An infant simulator programme did not reduce teenage pregnancy

Abstract

ed by: Amanda J Friend, Department of Paediatrics, Leeds General Infirmary, Leeds, UK. Just like in everyday life, new or sophisticated devices in the medical world can wow us. The trial by Brinkman et al is a reminder that we have to keep our heads level and always ask for evidence before spending precious resources in these supposedly marvellous gadgets. A few years ago, a newspaper story caught my attention. The local health and social care programme had bought more than a hundred baby simulators and were going to use them in a public middle school aiming to reduce teen pregnancies. I remember searching for evidence about it and feeling disappointed after not finding any good trials. I did run into Dr Brinkman et al’s protocol. Now that their study has been published, my concern was confirmed. The trial showed that these robots do not reduce pregnancies; on the contrary, the number was larger in the intervention group. The authors adjusted for socioeconomic status, family type, sexual activity before enrolling, previous pregnancy, psychological stress, alcohol or drug use and still an increase in teen pregnancy risk was noted. Granted, this study was done in a high income country, not in my setting in Mexico, so we can’t assume that the results would be the same here. But the least, our health authorities should do is report the outcomes of the 900 local students who entered the programme. If the robots did reduce pregnancies, great. If they did not, just like this study suggests, it will be a learnt lesson so that we don’t spend our limited budget in futile preventive interventions, no matter how shiny or modern they look. Giordano Pérez-Gaxiola Correspondence to Dr Giordano Pérez-Gaxiola, Evidence-Based Medicine, Hospital Pediátrico de Sinaloa, Blvd. Constitución y Donato Guerra SN, Col. Almada, Culiacan 80200, Mexico; giordano@ sinestetoscopio.com Contributors GP-G wrote the commentary. Amanda J Friend wrote the structured abstract. Competing interests None. Provenance and peer review Commissioned; internally peer reviewed. REFERENCES 1 Zermeño Y. 900 teenagers will take care of their virtual babies. Noroeste [Culiacán] 8 October, 2013. http:// www.noroeste.com.mx/publicaciones. php?id=901171 2 Brinkman SA, Johnson SE, Lawrence D, et al. Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial. Trials 2010;11:100–10. Table 1 Pregnancy outcomes Outcomes Intervention group events Control group events Adjusted HR (95% CI) Total pregnancies 210 (17%) 168 (11%) 1.36 (1.10 to 1.67) % of pregnancies ending in abortion 54 60 1.23 (0.89 to –1.69)