Abstract
Keywords
United Nations: We can end poverty: Millennium development goals and beyond 2015. Available at: http://www.un.org/millenniumgoals/childhealth.shtml. Accessed November 16, 2015.
World Health Organization: Health for the world's adolescents: A second chance in the second decade. Available at: http://public.tableausoftware.com/profile/digitalteam#!/vizhome/shared/3JW3RBSZ3. Accessed November 16, 2015.
World Health Organization: Health for the world's adolescents: A second chance in the second decade. Available at: http://public.tableausoftware.com/profile/digitalteam#!/vizhome/shared/3JW3RBSZ3. Accessed November 16, 2015.
Methods
- 1.Overview of systematic reviews: We conducted an overview of systematic reviews for interventions where recent systematic reviews existed;
- 2.Updating existing reviews: We updated the existing systematic reviews if the existing review only included evidence prior to 2011; and
- 3.De novo review: For interventions where no reviews existed, we conducted a de novo review.
Methodology for de novo review
Methodology for existing systematic review
Methodology for updated review
Results

Author, year | Design | Country | Setting | Intervention | Target population | Outcomes |
---|---|---|---|---|---|---|
Aarons et al., 2000 [41] | RCT | U.S.A. | School based | Reproductive health classes, the Postponing Sexual Involvement curriculum, health risk screening, and “booster” educational activities during the following (eighth grade) school year. | Eighth-grade students | Use of contraception |
Agha and Van Rossem, 2004 [42] | Quasi | Zambia | Community based | Peer-led education projects focusing on promoting abstinence and condom use among male and female school children. Peer educators consisted of people aged 18–22 years who were trained by a professional peer education trainer to convey their messages through a mixture of techniques. | Males and females aged 14–23 years | Abstinence, multiple sexual partners, condom use |
Baptiste et al., 2006 [43] | RCT | South Africa and Trinidad and Tobago | Community based | Community participatory research framework to adapt and deliver family-based prevention. | Youth | Communication, HIV knowledge and prevalence |
Barnet et al., 2007 [44] | RCT | U.S.A. | Home based | Home visiting or routine care. They delivered a parenting curriculum, encouraged contraceptive use, connected the teen with primary care, and promoted school continuation. | Pregnant females aged 12–18 years | Birth control after index child, repeat pregnancy |
Berenson and Rahman, 2012 [45] | RCT | U.S.A. | Clinic | Face-to-face behavioral counseling and education at their baseline clinic visit or this same intervention followed by monthly phone calls for 6 months or standard care. | Females aged 16–24 years | Consistent contraceptive use, hormonal contraceptive use, condom use, dual usage, no contraception |
Morrison-Beedy et al., 2012 [94] | RCT | U.S.A. | Community based | Peer education groups. Theory-based sexual risk reduction intervention or a structurally equivalent health promotion control group. | Females aged 15–19 years | Multiple sexual partners, intercourse |
Black et al., 2006 [46] | RCT | U.S.A. | Home based | Home visiting or routine care. Home-based intervention curriculum was based on social cognitive theory and focused on interpersonal negotiation skills, adolescent development, and parenting. | Postpartum females 13.5–17.9 years | Repeat pregnancy |
Blake et al., 2003 [47] | Quasi | U.S.A. | School based | Condom availability in high school | High-school adolescents | Condom use |
Bonell et al., 2013 [48] | RCT | England | Community based | “Teens and toddlers” intervention: 18–20 weekly sessions in preschool nurseries | Teens | Contraception use |
Brieger et al., 2001 [49] | Quasi | West Africa: Nigeria and Gambia | Community based | Peer education groups. Peer educators provided information and counseling through one-on-one sessions, group talks and presentations, and distribution of print materials. | Male and female adolescents | Knowledge |
Bull et al., 2012 [50] | RCT | U.S.A. | Community social media | Exposure to Just/Us, a Facebook page developed with youth input, or to control content on 18–24 News, a Facebook page with current events for 2 months. | Youth | Condom use |
