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首页> 外文期刊>Prevention science: the official journal of the Society for Prevention Research >Effectiveness of School-Based Teen Pregnancy Prevention Programs in the USA: a Systematic Review and Meta-Analysis
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Effectiveness of School-Based Teen Pregnancy Prevention Programs in the USA: a Systematic Review and Meta-Analysis

机译：校本青少年妊娠预防计划的有效性：系统审查和荟萃分析

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School-based programs have been a mainstay of youth pregnancy prevention efforts in the USA. We conducted a systematic review and meta-analysis to assess their effectiveness. Eligible studies evaluated the effect on pregnancy rates of programs delivered in elementary, middle, or high schools in the USA and Canada, published between January 1985 and September 2016. The primary outcome was pregnancy; secondary outcomes were delay in sexual initiation, condom use, and oral contraception use. Randomized controlled trials (RCTs) and non-RCTs with comparator groups were eligible. We developed a comprehensive search strategy, applied to major bibliographic databases, article bibliographies, gray literature, and contact with authors. We calculated risk ratios (RR) with 95% confidence intervals (CI) for each outcome and pooled data in random effects meta-analysis. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess evidence quality. Ten RCTs and 11 non-RCTs conducted from 1984 to 2016 yielded 30 unique pooled comparisons for pregnancy, of which 24 were not statistically significant. Six showed statistically significant changes in pregnancy rates: two with increased risk (RR 1.30, 95% CI 1.02-1.65; and RR 1.39, 95% CI 1.10-1.75) and four with decreased risk ranging from RR 0.56, 95% CI 0.41-0.77, to RR 0.75, 95% CI 0.58-0.96. All studies were at high risk of bias, and the quality of evidence was low or very low. Identified evidence indicated no consistent difference in rates of pregnancies between intervention recipients and controls.
机译：基于学校的计划一直是美国青年怀孕预防努力的主要课程。我们进行了系统审查和荟萃分析，以评估其有效性。符合条件的研究评估了美国和加拿大在1985年1月至2016年1月之间发布的小学，中学或高中交付的妊娠率的影响。主要结果是怀孕;二次结果是性启动，避孕套和口服避孕药的延迟。随机对照试验（RCT）和具有比较组的非RCT符合条件。我们开发了一个全面的搜索策略，适用于主要的书目数据库，文章参考书目，灰色文学和与作者联系。我们计算出风险比（RR）为每种结果的95％置信区间（CI），随机效应META分析中的每个结果和汇总数据。我们使用建议评估，开发和评估（等级）进行评分来评估证据质量。从1984年到2016年进行的十个RCT和11个非RCT，产生了30种独特的怀孕汇总比较，其中24个没有统计学意义。六显示妊娠率的统计学显着变化：两个风险增加（RR 1.30,95％CI 1.02-1.65;和RR 1.39,95％CI 1.10-1.75）和4次，风险降低0.56，95％CI 0.41- 0.77，至RR 0.75,95％CI 0.58-0.96。所有研究均处于高风险，证据质量低或非常低。确定的证据表明，干预受者与控制之间的怀孕率没有一致的差异。

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