Barnet 2009.
| Methods | Location: Baltimore, MD (USA) Recruitment time: February 2003 to October 2007 Sample size calculation and outcome of focus: not specified |
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| Participants | General with N: 237 pregnant adolescents Source: 5 urban prenatal care clinics providing prenatal care to mainly low‐income African American women without insurance or under Medicaid Inclusion criteria: 12 to 18 years old, pregnancy >= 24 weeks gestation Exclusion criteria: pregnancy did not result in live birth and withdrawn if the infant died in neonatal period, since parenting was an intervention focus. |
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| Interventions | Computer‐assisted motivational intervention (CAMI) on quarterly basis; motivational interviewing on contraception by CAMI counselors; parenting curriculum from Black 2006 included contraception
1) CAMI+: multi‐component home‐visiting intervention (parent training and case management) 2) CAMI‐only: single component, home‐based intervention 3) Usual care Timing: 6 weeks to 24 months postpartum with maximum of 9 quarterly sessions |
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| Outcomes | Primary: repeat birth by 24 months postpartum (assessed via Vital Statistics) Secondary: abortion since index child's birth Additional data provided by investigator: losses by arm to help interpret abortion information obtained at 24‐month interview |
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| Notes | If participant became pregnant, CAMI was stopped because questions on contraception were no longer relevant and program did not allow skipping. Secondary article (Barnet 2010) examined cost‐effectiveness. |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Randomly assigned, 'computer‐generated permuted blocks'. Investigator communicated that ratio was 3:3:2, with 6 used for intervention groups and 4 for control. Block size 16 would account for ratio rather than reported block size 6. |
| Allocation concealment (selection bias) | Unclear risk | No information |
| Blinding (performance bias and detection bias) All outcomes | Low risk | Outcome assessment: obtained from Vital Statistics |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Loss to follow‐up: none for primary outcome (obtained from Vital Statistics) Investigator provided loss by study arm at 24 month‐interview (counts and %): 17% CAMI+, 16% CAMI‐only, 24% Usual care Exclusions after randomization: 1 participant with stillborn infant and 1 whose 2‐month‐old infant died |