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Parent-directed intervention versus controls whilst their child waits for diagnostic assessment: a systematic review
C Bernie1,2,3, M Mitchell4,5, K Williams4,6,7,8
1Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia. Charmaine.Bernie@rch.org.au.
Insights
This systematic review explores parent-directed interventions for children awaiting diagnostic assessments. It synthesizes evidence on educational programs and support groups to improve child health outcomes during waiting periods.
Area of Science:
- Child Health
- Developmental Pediatrics
- Health Services Research
Background:
- Long waiting lists for publicly funded health services impact children and families.
- Parents and caregivers are crucial supports for children's well-being.
- There is a need to understand effective interim interventions during diagnostic waiting periods.
Purpose of the Study:
- To systematically review and synthesize evidence on parent-directed interventions for children aged 1-12 years awaiting diagnostic assessment.
- To identify effective strategies for supporting primary caregivers during these waiting periods.
- To inform the adoption of proven interventions and stimulate innovation in child health services.
Main Methods:
- Systematic review of intervention studies including educational programs, information, group, or individual therapy for primary caregivers.
- Inclusion of studies with >5 participants and a control/comparison group.
- Searches of major health and education databases (PubMed, MEDLINE, PsycINFO, CINAHL, ERIC) and grey literature, with data extraction and risk of bias assessment by two reviewers.
- Meta-analysis using a random-effects model where applicable, following PRISMA guidelines.
Main Results:
- The review will synthesize findings from eligible intervention studies.
- Results will be tabulated, summarized, and potentially meta-analyzed.
- Specific outcomes of parent-directed interventions will be detailed.
Conclusions:
- Effective parent-directed interventions can support families during lengthy diagnostic waiting periods.
- Evidence-based interventions can be adopted to improve child health and well-being.
- This review aims to guide future service development and intervention innovation.
Background:
Waiting lists are an ongoing issue for publicly funded community and hospital-based health services. Parents and caregivers are instrumental supports in the health and well-being of young and school-aged children, yet little is known about the way they can be supported during waiting periods. Given mounting evidence about the value of early intervention in physical and mental health literature, and waits for some public health services extending past 12 months, it is both timely and warranted to explore interim interventions that may be applied in this period.
Methods:
Intervention studies that have applied an educational programme, information, group-based support or individualised therapy to primary caregivers of children (heron referred to as parent-directed interventions), waiting for diagnostic assessment at any inpatient or outpatient health service and aged between 1 and 12 years of age, will be reviewed. These will include intervention studies of any type that have included more than 5 participants or participant groups and where a control or comparison group has been included. Abstract screening, full-text review, data extraction and risk of bias will be conducted by two reviewers. Relevant databases in health and education will be systematically searched using key words and Medical Subject Headings (MeSH) and grey literature will be explored. Databases will include PubMed, Ovid for MEDLINE and PsycINFO, EBSCO for the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and the Education Resources Information Center (ERIC). Covidence© will be used to support abstract and full text screening, which will be completed by two main reviewers. Results will be tabulated, summarised and meta-analysed using a random-effects model, in any instance where concordant outcome measures have been applied. Results will be published and reported in line with PRISMA reporting guidelines.
Discussion:
Given little is known about effective support for families when children are awaiting diagnostic assessment for any medical, developmental or behavioural condition, the authors will synthesise existing evidence about parent-directed interventions in this period. It is hoped that by understanding the existing evidence interventions that are proven to be effective will be adopted and intervention innovation can occur.
Systematic Review Registration:
PROSPERO 2020 CRD42020159360.
