Clinical / Professional Assurance – Teens

Developing an evidence-informed, clinically-backed & peer-reviewed online Menstrual Cycle Support course for teens (13-18yrs) on UK-wide social prescription.

UK Launch: 21 March 2024, House of Commons

This page documents the evidence-informed and Patient and Public Involvement (PPI) research undertaken to develop and launch the course alongside clinicians, teachers, parents and young people themselves. 

The course was developed by Menstrual Cycle Support, in partnership with Endometriosis UK.

Read the full project report here:

Menstrual Cycle Support Course for teens – project report

Project Brief & Partnership Outline

The brief:
To create, evaluate, test and launch a MCS multimedia self-paced eLearning course on social prescription for teenagers (13-18 years), using an iterative co–design and mixed-methods approach with young people, schools / colleges and clinicians across the UK.

Partnership:
Following the launch of Menstrual Cycle Support’s flagship online menstrual literacy course for adults on social prescription at the House of Lords (Oct 2022), currently available in over 500 GP surgeries across the UK, menstrual health charity, Endometriosis UK, and digital menstrual health, education and research organisation, Menstrual Cycle Support (MCS), have partnered to develop and launch a menstrual literacy course on social prescription suitable for teenagers.

Menstrual Cycle Support has worked with paediatric healthcare professionals, leading menstrual health researchers, educators and school safeguarding leads; teamed up with 8x Independent and State/Academy secondary schools from across the UK; and, worked closely with a Youth Advisory Board of 20x teenagers and young people to ensure diverse voices were heard from across the country in our mixed-methods approach to creating, evaluating and testing the course for teenagers.

The course for teenagers is an adaptation of the Menstrual Cycle Support course for adults and both are informed by the latest evidence-based research in menstrual literacy, health and education, as well as up-to-date evidence in social prescribing.

Menstrual Cycle Support course for teens: digital menstrual health management programme

  • Can be taken on any device, including smart phone
  • 45 minutes
  • Four-step course (each step is 5-15 minutes)
  • Self-paced
  • Can be taken in one go, or come back as many times as needed
  • Learn the cycle phases, how to track and chart, how to notice patterns and get the support you need at home, at school / college and at work.
  • Anonymous NHS-approved before and after questionnaire to measure impact

As with the Menstrual Cycle Support menstrual literacy course for adults, the evidence-informed and clinically-backed menstrual literacy online course for teenagers (13-18yrs) on social prescription, is, a mindfulness-based programme designed to:

  • Support self-management of low to moderate period pain (or other menstrual cycle associated pain) and / or low to moderate mental health issues exacerbated by the menstrual cycle.
  • To help recognise ‘red flag symptoms’ to know:
    • when to get medical support and
    • how to evidence experience in healthcare appointments with a ‘three month cycle chart’\
  • To provide an accessible language to describe the menstrual cycle experience and science to friends, teachers, GPs and employers.
  • To explore tracking & charting methods available and how a mindful ‘menstrual cycle awareness’ approach (or inner tracking) can support a chosen tracking method
  • To understand different approaches to managing menstruation.
  • The course is designed for anyone with a menstrual cycle (or anyone who feels they are due to start their period soon and want to find out how to manage the experience).
  • The course is designed to be suitable for those with missing / irregular periods or those on medication, including hormonal contraception.

3. Objectives of the Menstrual Cycle Support course for teens

The course is designed to reduce feelings of hopelessness around the menstrual cycle, alleviate and manage menstrual cycle symptoms through stress-reduction and increase mental health and wellbeing. It is also hoped the courses will help to speed up diagnosis times and reduce wasted GP appointments by empowering patients with the confidence, tools and language to express their symptoms and needs, as well as provide ongoing support for participants if they are waiting for a secondary care appointment.

4. Iterative co-design with young people, clinicians and schools / colleges using mixed-methods approach (summary)

In order to ensure the content of the teens course is evidence-informed, clinically backed and co-designed by young people themselves, Menstrual Cycle Support carried out a mixed-methods and PPI (Patient and Public Involvement) approach to evaluate the suitability of the adult course for teenagers, adapting the course based on feedback for launch.

