Eficácia das intervenções de educação para a fertilidade em adolescentes: Protocolo de revisão sistemática e meta-análise
Publicação Antecipada
DOI:
https://doi.org/10.31211/rpics.2026.12.1.412Palavras-chave:
Adolescência, Ensaios controlados aleatorizados, Fertilidade, Literacia em saúde, Saúde reprodutiva, Revisão sistemáticaResumo
Objetivo: Este protocolo foi concebido para avaliar a eficácia de intervenções de educação para a fertilidade em adolescentes de 12 a 19 anos. O objetivo principal é avaliar o impacto no conhecimento, atitudes e comportamentos relacionados com a fertilidade. Métodos: Esta revisão incluirá ensaios controlados aleatorizados que examinem programas educativos centrados na fertilidade e na saúde reprodutiva em adolescentes. Os estudos elegíveis deverão reportar resultados sobre conhecimento, atitudes ou intenções/ações comportamentais e incluir uma componente de fertilidade explícita. Será realizada uma pesquisa sistemática na CENTRAL, APA PsycInfo, MEDLINE e Web of Science Core Collection (SCIE e SSCI). Serão incluídos estudos publicados entre janeiro de 2010 e novembro de 2024, período em que estas intervenções se tornaram amplamente implementadas em contexto escolar. A pesquisa será repetida antes da publicação. Serão elegíveis estudos em inglês, português e espanhol. Dois revisores independentes procederão à triagem, extração de dados e avaliação da qualidade metodológica com o Effective Public Health Practice Project Quality Assessment Tool. Os dados serão sintetizados por meta-análise, quando apropriado, com modelos de efeitos aleatórios, serão utilizadas diferenças médias padronizadas para resultados contínuos e razões de risco/odds ratio para resultados dicotómicos. A heterogeneidade entre estudos será quantificada (I² e τ²), e análises de subgrupos e de sensibilidade pré-especificadas explorarão essa heterogeneidade. Conclusões: A revisão sistemática fornecerá evidência sobre a eficácia da educação para a fertilidade em adolescentes, apoiando o desenvolvimento de estratégias educativas e de saúde pública dirigidas à melhoria da literacia em saúde reprodutiva e da tomada de decisões informadas dos jovens. Ética e disseminação: Não é necessária aprovação ética, pois este protocolo sintetizará apenas dados publicados e agregados; os resultados serão disseminados através de publicação com revisão por pares. Registo: PROSPERO CRD42024611088.
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Referências
Alfaraj, S., Aleraij, S., Morad, S., Alomar, N., Al Rajih, H., Alhussain, H., Abushrai, F., & Al Thubaiti, A. (2019). Fertility awareness, intentions concerning childbearing, and attitudes toward parenthood among female health professions students in Saudi Arabia. International Journal of Health Sciences, 13(3), 34–39. https://bit.ly/47KpvOy
Armijo-Olivo, S., Stiles, C. R., Hagen, N. A., Biondo, P. D., & Cummings, G. G. (2012). Assessment of study quality for systematic reviews: a comparison of the Cochrane collaboration risk of bias tool and the effective public health practice project quality assessment tool: Methodological research. Journal of Evaluation in Clinical Practice, 18(1), 12–18. https://doi.org/b5xc6m
Bhana, D., Aggleton, P., Miedema, E., & Ngidi, N. D. (2024). Beyond controversy – International perspectives on sexual and reproductive health education. Health Education Journal, 83(8), 821–829. https://doi.org/qp7b
Bodin, M., Plantin, L., Schmidt, L., Ziebe, S., & Elmerstig, E. (2023). The pros and cons of fertility awareness and information: A generational, Swedish perspective. Human Fertility, 26(2), 216–225. https://doi.org/gmtmhg
Boivin, J., Koert, E., Harris, T., O'Shea, L., Perryman, A., Parker, K., & Harrison, C. (2018). An experimental evaluation of the benefits and costs of providing fertility information to adolescents and emerging adults. Human Reproduction, 33(7), 1247–1253. https://doi.org/jtvf
Capotosto, M. P. (2021). An integrative review of fertility knowledge and fertility-awareness practices among women trying to conceive. Nursing for Women's Health, 25(3), 198–206. https://doi.org/qp7c
Dahl, R. E., Allen, N. B., Wilbrecht, L., & Suleiman, A. B. (2018). Importance of investing in adolescence from a developmental science perspective. Nature, 554(7693), 441–450. https://doi.org/gcx7tb
Delbaere, I., Verbiest, S., & Tydén, T. (2020). Knowledge about the impact of age on fertility: A brief review. Upsala Journal of Medical Sciences, 125(2), 167–174. https://doi.org/gjfmvh
Effective Public Health Practice Project. (2010). Quality assessment tool for quantitative studies. Effective Public Health Practice Project. https://bit.ly/4t2lAFq
