为年轻人提供的青少年友好型计划生育服务：系统评价更新。
Youth-Friendly Family Planning Services for Young People: A Systematic Review Update.
机构信息
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
Office of Population Affairs, HHS, Washington, District of Columbia.
出版信息
Am J Prev Med. 2018 Nov;55(5):725-735. doi: 10.1016/j.amepre.2018.06.010.
CONTEXT
Youth-friendly family planning services may improve youth reproductive health outcomes. A systematic review conducted in 2011 was updated in 2016 to incorporate recent data examining the effects of youth-friendly family planning services on reproductive health outcomes and the facilitators and barriers facing young people in accessing family planning services.
EVIDENCE ACQUISITION
PubMed, POPLINE, EMBASE, and other databases were used to identify relevant articles published from March 2011 through April 2016.
EVIDENCE SYNTHESIS
Eighteen studies met inclusion criteria and were added to 19 studies from the review conducted in 2011. Of these, seven assessed the effect of youth-friendly services on outcomes: two showed a positive effect on reducing teen pregnancy, three on contraceptive use, and three on knowledge and patient satisfaction (not mutually exclusive). Facilitators or barriers were described in 32 studies. However, none were RCTs and most were at high risk for bias due to selection, self-report, and recall bias among others.
CONCLUSIONS
The studies in this review suggest some positive effects of youth-friendly family planning services on reproductive health outcomes, but the need for more rigorous research persists. This review identified numerous factors relevant to young people's access to family planning services, reaffirming findings from the initial review: young people value confidentiality, supportive provider interaction, specialized provider training, and the removal of logistic barriers. Further, it illuminates the importance young people place on receiving comprehensive, client-centered family planning counseling. These findings should be considered when developing, implementing, and evaluating reproductive health services for young people.
THEME INFORMATION
This article is part of a theme issue entitled Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services, which is sponsored by the Office of Population Affairs, U.S. Department of Health and Human Services.
背景
青年友好型计划生育服务可能改善青年生殖健康结果。2011 年进行的系统评价于 2016 年更新，纳入了最近的数据，以检验青年友好型计划生育服务对生殖健康结果的影响，以及年轻人在获得计划生育服务方面面临的促进因素和障碍。
证据采集
使用 PubMed、POPLINE、EMBASE 和其他数据库来确定从 2011 年 3 月至 2016 年 4 月期间发表的相关文章。
证据综合
有 18 项研究符合纳入标准，并被添加到 2011 年进行的综述中的 19 项研究中。其中，有 7 项研究评估了青年友好服务对结果的影响：两项研究显示减少青少年怀孕有积极影响，三项研究显示对避孕使用有积极影响，三项研究显示对知识和患者满意度有积极影响（非相互排斥）。32 项研究描述了促进因素或障碍。然而，没有一项是随机对照试验，由于选择、自我报告和回忆偏倚等原因，大多数研究的偏倚风险较高。
结论
本综述中的研究表明，青年友好型计划生育服务对生殖健康结果有一些积极影响，但仍需要更严格的研究。本综述确定了许多与年轻人获得计划生育服务相关的因素，这再次证实了最初综述的发现：年轻人重视保密性、支持性提供者互动、专门提供者培训以及消除后勤障碍。此外，它还凸显了年轻人对接受全面、以客户为中心的计划生育咨询的重视。在为年轻人制定、实施和评估生殖健康服务时，应考虑这些发现。
主题信息
本文是由美国人口事务办公室赞助的主题问题的一部分，题为“更新用于制定美国提供优质计划生育服务建议的系统评价”，该主题问题由美国卫生与公众服务部人口事务办公室赞助。
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