Table 1 Thematic Analysis of Articles Included Following Full Text Screening

 Cowan et al. 2010 [25]

Zimbabwe

Girls and boys ages 18–22

Cognitive

Youth: HIV prevention, sexual risk behavior, gender equity; Community: adult support of youth SRH, safe spaces

Cluster RCT: 2 arm

School-based youth groups (4 years, 24 sessions in year 4);

Parent + community stakeholder program (22 sessions);

Nurse training program in clinics

Intervention: sig increase in STI knowledge, & pregnancy prevention; no effects on HIV knowledge, sexual behavior, clinic attendance or HIV rates; increase in condom negotiation self-efficacy for females only at 4 yrs

 Stark et al. 2018 [26]

Ethiopia (refugees)

Girls and boys ages 13–19

none

Creating safe spaces, economic empowerment

Quasi-Experimental

Community-based groups;

10 90 min weekly sessions;

10 caregiver discussion groups

No sig intervention effects on SRH outcomes

 USAID 2017 [27]

Ethiopia

Girls and boys ages 10–24

none

YFS: Family planning service delivery for youth; contraception education & provision

Quasi-Experimental: 2 arm

Counseling & provision of contraception at clinics; Family planning outreach activities

Rates of new acceptors of contraception higher at intervention sites post-intervention, but no statistical differences; uptake of implants increased at interventions sites; no difference for IUDs

 Ezeanolue et al. 2016 [28]

Nigeria

Male partners, avg. age = 38

none

Pregnancy education, ANC care education, HIV transmission, HIV integrated services

Cluster RCT: 2 arm

Church-based/family-based;

1 session: pregnancy and health education via a “game show”

Male partners in intervention group showed higher rates of HIV testing compared with controls at post-intervention (post-delivery)

 Ishola et al. 2015 [29]

Nigeria

HIV+ pregnant women

Mindfulness, Cognitive, Goal Setting

HIV post-test counseling

Solomon 4-group

PMTCT Center groups;

1 ACT session + weekly text messages for 3-months

Intervention: sig improvements in psychological flexibility at post-intervention

 Okonofua et al. 2003 [30]

Nigeria

Girls and boys ages 14–20

(n = 1896)

none

Reproductive health education, STI prevention & referrals; clubs & campaigns in school, public lectures

RCT: 2 arm

School-based RH clubs;

Peer-educator training, peer delivered counseling (individual or group-based), peer outreach;

Health provider training in STI treatment (30 h of lectures)

Intervention: sig higher STI knowledge, awareness of partner’s STIs, & STI treatment-seeking; sig reduced STI prevalence at post-intervention

 Mercy Corps 2015 [31]

Niger

Girls ages 10–18

(n = 829)

Support networking

(Safe spaces: SS)

RH education, risk of early pregnancy (Livelihood Training)

Post test with a control

Community-based groups;

87–91 h of direct intervention (SS over 9 months, SS+ Livelihood Training over 19 months)

Sig reductions in attitudes on contraceptive use & age to have a baby in both groups at post-intervention; SS only had sig higher RH knowledge

 Bass et al. 2013 [32]

Dem Rep

Congo (DRC)

Women avg. age = 36.9; 33.8

Cognitive

none

Mixed Method

Community-based groups;

1 individual session + 11,120 min group sessions

Intervention: sig improved anxiety, PTSD symptoms, depression

 OCallaghan et al. 2013 [33]

Dem Rep

Congo

Girls ages 12–17 (war affected)

Relaxation, problem solving, coping skills, emotion regulation, cognitive, psychoeducation

none

RCT: 2 arm

15,120 min sessions 3 days per week

Intervention: sig reduced PTSS symptoms, distress, anxiety, depression at post-intervention

 Panter-Brick et al. 2018 [34]

Jordan

(Syrian Refugees)

Girls and boys ages 12–18

Support networking, communication skills, relaxation, psychoeducation, resilience building

Gender equity, creating safe spaces

RCT: 2-arm

Community youth center groups;

2 sessions per week for 8 weeks;

Structured group activities

Intervention: sig improved MH, insecurity & distress at post-intervention; sustained effects for distress at 1-yr follow-up

 Langhe-Nielson et al. 2011 [35]

Palestine

(Gaza)

Refugees

Girls and boys ages 12–17

Narrative

none

Quasi Experimental

School-based groups in camps;