Chen et al., 2010 [51] | RCT | U.S.A. | Community and school based | “Focus on Youth in the Caribbean” (FOYC) is based on the Protection Motivation Theory (PMT), consists of 10 primary sessions (delivered weekly after a baseline survey) and two annual boosters (delivered after 12 and 24 months postintervention assessment). The sessions are designed to augment decision-making skills, including the development of a lifelong perspective in decision-making, communication and listening skills, and protective knowledge and skills regarding safer sexual behavior. GFI and CImPACT are parenting interventions. GFI includes a 20-minute video filmed in the USA, which addresses decision-making regarding future planning for the parent and child; the video is followed by a structured discussion among the participants. CImPACT includes a 20-minute video filmed in the Bahamas addressing parent–child communication about sexual decision-making, followed by role-playing and a condom demonstration. | Males and females aged 10–12 years | Knowledge, condom use |
Clark et al., 2005 [52] | RCT | U.S.A. | School based | The AIM is a 10-session curriculum based on the theory of possible selves. Class exercises encourage students to articulate a possible future self-identity and to develop self-promotion skills. | Seventh-grade African-Americans | Abstinence, sex initiation |
Cornelius et al., 2013 [53] | Pre–post | U.S.A. | Community social media | Becoming a Responsible Teen (BART) is a community-based HIV prevention curriculum, which consists of interactive group discussions and role plays that allow participants to practice behavioral skills for safer sex. BART was followed by the delivery of daily multimedia messages for 3 months | African-American adolescents | Knowledge, condom use, HIV prevention scores |
Coyle et al., 2001 [54] | RCT | U.S.A. | School based | Safer Choices, a theory-based, multicomponent educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high-school students. | Ninth-grade students | Condom use |
Coyle et al., 2004 [56] | RCT | U.S.A. | School based | Draw the Line/Respect the Line, a theoretically based curriculum designed to reduce sexual risk behaviors among middle-school adolescents. | Sixth graders | Sex initiation, knowledge |
Coyle et al., 2013 [55] | RCT | U.S.A. | School based | (1) HIV/STI/pregnancy prevention curriculum only; (2) service learning only; (3) HIV/STI/pregnancy prevention curriculum plus service learning; or (4) an attention control curriculum | High-school adolescents | Mean sexual intercourse, mean use of condom |
Daniel 2008 [124] | Quasi | India | Community based | Orientation and training of reproductive health teams of community leaders and influential residents, and through group meetings with young couples' parents and in-laws; messages were disseminated through street theater performances and wall paintings, and formal and informal rural health service providers were trained on reproductive health issues and contraception. | Young couples aged <25 years | Contraceptive use, knowledge and attitude |
Danielson et al., 1990 [57] | RCT | U.S.A. | Clinic | A reproductive health intervention combining a highly explicit half-hour slide-tape program with a personal health consultation was provided. | Males aged 15–18 years | Consistent contraceptive use, hormonal contraceptive use, condom use, dual usage, no contraception |
DiClemente et al., 2004 [58] | RCT | U.S.A. | Community based | Peer education groups. All participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition. | Females aged 14–18 years | Condom use |
DiClemente et al., 2009 [59] | RCT | U.S.A. | Clinic | Intervention participants received two 4-hour group sessions and four telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk and were given vouchers facilitating male partners' STD testing/treatment. | Females aged 15–21 year | Condom use |
Dilorio et al., 2007 [60] | RCT | U.S.A. | Community based | HIV education, communication skills, take-home activities for fathers and adolescents. | Males aged 11–14 years | Condom use |
Downs et al., 2004 [61] | RCT | U.S.A. | Community based | Video-based sessions versus book-based information | Urban adolescent girls | Abstinence, condom use, STI |
Elliott et al., 2012 [62] | Quasi | Scotland | School based | Healthy Respect 2 (HR2) combined sex education with youth-friendly sexual health services, media campaigns and branding, and encouraged joint working between health services, local government and the voluntary sector. | 15- to 16-year-old adolescents | Knowledge, condom acceptability, having sex, condom use |
