Healthcare: Critical Analysis of Sexual Risk Behaviors Research

This assignment presents a critical analysis of three research papers focusing on sexual risk behavior and adolescent health. The first paper, a systematic review and meta-analysis by Marseille et al. (2018), examines the effectiveness of school-based teen pregnancy prevention programs in the United States, highlighting the need for such interventions and the limitations of the included studies. The second paper, by Travers et al. (2019), discusses the implementation of adolescent sexual healthcare practices in the Bronx, New York, and the challenges faced in providing resources. The third paper, by Zullig et al. (2020), investigates the impact of STI/HIV prevention strategies on life satisfaction among African American adolescents. The analysis evaluates the strengths and weaknesses of each study, including methodologies, results, and limitations, and concludes with discussion questions regarding the evidence for systematic reviews, the role of awareness, the implementation of area-based programs, and survey reliability.

Running head:HEALTHCARE
Sexual Risk Behavior Critical Analysis
Name of the Student
Name of the University
Author Note

1HEALTHCARE
The first paper by Marseille et al. (2018) is a systematic review and meta-analysis that
assesses the effectiveness of teenage pregnancy prevention programs in the schools of the
United States. The introduction of this paper provides a background for the study by
describing the prevalence of STIs and teenage pregnancy, highlighting the need for such
interventions. The rationale of the systematic review was detailed and justified the research
question. None of the previous review papers target the effectiveness of pregnancy risk-
reducing programs in schools. The methods utilized were those suggested by Cochrane
collaboration, and the meta-analysis was conducted by pooling the studies into non-RCT and
RCT studies. As for the results, this systematic review included studies that showed variable
results. Overall, the analysis showed no significant difference in pregnancy rates due to
school-based prevention programs. However, it also declares that even though the data was
not promising, there may be specified approaches that are useful.
The strength of this paper is that it is a systematic review, which ensures high validity,
and the review method is approved by Cochrane Collaboration. The limitation is that this
included studies that had a very high risk of bias. The level of evidence that was included in
the systematic review was low or very low.
The second paper by Travers et al. (2019) focuses on the implementation of
adolescent sexual healthcare practices in New York. The introduction highlighted the need
for this implementation by examining the statistics of sexual health-related issues in the
Bronx, New York, as well as their prevalence in different races. Evidence-based healthcare
practices were implemented in the clinical settings of the Bronx. Bronx Teens Connection
(BxTC) aimed to provide training and technical assistance to the healthcare workers, and a
survey was conducted to evaluate success. The results show a steady increase in
contraceptive use and hormonal implants in adolescents.

2HEALTHCARE
The major setback in this process was the limitations of resources. The data was
presented from a small number of centers in the Bronx, and the small sample size may reduce
the reliability of the paper. The strength is that it provides an overview of a program focused
on a specific region, namely the Bronx. While it is not generalized, it combats the problem by
focusing on a region that needs it.
In the final reading by Zullig et al. (2020) focuses on the aspect of HIV/STI
prevention in African American adolescents and whether better sexual health improves life
satisfaction or not. The introduction and literature review points out the rationale behind this
study. It states that while the sexual risk behaviors in African American adolescents are well
documented, the impact of better sexual health remains unexplored. The research method is a
randomized controlled trial by comparing normal health intervention and sexual-risk
reduction intervention. The results suggest that there is a significant increase in life
satisfaction among females in the intervention, while the results for males are inconclusive.
The results were detailed and comprehensive.
The strength of this study was that it was a randomized controlled trial and that itself
provides a high level of evidence. The limitation lies in the small sample size and data from a
single source, posing the risk of bias.
Q1: Is there enough evidence to conduct a systematic review of more specified school-based
pregnancy prevention approaches?
Q2: Is it possible to reduce sexual risk behavior simply by spreading awareness?
Q3: Should area-based programs be implemented like the one in the Bronx? How should the
areas be selected, and is there a standard for such programs?
Q4: How to ensure reliability in a patient survey related to such a sensitive topic?

3HEALTHCARE
Reference
Marseille, E., Mirzazadeh, A., Biggs, M. A., Miller, A. P., Horvath, H., Lightfoot, M., ... &
Kahn, J. G. (2018). Effectiveness of school-based teen pregnancy prevention
programs in the USA: A systematic review and meta-analysis. Prevention
Science, 19(4), 468-489. https://doi.org/10.1007/s11121-017-0861-6
Travers, M., O'Uhuru, D., Mueller, T., & Bedell, J. (2019). Implementing adolescent sexual
and reproductive health clinical best practice in the Bronx, New York. Journal of
Adolescent Health, 64(3), 376-381. https://doi.org/10.1016/j.jadohealth.2018.09.020
Zullig, K. J., Valois, R. F., Hobbs, G. R., Kerr, J. C., Romer, D., Carey, M. P., ... & Vanable,
P. A. (2020). Can a multilevel STI/HIV prevention strategy for high risk African
American adolescents improve life satisfaction?. Journal of Happiness Studies, 21(2),
417-436. https://doi.org/10.1007/s10902-019-00084-z