African Population and Health Research Center (APHRC), P.O. Box 10787-00100 GPO, Nairobi, Kenya.
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
Reprod Health. 2024 Nov 25;21(1):173. doi: 10.1186/s12978-024-01912-z.
Across sub-Saharan Africa, adolescents face the triple tragedy: unintended pregnancies, unsafe abortion, and sexually transmitted infections including HIV due to various reasons, among them, poor parent-adolescent communication on sexual and reproductive health. Effective interventions such as improving parent‒adolescent communication has been recognized as a protective factor for adolescent sexual and reproductive health outcomes. Research shows that parent-adolescent communication is associated with reduced adolescent engagement in risky sexual behaviours, including early sexual initiation, lower rates of teenage pregnancy, sexually transmitted infections, and increased self-efficacy in decision making. Despite the potential role of parent-adolescent communication in promoting optimal adolescent sexual and reproductive health, limited research evidence exists on interventions to improve parent-adolescent communication on sexual and reproductive health in sub-Saharan African countries. The aim of this systematic review is to assess the role of parent-adolescent communication intervention programs in improving sexual and reproductive health outcomes.
We will pool evidence from published literature from January 1990 up to and including February 2024 from multiple databases: PubMed, Web of Science, Scopus, African Journals Online, JSTOR, Directory of Open Access Journals, and Google Scholar. Articles published in the English language will be included. Two reviewers will conduct screening for titles, abstracts, and full texts, while a third reviewer will arbitrate in cases of lack of concurrence. Experimental, quasi-experimental and observational study designs will be included.. A data extraction tool based on Microsoft Excel will be used to extract data items from different studies. We will focus on the following outcomes: initiation of sexual activity, use of condoms and contraceptives, reduced risky sexual behaviours such as unprotected sex, and lower rates of teenage pregnancy. When feasible, articles will be combined for statistical meta-analysis. Effect sizes, either reported as weighted mean differences for continuous data or as odds ratios for binary data, will be presented as proportions with 95% confidence intervals. We will use the random effects model to meta-analyse the include studies as we expect considerable variability across study designs. This will provide an average effect size that accounts for variability of results within studies. Sensitivity analysis will also be conducted to assess the robustness of the findings or conclusions of the meta-analysis. The review findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
This review provides insights into parent-based intervention programs that have been implemented in sub-Saharan African countries to improve adolescent sexual and reproductive health via promotion of parent-adolescent sexuality communication. The findings will guide further research on this issue as well as inform policy makers on which interventions have a potential effect in improving adolescent sexual and reproductive health. Protocol Registration Number: CRD42024525191 (PROSPERO), Date of registration: 27/03/2024.
在撒哈拉以南非洲地区，青少年面临着三重悲剧：意外怀孕、不安全的堕胎以及性传播感染，包括艾滋病毒，这是多种原因造成的，其中包括父母与青少年在性和生殖健康方面沟通不畅。改善父母与青少年之间的沟通等有效干预措施已被认为是保护青少年性与生殖健康的一个因素。研究表明，父母与青少年的沟通与青少年参与危险性行为的减少有关，包括性早熟、青少年怀孕率降低、性传播感染以及决策自我效能感的提高。尽管父母与青少年之间的沟通在促进青少年性与生殖健康方面具有潜在作用，但在撒哈拉以南非洲国家，关于改善父母与青少年之间性与生殖健康沟通的干预措施的研究证据有限。本系统评价旨在评估父母与青少年沟通干预方案在改善性与生殖健康结果方面的作用。
我们将从多个数据库（PubMed、Web of Science、Scopus、African Journals Online、JSTOR、Directory of Open Access Journals 和 Google Scholar）中汇集 1990 年 1 月至 2024 年 2 月期间发表的文献中的证据。将纳入发表在英语文献中的文章。两位审稿人将对标题、摘要和全文进行筛选，而第三位审稿人将在意见不一致时进行仲裁。将纳入实验、准实验和观察性研究设计。将使用基于 Microsoft Excel 的数据提取工具从不同的研究中提取数据项。我们将重点关注以下结果：性活动的开始、避孕套和避孕药的使用、减少危险的性行为，如无保护性行为，以及青少年怀孕率的降低。在可行的情况下，将对文章进行合并进行统计荟萃分析。效应量将报告为连续数据的加权均数差或二分类数据的优势比，并以 95%置信区间表示为比例。我们将使用随机效应模型对纳入的研究进行荟萃分析，因为我们预计研究设计之间会有很大的变异性。这将提供一个考虑到研究内结果变异性的平均效应大小。还将进行敏感性分析，以评估荟萃分析结果或结论的稳健性。综述结果将根据系统评价和荟萃分析的首选报告项目报告。
本综述提供了有关在撒哈拉以南非洲国家实施的基于父母的干预计划的见解，这些计划通过促进父母与青少年的性沟通来改善青少年的性与生殖健康。研究结果将指导这一问题的进一步研究，并为政策制定者提供有关哪些干预措施有可能改善青少年性与生殖健康的信息。注册编号：CRD42024525191（PROSPERO），注册日期：2024 年 3 月 27 日。
