Australian Study Casts Doubt on Effectiveness of Infant Simulators in Preventing Teenage Pregnancy

IF 4.4 3区 医学 Q1 Social Sciences International Perspectives on Sexual and Reproductive Health Pub Date : 2016-12-01 DOI:10.1363/intsexrephea.42.4.227
S. London
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Abstract

Programs that aim to reduce teen pregnancy by training and requiring youth to care for lifelike infant dolls may not be effective, according to a school-based, cluster randomized controlled trial among young women in Australia. (1) Greater proportions of 13-15-year-old females who participated in a virtual infant parenting (VIP) program--which used infant simulators with realistic sleeping and feeding patterns--than of peers who received a standard health education curriculum experienced a live birth (8% vs. 4%) or an induced abortion (9% vs. 6%) by age 20. In analyses that accounted for factors that could affect these outcomes, VIP program participants still had a 40% higher risk than controls of experiencing a live birth, stillbirth or induced abortion by age 20. The trial was conducted in schools in the Perth metropolitan area of Western Australia between 2003 and 2006. Non-Catholic government and nongovernment schools were randomly assigned to deliver a VIP pregnancy prevention program or the standard health education curriculum to female youth in grades 9 and 10. The VIP program, Baby Think It Over, was adapted from a similar U.S. program; it aimed to delay pregnancy and to improve knowledge and awareness of preconception health issues. It was delivered by school health nurses over six days and entailed small group educational sessions, a comprehensive reference workbook, a video documentary of teenage mothers talking about their experiences, and caring for an infant simulator from a Friday afternoon through the following Monday morning. In the trial, a total of 57 schools were randomized--28 to the VIP program group and 29 to the control group; however, one intervention school was excluded because it did not recruit students according to the study's protocol. The overall rate of consent and participation of eligible female students was 58% at VIP program schools, translating to a sample of 1,267 teenagers, and 50% at control schools, translating to a sample of 1,567 teenagers. Investigators followed all participants until age 20, and ascertained their experience of a pregnancy event (live birth, stillbirth or induced abortion) through use of linked hospital and abortion clinic records. The investigators used binomial and Cox proportional hazards regression analyses to assess differences in pregnancy event rates between the study groups. At the time of trial enrollment, participants in each group had a median age of 15. The majority of participants in the intervention and control groups lived with both their biological parents (58% and 63%, respectively) and were sexually inexperienced (84% and 81%). Forty-two percent of youth in the VIP program group and 26% in the control group had a high level of socioeconomic disadvantage--that is, they were living in a household with a below-median socioeconomic index for their district. …
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澳大利亚的一项研究对婴儿模拟器预防少女怀孕的有效性提出了质疑
一项针对澳大利亚年轻女性的基于学校的随机对照试验表明,旨在通过培训和要求青少年照顾栩栩如生的婴儿娃娃来减少青少年怀孕的计划可能并不有效。(1)与接受标准健康教育课程的同龄人相比,参加虚拟婴儿养育(VIP)项目(该项目使用具有真实睡眠和喂养模式的婴儿模拟器)的13-15岁女性在20岁之前经历活产(8%对4%)或人工流产(9%对6%)的比例更高。在对可能影响这些结果的因素进行的分析中,VIP项目参与者在20岁之前经历活产、死产或人工流产的风险仍比对照组高40%。这项试验于2003年至2006年在西澳大利亚州珀斯市区的学校进行。非天主教政府和非政府学校被随机分配,为9年级和10年级的女青年提供VIP怀孕预防计划或标准健康教育课程。VIP节目《宝贝再想想》(Baby Think It Over)改编自美国的一个类似节目;它的目的是推迟怀孕,提高对孕前健康问题的认识和认识。该项目由学校保健护士在6天内提供,包括小组教育课程、综合参考手册、青少年母亲谈论她们经历的视频纪录片,以及从周五下午到下周一上午照顾婴儿模拟器。在试验中,共有57所学校被随机分配——28所进入VIP项目组,29所进入对照组;然而,一所干预学校被排除在外,因为它没有按照研究方案招收学生。在VIP项目学校,符合条件的女学生的总体同意率和参与率为58%,转化为1267名青少年的样本,而在对照学校,50%转化为1567名青少年的样本。调查人员跟踪所有参与者直到20岁,并通过使用相关的医院和堕胎诊所记录确定她们的妊娠事件(活产、死产或人工流产)经历。研究人员使用二项和Cox比例风险回归分析来评估研究组之间妊娠发生率的差异。在试验登记时,每组参与者的中位年龄为15岁。干预组和对照组的大多数参与者(分别为58%和63%)与亲生父母一起生活,并且没有性经验(84%和81%)。VIP项目组中42%的年轻人和对照组中26%的年轻人处于高度的社会经济劣势——也就是说,他们生活在一个社会经济指数低于其所在地区中位数的家庭中。…
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