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Summary: Receptor‐like kinases (RLKs) are evolved for plant cell–cell communications. The typical RLK protein contains an extracellular and hypervariable N‐terminus to perceive various signals, a transmembrane domain to anchor into plasma membrane, and a cytoplasmic, highly conserved kinase domain to phosphorylate target proteins. To date, RLKs have manifested their significance in a myriad of biological processes during plant reproductive growth, especially in male fertility. This review first summarizes a recent update on RLKs and their interacting protein partners controlling anther and pollen development, pollen release from dehisced anther, and pollen function during pollination and fertilization. Then, regulatory networks of RLK signaling pathways are proposed. In addition, we predict RLKs in maize and rice genome, obtain homologs of well‐studied RLKs from phylogeny of three subfamilies and then analyze their expression patterns in developing anthers of maize and rice to excavate potential RLKs regulating male fertility in crops. Finally, current challenges and future prospects regarding RLKs are discussed. This review will contribute to a better understanding of plant male fertility control by RLKs, creating potential male sterile lines, and inspiring innovative crop breeding methods. [ABSTRACT FROM AUTHOR]

Adolescent pregnancy is a major public health issue with profound implications for health and socioeconomic factors. The use of long-acting reversible contraception (LARC) could be an interesting strategy to reduce the unintended pregnancy rate. However, the cost of LARC is still a barrier to widespread adoption. This study aimed to analyze the effectiveness and economic impact of LARC compared with non-LARC methods in preventing unintended pregnancy among adolescent girls. This systematic review was registered in PROSPERO (CRD42023387735) and conducted following the PRISMA guidelines. We included articles covering adolescents aged 10-19 years without language restrictions that evaluated the use of LARC compared with non-LARC in terms of effectiveness and the public health costs of unintended pregnancy. The search for articles included the databases MEDLINE/PubMed, Cochrane Library, Embase, and Lilacs, using the entry terms "Adolescent" and "Long-Acting Reversible Contraception." We evaluated the risk of bias and the certainty of the evidence for each outcome of interest. The search retrieved a total of 1,169 articles and, after the title and abstract, we identified 40 articles for full-text analysis. Out of the 40 studies evaluated, 4 articles met the eligibility criteria for cost evaluation, and 1 met the eligibility criteria for effectiveness as an outcome. In conclusion, LARC emerges as the most effective and cost-effective contraceptive method. The cost of utilizing LARC, especially the copper IUD, is significantly lower than the costs attributable to unintended pregnancies in adolescence. [ABSTRACT FROM AUTHOR]

• There is a lot of interest in contraceptive subdermal implant videos on social media. • Videos about contraception and contraceptive subdermal implants are popular on YouTube and TikTok. • The quality and reliability of the videos on TikTok were very low. • Although the medical reliability of the videos on YouTube was low, it was higher than that of the videos on TikTok. • The videos with relatively lower medical validity received more views, likes, and comments. • The medical accuracy and reliability of these videos are low, and there is a need to produce high-quality videos that will inform patients correctly. There are many videos on contraception on YouTube and TikTok, and women around the world use video platforms extensively to seek health information from videos of uncertain reliability and quality. The main objective of this research was to evaluate the scientific reliability and quality of the most popular social media videos about contraceptive subdermal implants. TikTok and YouTube videos were assessed separately by two gynecologists. The video quality was evaluated according to the DISCERN score, modified DISCERN score, and Global Quality Scale (GQS) score. The study included the 100 most popular videos, 44 of which were uploaded by health care professionals. The median DISCERN score for videos shared by health care professionals was 50 (range 15-75), whereas it was 22 (range 15-56) for videos shared by independent users (P <.001). The median modified DISCERN score was 4 (min-max 0-5), and the median GQS score was 4 (min-max 1-5) for the videos uploaded by health care professionals. The modified DISCERN and GQS scores of TikTok videos were lower than those of YouTube videos (both P <.001). Social media videos about contraceptive subdermal implants are popular and have been viewed tens of thousands of times, but the overall medical validity, which we evaluated according to the scoring systems, was poor. Despite the large number of videos, the content's quality and reliability are quite limited. There is a need to prioritize the education provided to patients by gynecologists, as well as to create high-quality content for YouTube and other similar platforms. [ABSTRACT FROM AUTHOR]

We examined the influence of education on fertility decisions in contemporary China, drawing upon theoretical insights that emphasise the role of social institutions, gender relations, and life course dynamics in shaping family behaviour. This led us to propose a set of hypotheses that explain the differential effect of education on each parity. We used information on female cohorts born between 1960 and 1989, coming from the China Family Panel Studies for 2010–2018. We applied event history models with both independent and simultaneous equations models to account for selection and endogeneity effects. The results point to a substantial contribution of the increased educational attainment in the population in the fertility decline and current low levels of fertility, beyond the role of fertility policies. Consistent with our hypotheses, the results show that woman's educational attainment has a strong negative effect on the hazard of bearing a second or third child. Male partner's educational attainment also has a negative effect on the hazard of transition to a second or third birth, yet with a weaker intensity. We also found that the negative effect of education on second birth rates significantly declines across birth cohorts. The results show little educational differentials in the probability of bearing a first child, while the better educated postpone first births. Moreover, the effect of fertility policies, measured at the individual level, gradually increases with the level of education. [ABSTRACT FROM AUTHOR]

