School-based interventions for improving contraceptive use in adolescents

Lopez, Laureen M; Bernholc, Alissa; Chen, Mario; Tolley, Elizabeth E.

doi:10.1002/14651858.cd012249

Cited by 69 publications

(92 citation statements)

References 90 publications

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“…The behaviors that distinguished the two lower risk clusters from the two higher ones—age at sexual initiation, birth control use at first intercourse and birth control use in the past year—are amenable to intervention . Adolescents’ exposure to comprehensive school‐based sexual education programs has been shown to be correlated with increased use of condoms and other contraceptives . Augmenting such programs with modules designed to increase adolescents’ awareness of how negative internalized emotions (e.g., poor body image, low self‐esteem) may compromise one's ability to negotiate safer sexual behavior might help reduce sexual risk behaviors among women who perceive themselves to be overweight.…”

Section: Discussionmentioning

confidence: 99%

Objective and Perceived Weight: Associations with Risky Adolescent Sexual Behavior

Akers

Cohen

Marshal³

et al. 2016

Perspect Sexual Reproductive

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CONTEXT Studies have shown that obesity is associated with increased sexual risk-taking, particularly among adolescent females, but the relationships between obesity, perceived weight and sexual risk behaviors are poorly understood. METHODS Integrative data analysis was performed that combined baseline data from the 1994–1995 National Longitudinal Study of Adolescent Health (from 17,606 respondents in grades 7–12) and the 1997 National Longitudinal Survey of Youth (from 7,752 respondents aged 12–16). Using six sexual behaviors measured in both data sets (age at first intercourse, various measures of contraceptive use and number of partners), cluster analysis was conducted that identified five distinct behavior clusters. Multivariate ordinal logistic regression analysis examined associations between adolescents’ weight status (categorized as underweight, normal-weight, overweight or obese) and weight perception and their cluster membership. RESULTS Among males, being underweight, rather than normal-weight, was negatively associated with membership in increasingly risky clusters (odds ratio, 0.5), as was the perception of being overweight, as opposed to about the right weight (0.8). However, being overweight was positively associated with males’ membership in increasingly risky clusters (1.3). Among females, being obese, rather than normal-weight, was negatively correlated with membership in increasingly risky clusters (0.8), while the perception of being overweight was positively correlated with such membership (1.1). CONCLUSIONS Both objective and subjective assessments of weight are associated with the clustering of risky sexual behaviors among adolescents, and these behavioral patterns differ by gender.

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Section: Discussionmentioning

confidence: 99%

Objective and Perceived Weight: Associations with Risky Adolescent Sexual Behavior

Akers

Cohen

Marshal³

et al. 2016

Perspect Sexual Reproductive

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“…There have been a large number of systematic reviews that evaluated the effectiveness of these programmes (Chin 2012; Dick 2006; DiClemente 2008; Flisher 2008; Gallant 2004; Harrison 2010; Johnson 2003; Johnson, 2011; Kim 2008; Kirby 2007; Lazarus 2010; Magnussen 2004; Medley 2009; Michielsen 2010; Paul 2008; Shepherd 2010; Yankah 2008), including reviews that have focused solely on school-based interventions (Bennet 2005; Fonner 2014; Kirby 2006; Lopez 2016; Paul 2008), and a review of reviews (Mavedzenge 2013). Many of these reviews have suggested that school- and community-based prevention programmes for adolescents have been effective in delaying self-reported sexual activity, HIV-related preventative behaviours, adolescent pregnancy, and STIs (Chin 2012; Fonner 2014; Johnson 2003; Johnson, 2011; Kirby 2009; Laud 2016), although others have reported less, or mixed, success (Bennet 2005; DiCenso 2002; Lopez 2016 Oringanje 2016). The logic model for how these programmes might be thought to influence sexual and reproductive health outcomes can be seen in Figure 1.…”

Section: Introductionmentioning

confidence: 99%

School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents

Mason‐Jones

Sinclair

Mathews

et al. 2016

Cochrane Database of Systematic Reviews

147

152

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BackgroundSchool-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs).ObjectivesTo evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents.Search methodsWe searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers.Selection criteriaWe included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents.Data collection and analysisTwo review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach.Main resultsWe included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America (Chile), and two in Europe (England and Scotland).Sexual and reproductive health educational programmesSix trials evaluated school-based educational interventions.In these trials, the educational programmes evaluated had no demonstrable effect on the prevalence of HIV (RR 1.03, 95% CI 0.80 to 1.32, three trials; 14,163 participants; low certainty evidence), or other STIs (herpes simplex virus prevalence: RR 1.04, 95% CI 0.94 to 1.15; three trials, 17,445 participants; moderate certainty evidence; syphilis prevalence: RR 0.81, 95% CI 0.47 to 1.39; one trial, 6977 participants; low certainty evidence). There was also no apparent effect on the number of young women who were pregnant at the end of the trial (RR 0.99, 95% CI 0.84 to 1.16; three trials, 8280 participants; moderate certainty evidence).Material or monetary incentive-based programmes to promote school attendanceTwo trials evaluated incentive-based programmes to promote school attendance.In these two trials, the inc...

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“…Further, we conducted a separate review on interventions to improve access to health services for children under five in LMIC . Several previous reviews have explored evidence for interventions to address specific health needs for adolescents (aged 10–19 years) such as preventing unintended pregnancies , increasing physical activity , prevention of HIV , smoking cessation and improving contraceptive use . Whilst most previous reviews have focussed on individual health outcomes related to specific health needs, few reviews have focussed on outcomes related to health service access for older children in LMIC.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of strategies to increase access to health services among children over five in low‐ and middle‐income countries

Bright

Felix

Kuper

et al. 2018

Tropical Med Int Health

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This review provides evidence of the range of interventions that were used to increase healthcare access for children above 5 years old in LMIC. Nevertheless, further research is needed to examine each of the identified intervention types and the influence of contextual factors, with robust study designs. There is also a need to assess the cost-effectiveness of the interventions to inform decision-makers on which are suitable for scale-up in their particular contexts.

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School-based interventions for improving contraceptive use in adolescents

Cited by 69 publications

References 90 publications

Objective and Perceived Weight: Associations with Risky Adolescent Sexual Behavior

Objective and Perceived Weight: Associations with Risky Adolescent Sexual Behavior

School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents

Systematic review of strategies to increase access to health services among children over five in low‐ and middle‐income countries

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