Florsheim 2011.
Methods | RCT. Couples randomly assigned to intervention or control conditions. Couples were recruited through medical clinics and schools | |
Participants | 105 pregnant adolescent women (aged 14‐18 years; mean 16.1 years) and their co‐parenting partner (aged 14‐24 years; mean 18.3 years) | |
Interventions | Intervention: Young Parenthood Program: couples‐focused prevention programme consisting of individual and couple interviews covering communication skills, managing pregnancy, decreasing hostility and preventing intimate partner violence. Based in various community locations or couples' homes, or both. Delivered by counsellors (5 graduate students in clinical psychology) using a detailed manual as reference. Intervention carried out in 3rd trimester of pregnancy. The intervention was delivered over 10 months (number of sessions and duration of each session unclear). 53 couples. Control: 'treatment as usual' which consisted of prenatal services and psychosocial services including vocational counseling and parenting classes. 52 couples |
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Outcomes | Interpersonal violence experienced, as measured by responses to questions and follow‐up probes during interviews | |
Follow‐up | 2‐3 months and 18 months following childbirth | |
Notes | ‐ | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Couples were "randomly assigned" to intervention or control |
Allocation concealment (selection bias) | Unclear risk | Not stated |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Of 105 couples recruited: 5 miscarried or gave child up for adoption, 6 declined treatment and 10 could not be located for follow‐up. Attrition at 2‐3 months' follow‐up: intervention group 13% (7/53); control group 17% (9/52). Attrition at 18 months' follow‐up: intervention group 17% (9/53); control group 19% (10/52). Low rates with similar rates in each arm, therefore unlikely to cause bias |
Selective reporting (reporting bias) | Low risk | All outcomes reported fully (number of participants, means and SDs provided) |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding not possible but counsellors given manual to adhere to and weekly supervision sessions. However, no objective measure of whether programme guidelines were adhered to in practice, therefore high risk of performance bias |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Interpersonal violence was assessed through discussion in semi‐structured interviews. Non‐blinding of assessors and subjective element to scoring introduce high risk of bias |