2 15 min writing sessions on traumatic memories for 3 days

No significant effects of intervention

 Barron et al. 2016 [36]

Palestine

Girls and Boys ages 11–15

Coping skills, relaxation psychoeducation, exposure

none

RCT: 2 arm

School-based groups;

5 sessions: Teaching Recovery Techniques (TRT)

Intervention: sig reduced PTSD symptoms at post-intervention

 Punamaki et al. 2014 [37]

Palestine

(Gaza)

Girls and boys ages 10–13

Coping skills, relaxation psychoeducation, exposure

none

RCT

School-based groups after school;

2 sessions per week for 6 weeks: Teaching Recovery Techniques (TRT)

No sig differences in emotion regulation (ER) at post-intervention, ER intensity mediated intervention effects on MH outcomes

 Qouta et al. 2012 [38]

Palestine

(Gaza)

Girls and boys ages 10–13

Coping skills, psychoeducation, creative expression

none

Cluster RCT: 2-arm

School-based groups;

2 sessions per week for 4 weeks;

1 psychologist per group

Intervention: sig reduced clinical PTSS in boys only compared with controls at post-intervention

 Diab et al. 2014 [39]

Palestine

Girls and boys ages 10–13

Relaxation, emotion regulation, problem solving, psychoeducation

none

Quasi Experimental

School-based groups (TRT);

Delivered by trained counselors; Structured group activities;

Homework to practice relaxation

No sig effects of intervention on MH outcomes at post-intervention

 Kalantari et al. 2010 [40]

Iran

(Afghani refugees)

Girls and boys ages 12–18

Narrative

none

Pre-post

School-based groups;

2 15 min sessions per day on trauma memories for 3 days

Intervention: sig decrease in traumatic grief at post-intervention (small sample size; n ~ 30)

 Mon et al. 2017 [41]

Myanmar

(HIV+ parent)

Girls and boys ages 10–16

Mindfulness, relaxation,

RH education: (puberty, HIV/STIs contraception, pregnancy)

RCT: 2- arm

Community center groups;

3 monthly sessions conducted by 3 trained instructors;

Homework to practice meditation

Intervention: sig higher RH knowledge at 3 mos but not 6 mos; sig higher emotion regulation & interpersonal effectiveness

 Mon et al. 2016 [42]

Myanmar (HIV+ parent)

Girls and boys ages 10–16

Mindfulness, relaxation,

RH education

Cluster RCT: 2- arm

Community center groups;

3 monthly sessions;

Homework to practice meditation

Intervention: sig lower conduct and emotional problems at 6 mos follow-up

 Newmann et al. 2016 [43]

Kenya

HIV+ men and women ages 18–45

none

Family planning talks, provision of condoms & effective contraception

RCT: 2 arm

Family planning integrated into HIV services

Intervention site: sig higher gender equity attitudes in men only, sig more effective contraception use in women only at 1 yr follow-up

 Bryant et al. 2017 [44]

Kenya

Women, avg. age = 35

Behavioral activation, problem solving, relaxation, support networking

none

RCT: 2 arm

Home-based individual sessions;

5 weekly 90 min sessions (Problem Management: PM+)

Intervention: sig greater reductions in distress; reductions in functional impairment; no differences in gender based violence at 6 mos follow-up

 Dawson et al. 2016 [45]

Kenya

Women, avg. age = 33 affected by GBV

Behavioral activation, problem solving, relaxation, support networking

none

Pilot

RCT: 2 arm

Home-based individual sessions;

5 weekly 90 min sessions (PM+)

Intervention: sig reductions in PTSD symptoms at post-intervention; no sig differences in distress or functional impairment

 Baiocchi et al. 2017 [46]

Kenya

Girls and boys ages 10–16

Girls Education: assertiveness training, problem solving, emotion regulation

Boys education: gender equality (Gender equity), sexual assault prevention (GBV),

Cluster RCT:

Matched pairs

School-based groups (boys and girls separate);

6 weekly 120 min sessions + 1 booster session at 3-mos;

Structured group activities

Intervention: sig increase in self-efficacy (perceived ability to cope with stress) and decrease in “estimated” rate of sexual assault at post-intervention

 Puffer et al. 2016 [47]

