• This is why research is important, teen pregnancy edition

    Most people, in general, would like to reduce the incidence of teen pregnancy. Yes, it’s at an all-time low here in the US, but that doesn’t mean there isn’t room for improvement, here and abroad.

    A number of people, and programs, have decided that one way to combat teen pregnancy is to teach teens how hard it is to raise a baby. They sometimes force kids to “couple up” in school and pretend they have a child. Sometimes, they even give them a doll – one that cries, wakes up at night, etc. – to bring home the point.

    I’ve often rolled my eyes at such things, but never said anything. Until now. From the Lancet, “Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia“:

    Background: Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia.

    Methods: In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13–15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups.

    This was a school-based randomized controlled trial of an infant simulator-based program to prevent teen pregnancy in girls age 13-15 years from 2003 through 2006. Fifty-seven schools participated, and more than 2800 girls were followed until they were 20. The outcome of interest was pregnancy during the teenage years.

    And… more girls in the intervention group got pregnant. In the intervention group, 8% of the girls had at least one birth, compared to 4% of those in the control group. Even after adjusting for potential confounders, the intervention group had a more-than one-third higher relative risk of pregnancy in the teenage years.

    So not only are those baby-doll-simulators likely a waste of time and money, they may be leading to an increase in teenage pregnancy.

    This is why research is important. So is what we do with it. I know if they try this kind of program with one of my kids, I’m going to open my mouth.

    @aaronecarroll

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