by Emily Krach
May 8, 2018

Teen Pregnancy Prevention in Chile: A Summary of Research Findings

Editor’s Note: May is National Teen Pregnancy Prevention Month. This is a summary of a research[i] article titled Adolescent Pregnancy Prevention: An Abstinence-Centered Randomized Controlled Intervention in a Chilean Public High School. It was published in the Journal of Adolescent Health in 2005. The research was reviewed and summarized by fourth year medical student Emily Krach as part of a two-week course taught through Georgetown University School of Medicine by FACTS Executive Director, Dr. Marguerite Duane.

Teen Pregnancy Prevention

Background
Many countries, including Chile, have experienced an increase in unplanned pregnancies and sexually transmitted infections among teenagers in recent years. Most studies regarding the prevention of teen pregnancy are purely observational studies rather than randomized controlled trials. This study sought to compare the TeenSTAR sex education program participants to those who received no intervention. A randomized, prospective, controlled trial was devised to determine the difference in pregnancy rates of those who participated in TeenSTAR and those who did not. The research was conducted at a public high school in Santiago, Chile. The researchers expected that the TeenSTAR participants would have a lower pregnancy rate than the control group.

Methodology
A total of 1,259 Chilean high school aged girls were studied. The participants all began the study during their first year of high school. Three cohorts separated the students depending on the year they started high school: 1996, 1997 or 1998. Throughout their four years of school, the students were followed for pregnancies. The entire 1996 cohort received no intervention with TeenSTAR, whereas the 1997 and 1998 cohorts were randomly divided into intervention and control groups.

The 1997 and 1998 intervention groups began the TeenSTAR Program in their first year of high school. This program trains participants in fertility awareness and has an abstinence-only approach to sexual education. The students learned about their fertility, including the physiology and biological applications, and the emotional aspects of sexuality. The TeenSTAR classes included 14 units, which consisted of at least one or more 45-minute class per unit. The 14 units involved group discussions, homework, videos, activities, and teaching about fertility awareness. These units covered various topics, including differences between genders, reproductive anatomy and physiology, knowing emotions and controlling behaviors and self-assurance. During the four years of high school, the cohorts were followed and all pregnancies were recorded, including those that ended in spontaneous abortions. No elective abortions were recorded; this practice is illegal in Chile.

Results

Average pregnancy rates per year (per each year of high school)

Cohort

TeenSTAR

Control

1996

3.86%

1997

0.87%

4.87%

1998

1.16%

5.88%

 

Cumulative pregnancy rates (percentage pregnant throughout 4 years of high school)

Cohort

TeenSTAR

Control

1996

14.7%

1997

3.3%

18.9%

1998

4.4%

22.6%

 

Discussion
In Chile, about 40,000 teenagers become pregnant each year, and the pregnancy rates in the control groups were comparable to high school pregnancy rates across the country. However, pregnancy rates in the intervention group were significantly less. The researchers have determined that programs like TeenSTAR, which have a goal of postponing the onset of sexual activity, are useful in altering teen and young adult sexual behavior, thus reducing teen pregnancy rates. Teaching about the choice of abstinence rather than earlier sexual activity, especially when promoted in a program such as TeenSTAR, can diminish unplanned pregnancies in teenagers.

The researchers believe TeenSTAR is successful because of its focus on overcoming impulses and growing in confidence, in the ability to negotiate and to attain a positive body image. Ideally, this program should provide well-trained teachers and run for an entire year to achieve greater impact.

Two limitations of the study were identified, including not knowing the extent of contraception use among the participants or whether any illegal abortions occurred. The researchers do not consider these limitations to have affected their conclusions.

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Editor’s Note: Teen STAR uses proven techniques to “teach chastity to adolescents.” The unique education program integrates teaching about a woman’s signs of fertility in a way that considers the whole person, including emotional, intellectual, relational, and spiritual aspects of human sexuality. The program utilizes curricula appropriate to different age groups, including middle and late adolescence.

In 2014, 40-50 percent of previously sexually active females and 30-50 percent of previously sexually active males discontinued sexual activity after participating in TeenSTAR. The program achieves primary and secondary prevention of teen pregnancy and sexually transmitted infections through the least expensive and most effective method: abstinent behavior. Teens also learn important life skills such as impulse control and mutual respect.

 

Author Bio: Emily Krach is a fourth year medical student at Marian University College of Osteopathic Medicine in Indianapolis, IN. She participated in a FABM elective during her fourth year. Upon graduation, she plans to specialize in family medicine at Fort Wayne Medical Education Program. She helped organize FABM workshops with FACTS speakers at her medical school during her last two years. In April 2018, she completed the Creighton Model NFP Medical Consultant training.

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References
[i] Cabezón, C, et al. “Adolescent Pregnancy Prevention: An Abstinence-Centered Randomized Controlled Intervention in a Chilean Public High School.” The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine., U.S. National Library of Medicine, Jan. 2005, www.ncbi.nlm.nih.gov/pubmed/15661598.

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