Kenya

Girls and boys ages 10–16

Modeling, problem solving, goal setting, coping skills, communication skills

HIV education & prevention, economic empowerment

Cluster RCT: 2 arm

Family-based/church-based;

9120 min sessions;

Parent groups, youth groups (boys and girls separated), & church leader discussion groups

Intervention: sig improved family communication at 1 & 3 mos, higher self-efficacy for safe sex at 1 mo; no effects on beliefs about sexual risk; marginal effects for HIV knowledge

 Cohen et al. 2017 [48]

Kenya

HIV+ Women ages 18–45

none

Integration of HIV & FP services; family planning counseling

Cluster RCT: 2 arm

Family counseling provided at HIV clinics

Sig increase in use of effective contraception, decrease in pregnancy rates at 1 & 2 yrs.

 Turan et al. 2015 [49]

Kenya

HIV+ mothers and infants

none

Integration of PMTCT and HIV care with antenatal care services

Cluster RCT: 2 arm

“Week-long” health care provider training on HIV, PMTCT and ANC care & service promotion

Intervention: sig higher HIV care enrollment at 1 yr, more likely to initiate & use ART during pregnancy

 Adam et al. 2013 [50]

Kenya

1st & 2nd yr University Students

none

HIV prevention: condom use, monogamy, abstinence

RCT: 2 arm

University-based/peer-delivered;

Peer educator training;

32 h over 4 weeks

No sig differences between groups at post-intervention

 Grossman et al. 2011 [51]

Kenya

HIV+ women ages 18–45

none

Family planning services integrated into HIV clinics

Cluster RCT: 2 arm

Trained peer educators delivered family planning education in groups (sessions not described)

Intervention: sig higher odds of using effective contraception at 1 yr, no sig difference in condom use

 Penfold et al. 2014 [52]

Tanzania

Women ages 13–49 and infants

none

Antenatal care education

Cluster RCT: 2 arm

Home-based individual sessions;

3 sessions pre-birth + 1 post-birth;

Delivered by trained volunteers

Sig higher reports of delaying first birth, exclusive breastfeeding, and cord cutting hygiene post-delivery

 Magoma et al. 2013 [53]

Tanzania

Pregnant women avg. age = 25

none

Birth planning education integrated into ANC services

Cluster RCT: 2 arm

Clinic-based sessions;

ANC providers received 2 days of didactic training

Intervention: effects moderated by SES; women more likely to deliver in health unit but not statistically significant for all women

 Ross et al. 2007 [54]

Tanzania

Girls and boys avg. age = 15.7

none

Increase provision of youth friendly SRH services, sexual health education, condom promotion/provision

Community RCT: 2 arm

School-based groups;

12 40-min sessions over 1 year;

Teacher led & peer-assisted;

Community-wide activities (e.g., condom promotion by youth)

Intervention: sig impact on SRH knowledge, HIV/STI knowledge, sexual behavior attitudes at 3 yrs.; no sig effects on HIV or STI prevalence

 Jordans et al. 2010 [55]

Nepal

Girls and boys ages 11–14

Creative expression, exposure, narrative, psychoeducation, resilience building

none

Cluster RCT: 2 arm

School-based groups;

15 60 min sessions over 5 weeks;

Structured groups activities

Intervention: moderate reductions in psychological problems for boys, increased prosocial behavior for girls at post-intervention

 Ssewamala et al. 2010 [56]

Uganda

(Aids Orphaned)

Girls and boys avg. age = 13.7

none

Economic empowerment

Quasi RCT

School-based groups;

12 sessions on financial planning; monthly peer mentorship meetings for 10 months

Intervention: sig improved sexual risk taking attitudes for boys at post-intervention; girls showed increased approval of sexual risk-taking

 Bolton et al. 2007 [57]

Uganda

Girls and boys ages14–17

Interpersonal therapy; creative expression

none

RCT: 2 arm

Groups held in displaced person camps;

16 weekly 90–120 min sessions

Intervention: girls only showed sig improvements in depression at post-intervention; no effect on anxiety

 Devries et al. 2017 [58]

Uganda

Girls and boys ages 11–14

Goal setting, psychoeducation- staff

Sexual/emotional violence education; power in relationships

Cluster RCT: 2 arm

School-based group sessions;

Good Schools Toolkit: activities for students and staff

Intervention: sig reduced levels of violence (including sexual) at 3 mos follow-up

