for the main comparison.
| Behavioral intervention based on social cognitive theory compared with usual care or education for improving contraceptive use | ||||
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Patient or population: adolescents and women with need for contraception Settings: clinic or home Intervention: behavioral intervention based on social cognitive theory Comparison: usual care or education | ||||
| Outcomes | Relative effect (95% CI) | Participants (studies) | Quality of the evidence (GRADE) | Comments |
| Second birth in 2 years | OR 0.41 (0.17 to 1.00) | Black 2006 | High | Home‐based curriculum (19 sessions) to delay second birth vs usual care; adolescent mothers |
| Consistency of hormonal contraceptive use at: 12 months; 18 months; 24 months |
Reported adjusted RR:
1.46 (1.13 to 1.89); 1.36 (1.02 to 1.83); 1.30 (1.06 to 1.58) |
Sieving 2013 | Moderate | Case management and leadership (18 months) vs usual care; adolescent girls |
| Consistency of condom use at: 12 months; 24 months |
Reported adjusted RR: 1.45 (1.26 to 1.67); 1.57 (1.28 to 1.94) |
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| Consistency of dual method use (OCs + condoms) at: 12 months; 24 months |
Reported adjusted RR: 1.58 (1.03 to 2.43); 1.36 (1.01 to 1.85) |
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| Use of effective contraceptive method:
at 7 months after baseline (after year 1 sessions); at 19 months after baseline (12 months after year 2 sessions) |
Reported adjusted OR ± SE: 1.62 ± 0.22 (P = 0.03); 1.76 ± 0.29 (P = 0.05) |
Coyle 2001 | Moderate | School‐based curriculum (20 sessions) to prevent pregnancy and HIV/STI vs usual education; grade 9 students |
| Condom use at last sex: at 7 months after baseline; at 19 months after baseline |
Reported adjusted OR ± SE: 1.91 ± 0.27 (P = 0.02); 1.68 ± 0.25 (P = 0.04) |
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| Frequency of sex without condom in past 3 months: at 7 months after baseline; at 19 months after baseline |
Reported ratio of adjusted means ± SE: 0.50 ± 0.31 (P = 0.03); 0.63 ± 0.23 (P = 0.05) |
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| Condom use at last sex (at 6 months after baseline) | Reported adjusted OR 2.12 (1.24 to 3.56) | Coyle 2006 | Moderate | School‐based curriculum (14 sessions) to prevent pregnancy and HIV/STI vs usual activities; alternative high school students Included Theory of Planned Behavior (+ earlier Theory of Reasoned Action) |
| Less frequent sex without condom in past 3 months (at 6 months after baseline) | Reported adjusted MD −1.09 ± SE 0.36; P = 0.002 | |||
| Risk avoidance group, unprotected sex at last sex: at 3 months; > 15 months |
Reported adjusted OR: 0.70 (0.52 to 0.93); 0.61 (0.45 to 0.85) |
Markham 2012 | Moderate | School‐based curriculum (24 sessions) to prevent pregnancy and HIV/STI (through risk avoidance or risk reduction) vs usual education; grade 7 and 8 students Included Theory of Planned Behavior |
| Risk reduction group, unprotected sex at last sex; sex without condom in past 3 months (at 3 months) |
Reported adjusted OR: 0.67 (0.47 to 0.96); 0.59 (0.36 to 0.95) |
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| CI: confidence interval; MD: mean difference; OR: odds ratio; RR: risk ratio; SE: standard error | ||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||