High fertility constitutes a challenge to men's health conditions in Nigeria, a low-income country. Religion and ethnicity are central to the current Male Fertility (MF) level in Nigeria. This study determined the relationship between Male Fertility (MF) and Religion Ethnic Interaction (REI) amidst other socio-demographic characteristics in Nigeria. Nigeria Demographic and Health Survey data, 2018 was used. Men aged 15–59 years [n = 8,786] were sampled using a multi-stage approach. Fertility was measured by the number of Children Ever Born (CEB). REI was generated using the combination of religion and ethnic groups; Hausa/Fulani Muslim, Igbo Christian, Yoruba Christian, and Yoruba Muslim. However, Hausa/Fulani Christians and Igbo Muslims were excluded from this study because a few men in these categories were available in the original sample. Weighted data were analyzed using the Negative Binomial (NB) model (α0.05). The mean age and CEB of the men were 32.9±12.0 years and 3.18±4.4 respectively. The mean CEB among men aged 45–59 years was highest among Hausa/Fulani Muslims (x = 11.57±5.98), but least among Yoruba Christians (x = 4.44±2.67). About 33.4% of the Hausa/Fulani Muslims had had ≥5 children, while 13.7% were reported among the Yoruba Christian men (p<0.001). The fertility Incidence Rate Ratio (IRR) was higher among Hausa/Fulani Muslims, but less among Igbo Christians, and Yoruba Christians than Yoruba Muslims. Restricting the analyzed data to only monogamous men revealed no significant differences in the fertility IRR of Yoruba Christians and Yoruba Muslims, but the fertility IRR was significantly higher among the Hausa/Fulani Muslims than Yoruba Muslims. A disparity exists in MF across the REI groups with the Hausa/Fulani Muslims being the major contributors to high MF. Therefore, bridging the gap in access to fertility control measures and programmes that might have resulted from religion and ethnic differences will reduce male fertility level in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Exposure to isotretinoin during pregnancy must be avoided due to its teratogenicity, but real-world data on its use are scarce. We aimed to describe (i) isotretinoin use in women of childbearing age in Germany; (ii) the occurrence of isotretinoin-exposed pregnancies; and (iii) malformations among children exposed in utero. Methods and findings: Using observational data from the German Pharmacoepidemiological Research Database (GePaRD, claims data from approximately 20% of the German population), we conducted annual cross-sectional analyses to determine age-standardized prevalence of isotretinoin use between 2004 and 2019 among girls and women aged 13 to 49 years. In cohort analyses, we estimated the number of exposed pregnancies by assessing whether there was prescription supply overlapping the beginning of pregnancy (estimated supply was varied in sensitivity analyses) or a dispensation within the first 8 weeks of pregnancy. Data of live-born children classified as exposed in a critical period according to these criteria were reviewed to assess the presence of congenital malformations. The age-standardized prevalence of isotretinoin use per 1,000 girls and women increased from 1.20 (95% confidence interval [CI]: 1.16, 1.24) in 2004 to 1.96 (95% CI: 1.92, 2.01) in 2019. In the base case analysis, we identified 178 pregnancies exposed to isotretinoin, with the number per year doubling during the study period, and at least 45% of exposed pregnancies ended in an induced abortion. In sensitivity analyses, the number of exposed pregnancies ranged between 172 and 375. Among live-born children, 6 had major congenital malformations. The main limitation of this study was the lack of information on the prescribed dose, i.e., the supply had to be estimated based on the dispensed amount of isotretinoin. Conclusions: Isotretinoin use among girls and women of childbearing age increased in Germany between 2004 and 2019, and there was a considerable number of pregnancies likely exposed to isotretinoin in a critical period. This highlights the importance of monitoring compliance with the existing risk minimization measures for isotretinoin in Germany. Jonas Reinold and colleagues investigate how isotretinoin use has changed over a 15 year period in Germany and the potential for in-utero exposure. Author summary: Why was this study done?: Systemic (oral) isotretinoin is used in the treatment of moderate to severe acne. Given that isotretinoin is one of the strongest human teratogens known today, it is important to monitor the use of isotretinoin in girls and women of childbearing age as well as the occurrence of pregnancies exposed to this drug. There is a lack of population-based studies addressing these research questions. What did the researchers do and find?: Using a database covering 20% of the German population, we conducted cross-sectional analyses to assess the prevalence of isotretinoin use between 2004 and 2019 in girls and women of childbearing age. We found that the age-standardized prevalence of isotretinoin use increased from 1.20 to 1.96 per 1,000 girls/women during this period. In cohort analyses, we estimated the number of pregnancies likely exposed to isotretinoin in a critical period. In the base case analysis, we identified 178 of such pregnancies. Sensitivity analyses considering the recommended one-month washout period suggested that there could have been additional pregnancies exposed to isotretinoin because they started before the end of the washout period. What do these findings mean?: Isotretinoin use among girls and women of childbearing age increased in Germany between 2004 and 2019, and there were a considerable number of pregnancies likely exposed to isotretinoin in a critical period. This highlights the importance of monitoring compliance with the existing risk minimization measures for isotretinoin in Germany. It also seems important to increase awareness regarding the component of the pregnancy prevention program that recommends contraception also in the month after treatment cessation. The main limitation of this study was the lack of information on the prescribed dose of isotretinoin. We therefore estimated the dose based on the dispensed amount of isotretinoin and varied the underlying assumptions. [ABSTRACT FROM AUTHOR]

