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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Linda Wright-De Agüero, PhD MPH1, S Jay Smith, MIS, MS1, Ping Hu Johnson, MD, PhD, CHES2, Karen Taylor Valverde, MA1, Kate Curtis, PhD3, Barbara Cohen, BA4, Meredith Reynolds, PhD3, Craig W. Thomas, MA1, and Susan Scrimshaw5. (1) Epidemiology Program Office, Division of Prevention Research and Analytic Methods, Community Guide Branch, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K73, Atlanta, GA 30341-3717, (770) 488-8232, lkw1@cdc.gov, (2) Health, Physical Education and Sports Science, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA 30314, (3) National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K34, Atlanta, GA 30341, (4) Office of Public Health and Science, U.S. Department of Health and Human Services, 4350 East West Highway, Suite 200 West, Bethesda, MD 20814, (5) School of Public Health, University of Illinois, Chicago, 2121 West Taylor Street, Chicago, IL 60612
Background: As part of the systematic reviews conducted for the Task Force on Community Preventive Services (TF), we examined the effectiveness, applicability, and other effects of interventions providing contraceptive education and services. Methods: We searched for interventions published during 1980-2000 reporting a comparison group and predetermined health (e.g., pregnancy) and behavioral (e.g., contraceptive use) outcomes. By using a standardized protocol, studies were evaluated on suitability of design and quality of execution. Studies were summarized descriptively and analyzed by using weighted multiple regression stratified by sex after controlling for program, design, and demographic factors. Results: We found 56 interventions;19 were excluded from summarization because of limited quality of execution. Of 37 included interventions, 95% (n=35) targeted adolescents (aged£ 19 years) and 57% (n=21) targeted predominantly minorities (³70% nonwhite); 62% (n=23) focused on preventing a primary pregnancy, and 38% (n=14) a repeat pregnancy. Regression analysis of 22 studies determined that interventions focusing on primary prevention (versus repeat pregnancy) among adolescent females demonstrated °Ü50% reductions in pregnancy, especially in areas with higher baseline rates of pregnancy. Insufficient evidence exists to assess the effectiveness of contraceptive programs for adolescent males. No evidence of negative effects of the intervention was identified in the body of evidence or by the review team. Conclusions: On the basis of this review, the TF recommends contraceptive education and services among adolescent females for primary pregnancy planning and prevention. The intervention should be applicable for most racial/ethnic female populations, if culturally adapted, and in different settings.
Learning Objectives:
Keywords: Contraception, Pregnancy
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.