Independent Peer Reviews

This included running 2x Independent Peer Reviews, the first with paediatric healthcare professionals, social prescribers, researchers and educators; the second with teenagers themselves. We invited the teenagers involved to be a member of our Youth Advisory Board.

Working with Founding Partner Schools

We established partnerships with a mixture of Independent and State / Academy secondary schools from across the UK, ensuring a variety of social and economic demographics and inclusivity of schools with high numbers of students from diverse ethnic backgrounds. These Founding Partner Schools then helped us by finding interested students to participate in focus groups (in-person and virtual).

Focus Groups

We ran a series of 4x focus groups with 26 students aged between 13-18 years and 8 teachers- two with students in person (at the schools – Epsom College and Camborne International Science Academy), one with teachers in person (Epsom College) and a virtual focus group to ensure all partner schools were able to participate. Teachers also participated in the focus groups. Students were invited to be a member of the Youth Advisory Board.

Menstrual Cycle Support Youth Advisory Board

The Youth Advisory Board (20 young people aged 15-23 yrs) helped to test the course and also helped select the logo for the course. The teen course video presenters – 5x menstrual activist students from Falmouth University also sit on the Youth Advisory Board.

Independent Professional Assessment (Clinical, Education, EDI)

Prior to launch, 3x independent assessments of the course were carried by a clinical consultant, an education consultant and a Diversity, Equality and Inclusivity consultant, who provided feedback for immediate implementation (which was actioned) and suggestions for ongoing improvement.

Primary Care Network Partners

Menstrual Cycle Support Primary Care Network partners, representing 135 surgeries have agreed to begin prescribing the course from launch, helping to begin to capture measurable impact through our NHS approved questionnaire.

Iterative co-design

The PPI (Patient and Public Involvement) research from our mixed-methods evaluation approach was analysed and used to help adapt the adult course for application for teenagers and to ensure an iterative co-design.

5. Measuring Impact

At Menstrual Cycle Support, we carefully measure the impact of our programmes to ensure we build robust evidence-based content, continuously update the course based on feedback of participants and inform the wider menstrual health research bodies in the UK. (In 2024, for example, we are presenting abstracts to the UK’s leading menstrual health research conferences on the impact of our course for adults).

We work closely with the leading social prescribing data analysis organisation, Meaningful Measures Ltd, and have applied their NHS-approved methodology to measure the impact of the course for teens. This validated tool is an individualised outcome measure used for evaluation of biopsychosocial and person-centred approaches to supporting people.

We aim to publish our first Impact Report of the course for teens, 12-18 months following launch.

6. Menstrual Cycle peer Support groups in schools / colleges & surgeries

Social connection benefits

Menstrual Cycle Support recognises the importance and benefit of peer support. Research into social prescribing activities shows how “good social connections improve health literacy and reduce health inequalities… [enabling] an improved sense of belonging. Some of the health and social benefits of social connection include lower stress and anxiety, reduced isolation or loneliness, more motivation and energy, improved mood, more confidence and reduced pain with fewer symptoms.

To enable safe social connection for teenagers through our digital platform, we have created a Menstrual Cycle peer Support group online toolkit so that teaching staff and students are empowered to set up / facilitate a group in their setting.

Best-practice tips for teachers

This toolkit, intended for us in places of education, provides best-practice tips for teachers for setting up and facilitating/ enabling a peer support group for participants who have completed the Menstrual Cycle Support course for teens.

The Menstrual Cycle peer Support group is not intended to teach the content of the course but to enable participants to discuss, practice and share what they have learned in a safe and supportive space.

Nature connection

It is recommended, in warmer months, that the peer support group is held outside, this is in line with the evidence that spending more time outside and in nature improves your mental health, as well as the research about the benefits of ‘green social prescribing’, which enables individuals to connect with nature, their community and themselves too.