title: Programs to reduce teen pregnancy, sexually transmitted infections, and associated sexual risk behaviors: a systematic review.
abstract: OBJECTIVE
  This systematic review provides a comprehensive, updated assessment of programs with evidence of effectiveness in reducing teen pregnancy, sexually transmitted infections (STIs), or associated sexual risk behaviors.
  
  
  METHODS
  The review was conducted in four steps. First, multiple literature search strategies were used to identify relevant studies released from 1989 through January 2011. Second, identified studies were screened against prespecified eligibility criteria. Third, studies were assessed by teams of two trained reviewers for the quality and execution of their research designs. Fourth, for studies that passed the quality assessment, the review team extracted and analyzed information on the research design, study sample, evaluation setting, and program impacts.
  
  
  RESULTS
  A total of 88 studies met the review criteria for study quality and were included in the data extraction and analysis. The studies examined a range of programs delivered in diverse settings. Most studies had mixed-gender and predominately African-American research samples (70% and 51%, respectively). Randomized controlled trials accounted for the large majority (87%) of included studies. Most studies (76%) included multiple follow-ups, with sample sizes ranging from 62 to 5,244. Analysis of the study impact findings identified 31 programs with evidence of effectiveness.
  
  
  CONCLUSIONS
  Research conducted since the late 1980s has identified more than two dozen teen pregnancy and STI prevention programs with evidence of effectiveness. Key strengths of this research are the large number of randomized controlled trials, the common use of multiple follow-up periods, and attention to a broad range of programs delivered in diverse settings. Two main gaps are a lack of replication studies and the need for more research on Latino youth and other high-risk populations. In addressing these gaps, researchers must overcome common limitations in study design, analysis, and reporting that have negatively affected prior research.
authors: Mathematica Policy Research, Princeton, New Jersey. Electronic address: bgoesling@mathematica-mpr.com.
authors: Brian
authors: B
authors: Goesling
authors: Mathematica Policy Research, Princeton, New Jersey.
authors: Silvie
authors: S
authors: Colman
authors: Mathematica Policy Research, Princeton, New Jersey.
authors: Christopher
authors: C
authors: Trenholm
authors: Child Trends, Bethesda, Maryland.
authors: Mary
authors: M
authors: Terzian
authors: Child Trends, Bethesda, Maryland.
authors: Kristin
authors: K
authors: Moore
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003153:Community Health Services / Q000458:organization & administration; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*
keywords: Evidence-based programs; HIV; Sexually transmitted infections; Systematic review; Teen pregnancy