Systematic Review and Narrative Synthesis of the Effectiveness of Contraceptive Service Interventions for Young People, Delivered in Educational Settings

Study ObjectiveThis review was undertaken to determine the effectiveness of contraception service interventions for young people that were delivered in educational settings.DesignWe conducted a systematic review and narrative synthesis.SettingInterventions were included where they were delivered in educational institutions, including schools, colleges, and pupil referral units.ParticipantsYoung people aged 19 and under. Studies of wider age groups were included if the majority of participants were aged under 19 years.InterventionsWe included interventions which consisted of contraceptive service provision, and also interventions to encourage young people to use existing contraceptive services.Main Outcome MeasuresThe main outcome measures used in the studies were: rate of teenage pregnancy, rate of contraceptive use, and sexual behavior. Many outcome measures were self reported.ResultsTwenty-nine papers were included which reported on interventions to prevent adolescent pregnancy (and repeat pregnancy), school-based health centers, contraceptive use in college students, and multicomponent interventions. Intensive case management intervention conducted by a culturally matched school-based social worker (along with other components including peer education) were shown to be effective in preventing repeat adolescent pregnancy, at least for the duration of the intervention. Also, school-based health centers appear to be most effective when contraception provision is made available on site.ConclusionsThe evidence from these papers is limited, in terms of both quality and quantity, along with consistency of findings, but some recommendations in relation to effective interventions can be made.