Prevention programmes involving baby simulator dolls do not reduce the risk of teenage pregnancy, and may actually increase the number of babies born to young women, a new Australian study has found.
The first randomised controlled trial to test the effectiveness of this intervention found that teenage girls who took part were more, not less, likely to become pregnant compared to girls who did not take part.
"Our study shows that the pregnancy prevention programme delivered in Western Australia, which involves an infant simulator, does not reduce the risk of pregnancy in teenage girls," said lead author Dr Sally Brinkman, from Telethon Kids Institute, University of Western Australia.
"In fact, the risk of pregnancy is actually increased compared to girls who did not take part in the intervention," said Brinkman.
The Virtual Infant Parenting (VIP) programme is an Australian adaptation of the US programme RealityWorks (often referred to as "Baby Think It Over").
Intended as a pregnancy prevention programme, the VIP programme is delivered in schools and includes educational sessions (for example, impact of taking drugs on a healthy pregnancy, good nutrition, the financial costs of having a baby, sexual health, and contraception), a workbook, watching a video documentary of teenage mothers talking about their experiences, and caring for an infant simulator over the weekend.
The infant simulator is a doll that cries when it needs to be fed, burped, rocked or changed and measures and reports on mishandling, crying time, the number of changes and general care, researchers wrote in the study published in The Lancet.
The use of infant simulator programmes is common in developed countries and their use is increasing in low and middle income countries. Despite this, there is no robust evidence of their effectiveness.
While some studies have looked at the effect on girls' intentions to get pregnant, or attitudes to pregnancy, no randomised trials have objectively measured the impact on pregnancy.
A total of 57 schools in Western Australia took part in the study. Schools were randomly allocated to receive either the VIP programme (1,267 girls), which is delivered by school nurses over 6 consecutive days, or to receive the standard health education curriculum (1,567 girls).
The researchers then linked this information to data from hospital records and abortion clinics. All girls were aged 13-15 at the start of the study and they were followed until the age of 20.
Compared to girls in the control group, girls enrolled on the VIP programme had higher rates of pregnancy and abortion.
As many as 8 per cent (97/1,267) of the girls in the intervention group had at least one birth, compared to 4 per cent (67/1,567) in the control group.
Similarly, 9 per cent (113/1,267) of girls in the intervention group had an abortion, compared to 6 per cent (101/1,567) in the control group.
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