Systematic Review of Interventions for Reproductive Life Planning

Abstract

Objective: To systematically review the literature on interventions for reproductive life planning (RLP).

Data sources: We searched PubMed, CINAHL Plus, and PsycINFO for studies of the implementation and/or evaluation of an RLP intervention using the following search terms: reproductive life planning, intervention, program, evaluation, trial, strategy, assessment, survey, tool, and education. No limitations were set on languages or geographic locations of the studies. Records from 1990 through 2017 were searched.

Study selection: The initial search yielded 133 results after duplicates were excluded. Titles and abstracts were screened to determine whether articles met the inclusion criteria, and 110 articles were excluded. We completed a full-text review of 23 articles, and 9 articles met inclusion criteria. A secondary citations search and manual review of reference lists of articles already included in the review yielded an additional three articles. A total of 12 articles were identified for final inclusion.

Data extraction: We reviewed each article to assess study design, sample size and participants, study objectives, and outcome measures of the RLP intervention or evaluation implemented.

Data synthesis: We grouped studies into three categories according to outcomes measured: perceptions and acceptability of the intervention, change in knowledge after the intervention, and change in health behavior after the intervention. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the evidence of effectiveness for each outcome measured in each study.

Conclusion: There is a dearth of literature in which researchers tested and documented the effectiveness of extant RLP interventions. Current evidence highlights a positive reception of RLP in clinical practice, but data are limited with regard to its effectiveness in initiating changes in knowledge or behavioral outcomes. Process and outcome evaluations are needed to build the evidence base for RLP.

Keywords: intervention; maternal health; preconception care; reproductive life planning; unintended pregnancy.