Mataraarachchi Dilini, Shepherd Thomas, Bajpai Ram, Ariyadasa Gayan, Corp Nadia, Paudyal Priyamvada
School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, UK.
Institute for Global Health and Wellbeing, School of Medicine, Keele University, Keele, UK.
Int Health. 2025 Sep 3;17(5):617-648. doi: 10.1093/inthealth/ihaf017.
Family-based sexual health interventions (FBSHI) have received considerable attention for their success in promoting adolescent sexual health outcomes. However, their effectiveness in low- and middle-income countries (LMICs) is unclear. Systematic searches were conducted for studies published from January 2000 to October 2023 using five electronic databases. Studies were included if they included adolescents aged 10-19 y and their family members (parents, siblings or primary caregivers) in a key intervention component, evaluated the effectiveness of the interventions using an experimental or quasi-experimental design, assessed sexual and reproductive health outcomes reported by adolescents and were carried out in LMICs. The review included nine studies, with 2404 adolescent participants and their families. Meta-analysis was carried out using a random-effects model. The key themes that emerged from this systematic review were: (i) FBSHI significantly improved adolescents' sexual health knowledge; and (ii) the impact of FBSHI on molding adolescents' sexual health attitudes, practices and family communication around sexual health topics was inconsistent. The importance of conducting combined interventions that involved adolescents and their parents to elicit better outcomes was highlighted in the review. Future research should prioritize under-represented geographical regions such as Asia and include culturally adopted, contextually relevant material to increase the acceptability and effectiveness in LMIC settings. By synthesizing existing literature, this review contributes to gaining a comprehensive understanding of varying strategies that can be used to ensure the effectiveness of family-based sexual health interventions in promoting adolescent sexual health in the LMIC setting. The review also highlights areas not explored by the existing research and that need attention when conducting further research.
基于家庭的性健康干预措施（FBSHI）因其在促进青少年性健康成果方面的成功而受到了广泛关注。然而，其在低收入和中等收入国家（LMICs）的有效性尚不清楚。我们使用五个电子数据库对2000年1月至2023年10月发表的研究进行了系统检索。纳入标准为：研究在关键干预部分纳入了10至19岁的青少年及其家庭成员（父母、兄弟姐妹或主要照顾者）；采用实验性或准实验性设计评估干预措施的有效性；评估青少年报告的性与生殖健康成果；研究在低收入和中等收入国家开展。该综述纳入了9项研究，涉及2404名青少年参与者及其家庭。使用随机效应模型进行了荟萃分析。该系统综述得出的关键主题为：（i）基于家庭的性健康干预措施显著提高了青少年的性健康知识；（ii）基于家庭的性健康干预措施对塑造青少年的性健康态度、行为以及围绕性健康话题的家庭沟通的影响并不一致。综述强调了开展涉及青少年及其父母的联合干预以取得更好效果的重要性。未来的研究应优先关注亚洲等代表性不足的地理区域，并纳入文化适应性强、与当地相关的材料，以提高在低收入和中等收入国家环境中的可接受性和有效性。通过综合现有文献，本综述有助于全面了解可用于确保基于家庭的性健康干预措施在低收入和中等收入国家促进青少年性健康方面有效性的各种策略。该综述还突出了现有研究未探索的领域以及在进行进一步研究时需要关注的领域。