The study comprehensively analyzed the nexus between economic growth, health expenditures, education, and the environment in Nigeria, using data obtained from Central bank of Nigeria and World Bank. By utilizing a robust dataset spanning from 1981 to 2021, the study employed autoregressive distributed lag (ARDL) approach to uncover intricate relationships. Results, both short-run and long-run analyses, reveal that health and education spending, and gross fixed capital formation positively correlated with economic growth. Conversely, the findings demonstrated that population growth and carbon dioxide emissions (CO2) exerted detrimental effects on economic growth due to the negative impact on the health of the working population. Additionally, the inverted U-shaped relationship between the macroeconomic footprint and income confirms the validity of Nigeria's Environmental Kuznets Curve (EKC) phenomenon. Lastly, the findings of this study hold important policy implications, emphasizing the need for technological advancements and innovative solutions to address the challenges associated with economic growth, health expenditures, education, and the environment in Nigeria. Policy measures promoting birth control through contraception and family planning should be embraced to effectively manage the country's rapidly growing population. [ABSTRACT FROM AUTHOR]

Pest rodents pose a serious threat to island biodiversity. Fertility control could be an alternative approach to control the impact of rodents on these islands. In this study, we examined the antifertility effects of EP‐1 baits containing quinestrol (E) and levonorgestrel (P) using a dose of 50 ppm E and P at three different ratios (E:P ratio = 1:2, 1:1, and 2:1) on Pacific rats (Rattus exulans) in the Xisha Islands, Hainan, China. Compared to the control group, all animals in EP‐1 treatment groups showed significantly decreased food intake and body weight. In treated males, there were obvious abnormalities in testis structure and a significant decrease of relative seminal vesicle weight, but no significant effect on relative uterine and ovarian weights (g kg−1 body weight), or ovarian structure in females. Adding 8% sucrose to the original 50‐ppm baits (E:P ratio = 1:1) significantly increased bait palatability for males and females. This dose induced uterine edema and abnormalities of ovarian structure in females but had no significant negative effect on the relative testis, epididymis, and seminal vesicle weights (g kg−1 body weight) or sperm density in males. In summary, 50‐ppm EP‐1 (1:1) baits have the potential to disrupt the fertility of females, and 8% sucrose addition to the EP‐1 baits (E:P ratio = 1:1) could improve bait palatability. This dose disrupted the testis structure in males. Future studies are needed to improve bait acceptance and assess the antifertility effects of EP‐1 (1:1) on Pacific rats in captive breeding trials and under field conditions. [ABSTRACT FROM AUTHOR]

Fertility control is often heralded as a humane and effective technique for management of overabundant wildlife, including rodents. The intention is to reduce the use of lethal and inhumane methods, increase farm productivity and food security as well as reduce disease transmission, particularly of zoonoses. We developed a framework to guide researchers and stakeholders planning to assess the effectiveness of a potential contraceptive agent for a particular species. Our guidelines describe the overarching research questions which must be sequentially addressed to ensure adequate data are collected so that a contraceptive can be registered for use in broad‐scale rodent management. The framework indicates that studies should be undertaken iteratively and, at times, in parallel, with initial research being conducted on (1) laboratory‐based captive assessments of contraceptive effects in individuals; (2) simulation of contraceptive delivery using bait markers and/or surgical sterilization of different proportions of a field‐based or enclosure population to determine how population dynamics are affected; (3) development of mathematical models which predict the outcomes of different fertility control scenarios; and (4) implementation of large‐scale, replicated trials to validate contraceptive efficacy under various management‐scale field situations. In some circumstances, fertility control may be most effective when integrated with other methods (e.g. some culling). Assessment of non‐target effects, direct and indirect, and the environmental fate of the contraceptive must also be determined. Developing fertility control for a species is a resource‐intensive commitment but will likely be less costly than the ongoing environmental and economic impacts by rodents and rodenticides in many contexts. [ABSTRACT FROM AUTHOR]

The US Supreme Court's ruling in Dobbs v. Jackson Women's Health Organization has potentially profound implications for contraception. Contraceptives came up frequently in oral arguments and constitutional protections for abortion and birth control are fundamentally linked (Griswold v. Connecticut, 381 US 479, 1965). Moreover, in recent decisions (Burwell v. Hobby Lobby Stores, Inc. 573 US 682, 2014) the court has endorsed the position of some religious groups that certain forms of contraception are "abortifacients," essentially a form of abortion. This legal blurring of distinct scientific boundaries between abortion and birth control provides legal pathways for birth control restrictions. That said, in the immediate wake of Dobbs, policy change on birth control has been limited, media coverage on the risks posed to birth control have been scarce, and public support of birth control access has remained robust. We review the current landscape of birth control politics and policy after Dobbs, including state and federal policy responses, elite rhetoric, interest group advocacy, media coverage, and public opinion. Our analysis contributes to an emerging literature on birth control politics and policy. [ABSTRACT FROM AUTHOR]