Erulkar et al., 2004 [121] | Quasi | Kenya | Community based | The Nyeri Youth Health Project, a community-based project for young people. Adult counselors worked in their own communities to educate both adolescents and parents on reproductive health and to encourage dialogue between them. The counselors were trained for 1 month and used a life skills curriculum entitled “Life Planning Skills for Adolescents in Kenya,” which includes sessions on community, family and individual values, adolescent development, sexuality, gender roles, relationships, pregnancy, STIs, HIV/AIDS, harmful traditional practices, substance abuse, planning for the future, children's rights, and advocacy. | 10–24 years of age | Sexual initiation, secondary abstinence, condom use, sex partners, communication with parents |
Ferguson, 1998 [63] | RCT | U.S.A. | Community based | Peer education groups. Peer counseling in a culturally specific adolescent pregnancy prevention program. | Females aged 12–16 years | Condom use |
Forehand et al., 2007 [64] | RCT | U.S.A. | Community | Enhanced communication intervention (five sessions), single-session communication intervention(one session) | African-American parent–preadolescent dyads (child, aged 9–12 years) | Mean change in knowledge |
Garcia et al., 2012 [65] | RCT | Peru | Community based | The intervention comprised four modalities: strengthened STI syndromic management by pharmacy workers and clinicians; mobile-team outreach for STI screening and pathogen-specific treatment; periodic presumptive treatment of FSWs for trichomoniasis; and condom promotion. | Urban young men (aged 18–29 years) and female sex workers | Sexual intercourse, STI prevalence |
Gold et al., 2004 [66] | RCT | U.S.A. | Clinic based | The intervention group received information about EC and was told how to access EC and in addition received one complete course of EC for future use. Participants in the AEC group were informed that they could obtain up to two additional courses of advance EC during the 6 months of the study and were told that they could obtain these subsequent courses from the study office whenever they requested them. Participants in the control group received written and verbal information about EC and were told how to access EC on request from the adolescent clinic. | Urban adolescent females aged 15–20 years | EC use |
Hall et al., 2012 [67] | RCT | U.S.A. | Community text messaging | The intervention group received 180 daily text messages, including 47 individual messages (which were repeated up to four times over the study). | Young women aged 13–25 years | OC knowledge |
Harper et al., 2009 [68] | Quasi | U.S.A. | Community based | Peer education groups. Nine-session SHERO's (a female-gendered version of the word hero) intervention or a single-session information-only HIV prevention intervention. | Females aged 12–21 years | Intercourse, knowledge |
Herceg-Baron et al., 1986 [69] | Quasi | U.S.A. | Clinic | Increase family + teenager or teenager + clinic staff contact | Adolescent aged 12–17 years | Contraceptive use, unintended pregnancy |
Howard and McCabe, 1990 [70] | Quasi | U.S.A. | Community based | Peer education. The program is led by older teenagers and focuses on helping students resist peer and social pressures to initiate sexual activity. | Males and females aged 14–16 years | Intercourse |
Hughes et al., 1995 [71] | RCT | U.S.A. | Clinic | Increase in family planning clinic for education counseling and access compared with no clinic. | Females aged 14–18 years | Unintended pregnancy, intercourse |
Jemmott III et al., 1998 [72] | RCT | U.S.A. | School based | HIV and abstinence education: intervention involved eight 1-hour modules implemented by adult facilitators or peer cofacilitators. Abstinence education enforced delaying sexual intercourse or reducing its frequency; safer sex intervention stressed condom use; control intervention concerned health issues unrelated to sexual behaviors. | African-American adolescents | Having sex, condom use, knowledge, self-efficacy |
Jemmott et al., 2005 [73] | RCT | U.S.A. | Clinic | Counseling, skills building, and case management services | Females aged 12–19 years | Knowledge, number of sex partners, unprotected intercourse |
