Please access these Web sites via the online version of this summary at http: Conclusion Compared with conventional school sex education at age 13—14 y, this form of peer-led sex education was not associated with change in teenage abortions, but may have led to fewer teenage births and was popular with pupils. There were no differences between the two arms for girls or boys in any other aspect of sexual health, including sexually transmitted diseases. From this information, the schools were ranked and divided into three risk strata of approximately equal size. The mean standard deviation age of students at third questionnaire follow-up was Here we present the final follow-up to age 20 y, with anonymised linkage of all girls in the trial to routine statutory reports of abortions and live births, to assess the effectiveness of peer-led SRE in reducing unintended teenage pregnancy. Approaches recommended in the strategy to achieve this goal include the provision of effective sexual health advice services for young people, active engagement of health, social, youth support, and other services in the reduction of teenage pregnancies, and the improvement of sex and relationships education SRE. Even though peer-led SRE requires more resources than teacher-led SRE, this form of SRE should probably still be considered as part of a broad teenage prevention strategy, suggest the researchers. Outcomes The primary outcome, chosen as a clear indicator of an unintended pregnancy, was abortion before age 20 from routine statutory data collected until 31 December
Peer educators gave signed consent to participate. For continuous outcomes, the difference between the means in the two arms is used, derived from linear regression. These abortions were included in analysis by age 20, but not by age We sent the trial register to the Office for National Statistics for matching to birth registrations, and to Northgate Information Solutions for matching to maternity registrations. All pupils in Year 9 8th grade, aged 13—14 y were eligible to take part unless their parents opted to withdraw them, following written information to parents [ 11 ]. However, little is known about the long-term effectiveness of peer-led SRE. The trial was approved by the committee on the ethics of human research at University College London. Although the annual under pregnancy rate in England is falling, it is still very high, and it is extremely unlikely that the main goal of the Teenage Pregnancy Strategy will be achieved. Specifically we stratified pupils into eight strata according to gender and the questionnaire they last completed none, baseline, first, or second follow-up. We sent the trial register to the Department of Health for abortion matching. The main goal of the strategy is to halve the under pregnancy rate—there were Outcomes The primary outcome, chosen as a clear indicator of an unintended pregnancy, was abortion before age 20 from routine statutory data collected until 31 December Methods and Findings Twenty-seven representative schools in England, with over 9, pupils aged 13—14 y at baseline, took part in the trial. Such weighting is a standard approach to dealing with missing data, particularly in surveys. Fewer girls in the peer-led arm self-reported a pregnancy by age 18 y 7. The researchers then used routine data on abortions and live births to find out how many female study participants had had an unintended pregnancy before the age of 20 y. Fitted probabilities of questionnaire completion were calculated for each pupil who completed a questionnaire and their inverse was taken as the weight, and then scaled to the total number of pupils within that stratum and trial arm. This estimate of the total variance for a school is the sum of its within-school variance and the between-schools estimated variance, the latter estimated as described elsewhere [ 11 ]. The two arms were well balanced with respect to demographic data and the proportion of pupils reporting sexual intercourse at baseline Figure 2. The proportion of girls who had one or more abortions before age 20 y was the same in each arm intervention, 5. The sessions used participatory learning methods designed to improve the younger pupils' skills in sexual communication and condom use and their knowledge about pregnancy, sexually transmitted infections STIs , contraception, and local sexual health services. Girls were matched to routine data derived from statutory abortion notification forms using date of birth and postcode, with confirmation of matches using name held on paper records only. Why Was This Study Done? For both live births and abortions, matching was done by staff who were blind to allocation, and individually matched data were aggregated and returned to us as a simple count per school, so that no participant with an abortion or live birth could be identified. The mean standard deviation age of students at third questionnaire follow-up was This replaced adjustment for school risk stratum incorporated in the primary analysis.
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