For agricultural production is used almost 40% of the global land from where it dominates conventional agriculture which uses large amounts of inputs in the form of fertilizers and pesticides leading to the contamination of soil, water resources, air pollution and land erosion, affects biodiversity and extinction of many plants and animals. On the other hand, the world's population is constantly growing and currently numbers more than 8 billion people and it is estimated that food production will have to double by 2050. In order to meet the future needs of the population for food raw materials, food production must significantly increase, and at the same time, the impact of agriculture on the environment and natural resources must be drastically reduced. Sustainable agriculture is emerging as one of the solutions. This way of agricultural practice refers to the management and preservation of natural resources through organizational and technological changes in modern agricultural production in order to satisfy human needs and preserve the environment. One of the most important natural resources on which the entire agricultural production relies is land. In intensively cultivated lands, there is a noticeable trend of intense degradation, which represents a major problem facing humanity. The paper reviews the decrease in soil fertility based on the samples collected during the five-year monitoring, as well as a proposal for measures to increase fertility and future preservation of this environmental resource. [ABSTRACT FROM AUTHOR]

Following the vote in favour of birth control at the 1930 Lambeth Conference, the Church of England became the first major Christian denomination explicitly to condone the use of birth control. This paper argues that the bishop of Winchester, Theodore Woods, was the previously unheralded principal actor responsible for reversing the position of the Church. Woods was convinced that the Church needed to 'modernise' its position in order to secure a receptive audience for its higher-ordered teachings on marriage, sex and especially procreation. In turn, he hoped to bring about an increased birthrate amongst the eugenically 'desirable' English middle and upper classes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several countries nowadays and in the past face a birth rates below replacement level. To what extent should the fertility of this shrinking population be increased during a given planning period such that it approaches stationarity at the end as close as possible? Both immediate adaptation to the replacement level as well as delaying it to the end of the planning period are suboptimal. METHODS: Distributed parameter optimal control theory provides an appropriate tool to ascertain the efficient intertemporal trade-off between costly birth control and zero population growth. RESULTS: It turns out that the optimal adaptation rate of the net reproduction rate (NRR) balances between unacceptable adjustment costs for fertility and huge deviations of the terminal age composition from the desired stationary one. The optimal adaptation rate is monotonically increasing with a curvature that depends on the growth rates of the NRR, the fertile population, and the value of newborns. CONTRIBUTION: The paper analytically characterizes the shape of the transition to a stationary population in an optimal way. [ABSTRACT FROM AUTHOR]

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Copyright of Reflexão & Ação is the property of Universidade de Santa Cruz do Sul and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To examine the contraceptive preferences of women based on their age and to track changes in these preferences over time. Methods: This was an observational, retrospective cross-sectional study. Data from 2742 patients were evaluated for this study. The patient group of the first 4 years was classified as Group I (n=1371) and the last 4 years was classified as Group II (n=1371). The preferred contraception methods between the groups and their changes across the years were examined. Results: Coitus interruptus was found to be the prevailing contraceptive method across all age groups, with 304 (70.9%) in 18-24 age group; 1314 (65.4%) in 25-40 age group; and 148 (48.8%) in 41-53 age group using this method. Breastfeeding rates were also analyzed across age groups, revealing that 11% of patients aged 18-24 years, 5% of patients aged 25-40 years, and 1.7% of patients aged 41-53 years were breastfeeding. Among these patients, 114 (74.5%) were not using any contraception method, while coitus interruptus remained the most popular choice. Conclusion: It was determined that there are many couples who do not have sufficient knowledge regarding family planning and birth control in our country. At the same time, the use of birth control methods has increased due to the increase in the education level of women and easier access to sexual health services. [ABSTRACT FROM AUTHOR]

In North America, range constraints due to burgeoning development increasingly encroach on wild horse habitat and necessitate effective but humane reproductive management. The largest free-roaming wild horse fertility control program by population (>3500) and territory size (≈300,000 acres) is located within Nevada's Virginia Range. Data from a field study investigated porcine zona pellucida (pZP) immunocontraception via remote dart delivery to mares in this population. Analyses aimed to measure efficacy by treatment effects on annual birth rates and population demographics and to evaluate treatment frequency and season against these variables. Analyses included mares' monthly data (January 2019–December 2022; 48 months), characterized by cumulative vaccination numbers subset into four classifications considering the vaccine as having no loss of efficacy or a loss within a 6-, 12-, and 18-month period post vaccination; from foaling data, the likelihood of being in foal and of conceiving in that month; and from age, as mature or immature (<1 years-old). A downward foaling rate and trend in the numbers of mature mares, descriptively presented at monthly intervals, showed markedly declining annual seasonal breeding peaks, with no observed change in foaling season or duration. Within four years, population coverage surpassed 70% and was associated with a 58% reduction in foaling, with only a 10% conception rate. Vaccinated mares increased proportionally: assuming a 12-month decay rate, the system reached stability at an average ≈1.0 vaccination/mare/year, providing a robust recommendation for treatment frequency contributing to best management practices. [ABSTRACT FROM AUTHOR]