Jemmott et al., 2010 [74] | RCT | South Africa | School based | Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior. | Sixth-grade students | Having sex, multiple sex partners, condom use |
Mason-Jones et al., 2011 [89] | Quasi | U.S.A. | Community based | Peer-led education sessions. Peer educators were recruited and trained to provide information and support to their fellow students. | Males and females aged 15–16 years | Abstinence, condom use |
Key et al., 2008 [75] | Quasi | U.S.A. | School based | School-based social work services coordinated with comprehensive health care. | Teen mothers | Contraception, pregnancy |
Kiene and Barta, 2006 [76] | RCT | U.S.A. | Community computer based | Custom computerized intervention. Content and delivery were based on the Information–Motivation–Behavioral Skills model of health behavior change and used Motivational Interviewing techniques. | College students | Knowledge, condom availability and use, sexual risk behavior |
Kim et al., 2001 [123] | Quasi | Zimbabwe | Community-based mass media | Multimedia campaign promoted sexual responsibility among young people in Zimbabwe, while strengthening their access to reproductive health services by training providers. | 10–24 years of age | Contraceptive knowledge, contraceptive use |
Kinsler et al., 2004 [77] | Quasi | U.S.A. | School based | HIV prevention education: Project Light uses a cognitive-behavioral approach to motivate the program participants to change their risk behaviors and adopt safer behaviors. | Primary and secondary school students | Knowledge, efficacy, communication |
Kirby et al., 2004 [79] | RCT | U.S.A. | School based | Safer Choices was designed to reduce unprotected sex by delaying initiation of sex, reducing its frequency, or increasing condom use. Its five components included: school organization, an intensive curriculum with staff development, peer resources and school environment, parent education, and school-community linkages. | Ninth-grade adolescents | Sexual risk-taking |
Kirby et al., 2010 [78] | RCT | U.S.A. | Clinic- and telephone-based follow-ups | Regular clinic services or regular clinic services plus nine follow-up phone calls over 12 months to improve sexual risk behaviors. | Females aged 14–18 years | Use of contraception |
Kisker et al., 1996 [80] | Quasi | U.S.A. | School based | School-Based Adolescent Health Care Program, which provided comprehensive health-related services. | Youth | Health care access, knowledge, sexual risk behaviors |
Klepp et al., 1997 [81] | RCT | Tanzania | School based | Sexual and HIV risk reduction and awareness | Sixth graders | Knowledge, sexual initiation |
Kogan et al., 2012 [82] | RCT | U.S.A. | Community based | The Strong African American Families–Teen (SAAF–T) program, a family-centered preventive intervention that included an optional condom skills unit. | 16-year-old African-American and their caregivers | Unprotected intercourse and condom use efficacy |
Koo et al., 2011 [83] | RCT | U.S.A. | School based | 10–13 classroom sessions related to delaying sexual initiation | Fifth-grade students | Knowledge, communication, having sex, abstinence |
Larkey et al., 2010 [84] | RCT | Tanzania | Community and school based | Provision of youth-friendly health services, as part of a package of interventions including reproductive health education in primary school; the provision of youth-friendly sexual and reproductive health services; community-based condom promotion and distribution; and community-wide activities. | Adolescents 15 years onward and community people | Prevalence of STI, clinic visit and condom distribution |
Lewis et al., 2010 [85] | Quasi | Australia | Clinic | Contraceptive education and use of Implanon or depot medroxyprogesterone acetate (DMPA) or nothing | Postpartum females (12–18 years old) | Unintended pregnancy |
Lim et al., 2012 [86] | Quasi | Australia, New Zealand | Community text messaging | The 12-month intervention included SMS (catchy sexually transmissible infections prevention slogans) and e-mails. | Youth aged 16–29 years | Having sex, condom use, STI test |
Lou et al., 2004 [122] | Quasi | China | Community based | The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among unmarried youths, in addition to the routine program activities, which were exclusively provided in the control site. | 15–24 years of age | Contraceptive use, condom use |
