd, Currie & Smith, 1999), and for girls the media came second, after friends. Sheerin (1998) also discussed the relationship between peer pressure and acceptable standards of behaviour among young people in relation to risk-taking behaviours. While the young people demonstrated an awareness of health risks involved in these behaviours, the consideration of future health risks was deemed to be less important than the immediate needs of young people, namely approval from peers.

A consideration specific to adolescents and risk of pregnancy is cognitive developmental concerns and the degree to which young people are making fully informed and rational decisions. Researchers in the US found evidence to suggest that age and cognitive functioning (e.g. the ability to take more than one perspective) is related to better decision making around contraception (Johnson & Greene, 1993). Additional aspects of adolescent reasoning (e.g. formal operational thinking) have been identified as relevant to decision making about contraception. An important related concept here is literacy levels of early school leavers, and the extent to which this acts as a barrier in terms of effective sexual health promotion and information. Sheerin (1998) found that barriers to service use identified by marginalised youth included a lack of understanding of the language used by health professionals.

Attitudes of early school-leavers towards pregnancy must also be explored. Research using small samples of or case studies of young pregnant women, demonstrate that pregnancy may be motivated in adolescents by hopes of achieving adult status, prestige, autonomy or to demonstrate love for the partner. Dempsey, Heslin & Bradley (2001) conducted the first Irish study assessing the range of attitudes and experiences that make up teenage pregnancy. Factors which influence reactions to pregnancy include status of the relationship, relationship with parents, age, goals and ambitions, whether the pregnancy was wanted or unwanted, individuals sense of self-worth, and practical implications of having a baby. Some respondents viewed having a baby as a positive direction in their lives. The degree to which these attitudes extend to early school-leavers needs to be explored.

A related issue is self-esteem among early school-leavers, and it's relation to motivations underlying pregnancy and sexual risk-taking; a lack of self-esteem may leave young people unable to say no to unprotected sex. Unprotected early sexual activity is also often associated with low expectations and aspirations and low educational attainment. This was clearly outlined in a British report by the Social Exclusion Unit (1998) and is related to young women's motivation to become pregnant. Low achievement can occur as a direct result of pregnancy, resulting in young women being unable to finish education, but growing evidence appears to suggest that many young women disengaged from education and were low achievers prior to pregnancy (e.g. Phoenix 1991). Sheerin (1998) also addressed aspirations of marginalised youth in the Midlands, and identified a marked difference between male and female participants. Boys had a more positive outlook on future employment and young women had much more limited aspirations for their future lives and work. With such limited personal aspirations and goals, pregnancy may appear to be an attractive option for these young women. These findings point to the need for enhancement of self-esteem among young girls in particular, and a new clarification of the role or importance of work in the lives of disadvantaged young people who have left school. The extent to which low self-esteem and aspirations influence sexual risk-taking in early-school leavers needs to be explored in detail.

Other important issues to be addressed in the present study include an exploration of how sexual attitudes and behaviours of early school leavers may vary according to urban or rural locations. For example, unpublished research in 2002 found that young people in rural areas are more likely to be older when they have their first sexual encounter - 16 or 17 on average compared to 15 or 16 for those in urban areas. In addition, situational factors which may promote sexual risk-taking in early school-leavers need to be explored. Such factors include alcohol and substance abuse, particularly in the current climate of under-age drinking. Young people who feel under pressure to have sex have identified the following as the main sources of pressure: drink and drugs, older friends, partner. Effect of drink and drugs have also been identified by young people as a barrier to contraceptive use.

Research Aim:
To gain an in-depth understanding of sexual health and behaviour issues relevant to early school-leavers, from the perspective of the young people themselves.

Research Objectives:
To obtain information directly from early school-leavers regarding a range aspects of sexual behaviour and attitudes, including issues surrounding contraception, STI's, crisis pregnancy, sexual identity, and perceived information and service needs.

To obtain in-depth information on specific issues relating to sexual risk-taking in early school-leavers. These include:

Research deliverables:
1. The study will provide insight into pertinent issues relating to early school-leaver's sexual health and behaviour. Specifically, the study will provide

2. The results from this qualitative study will compliment the quantitative and qualitative research that will be carried out with young people in school settings, and allow for a comparison of relevant issues for young people within and outside the school community.

Methodology and sampling considerations:
A qualitative methodology would be appropriate in terms of meeting the study objectives, which are exploratory in nature. Using a qualitative methodology will also centralise the experiences of early school-leavers in the data collection process. Possible methods include use of focus groups/ interviews. The CPA is also open to suggestions regarding innovative data collection methods which may be suited to the study aims and population.

The sample will contain male and female early school-leavers from urban and rural (geographically isolated areas) locations. It is possible that the sample could be recruited through Youthreach and Community Training workshops. Alternatively, the study could employ a snowball sampling method to access early school-leavers who are not in contact with any form of service/ training centre. The age-range of respondents may depend on the ways in which the sample is recruited, e.g. the age of participants on the Youthreach programme is 15 - 18 years. Issues of informed/ parental consent will be of key importance in this study.

Budget guidance:
The budget available for this study is 47,500, inclusive of VAT.

Timetable for reporting process:
The suggested timeframe for this study is 6 months.

Linked research:
The aims and objectives of this research are linked to those of research brief 1 and 3b.
Please refer to the Invitation to Tender letter for information relating to expected outputs, reporting arrangements, ethical consideration, terms of reference, contacts and details for submission and content of tender bids. This information is elaborated in section 2.2 of the Invitation to Tender letter.

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