Background: A growing number of reproductive-age women in the U.S. have chronic medical conditions, increasing their risk of perinatal morbidity and mortality. Still, they experience unintended pregnancies at similar rates to low-risk mothers. We have limited understanding of how these individuals consider decisions about pregnancy and contraceptive use. The purpose of this study was to understand factors that influence reproductive decision-making among pregnant women with chronic medical conditions. Methods: We conducted 28 semi-structured interviews with pregnant women with pre-existing medical conditions admitted to a tertiary maternal hospital to examine factors influencing reproductive decision making. Maternal demographic characteristics, medical history, and pregnancy outcome data were obtained through participant surveys and abstraction from electronic health records. Interview transcripts were coded and analyzed using Dedoose® with both deductive and inductive content analysis. Results: Out of 33 eligible participants, 30 consented to participate and 28 completed interviews. The majority of participants identified as black, Christian, made less than $23,000 yearly, and had a variety of preexisting medical conditions. Overarching themes included: 1) Perceived risks-benefits of pregnancy, 2) Perceived risks-benefits of birth control, 3) Determinants of contraceptive utilization, and 4) Perceived reproductive self-agency. Contraception was viewed as acceptable, but with concerning physical and psychological side effects. Although some considered pregnancy as a health threat, more experienced pregnancy as positive and empowering. Few planned their pregnancies. Conclusions: Preexisting health conditions did not significantly influence reproductive decision-making. Barriers to birth control use were generally based in patient value-systems instead of external factors. Interventions to improve uptake and use of birth control in this cohort should focus on improving care for chronic health conditions and influencing patient knowledge and attitudes toward contraception. [ABSTRACT FROM AUTHOR]

Background: Current measures of reproductive health care quality, such as rates of "unintended" pregnancies, neglect to incorporate patients' desires and center their reproductive autonomy. This study explores patients' perspectives on and receptivity to alternative metrics for measuring quality of such care. Methods: An online research recruitment firm identified eligible participants living in New York, ages 18–45, self-identifying as women, and having visited a primary care provider in the last year. We conducted five virtual focus groups and eight in-depth interviews with participants (N = 30) in 2021. Semi-structured guides queried on ideal clinic interactions when preventing or attempting pregnancy and their perspectives on how to measure the quality of such encounters, including receptivity to using our definition of reproductive autonomy to develop one such metric: "whether the patient got the reproductive health service or counseling that they wanted to get, while having all the information about and access to their options, and not feeling forced into anything." We employed an inductive thematic analysis. Results: Participants wanted care that was non-judgmental, respectful, and responsive to their needs and preferences. For pregnancy prevention, many preferred unbiased information about contraceptive options to help make their own decisions. For pregnancy, many desired comprehensive information and more provider support. There was considerable support for using reproductive autonomy to measure quality of care. Conclusions: Patients had distinct desires in their preferred approach to discussions about preventing versus attempting pregnancy. Quality of reproductive health care should be measured from the patient's perspective. Given participants' demonstrated support, future research is needed to develop and test a new metric that assesses patients' perceptions of reproductive autonomy during clinical encounters. [ABSTRACT FROM AUTHOR]

Most evidence-based teen pregnancy prevention programs focus on individual-level sexual health outcomes (e.g., STIs, pregnancy, teen births). To expand program and intervention approaches within teen pregnancy prevention (TPP), the Department of Health and Human Services funded two grantees, Innovative Teen Pregnancy Prevention Programs (iTP3) and Innovation Next (IN) to support and enable early innovation to advance adolescent health and prevent teen pregnancy. The pipeline to support and enable innovation in adolescent health is complex, resulting in barriers and challenges to research and evaluation of novel programs. This paper presents some of the barriers encountered by the grantees. Data for this paper was collected from key personnel and secondary data sources. Focus group participants included seven representatives (n = 7) across the two organizations. Focus group questions assessed barriers related to innovative intervention development and evaluation. Key findings include four barriers to evaluation when fostering innovative adolescent-focused pregnancy prevention interventions. These included (a) funding constraints on evaluation activities, (b) innovation readiness for rigorous testing, (c) evaluation knowledge and expertise on innovation-development teams, and (d) challenges with evaluation requirements. Novel and promising system- and technology-focused interventions with the potential to impact TPP require alternative tools and approaches for evaluation. This would allow research to focus on how systems-level change mechanisms (i.e., policy, access to care) impact sexual risk behaviors and better understand ecological and social determinants of health for the priority population. The advancement of approaches to impact adolescent health identifies the need to expand the focus of evidence-based interventions beyond the adolescent themselves and understand approaches that impact external contexts and environments related to reducing sexual and reproductive health (SRH) risk-taking. [ABSTRACT FROM AUTHOR]

States, local, tribal, and territorial governments received almost 20% of all federal spending in fiscal year 2022, about $1.2 trillion dollars (US Office of Management and Budget, 2023a). For a strong, well-functioning democracy, the federal government must be able to disperse grant funds efficiently and effectively. Rates of teen pregnancy in the USA, while decreasing in recent years, are still consistently higher than that of other western industrialized nations (Centers for Disease Control and Prevention, 2023). The Office of Population Affairs' (OPA) Teen Pregnancy Prevention program combines cutting edge research with innovative grant distribution to creatively tackle this issue. In this commentary, we explore some of the strengths of OPA's grant distribution program in the hope that others may emulate best practices from this program. Specifically, the special issue highlights how OPA's grant program took a customer-centered focus by prioritizing work with end users and community. This evidence-based focus enabled the testing of ideas, which in turn could be iterated and scaled up. Through grantee innovation networks, they created space for external expertise, creative thinking, and diversity of thought. Other programs, policymakers, and their partners may learn from OPA's success, which arises from three core characteristics: (1) their funding stature allows long-term and flexible allocation of funding toward innovation; (2) OPA focuses on creating and supporting local communities and networks of innovation; (3) OPA emphasizes evidence-based decision-making and rigorous evaluation throughout the grant process. With a fifth of the federal budget being dispersed through grant-making and teen pregnancy still at high rates, OPA offers an exciting avenue for innovation and success in both of these areas. This commentary concludes with some recommendations for future practice. [ABSTRACT FROM AUTHOR]