Fauser, B. C., Adamson, G. D., Boivin, J., Chambers, G. M., de Geyter, C., Dyer, S., Inhorn, M. C., Schmidt, L., Serour, G. I., & Tarlatzis, B. (2024). Declining global fertility rates and the implications for family planning and family building: An IFFS consensus document based on a narrative review of the literature. Human Reproduction Update, 30(2), 153–173. https://doi.org/gtd582
Fekete, J. T., & Győrffy, B. (2025). MetaAnalysisOnline.com: Web-Based tool for the rapid meta‑analysis of clinical and epidemiological studies. Journal of Medical Internet Research, 27, Article e64016. https://doi.org/qqn9
Harper, J. C., Hammarberg, K., Simopoulou, M., Koert, E., Pedro, J., Massin, N., Fincham, A., Balen, A., & Initiative, I. F. E. (2021). The International Fertility Education Initiative: Research and action to improve fertility awareness. Human Reproduction Open, 2021(4). https://doi.org/n4df
Heywood, W., Pitts, M. K., Patrick, K., & Mitchell, A. (2016). Fertility knowledge and intentions to have children in a national study of Australian secondary school students. Australian and New Zealand Journal of Public Health, 40(5), 462–467. https://doi.org/f89tfk
Herzberger, E. H., Sun, B., Engel, O., Wolf, Y., Herzberger, S., Kimhy, R. B., Miller, N., Wiser, A., & Hershko-Klement, A. (2022). How effective is digital educational content in shaping fertility awareness? An interventional, cross-sectional study. Journal of Assisted Reproduction and Genetics, 39(10), 2335–2341. https://doi.org/qp7f
Hu, J., Li, N., Lv, Y., Liu, J., Xie, J., & Zhang, H. (2017). Investigation on indoor air pollution and childhood allergies in households in six Chinese cities by subjective survey and field measurements. International Journal of Environmental Research and Public Health, 14(9), Article 979. https://doi.org/gb23pd
Hviid Malling, G. M., Schmidt, L., Pitsillos, T., Hammarberg, K., Tydén, T., Friberg, B., Jensen, I., & Ziebe, S. (2022). Taking fertility for granted – A qualitative exploration of fertility awareness among young, childless men in Denmark and Sweden. Human Fertility, 25(2), 337–348. https://doi.org/gjdbpr
Knight, J. (2016). The complete guide to fertility awareness. Routledge. https://doi.org/n4b6
Koert, E., Sylvest, R., Vittrup, I., Hvidman, H., Birch Petersen, K., Boivin, J., Nyboe Andersen, A., & Schmidt, L. (2020). Women's perceptions of fertility assessment and counselling 6 years after attending a fertility assessment and counselling clinic in Denmark. Human Reproduction Open, 2020(4), Article hoaa036. https://doi.org/n4d3
Liang, Y., Huang, J., Zhao, Q., Mo, H., Su, Z., Feng, S., Li, S., & Ruan, X. (2025). Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15–49 years) from 1990 to 2021, with projections to 2040. Human Reproduction, 40(3), 529–544. https://doi.org/g9j5tv
Maeda, E., Nakamura, F., Kobayashi, Y., Boivin, J., Sugimori, H., Murata, K., & Saito, H. (2016). Effects of fertility education on knowledge, desires and anxiety among the reproductive-aged population: Findings from a randomized controlled trial. Human Reproduction, 31(9), 2051–2060. https://doi.org/ggmcqg
Mantovani, A., Lando, M. G., Borella, N., Scoccia, E., Pecoraro, B., Gobbi, F., Bisoffi, Z., Valenti, L., Tilg, H., Byrne, C. D., & Targher, G. (2024). Relationship between Helicobacter pylori infection and risk of metabolic dysfunction-associated steatotic liver disease: An updated meta-analysis. Liver International, 44(7), 1513–1525. https://doi.org/qp7g
Maqbool, M., Khan, M., Mohammad, M., Adesina, M. A., & Fekadu, G. (2019). Awareness about reproductive health in adolescents and youth: A review. Journal of Applied Pharmaceutical Sciences and Research, 2(3), 1–5. https://doi.org/qp7h
Martins, M., Martins, R., Nunes, F., & Costa, M. E. (2023). P-570 Which fertility education interventions have been delivered to adolescents and are effective in increasing fertility knowledge? A systematic review. Human Reproduction, 38(Supl. 1), i458–i459. https://doi.org/qp7j
Martins, M. V., Koert, E., Sylvest, R., Maeda, E., Moura-Ramos, M., Hammarberg, K., & Harper, J., on behalf of ESHRE’s International Reproductive Health Education Collaboration (IRHEC) (2024). Fertility education: Recommendations for developing and implementing tools to improve fertility literacy. Human Reproduction, 39(2), 293–302. https://doi.org/gtvtkv
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4, Article 1. https://doi.org/gcsk56