 Atwood et al. 2012 [59]

Liberia

6th grade girls and boys

(n = 812)

HIV prevention, condom use attitudes, perceived sexual risk, sexual refusal self-efficacy; condom negotiation self-efficacy

Match Group RCT: 2 arm

School-based groups;

1 male & 1 female health educator delivered education in health class weekly over 8 weeks

Intervention: sig improved attitudes about condoms, increased condom use at 9 mos; no effect on age first sex or multiple sex partners

 Hossain et al. 2013 [60]

Cote

d’lvoire

Men avg. age = 32

none

Gender-based violence, healthy relationships

Pilot RCT: 2 arm

Community program + men’s discussion group;

16 sessions over 4 months

Intervention: sig lower reports of GBV, improved attitudes about GBV at 1 yr follow-up

 Gupta et al. 2013 [61]

Cote

d’lvoire

Women avg. age = 37

Communication skills

Gender norms & attitudes, economic empowerment, GBV

RCT

2 arm

Community-based groups for women and their male partners;

8 1.5–2.5 h sessions over 16 weeks;

Delivered by 1 male & 1 female facilitator

Intervention: acceptance of wife beating reduced at 3 mos, no sig differences in reported IPV or attitudes about sex refusal

 Villaruel et al. 2010 [62]

Mexico

Girls avg. age = 17.6

(n = 829)

none

Sexual risk reduction, pregnancy education, contraception, parent-adolescent sex talks

RCT: 2 arm

School-based groups;

6 h of sessions total;

Structured group activities;

Parent groups

Intervention: sig more likely to be older & use a condom at first sex at 48 mos; no effect on consistent condom use

 Kaljee et al. 2005 [63]

Vietnam

Boys and girls ages 15–20

(n = 480)

HIV/AIDS Knowledge, effective contraception, intentions to use condoms, sexual decision making skills

RCT

School-based groups;

10 weekly 2 h sessions;

1 facilitator per group (same gender groups);

Parent groups

Intervention: sig greater HIV/AIDS knowledge; condom use self-efficacy and condom negotiation self-efficacy; perceived efficacy of condoms; intentions to use condoms at post-intervention and 6 mos

 Leventhal et al. 2016 [64]

India

Girls, avg. age = 13

Emotion regulation, assertiveness training, communication skills, problem solving, resilience building

Gender equity, gender based violence; RH heath education (health curriculum)

RCT: 3- arm

School-based groups;

1 session weekly for 21–23 weeks;

2 trained facilitators per group;

Structured group activities

Psychosocial curriculum + health curriculum group had sig higher gender equality attitudes and RH health knowledge than controls at post-intervention

 Leventhal et al. 2015 [65]

India

Middle school girls

Resilience building, emotion regulation, assertiveness training problem solving, goal setting, communication skills

none

Stratified Block RCT: 4 groups

School-based groups;

23 60 min weekly sessions;

Structured group activities

Intervention: sig higher emotional resilience, self-efficacy (belief that one can cope with adversity and perform difficult tasks), well-being at post-intervention; no effect for depression

 Raj et al. 2016 [66]

India

Couples; husbands ages 18–30

Gender equity, family planning counseling, contraception education, sexual-risk behaviors

Cluster RCT: 2 arm

Clinic-based or home sessions;

2 individual sessions delivered by male health providers to men &

1 couples session over 3 months

Intervention: women sig more likely to communicate about contraception & use effective contraception at 9 mos, less likely to report IPV at 18 mos; men sig less likely to report acceptance of IPV at 9 & 18 mos; no effect on pregnancy rates

 Jewkes et al. 2008 [67]

South

Africa

Girls and boys ages 15–26

Communication skills; coping skills

HIV prevention, STIs pregnancy prevention, sexual risk taking, condom use, GBV

Cluster RCT: 2 arm

Community-based groups;

13 3 h sessions (girls and boys separated), 3 peer group meetings, 1 community meeting

Intervention: reduced reported GBV in boys but not significant at p < .05; no sig effects for girls at 2 yrs.; no sig effects on HIV prevalence

 Taylor et al. 2014 [68]

South

Africa

Girls and boys avg. age = 14

(n = 816)

none

Pregnancy prevention, gender norms, education on puberty, decision-making, healthy relationships

