Interventions intended to reduce pregnancy-related outcomes among adolescents

Additional Info

  • Authors: Lauren S. Scher, Rebecca A. Maynard, Matthew Stagner
  • Published date: 2006-12-19
  • Coordinating group(s): Social Welfare
  • Type of document: Protocol, Review, Plain language summary, Other
  • PLS Title: Teen pregnancy prevention programs are mostlyineffective. Multi-component programs may work.
  • PLS Description: This review examines the effectiveness of teenage pregnancy prevention programs inlowering sexual activity rates, encouraging the use of contraception, and reducing pregnancy among teens.
  • Title: Interventions intended to reduce pregnancy-related outcomes among adolescents
  • Spanish PLS: Los programas de prevención del embarazo precoz son mayormente ineficaces, aunque tal vez funcionen aquellos que sean multicomponentes
  • Spanish PLS Description: Altas tasas de actividad sexual y de embarazos y partos de mujeres adolescentes, particularmente en Estados Unidos, han llevado a desarrollar una amplia gama de iniciativas para prevenir el embarazo precoz, algunas con énfasis en los métodos anticonceptivos y otras promoviendo la abstinencia sexual como principal medio de reducción de dichas tasas. Esta revisión analiza la eficacia de los programas de prevención de embarazo precoz para disminuir las tasas de actividad sexual, alentar el uso de métodos anticonceptivos y reducir los embarazos entre mujeres adolescentes.
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About this systematic review

This Campbell systematic review examines the effectiveness of teenage pregnancy prevention programs in promoting abstinence, encouraging the use of contraception and reducing the likelihood of pregnancy among teens. The review summarise findings from 31 studies conducted in the US or in developed countries with higher than average rates of unplanned teen pregnancy, such as Canada, England, New Zealand, and Australia.

What are the main results?

Taken together, the findings for each of the first three types of interventions   one-time consultations, sex education programs focused on contraception, and sex education programs focused on promoting abstinence   show no evidence of having reduced sexual activity or pregnancy rates among participating youth.

The most promising results are for multi-component youth development programs, which resulted in modest reductions (six percentage points) in pregnancy rates among participants as compared with their control group counterparts. The impacts were larger for females than males.

Executive summary
This review synthesizes the evidence on the effectiveness of programs aimed at reducing sexual risk-taking among teens. By including only rigorous randomized controlled trials that meet additional methodological criteria, it uses meta-analytic techniques to estimates the average effects that interventions have on reducing sexual experience, unprotected sexual activity, and pregnancy rates. It focuses on four main types of interventions: (1) one-time consultations; (2) sex education programs with an abstinence focus (and no contraceptive focus); (3) sex education programs with a contraception component; and (4) multi-component youth development programs. In total, this review presents findings based on over 37,000 youth who were the subjects of 31 studies that reported on a total of 38 randomized trials of interventions aimed at reducing teen sexual activity and pregnancy.
This review finds no consistent evidence that the types of pregnancy prevention programs evaluated rigorously to date will alter in intended ways the sexual activity or pregnancy risks of youth. However, this overall pooling of studies mixes results of different program types serving different populations of adolescents. When looking more specifically by intervention type, the following results were found:
  • too little evidence to make specific judgments about one-time consultations
  • limited evidence regarding sex education programs with an abstinence focus
  • no consistent evidence that that sex education programs altered the likelihood that youth would initiate sex, would risk pregnancy, or would become (or get someone) pregnant
  • the most promising results are for the more intensive multi-component youth development programs serving higher risk adolescents. Moreover, within this category, the results tend to be most favorable for females. However, there is a paucity of rigorous evaluations of such programs, and further replication and evaluation is warranted.

While the body of knowledge in this field is continually grow ing, th is review highlights the relative dearth of evidence to jud g e the ove ra ll ef f ectiven ess of partic ular inte rven tion stra tegies. For this reason, furth e r research and evaluatio n is necessary, includ ing studying pr o g ram s that have not yet been evaluated rigorously and program s that have been replicated and are serving new populations of adolescents in different communities. Once a larger body of m o re sim ilar program s have been ev aluated rigorous ly and reported consistently, then it will be possible to pool the evidence to m a ke more concrete conclusions regarding program efficacy.  

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