Interventions that enhance health services for parents and infants to improve child development and social and emotional well-being in high-income countries: a systematic review

Lisa Hurt, Shantini Paranjothy, Patricia Lucas, Debbie Watson, Mala Mann, Lucy Griffiths, Samuel Ginja, Tapio Paljarvi, Jo Williams, Mark Bellis, Raghu Lingam

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Experiences in the first 1000 days of life have a critical influence on child development and health. Health services that provide support for families need evidence about how best to improve their provision.
Methods We systematically reviewed the evidence for interventions in high-income countries to improve child development by enhancing health service contact with parents from the antenatal period to 24 months postpartum. We searched 15 databases and trial registers for studies published in any language between 01 January 1996 and 01 April 2016. We also searched 58 programme or organisation websites and the electronic table of contents of eight journals.
Results Primary outcomes were motor, cognitive and language development, and social-emotional well-being measured to 39 months of age (to allow the interventions time to produce demonstrable effects). Results were reported using narrative synthesis due to the variation in study populations, intervention design and outcome measurement. 22 of the 12 986 studies identified met eligibility criteria. Using Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group criteria, the quality of evidence overall was moderate to low. There was limited evidence for intervention effectiveness: positive effects were seen in 1/6 studies for motor development, 4/11 for language development, 4/8 for cognitive development and 3/19 for social-emotional well-being. However, most studies showing positive effects were at high/unclear risk of bias, within-study effects were inconsistent and negative effects were also seen. Intervention content and intensity varied greatly, but this was not associated with effectiveness.
Conclusions There is insufficient evidence that interventions currently available to enhance health service contacts up to 24 months postpartum are effective for improving child development. There is an urgent need for robust evaluation of existing interventions and to develop and evaluate novel interventions to enhance the offer to all families.
LanguageEnglish
Pages1-20
Number of pages21
JournalBMJ Open
Volume8
Issue number2
DOIs
Publication statusPublished - 8 Feb 2018

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Child Health Services
Child Development
Health Services
Language Development
Parents
Postpartum Period
Language
Organizations
Databases
Population

Keywords

  • child development
  • child emotional well-being
  • universal services
  • Interventions

Cite this

Hurt, Lisa ; Paranjothy, Shantini ; Lucas, Patricia ; Watson, Debbie ; Mann, Mala ; Griffiths, Lucy ; Ginja, Samuel ; Paljarvi, Tapio ; Williams, Jo ; Bellis, Mark ; Lingam, Raghu. / Interventions that enhance health services for parents and infants to improve child development and social and emotional well-being in high-income countries: a systematic review. In: BMJ Open. 2018 ; Vol. 8, No. 2. pp. 1-20.
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Interventions that enhance health services for parents and infants to improve child development and social and emotional well-being in high-income countries: a systematic review. / Hurt, Lisa; Paranjothy, Shantini; Lucas, Patricia; Watson, Debbie; Mann, Mala; Griffiths, Lucy; Ginja, Samuel; Paljarvi, Tapio; Williams, Jo; Bellis, Mark; Lingam, Raghu.

In: BMJ Open, Vol. 8, No. 2, 08.02.2018, p. 1-20.

Research output: Contribution to journalArticle

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T1 - Interventions that enhance health services for parents and infants to improve child development and social and emotional well-being in high-income countries: a systematic review

AU - Hurt, Lisa

AU - Paranjothy, Shantini

AU - Lucas, Patricia

AU - Watson, Debbie

AU - Mann, Mala

AU - Griffiths, Lucy

AU - Ginja, Samuel

AU - Paljarvi, Tapio

AU - Williams, Jo

AU - Bellis, Mark

AU - Lingam, Raghu

PY - 2018/2/8

Y1 - 2018/2/8

N2 - Background Experiences in the first 1000 days of life have a critical influence on child development and health. Health services that provide support for families need evidence about how best to improve their provision.Methods We systematically reviewed the evidence for interventions in high-income countries to improve child development by enhancing health service contact with parents from the antenatal period to 24 months postpartum. We searched 15 databases and trial registers for studies published in any language between 01 January 1996 and 01 April 2016. We also searched 58 programme or organisation websites and the electronic table of contents of eight journals.Results Primary outcomes were motor, cognitive and language development, and social-emotional well-being measured to 39 months of age (to allow the interventions time to produce demonstrable effects). Results were reported using narrative synthesis due to the variation in study populations, intervention design and outcome measurement. 22 of the 12 986 studies identified met eligibility criteria. Using Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group criteria, the quality of evidence overall was moderate to low. There was limited evidence for intervention effectiveness: positive effects were seen in 1/6 studies for motor development, 4/11 for language development, 4/8 for cognitive development and 3/19 for social-emotional well-being. However, most studies showing positive effects were at high/unclear risk of bias, within-study effects were inconsistent and negative effects were also seen. Intervention content and intensity varied greatly, but this was not associated with effectiveness.Conclusions There is insufficient evidence that interventions currently available to enhance health service contacts up to 24 months postpartum are effective for improving child development. There is an urgent need for robust evaluation of existing interventions and to develop and evaluate novel interventions to enhance the offer to all families.

AB - Background Experiences in the first 1000 days of life have a critical influence on child development and health. Health services that provide support for families need evidence about how best to improve their provision.Methods We systematically reviewed the evidence for interventions in high-income countries to improve child development by enhancing health service contact with parents from the antenatal period to 24 months postpartum. We searched 15 databases and trial registers for studies published in any language between 01 January 1996 and 01 April 2016. We also searched 58 programme or organisation websites and the electronic table of contents of eight journals.Results Primary outcomes were motor, cognitive and language development, and social-emotional well-being measured to 39 months of age (to allow the interventions time to produce demonstrable effects). Results were reported using narrative synthesis due to the variation in study populations, intervention design and outcome measurement. 22 of the 12 986 studies identified met eligibility criteria. Using Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group criteria, the quality of evidence overall was moderate to low. There was limited evidence for intervention effectiveness: positive effects were seen in 1/6 studies for motor development, 4/11 for language development, 4/8 for cognitive development and 3/19 for social-emotional well-being. However, most studies showing positive effects were at high/unclear risk of bias, within-study effects were inconsistent and negative effects were also seen. Intervention content and intensity varied greatly, but this was not associated with effectiveness.Conclusions There is insufficient evidence that interventions currently available to enhance health service contacts up to 24 months postpartum are effective for improving child development. There is an urgent need for robust evaluation of existing interventions and to develop and evaluate novel interventions to enhance the offer to all families.

KW - child development

KW - child emotional well-being

KW - universal services

KW - Interventions

U2 - 10.1136/bmjopen-2016-014899

DO - 10.1136/bmjopen-2016-014899

M3 - Article

VL - 8

SP - 1

EP - 20

JO - BMJ Open

T2 - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 2

ER -