RCT: 2 arm

School-based groups;

12 weekly sessions;

Structured group activities

Intervention: sig healthier attitudes, intentions for abstinence, plans to communicate with partner about pregnancy, higher reported condom use at 8 mos follow-up

 Matthews et al. 2016 [69]

South

Africa

Girls and boys avg. age = 13

Assertiveness training, communication skills

HIV prevention, IPV prevention, gender equity, GBV, sexual decision-making, healthy relationships

Cluster RCT: 2 arm

School-based groups after school;

21 60–90 min education sessions; School IPV prevention program;

School-based youth friendly health service

No sig differences in sexual risk behavior at 12 mos; intervention sig less likely to report experiencing sexual violence; higher HIV knowledge & condom knowledge

 Jones et al. 2013 [70]

South

Africa

Pregnant women avg. age = 28

Communication skills, problem-solving, assertiveness training

HIV/STI prevention, contraceptive use, PMTCT service usage

RCT: 2 arm

Clinic-based/Couples-based;

4 weekly 90–120 min couples sessions

Intervention: sig decreased partner violence, increased HIV knowledge, condom use, use of sexual negotiation skills at post-intervention

 Mott MacDonald Team 2017 [71]

Zambia

Girls ages 10–14; 15–19

Resilience building

Vouchers for SRH services, economic empowerment, health education

RCT: 2 arm

Weekly meetings over 2 years

No sig evidence for effects on SRH outcomes at 2 yrs

 Vance et al. 2013 [72]

Ghana &

Zambia

Women postpartum avg. age = 24

none

Family planning messages integrated with immunization services, family planning referrals, LAM education

Cluster RCT: 2 arm

Clinic-based individual sessions;

4 sessions, 30 s each; Vaccinators trained via manual to provide LAM education, family planning messages & referrals

No sig differences between groups and very few women knew LAM criteria at post-intervention

 Rockiki et al. 2017 [73]

Ghana

Girls ages 14–24

none

Pregnancy prevention, reproductive anatomy, STI prevention and education, effective contraception education

Cluster

RCT: 3-arm

1 text message per week for 12 weeks (unidirectional = RH information; interactive = quiz + feedback and encouragement)

Interactive: sig higher RH knowledge than unidirectional & control at 3-mos; no sig differences at 15-mos

 Aninanya et al. 2015 [74]

Ghana

Girls and boys ages 10–19

none

SRH education, sexual attitudes and behaviors; promoting youth SRH, ANC, prenatal, and HIV/STI service usage

Cluster RCT

School-based youth groups;

Peer outreach activities;

Youth friendly health services provider training (1 session);

Community mobilization meetings (50+ sessions);

Delivered by government workers

Intervention: sig higher odds of STI, ANC, and prenatal service usage at 3 yrs.; no sig differences in HIV or SRH service usage

 Carlson et al. 2013 [75]

Mongolia

Female sex workers, avg. age = 25

Motivation

enhancement

HIV risk reduction, gender-based violence

Cluster RCT: 3 arm

Groups held at NGO building;

4 weekly 90 min sessions;

2 wrap-up sessions for MI group

Intervention: sig reductions in violence from paying sex partners in MI alone, MI+ risk reduction, and also controls at 6 mos follow-up

 Khan et al. 2017 [76]

Pakistan

Pregnant women ages 18–30

Psychoeducation, relaxation, support networking

none

Pilot RCT: 2 arm

Home-based/family-based;

1 20 min session + 1 60 min session

No sig differences between groups at post-intervention

 Bhutta et al. 2011 [77]

Pakistan

none

Antenatal care promotion

Cluster RCT: 2 arm

Community-based groups; quarterly sessions delivered by lay workers

No sig differences between groups

 Bastani et al. 2006 [78]

Iran

Pregnant women ages 18–30

Relaxation, psychoeducation

none

RCT: 2 arm

Clinic-based groups;

7 weekly 90 min sessions;

Delivered by trained nurses

Intervention: sig lower anxiety & stress post-delivery, sig reductions in low birth weight and C-sections

 Berger et al. 2014 [79]

Israel

Girls and boys ages 11–13

Emotional regulation, relaxation

none

Quasi RCT: 2 arm

16 90 min weekly sessions

Intervention: sig reductions in PTSD symptoms, anxiety, somatic symptoms at post-intervention