Effectiveness of theory-based educational interventions on fertility and childbearing intentions: a systematic review and meta-analysis among Iranian populations.
Mohammad Heidari, Leila Asadi, Mojtaba Fattahi Ardakani et al.
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In 30 seconds
This systematic review and meta-analysis assessed theory-based educational interventions and fertility or childbearing intentions among Iranian populations. Across 12 studies involving 1118 participants, interventions were associated with a significant increase in intentions (pooled SMD 0.79; 95% CI 0.48 to 1.09), with substantial heterogeneity (I 2 = 88.5%). Effects were significant at both short-term and long-term follow-up. Interventions based on the Theory of Planned Behaviour had the largest reported effect, while multimedia education without a theoretical foundation showed no significant effect.
Key findings
- Across 12 studies and 1118 participants, interventions increased fertility and childbearing intentions (SMD 0.79; 95% CI 0.48 to 1.09; I 2 = 88.5%).
- Effects were significant at short-term follow-up (SMD 0.52; 95% CI 0.15 to 0.90) and long-term follow-up (SMD 0.96; 95% CI 0.53 to 1.39).
- The Theory of Planned Behaviour had the largest reported effect (SMD 1.01; 95% CI 0.55 to 1.48); multimedia education without a theoretical foundation showed no significant effect (SMD 0.05).
- Three-, five-, and eight-session interventions showed significant effects, whereas two- and four-session interventions did not.
Why it matters
Fertility intentions are a relevant outcome for educational programmes addressing childbearing. The pooled findings suggest that theory-based approaches, particularly those grounded in the Theory of Planned Behaviour, may be more effective than education without a theoretical foundation in the Iranian populations studied. The substantial heterogeneity and reliance on intention outcomes mean the results should be interpreted as evidence about stated intentions, not demonstrated changes in fertility behaviour.
What to keep in mind
The review reports substantial heterogeneity; most included studies were small, quasi-experimental, and relied on self-reported intention.