Kågesten Anna, Parekh Jenita, Tunçalp Ozge, Turke Shani, Blum Robert William
Anna Kågesten, Jenita Parekh, Shani Turke, and Robert William Blum are with the Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Özge Tunçalp is with the UNDP/UNFPA/UNICEF/WHO/The World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Am J Public Health. 2014 Dec;104(12):e23-36. doi: 10.2105/AJPH.2014.302246. Epub 2014 Oct 16.
We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998-2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects.
我们系统回顾了关于青少年综合健康（CAH）项目（1998 - 2013年）的同行评审文献和灰色文献，包括性健康和生殖健康服务。我们筛选了36119条记录，并使用预定义标准提取文章。我们将数据综合为描述性特征，并根据证据水平评估质量。我们提取了46个项目的数据，其中19个被定义为综合性项目。10个符合所有纳入标准。大多数项目基于美国；其他项目在埃及、埃塞俄比亚和墨西哥实施。3个项目显示出严格的证据；5个有强有力的证据，2个有适度的证据。那些有严格或强有力证据的项目直接或间接影响了青少年的性健康和生殖健康。由于评估不足，许多CAH项目的长期影响无法得到证实。需要采用考虑到许多项目复杂运行条件的评估方法，以更好地理解项目效果背后的机制。
