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• W8024499 abstract "Editor—DiCenso et al provided a rigorous, systematic review of randomised, controlled trials to reduce unintended pregnancies in adolescents.1 They did not, however, provide a balanced interpretation of their findings. Specifically, the main research question in the study and the conclusions that were drawn from it are inconsistent. Since within 21 of 26 trials reviewed, or 81%, the control condition was actually conventional sex education, this was not a study about whether or not sex education works.Rather, this was a study that compared the efficacy of theory driven sex education with conventional sex education. What DiCenso et al found, contrary to previous findings,2 is that theory driven sex education did not outperform conventional sex education. The strongest conclusion that can be drawn is that in this select group of studies, the two conditions come out equal in terms of behavioural outcomes. It is troubling that DiCenso et al point this out only late in their paper as essentially an afterthought.In addition, given the study's findings, it would seem crucial for DiCenso et al to suggest answers to this question: Why are some sex education programmes successful and others are not? Despite 10 hypotheses tested and considerable heterogeneity among studies, they were not able to answer this question. As a result it seems that the field is no further ahead in understanding this now than it was before this study. At the very least, DiCenso et al could have better addressed this issue, as others have done.2My objection is not to the study. Such reviews can and often do help move the field forward. Rather, as I have said previously,3 my objection is to conclusions drawn from a study that did not ask the questions in the context of that study. Since nearly all of the adolescents in these trials received some type of sex education, we cannot know what the natural trajectory of behaviour would have been without such education. Thus the strongest interpretation of these data is that theory based programmes did not have more impact than conventional programmes, within the set of studies reviewed. Although this runs counter to much of the literature in this field,2,4,5 it is the result of this particular review and one that demands further interpretation and exploration." @default.
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• W8024499 date "2002-10-05" @default.
• W8024499 modified "2023-09-25" @default.
• W8024499 title "Reducing unintended pregnancy among adolescents" @default.
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• W8024499 doi "https://doi.org/10.1136/bmj.325.7367.777/a" @default.
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