Marcell et al., 2013 [87] | Quasi | U.S.A. | Community based | Peer education. Participants received three 1-hour curriculum sessions on consecutive days. | Males aged 16–24 years | Multiple sexual partners, intercourse, condom use, knowledge |
Markham et al., 2012 [88] | RCT | U.S.A. | School based | Group and individualized computer-based activities addressing psychosocial variables. The risk avoidance (RA) program met federal abstinence education guidelines; the risk reduction (RR) program emphasized abstinence and included computer-based condom skills training. | African-American and Hispanic seventh- to ninth-grade students | Having sex, unprotected sex, sexual initiation, number of sex partners |
McBride et al., 2007 [90] | Quasi | U.S.A. | Community based | The Collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP): the program involves having youth participate with parents and/or other adult caregivers who can steer them through pubertal changes, increases in romantic thoughts and feelings, and social pressure to engage in risky behavior, which may involve sexual activity. | Males and females aged 9–11 years | Parent–adolescent communication |
Meekers, 2000 [91] | Quasi | South Africa | Community based | Targeted social marketing program on reproductive health beliefs and behavior | Young females | Knowledge and awareness |
Meekers et al., 2005 [92] | Pre–post | Cameroon | Community based | “100% Jeune” social marketing campaign | Youth 15–24 years old | Perceived condom attributes and access, self-efficacy, and perceived social support |
Merakou and Kourea-Kremastinou, 2006 [93] | Quasi | U.S.A. | School based | Peer education. Recruitment and training of the peer educators, implementation of HIV prevention activities in schools on behalf of the peer educators and evaluation. | 13- to 17-year-old adolescents | Sexual encounter, condom use |
Munodawafa et al., 1995 [95] | Quasi | Zimbabwe | School based | Student nurses to provide health instruction among rural school-age populations. | School-based adolescents | Knowledge |
O-Donnell et al., 2005 [96] | RCT | U.S.A. | Community based | “Saving sex for later”—a parent and youth education program | Females and males aged 10–11 years | Communication |
Ozcebe et al., 2004 [97] | Pre–post | Turkey | Community based | Peer education groups. An education program was scheduled every week and included the following discussion subjects: male and female anatomy–physiology of the reproductive system; types of STIs; etiopathology, progress and treatment of HIV/AIDS; preventive precautions against sexually transmitted diseases and HIV/AIDS; family planning methods; and communication skills. | Male and female adolescents | Knowledge |
Pearlman et al., 2002 [98] | Quasi | U.S.A. | Community based | Peer education program. Short course and ongoing group work to plan HIV/AIDS outreach activities supervised by an adult. | Youth | Knowledge, perception, risk raking behaviors |
Peltzer et al., 2011 [99] | RCT | U.S.A. | Clinic | Counseling, skills building: 18-minute information–education segment used a tabletop flip chart and visual materials to illustrate key concepts and interactive activities to dispute HIV myths, stigmas, and misinformation. The information component focused on HIV destigmatization as well as providing accurate risk information including risks related to male circumcision. | Males aged 18–35 years | Knowledge, number of sex partner, unprotected intercourse |
Petersen et al., 2007 [100] | RCT | U.S.A. | PHC | Contraceptive counseling with optional advance EC prescription | Women aged 16–44 years | EC acceptance (only for 16- to 25-year age group) |
Pinkleton et al., 2008 [101] | Quasi | U.S.A. | Community and school | Teen-led, media literacy curriculum focused on sexual portrayals in the media. | Primary- to middle-school students | Knowledge, efficacy, abstinence |
Prado et al., 2012 [102] | RCT | U.S.A. | Community based | Family-specific interventions designed to reduce HIV risk behaviors | Hispanic males and females aged 12–17 years | Parent–adolescent communication, intercourse |
Raymond et al., 2006 [103] | RCT | U.S.A. | Clinic based | Two methods of access to emergency contraceptive pills: increased access (two packages of pills dispensed in advance with unlimited resupply at no charge) or standard access (pills dispensed when needed at usual charges) | Females aged 14–24 years | Pregnancy, having sex, use of contraception, STI |
