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School-based interventions for improving contraceptive use in adolescents.

Laureen M Lopez1, Alissa Bernholc, Mario Chen

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Area of Science:

  • Public Health
  • Adolescent Health
  • Contraception

Background:

  • Adolescents, particularly young women, face significant barriers to modern contraceptive access globally.
  • Disparities in contraceptive use are influenced by geographic, political, and cultural factors.
  • Projected birth rates in developing regions were substantially higher than in developed regions in 2015.

Purpose of the Study:

  • To identify and evaluate school-based interventions aimed at increasing contraceptive use among adolescents.
  • To synthesize evidence from randomized controlled trials (RCTs) on the effectiveness of these interventions.

Main Methods:

  • Systematic search of multiple databases (PubMed, CENTRAL, ERIC, etc.) for eligible trials up to June 2016.
  • Inclusion of cluster and individual RCTs where participants were predominantly 19 years or younger.
  • Interventions focused on effective contraceptive methods and were delivered in middle or high school settings; primary outcomes were pregnancy and contraceptive use.

Main Results:

  • Eleven trials (10 cluster RCTs, 1 individual RCT) were included, primarily from the USA and UK.
  • Several interventions demonstrated positive effects, including increased reporting of effective contraception and condom use during last sex.
  • Some programs improved knowledge of emergency contraception and HIV/STI prevention, though one peer-led program showed decreased oral contraceptive use.

Conclusions:

  • School-based interventions show potential for improving adolescent contraceptive use and sexual health knowledge.
  • Emphasis was often placed on condom use for STI/HIV and pregnancy prevention, but other methods were also addressed.
  • The overall quality of evidence was rated as low, primarily due to issues with intervention fidelity, analysis of subsamples, and high participant attrition.