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

Study Objective: This review was undertaken to determine the effectiveness of contraception service interventions for young people that were delivered in educational settings. Design: We conducted a systematic review and narrative synthesis. Setting: Interventions were included where they were delivered in educational institutions, including schools, colleges, and pupil referral units. Participants: Young people aged 19 and under. Studies of wider age groups were included if the majority of participants were aged under 19 years. Interventions: We included interventions which consisted of contraceptive service provision, and also interventions to encourage young people to use existing contraceptive services. Main Outcome Measures: The 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. Results: Twenty-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. Conclusions: The 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.