Okine, R., Hughes, L. M., Smith, G., Bonus, M. L., Feinberg, E. C., & Bernardi, L. A. (2023). Undergraduate students have low fertility knowledge and high anxiety regarding future fertility: An opportunity for education. Heliyon, 9(3), Article e14623. https://doi.org/gt4mwq
Paez, A. (2017). Gray literature: An important resource in systematic reviews. Journal of Evidence-Based Medicine, 10(3), 233–240. https://doi.org/gbtnr9
Pedro, J., Brandão, T., Schmidt, L., Costa, M. E., & Martins, M. V. (2018). What do people know about fertility? A systematic review on fertility awareness and its associated factors. Upsala Journal of Medical Sciences, 123(2), 71–81. https://doi.org/n4c4
Pedro, J., Fernandes, J., Barros, A., Xavier, P., Almeida, V., Costa, M. E., Schmidt, L., & Martins, M. V. (2022). Effectiveness of a video-based education on fertility awareness: A randomized controlled trial with partnered women. Human Fertility, 25(3), 522–533. https://doi.org/n4c4
Polanin, J. R., Pigott, T. D., Espelage, D. L., & Grotpeter, J. K. (2019). Best practice guidelines for abstract screening large‐evidence systematic reviews and meta‐analyses. Research Synthesis Methods, 10(3), 330–342. https://doi.org/gf4s2v
Ragnar, M., E., Hammarberg, K., Carvalho, A., Delbaere, I., Fincham, A., Harper, J., Serdarogullari, M., Simopoulou, M., Stylianou, C. A., Sylvest, R., Grace, B., & International Reproductive Health Education Collaboration (IRHEC) (2025). Defending access to reproductive health information. Human Reproduction Open, 2025(2), Article hoaf016. https://doi.org/hbdqbr
Ren, Y., Xie, Y., Xu, Q., Long, M., Zheng, Y., Li, L., & Niu, C. (2023). University students' fertility awareness and its influencing factors: A systematic review. Reproductive Health, 20(1), Article 85. https://doi.org/n4c5
Salazar, A., Diaz-García, C., & García–Velasco, J. A. (2023). Third-party reproduction: A treatment that grows with societal changes. Fertility and Sterility, 120(3), 494–505. https://doi.org/qp7s
Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L. A., & the PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ, 350, Article g7647. https://doi.org/gcpzzq
Swift, B. E., & Liu, K. E. (2014). The effect of age, ethnicity, and level of education on fertility awareness and duration of infertility. Journal of Obstetrics and Gynaecology Canada, 36(11), 990–996. https://doi.org/n4c3
Sylvest, R., Koert, E., Balslev, J., Steenberg, M., Schmidt, L., & Ziebe, S. (2024). How to talk to young adults about fertility. Reproductive BioMedicine Online, 49(1), Article 103859. https://doi.org/qp7v
Thomas, H., Ciliska, D., Micucci, S., Wilson-Abra, J., & Dobbins, M. (2025). Effective Public Health Practice Project (EPHPP). https://www.ephpp.ca
Tripathi, N., & Sekher, T. V. (2013). Youth in India ready for sex education? Emerging evidence from national surveys. PLoS One, 8(8), Article e71584. https://doi.org/f5d34b
Veritas Health Innovation. (2025). Covidence systematic review software. www.covidence.org
Vincent, R., & Krishnakumar, K. (2022). School-based interventions for promoting sexual and reproductive health of adolescents in India: A review. Journal of Psychosexual Health, 4(2), 102–110. https://doi.org/qp7x
Wahyuningsih, S., Widati, S., Praveena, S. M., & Azkiya, M. W. (2024). Unveiling barriers to reproductive health awareness among rural adolescents: A systematic review. Frontiers in Reproductive Health, 6, Article 1444111. https://doi.org/qp7z
World Health Organization. (2021). Working for a brighter, healthier future. How WHO improves health and promotes well-being for the world’s adolescents. World Health Organization. https://bit.ly/4bXgoN7
World Health Organization. (2023). Infertility prevalence estimates, 1990–2021. World Health Organization. https://bit.ly/3NNtyTF
World Health Organization. (2025). Guideline for the prevention, diagnosis and treatment of infertility. World Health Organization. https://bit.ly/3QoxCu9
Zegers-Hochschild, F., Adamson, G. D., Dyer, S., Racowsky, C., De Mouzon, J., Sokol, R., Rienzi, L., Sunde, A., Schmidt, L., & Cooke, I. D. (2017). The international glossary on infertility and fertility care, 2017. Human Reproduction, 32(9), 1786–1801. https://doi.org/ggf
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Direitos de Autor (c) 2026 Mariana Martins, Filipa Bento Nogueira, Filipa Nunes, Raquel Martins
Este trabalho encontra-se publicado com a Creative Commons Atribuição-NãoComercial 4.0.
Os autores conservam os direitos de autor e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Creative Commons - Atribuição-NãoComercial 4.0 Internacional que permite a partilha do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