Rickert et al., 2006 [104] | RCT | U.S.A. | Clinic | Contraceptive education and Depo Now compared to initiating with a bridge method (pills, transdermal patch, or vaginal ring) | Female aged 14–26 years | Consistent contraceptive use, hormonal contraceptive use, condom use, dual usage, no contraception, unintended pregnancy |
Rocca et al., 2007 [105] | RCT | U.S.A. | Clinic based | Access to EC through advance provision, pharmacies, or clinics | Females aged 15–24 years | EC use |
Rosenbaum, 2009 [106] | Quasi | U.S.A. | Community based | Virginity pledgers | >15 years of age virginity pledgers | Premarital sex, sexually transmitted diseases, and anal and oral sex variables |
Ross et al., 2007 [107] | RCT | Tanzania | Community based | Community activities; teacher-led, peer-assisted sexual health education in Years 5–7 of primary school; training and supervision of health workers to provide “youth-friendly” sexual health services; and peer condom social marketing. | Adolescents | Knowledge, attitude, HIV, HSV |
Rotheram-borus et al., 1998 [108] | RCT | U.S.A. | Community based | (1) Seven sessions of 1.5 hours each (10.5 hours); (2) three sessions of 3.5 hours each (10.5 hours); or (3) a no-intervention condition. | Adolescent aged 13–24 years | Self-efficacy, condom use. |
Schreiber et al., 2010 [109] | RCT | U.S.A. | Clinic based | Routine postpartum contraceptive care and advanced supply of one pack of EC pills with unlimited supply thereafter upon request. | Postpartum teenage females | Sexual encounter, any contraception, condom use, EC use, pregnancy |
Shrier et al., 2001 [110] | RCT | U.S.A. | Clinic based | Counseling and education. Standard STD education or to watch a videotape and have an individualized intervention session. | Female adolescents diagnosed with STI | Condom use, knowledge |
Sieving et al., 2012 [111] | RCT | U.S.A. | Clinic | Counseling, skills building, and case management services. | Females aged 13–17 years | Number of sex partner |
Suffoletto et al., 2013 [112] | RCT | U.S.A. | Community text messaging | Intervention participants received a sequence of text messages that assessed risky encounters over the past week, were provided personalized feedback on risk behavior, and were prompted collaborative goal setting to not have a risky encounter for the coming week. | Females aged 18–25 years | Condom use |
Tocce et al., 2012 [113] | Quasi | U.S.A. | Clinic | Contraceptive education and etonogestrel implant (IPI) | Females aged 13–23 years | Consistent contraceptive use, hormonal contraceptive use, condom use, no contraception, unintended pregnancy |
Villarruel et al., 2006 [115] | RCT | U.S.A. | School based | The HIV and health-promotion control interventions consisted of six 50-minute modules delivered by adult facilitators to small, mixed-gender groups in English or Spanish. | Latino adolescents aged 13–18 years | Self-reported sexual behavior |
Villarruel et al., 2008 [114] | RCT | Mexico | Community | Parent education for adolescent sexual risk reduction | Parents of adolescents | Communication |
Walker et al., 2004 [116] | RCT | Mexico | School based | An HIV prevention course that promoted condom use, the same course with emergency contraception as backup, or the existing sex education course. | High-school students | Knowledge, condom use |
Weed et al., 2008 [117] | Quasi | U.S.A. | School based | Abstinence education program; the core of the program was a nine-unit abstinence curriculum taught consecutively over 20 class periods, called Reasonable Reasons to Wait: Keys to Character. | Seventh-grade adolescents | Sexual initiation |
Wiggins et al., 2009 [118] | Quasi | England | Community based | Intensive, multicomponent youth development program including sex and drugs education (Young People's Development Program) versus standard youth provision. | 13- to 15-year-old adolescents | Pregnancy, weekly cannabis use, and monthly drunkenness |
Winter and Breckenmaker, 1990 [119] | Quasi | U.S.A. | Clinic | In-depth counseling and education in an adolescent friendly environment | Teenagers | Contraceptive use, pregnancy |
Zimmer-Gembeck, 2001 [120] | Pre–post | U.S.A. | School based | Family planning care visits and contraceptive availability | Female adolescents | Use of contraception |