Congress has provided funding for the federal Teen Pregnancy Prevention (TPP) Program since 2009 for spending beginning in Fiscal Year 2010. Designated TPP programs develop, test, and evaluate innovations for reducing teen pregnancy, teen pregnancy disparities, and associated risk factors and for promoting positive youth development. Since its inception, the TPP Program has experimented with multiple uniquely structured cohorts of innovation and demonstration projects, producing critical insights into equitable and effective public health innovation while also serving as a highly productive contributor of evidence-based, TPP innovations for scale. This article briefly documents the innovation history of the TPP Program and its iterations in response to the shifting needs of the field. We then synthesize findings from the fifteen TPP innovators published in this special edition. We highlight emergent priorities of the TPP Program informed by this federal experiment in rigorous adolescent sexual health innovation development, testing, evaluation, and scaling and conclude by discussing how the TPP program adapted and refined its approach for fostering dynamic innovation-to-scale projects over time. [ABSTRACT FROM AUTHOR]

From 2015 to 2021, the US Department of Health and Human Services' Teen Pregnancy Prevention (TPP) program funded Power to Decide, a national reproductive health nonprofit organization, to catalyze innovation in adolescent sexual and reproductive health through the development of technology-based interventions. Power to Decide's initiative, Innovation Next, supported twenty innovation teams in using human-centered design (HCD) to develop new products, services, and programs. We describe the Innovation Next implementation model, which can inform future efforts to develop innovative, technology-based TPP programs using HCD. To that end, we draw on quantitative and qualitative data collected for program improvement to summarize key implementation findings. [ABSTRACT FROM AUTHOR]

Respecting the Circle of Life (RCL) is a teen pregnancy prevention program that was evaluated for effectiveness on sexual health risk behaviors through a two-arm randomized control trial (RCT) with American Indian (AI) youth ages 11–19. The objective of this study is to investigate the effects of RCL compared to a control group on items of condom and contraception self-efficacy. Linear regression analysis was used to compare differences in each item that included condom and contraception self-efficacy scales among the intervention and control participants at baseline, 3 and 9 months post intervention. Youth enrolled in the intervention reported higher levels of condom and contraception self-efficacy across almost all individual items. Exceptions include items related to partner negotiation of condom self-efficacy at 3 months (p = 0.227) and 9 months (p = 0.074) post intervention. Findings indicate RCL is effective at improving overall condom and contraception self-efficacy but did not impact the specific component of partner negotiation for either condom or contraception self-efficacy. This inquiry provides rationale to further explore components of RCL related to partner negotiation. [ABSTRACT FROM AUTHOR]

In 2019, Native youth had the highest rate of teen pregnancy of all racial/ethnic groups. "Respecting the Circle of Life" (RCL) is one of the first evidence-based teen pregnancy prevention programs for Native teens and there is interest in replicating the program across tribal communities. To inform replication, it is important to consider process data including quality, fidelity, and dosage as these may all moderate impact of the program. Participants were Native youth aged 11–19 and a trusted adult. This study includes participants randomized to the RCL program only (N = 266). Data sources include independent observations, facilitator self-assessments, attendance logs, and self-report assessments completed by enrolled youth at baseline and 3 months post assessment. Data was compiled and summed by cohort. Dosage was number of minutes participating in activities separated by theoretical constructs. Linear regression models were utilized to assess moderation of the effects of the intervention dosage on outcomes of interest. Eighteen facilitators delivered RCL. One hundred eighteen independent observations and 320 facilitator self-assessments were collected and entered. Findings indicate RCL was implemented with high fidelity and quality (4.40 to 4.82 out of a 5-point Likert scale; 96.6% of planned activities completed). Dosage was high with an average completion of 7 out of 9 lessons. There was no association between theoretical construct dosage and outcomes of interest. Overall, this study indicates RCL was delivered with high fidelity, quality, and dosage in this trial. This paper informs future replication of RCL and provides support for hiring paraprofessionals from the local community as facilitators, delivering the RCL to peer groups of the same age and sex, delivering the RCL with short duration and high frequency, and encouraging youth to attend all RCL lessons, but continue to serve youth who have missed one or more lessons. [ABSTRACT FROM AUTHOR]

