Brief evidence-based interventions for universal child health services: a restricted evidence assessment of the literature
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Published on: July 18, 2020
James J Newham1, Karen McLean2, Samuel Ginja3
1Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
Insights
Brief interventions in universal child health services (UCHS) can improve child and parent wellbeing. Three evidence-based programs showed promise for enhancing parental mental health and infant sleep within UCHS platforms.
Area of Science:
- Child Health Services Research
- Public Health Interventions
- Developmental Psychology
Background:
- Universal child health services (UCHS) are vital for delivering interventions to support families and improve child health.
- Identifying brief, evidence-based interventions for common child issues is crucial for UCHS implementation.
Purpose of the Study:
- To identify brief, evidence-based interventions for common child health and developmental problems suitable for UCHS.
- To assess the potential scalability of these interventions within UCHS platforms.
Main Methods:
- A restricted evidence assessment (REA) of electronic databases and grey literature from 2006-2019.
- Included studies focused on child social-emotional wellbeing, infant sleep, home learning, or parent mental health, using comparison groups and brief interventions (≤4 sessions) in non-tertiary settings.
Main Results:
- Seventeen studies met eligibility criteria; three interventions were identified as potentially scalable for UCHS.
- These included universal child behavioral intervention (improved parental mental health), universal screening (improved maternal mental health), and targeted child behavioral intervention (improved infant sleep and parental mental health).
- Key lessons emphasize maximizing information in initial sessions, a holistic family approach, and acknowledging barriers for vulnerable populations.
Conclusions:
- Implementing brief, evidence-based interventions in UCHS can enhance maternal and child health outcomes.
- The study recommends three "best bet" interventions for improved service responsiveness and equity.
- UCHS offer a pragmatic platform for delivering scalable, effective interventions for early childhood challenges.
Background:
Universal child health services (UCHS) provide an important pragmatic platform for the delivery of universal and targeted interventions to support families and optimize child health outcomes. We aimed to identify brief, evidence-based interventions for common health and developmental problems that could be potentially implemented in UCHS.
Methods:
A restricted evidence assessment (REA) of electronic databases and grey literature was undertaken covering January 2006 to August 2019. Studies were eligible if (i) outcomes related to one or more of four areas: child social and emotional wellbeing (SEWB), infant sleep, home learning environment or parent mental health, (ii) a comparison group was used, (iii) universal or targeted intervention were delivered in non-tertiary settings, (iv) interventions did not last more than 4 sessions, and (v) children were aged between 2 weeks postpartum and 5 years at baseline.
Results:
Seventeen studies met the eligibility criteria. Of these, three interventions could possibly be implemented at scale within UCHS platforms: (1) a universal child behavioural intervention which did not affect its primary outcome of infant sleep but improved parental mental health, (2) a universal screening programme which improved maternal mental health, and (3) a targeted child behavioural intervention which improved parent-reported infant sleep problems and parental mental health. Key lessons learnt include: (1) Interventions should impart the maximal amount of information within an initial session with future sessions reinforcing key messages, (2) Interventions should see the family as a holistic unit by considering the needs of parents with an emphasis on identification, triage and referral, and (3) Brief interventions may be more acceptable for stigmatized topics, but still entail considerable barriers that deter the most vulnerable.
Conclusions:
Delivery and evaluation of brief evidence-based interventions from a UCHS could lead to improved maternal and child health outcomes through a more responsive and equitable service. We recommend three interventions that meet our criteria of "best bet" interventions.
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