Evaluating the Effectiveness of Educational Interventions in Family Planning for Men in Developing Countries: A Systematic Review.

Introduction: Unintended pregnancy is associated with national socioeconomic development and gender inequality. In addition to contraception, educational interventions that promote family planning and address gender dynamics are considered important in preventing unintended pregnancy. While the importance of encouraging men's participation in family planning has been advocated, most studies have focused on the application of interventions to women or populations in high-income countries only. Therefore, we conducted a systematic review to evaluate the effects of educational interventions on men in low- and middle-income countries in terms of knowledge, attitudes, practices, and gender dynamics. Methods: Three electronic databases (CINAHL, Ovid MEDLINE, and Web of Science) were searched for studies published from January 1980 to October 2022. Keywords such as "men/husband," "family planning," "contraception," and "education" were combined to identify studies. Two independent reviewers conducted screening and data extraction, and the risk of bias was assessed using the Risk of Bias 2 tool. The quality of evidence was evaluated according to the GRADE Handbook. Results: The database search identified 16,086 articles, of which 4 cluster randomized controlled trials (RCTs) and 1 RCT were ultimately included. Each of them was conducted in four different countries: Malawi, Guatemala, Tanzania, and India. Changes in knowledge, attitude, family planning, and gender dynamics were the outcomes used to assess the effectiveness of interventions. The five selected articles exhibited an effect on ≥1 indicator for each outcome. However, the quality of evidence was determined to be low or very low owing to the risk of bias, heterogeneity, and imprecision. Conclusions: Determining the effectiveness of educational interventions in family planning for men in low- and middle-income countries requires additional high-quality intervention studies. As family planning is influenced by various background factors, it is important to develop appropriate interventions for each context and define relevant indicators that can be compared across contexts.

Association between sleep habits and behavioral problems in early adolescence: a descriptive study.

BACKGROUND: Sleep habits are related to children's behavior, emotions, and cognitive functioning. A strong relationship exists between sleep habits and behavioral problems. However, precisely which sleep habits are associated with behavioral problems remains unclear. Therefore, the purpose of this study is to clarify the relationship between sleep habits and behavioral problems in early adolescence. METHODS: This study used data from a larger longitudinal research, specifically, data from the year 2021. First-year junior high school students (12-14 years) in Japan were surveyed; their parents (N = 1288) completed a parent-report questionnaire. The main survey items were subject attributes, the Pittsburgh Sleep Quality Index (PSQI), and the Strength and Difficulties Questionnaire (SDQ). RESULTS: Of the 652 valid responses received, 604 individuals who met the eligibility criteria (no developmental disability in the child and completion of all survey items) were included in the analysis. To examine the relationship between sleep habits and behavioral problems, logistic regression analysis using the inverse weighted method with propensity score was conducted with sleep habits (sleep quality, time to fall asleep, sleep duration, sleep efficiency, sleep difficulty, use of sleeping pills, difficulty waking during the day, and sleep disturbances) as explanatory variables and behavioral problems (overall difficulty in SDQ) as objective variables. The propensity score was calculated by employing the logistic regression using the inverse weighted method based on propensity scores. Propensity scores were calculated based on gender, family structure, household income, and parental educational background. The results showed that behavioral problems tended to be significantly higher in the group at risk for sleep quality, sleep difficulties, daytime arousal difficulties, and sleep disturbances than in the group with no risk. CONCLUSION: The results suggest that deterioration in sleep quality, sleep difficulties, daytime arousal difficulties, and sleep disturbances may increase the risk of behavioral problems in adolescents.