This study aims to investigate whether Girl2Girl, a text messaging-based pregnancy prevention program for cisgender LGB+ girls, had different effects on subgroups based on age, sexual identity, and experience with penile-vaginal sex. A total of 948 girls, 14–18 years old, were recruited nationally via social media and enrolled over the telephone. Once they completed the baseline, they were randomized to either Girl2Girl or an attention-matched control program that discussed "healthy lifestyle" topics (e.g., self-esteem). Both programs were 5 months long: Girls received daily messages for 8 weeks, and then went through a "latent" period of 3 months, and finished with a 1-week review. Outcome measures included condom-protected sex, uptake of other types of birth control, abstinence, and pregnancy. Measures were collected at baseline; 3-month, 6-month, 9-month, and 12-month post-intervention end, which was 17 months after enrollment. Effect modification was examined using longitudinal mixed effects models. Overall, results suggested significant moderating effects of age, (f2 =.12), sexual identity (f2 <.14), and sexual experience (f2 =.11) on rates of condom use and use of other contraception. Although there were no significant moderating effects on pregnancy, abstinence, or intentions to use condoms, use birth control, or be abstinent, (p's >.16), patterns of effects were in the same direction as for significant findings. For example, at 9-month post-intervention, among those who identified as bisexual, the incidence rate of protected sex events was 39% higher for intervention vs. control (IRR = 1.39, 95% CI: 1.06–2.70), adjusting for baseline rate of condom use and sexual experience. Similarly, at 12 months, among bisexual participants, intervention participants had a significantly higher IRR of condom-protected sexual events (IRR = 2.65, 95% CI: 1.31–5.34). There were also higher odds of uptake of birth control use other than condoms for intervention vs. control at 6- (OR = 1.10, 95% CI: 1.01–1.77), 9 m (OR = 1.11, 95% CI: 1.07–1.89), and 12-month (OR = 1.13, 95% CI: 1.07–1.78) follow-up. Girl2Girl appears to be particularly effective for older adolescents, bisexual girls, and those who have already had penile-vaginal sex. No one single approach is going to affect teen pregnancy. Instead, it is more likely that different intervention content and delivery methods will be more accessible and salient to some but not other youth. Understanding for whom the intervention works is just as important as understanding for whom the intervention does not, as this can inform opportunities for future intervention development. Clinical Trial Registration: ClinicalTrials.gov ID# NCT03029962. [ABSTRACT FROM AUTHOR]

In many countries, there is a high number of teenage pregnancies, Sexually Transmitted Infections (STIs), and unsafe sexual behavior, so there is a need for adolescent health intervention programs to change behavior. The effectiveness of comprehensive interventions in various contexts to reduce teenage pregnancy, STIs, and related sexual risk behaviors is reviewed in this systematic. This study aimed to identify risk sexual behavior, sexually transmitted infections, and adolescent pregnancy prevention interventions. Literature search strategy from January 2008 to December 2022 through electronic databases. Key words 'teenage prenancy' OR 'teen pregnancy' OR 'pregnancy adolescence', AND 'maternal education', AND 'randomised clinical trial', AND 'risk behavior'. Articles that were deemed worthy of following the PRISMA guidelines were 28 articles. Most studies looked at school-based, individual, community, clinic, and family-based care. Most studies were followed up after intervention at intervals from one month to seven years, and the majority of the population and sample were adolescents with ages ranging from 13 to 18 years. Implementation of research in urban, suburban, and rural areas. This program has proven successful in preventing pregnancy, contraceptive use, STI and HIV, sexual behavior, dropping out of school, knowledge about pregnancy, sexuality, attitudes towards sexuality, intention to change risky sexual behavior, self-efficacy, and increasing parent-children. This article describes some basic trends in adolescent pregnancy prevention interventions in several countries that can be used as a reference for health programs. Unproven effectiveness can be implemented in conjunction with other interventions that have a high-quality impact. [ABSTRACT FROM AUTHOR]

After a spontaneous or induced abortion, people may desire to delay or prevent a future pregnancy and many desire to use contraceptive methods to do so. Contraception counseling and provision at the time of abortion care are important components to improve contraceptive access and convenience for people undergoing abortion care. The majority of hormonal and barrier contraceptive methods may be safely initiated at the time of medication or procedural abortion or shortly thereafter, although delayed initiation may be necessary in certain circumstances. A patient-centered approach to contraceptive counseling can identify patients' priorities and mitigate provider coercion or pressure. [ABSTRACT FROM AUTHOR]

Managing fertility and sexual and reproductive health across the life course is associated with numerous responsibilities disproportionately experienced by women. This extends beyond dealing with the physical side effects of contraception and can include the emotional burden of planning conception and the financial cost of accessing health services. This scoping review aimed to map how reproductive responsibilities were defined and negotiated (if at all) between heterosexual casual and long-term partners during any reproductive life event. Original research in highincome countries published from 2015 onwards was sourced from Medline (Ovid), CINAHL and Scopus. In studies that focused on pregnancy prevention and abortion decision making, men felt conflict in their desire to be actively engaged while not wanting to impede their partner’s agency and bodily autonomy. Studies identified multiple barriers to engaging in reproductive work including the lack of acceptable male-controlled contraception, poor sexual health knowledge, financial constraints, and the feminisation of family planning services. Traditional gender roles further shaped men’s involvement in both pregnancy prevention and conception work. Despite this, studies reveal nuanced ways of sharing responsibilities – such as companionship during birth and abortion, ensuring contraception is used correctly during intercourse, and sharing the costs of reproductive health care. [ABSTRACT FROM AUTHOR]

