Systematic Review of Community- and Home-Based Interventions to Support Parenting and Reduce Risk of Child...

Area of Science:

• Pediatrics
• Child Development
• Public Health

Background:

• Substance-exposed newborns (SENs) face elevated risks for child maltreatment, out-of-home placement, and adverse health and developmental outcomes.
• Effective interventions are crucial to support parenting and mitigate risks for families with SENs.

Purpose of the Study:

• To systematically review community- and home-based interventions aimed at enhancing parenting and reducing maltreatment risk in families with SENs.
• To apply a program logic framework to analyze intervention effectiveness and coherence.

Main Methods:

• Systematic review of studies employing pre-experimental, quasi-experimental, and experimental designs.
• Identification and analysis of 12 distinct interventions.
• Assessment of intervention coherence with participants, theory of change, and program components.

Main Results:

• Five of nine rigorous studies demonstrated positive effects on parenting or maltreatment outcomes, despite some studies exhibiting high risk of bias.
• Only two interventions displayed full coherence across intended participants, theory of change, and program components.
• Significant heterogeneity in intervention design and reported outcomes was observed.

Conclusions:

• Existing interventions for SEN families yield variable results, highlighting the need for improved program design and evaluation.
• Further rigorous research is essential to develop and test theory-driven interventions that specifically address the complex needs of families with SENs.
• Enhanced coherence between intervention theory, components, and target population is critical for successful outcomes.