Sexual Health and Relationship Abuse Interventions in Pediatric Primary Care: A Systematic Review

J Adolesc Health. 2023 Apr;72(4):487-501. doi: 10.1016/j.jadohealth.2022.11.011. Epub 2023 Jan 7.

Abstract

Purpose: Supporting adolescents in developing healthy relationships and promoting sexual and reproductive health (SRH) is an important responsibility of pediatric primary care providers. Less is known about evidence-based interventions in pediatric settings focused on healthy relationships and SRH.

Methods: We conducted a systematic review to describe SRH and healthy relationship/adolescent relationship abuse (ARA) interventions for pediatric primary care over the past 20 years. Eligible articles were original research on an SRH-focused or ARA-focused intervention, conducted in-person within pediatric primary care or school-based health centers specifically for middle or high school-aged adolescents. Data abstracted from included articles included intervention description, content, delivery, evaluation design, and effectiveness of primary outcomes. Heterogeneous outcomes and evidence levels made conducting a meta-analysis infeasible.

Results: Nineteen studies described 17 interventions targeting a variety of SRH and ARA topics (e.g., sexually transmitted infections, contraception, ARA). Interventions largely focused on screening/counseling adolescents (89%). Interventions generally were reported as being effective in changing adolescent health or practice-level outcomes.

Discussion: This review provides preliminary evidence that SRH and ARA interventions in pediatric primary care settings can be effective in promoting adolescent health. Future work should consider ARA-specific prevention interventions, including parents in interventions, and strategies for implementation, dissemination, and scaling.

Keywords: Adolescent; Adolescent relationship abuse; Contraception counseling; Interventions; Pregnancy prevention; Primary care; Reproductive health; STI testing; Sexual health.

Publication types

  • Review
  • Systematic Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Child
  • Contraception
  • Humans
  • Primary Health Care
  • Reproductive Health
  • Sexual Behavior
  • Sexual Health*
  • Sexually Transmitted Diseases* / prevention & control