Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Adolesc Health. 2016 Sep;59(3 Suppl):S8-S15. doi: 10.1016/j.jadohealth.2016.04.021.
Adolescent pregnancy, particularly unintended pregnancy, can have lasting social, economic, and health outcomes. The objective of this review is to identify high-quality interventions and evaluations to decrease unintended and repeat pregnancy among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched for all languages for articles published through November 2015. Gray literature was searched by hand. Reference tracing was utilized, as well as unpacking systematic reviews. Selected articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Twenty-one high-quality interventions and evaluations were abstracted. Nine reported statistically significant declines in pregnancy rates (five cash transfer programs, one education curriculum, two life-skills curricula, and a provision of contraception intervention), seven reported increases in contraceptive use (three provision of contraception interventions, two life-skills curricula, a peer education program, and a mass media campaign), two reported decreases in sexual activity (a cash transfer program and an education and life-skills curriculum), and two reported an increase in age of sexual debut (both cash transfer programs). The selected high quality, effective interventions included in this review can inform researchers, donors, and policy makers about where to make strategic investments to decrease unintended pregnancy during young adulthood. Additionally, this review can assist with avoiding investments in interventions that failed to produce significant impact on the intended outcomes. The diversity of successful high-quality interventions, implemented in a range of venues, with a diversity of young people, suggests that there are multiple strategies that can work to prevent unintended pregnancy.
青少年怀孕，尤其是意外怀孕，可能会对社会、经济和健康产生持久的影响。本综述的目的是确定高质量的干预措施和评估方法，以降低中低收入国家年轻人中非意愿和重复怀孕的发生率。通过所有语言在 PubMed、Embase、PsycInfo、Cinahl Plus、Popline 和 Cochrane 数据库中搜索截至 2015 年 11 月发表的文章。通过手动搜索灰色文献。利用参考追踪和系统综述的拆解。选择的文章是那些使用标准化评分被评估为具有高质量干预和评估的文章。共提取了 21 项高质量的干预和评估。有 9 项报告了妊娠率的统计学显著下降（5 项现金转移计划、1 项教育课程、2 项生活技能课程和 1 项提供避孕干预），7 项报告了避孕使用率的增加（3 项提供避孕干预、2 项生活技能课程、1 项同伴教育计划和 1 项大众媒体运动），2 项报告了性活动的减少（1 项现金转移计划和 1 项教育和生活技能课程），2 项报告了性初潮年龄的增加（均为现金转移计划）。本综述中选择的高质量、有效的干预措施可以为研究人员、捐赠者和决策者提供信息，了解在哪里进行战略投资，以降低年轻人中非意愿怀孕的发生率。此外，本综述还可以帮助避免投资于对预期结果没有产生重大影响的干预措施。成功的高质量干预措施的多样性，在各种场所实施，针对不同的年轻人，表明有多种策略可以预防非意愿怀孕。