Purpose: Adolescent pregnancy remains an important public health issue in the United States as it has profound health consequences for both mother and child. Evidence shows that improved contraception use is a critical factor in decreasing rates of adolescent pregnancy. In order to provide effective and engaging contraception education, it is important to understand adolescents' attitudes, questions, and misconceptions around the topic and its delivery. Methods: Two searches were conducted using PubMed. Articles were limited to those published in the last 10 years that were written in English. The first search was completed using the search terms "Adolescent attitudes on sex education in the United States", and resulted in 688 articles. The second search was completed using the search terms "Adolescent attitudes on contraception in the United States", and resulted in 840 articles. Articles including contraception but focusing more on HIV, pre-exposure prophylaxis (PrEP), LGBTQ+ health and practices, human papillomavirus (HPV) vaccination, and studies completed in other countries were excluded. Remaining articles were screened by the authors for inclusion, and articles were included if they addressed information on adolescent attitudes on both contraception for pregnancy prevention and sex education, including education by schools, community organizations, the media, peers, parents, and physicians. A total of 56 articles were included in the review. Results: The overwhelming theme that emerged from the review is that adolescents prefer comprehensive sex education in a safe space that allows for exploration and questioning. Adolescents want to ask their parents questions about sexual health without fear of punishment, and they desire the opportunity to learn from their physicians in a confidential environment. Conclusion: The foundation of effective sex education is a non-judgmental, confidential, and safe space where adolescents can ask questions. There are multiple resources that adolescents use to gather information and establish their preferences and attitudes. [ABSTRACT FROM AUTHOR]

IntroductionSchool-based health centers (SBHCs) are an evidence-based model for providing contraceptives to adolescents. SBHCs ability to provide reproductive health services is often limited by school district policies, state laws, and health center policies.MethodsWe used data from the Teens Exploring and Managing Prevention (TEMPO) study to document demographic characteristics and birth control methods among patients at four SBHCs in New Mexico. A total of 264 teens were included in the baseline data collection at SBHCs in New Mexico. A baseline survey was administered via iPad, that specifically focused on questions related to sexual experiences and sexual health topics. Baseline questions included demographic questions, gender identity, sexual orientation, reasons for visits, reproductive practices, and birth control methods. Descriptive statistics were calculated, including means and standard deviations for continuous variables and categorical frequencies.ResultsOur findings present reproductive health behaviors among New Mexican patients attending schools with SBHCs. More than 74% of respondents were Hispanic or Latino. The most common reason teens went to the SBHC was for birth control, and just 62% of teens reported using birth control methods in the past.DiscussionThese behaviors are essential for policymakers to consider as they address policy gaps, the complex landscape of parental permission, reproductive rights, and health as a human right.

The size of the world’s population has profound implications for demand for food, energy and resources, land use change and greenhouse gas emissions. This study examines why most population projections have underestimated world population growth, and the implications for actions required to achieve sustainable societies. The main determinant of future population is family size choices. Population projections by different research groups embed different assumptions about drivers of fertility decline. The common assumptions that fertility decline is driven by economic betterment, urbanisation or education levels are not well supported in historical evidence. In contrast, voluntary family planning provision and promotion achieved rapid fertility decline, even in poor, rural and illiterate communities. Projections based on education and income as drivers of fertility decline ignore the reverse causation, that lowering fertility through family planning interventions enabled economic advancement and improved women’s education access. In recent decades, support for family planning has waned, and global fertility decline has decelerated as a result. Projections calibrated across the decades of strong family planning support have not acknowledged this change and are consequently underestimating global population growth. Scenarios used to model sustainable futures have used overly optimistic population projections while inferring these outcomes will happen without targeted measures to bring them about. Unless political will is rapidly restored for voluntary family planning programs, the global population will almost certainly exceed 10 billion, rendering sustainable food security and a safe climate unachievable.

Abstract Background Digital decision aids are becoming increasingly common in many areas of healthcare. These aids are designed to involve patients in medical decision making, with the aim of improving patient outcomes while decreasing healthcare burden. Previously developed contraceptive-based decision aids have been found to be effective at increasing women’s knowledge about reproductive health and contraception. Here, we sought to evaluate the effectiveness of a novel contraceptive-based decision aid at increasing women’s self-efficacy and knowledge about their reproductive health and contraceptive options, as well as their perceptions of their learning. This study was registered as a clinic trial at ClinicalTrials.gov (Contraception Decision Aid Use and Patient Outcomes, ID# NCT05177783) on 05/01/2022. Methods The Tuune® contraceptive decision aid’s effectiveness was evaluated by conducting an experiment in which 324 women were assigned to use the Tuune® decision aid or a control decision aid. Primary outcomes included reproductive health self-efficacy, reproductive health and contraceptive knowledge, and perceptions of learning. Secondary analyses examined whether prior experience using hormonal contraceptives moderated the relationship between decision aid and each outcome measure. Results Women assigned to use the Tuune® decision aid exhibited greater reproductive health self-efficacy, greater knowledge about reproductive health and contraception, and perceived having learned more than women assigned to use the control decision aid (ps ≤ .029). This pattern was also observed in women with previous contraceptive use experience, where women using Tuune® reported better outcomes than women using the control aid, regardless of their history of hormonal contraceptive use experience, although this interaction was not significant (p = .089). Conclusions Use of the Tuune® contraceptive-based decision aid improved each of the predicted outcomes relative to a control decision aid. This suggests that use of the Tuune® contraceptive-based decision aid is well poised to increase women’s confidence and knowledge about contraceptive use and may also reduce burden on healthcare systems.