Sexual and reproductive health interventions to prevent adolescent pregnancy


Quality assessment | Summary of findings | |||||||
---|---|---|---|---|---|---|---|---|
Number of studies | Design | Limitations | Consistency | Directness | Number of participants | RR/SMD (95% CI) | ||
Generalizability to population of interest | Generalizability to intervention of interest | Intervention | Control | |||||
Mean knowledge score: moderate outcome-specific quality of evidence | ||||||||
13 | RCT and pre–post | Study design is not robust | Twelve studies suggest benefit Substantial heterogeneity, I2 = 100% | All studies targeted adolescents | Multicomponent interventions | 6,206 | 6,293 | 2.04 (1.31–2.78) |
Mean efficacy score: moderate outcome-specific quality of evidence | ||||||||
5 | RCT and pre–post | Study design is not robust | Four studies suggest benefit Substantial heterogeneity, I2 = 99% | All studies targeted adolescents | Multicomponent intervention | 2,699 | 2,508 | .76 (.22–1.30) |
Use of any contraception: moderate outcome-specific quality of evidence | ||||||||
16 | RCT and pre–post | Study design is not robust | Five studies suggest benefit Substantial heterogeneity, I2 = 89% | All studies targeted adolescents | Multicomponent intervention | 9,269 | 9,364 | 1.07 (1.00–1.14) |
Condom use: moderate outcome-specific quality of evidence | ||||||||
23 | RCT and pre–post | Study design is not robust | Seven studies suggest benefit Considerable heterogeneity, I2 = 72% | All studies targeted adolescents | Multicomponent intervention | 9,659 | 9,842 | 1.11 (1.04–1.20) |
Sexual encounter: moderate outcome-specific quality of evidence | ||||||||
23 | RCT and pre–post | Study design is not robust | Only two studies suggest reduced sex Substantial heterogeneity, I2 = 88% | All studies targeted adolescents | Multicomponent intervention | 16,845 | 16,746 | 1.00 (.93–1.07) |
Adolescent pregnancies: moderate outcome-specific quality of evidence | ||||||||
18 | RCT | Four studies showed significant improvement Some heterogeneity, I2 = 54% | All studies targeted adolescents | Comprehensive interventions addressing communities, sexual and reproductive health services, contraceptive provision and school-based education, and youth development | 1,572 | 1,868 | .85 (.74–.98) | |
Repeat adolescent pregnancies: moderate outcome-specific quality of evidence | ||||||||
16 | RCT | Six studies showed significant improvement Considerable heterogeneity, I2 = 74% | All studies targeted adolescents | Parental skills training and encouraging young mothers to finish school, as well as comprehensive medical care | 1,572 | 1,868 | .63 (.49–.82) [I2: 74%] | |
STI: moderate outcome-specific quality of evidence | ||||||||
Six | RCT and pre–post | Study design is not robust | Only one study suggests reduced sex Considerable heterogeneity, I2 = 78% | All studies targeted adolescents | Multicomponent intervention | 298 | 367 | 1.8 (.79–1.46) [I2: 78%] |
Female genital mutilation


Quality assessment | Summary of findings | |||||||
---|---|---|---|---|---|---|---|---|
Number of studies | Design | Limitations | Consistency | Directness | Number of participants | SMD/RR (95% CI) | ||
Generalizability to population of interest | Generalizability to intervention of interest | Intervention | Control | |||||
Belief that FGM/C compromise human rights of women: low outcome-specific quality of evidence | ||||||||
One | Pre–post | Study design is not robust | Only one study | All studies targeted adolescents | Multicomponent intervention | 1,120 | 1,120 | 1.30 (.47–3.64) |
Prevalence of FGM/C: low outcome-specific quality of evidence | ||||||||
Three | Pre–post | Study design is not robust | Two studies showed reduced prevalence. Low heterogeneity, I2 = 38% | All studies targeted adolescents | Multicomponent intervention | 1,377 | 916 | .63 (.49–.82) |
Knowledge of harmful consequences of FGM/C: low outcome-specific quality of evidence | ||||||||
Three | Pre–post | Study design is not robust | Two studies showed benefit Substantial heterogeneity, I2 = 98% | All studies targeted adolescents | Multicomponent intervention | 2,368 | 1,987 | 1.53 (1.08–2.16) |
Intimate partner violence
Discussion
- Chin H.B.
- Sipe T.A.
- Elder R.
- et al.
Acknowledgments
Funding Sources
References
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