A systematic review of reviews of interventions to promote mental health and prevent mental health problems in children and young people

Background: There is a growing policy imperative to promote positive mental health as well as preventing the development of mental health problems in children. This paper summarises the results of published systematic reviews evaluating interventions to promote mental health and prevent mental illness in children. Method: A search was undertaken of ten electronic databases using a combination of medical subject headings (MeSH) and free text searches. Systematic reviews covering mental health promotion or mental illness prevention interventions aimed at infants, children or young people up to age 19 were included. Reviews of drug and alcohol prevention programmes or programmes to prevent childhood abuse and neglect were excluded because these have been the subject of recent good quality reviews of reviews. Critical appraisal of all studies was undertaken using a standardised appraisal tool for systematic reviews. Where possible effect sizes and 95% confidence intervals are reported. A narrative summary has been provided. Results: A total of 27 systematic reviews were included and grouped pragmatically under the following headings: parenting interventions; programmes for the prevention of anxiety and depression, programmes to promote self esteem, violence and aggression prevention programmes, school-based programmes, and general reviews. Included studies targeted a range of risk and protective factors, and a range of populations (including both parents and children). While, many lacked methodological rigour, overall, the evidence is strongly suggestive of the effectiveness of a range of interventions in promoting positive mental well-being, and reducing key risk factors for mental illness in children. Conclusion: A variety of programmes have been shown to be effective in promoting children’s mental health, albeit with modest effect sizes. Based on this evidence, arguments are advanced for the preferential provision of early preventive programmes

Family partnership model como enfoque para atender las necesidades psicológicas de los pacientes de oncología pediátrica

Objectives: To summarize recent scientific literature on the psychosocial needs of pediatric cancer patients and their families and the existing psychological interventions to address these needs. To outline the features of the Family Partnership Model, an intervention that has proven effective in other chronic pediatric problems and may be also helpful in this field. Methods: The most recent papers regarding the psychological needs of children with cancer and the interventions to meet them were reviewed. The principles of the Family Partnership Model as a method to enhance care and meet these children’s needs were discussed. Results and conclusions: Although significant psychopathology in children with cancer is relatively rare, psychological late effects such as subclinical PTSD in the survivors and their parents continue to be concerning. Renowned experts in this field have suggested that intervention frameworks useful for this population should provide tailored psychological support to families of children with cancer. Besides, the importance of interventions that can be delivered by health care professionals outside of mental health (e.g. physicians, nurses and teachers) have been highlighted. The Family Partnership Model is a holistic, family-centered and strengths-based approach that provides effective support specifically tailored to children’s and families’ needs. As it meets the most recent recommendations made by experts and has proven helpful in the treatment of child with other chronic illnesses, we think it is a really promising intervention framework.Objetivos: Resumir la literatura científica más reciente sobre las necesidades psicológicas de los pacientes de oncología pediátrica y sus familias y las intervenciones psicológicas existentes para atender dichas necesidades. Describir los principales rasgos del Family Partnership Model, una intervención que ha probado su eficacia en otros problemas pediátricos crónicos y podría ser también útil en este área. Método: Se revisaron los artículos más recientes sobre las necesidades psicológicas de los niños con cáncer y las intervenciones diseñadas para cubrirlas. Se discuten los principios del Family Partnership Model como método para mejorar la atención psicológica de este tipo de pacientes. Resultados y conclusiones: Aunque los trastornos psicopatológicos en niños con cáncer son relativamente raros, las consecuencias psicológicas a largo plazo, como el Trastorno de Estrés Postraumáutico que puede estar presente a nivel subclínico en los supervivientes y sus familias, siguen siendo preocupantes. Renombrados expertos en este campo han sugerido que las intervenciones efi caces para esta población deberían proporcionar apoyo psicológico adaptado a las necesidades específicas de los niños con cáncer y sus familias. Además, se ha destacado la importancia de las intervenciones psicológicas que pueden ser llevadas a cabo por profesionales de la salud no especialistas en salud mental (por ejemplo médicos, enfermeras y profesores). El Family Partnership Model es un enfoque holístico, centrado en la familia y basado en los puntos fuertes y competencias del paciente que proporciona apoyo psicológico específicamente diseñado a las necesidades de estos pacientes y sus familias. Como cumple las recomendaciones más recientes hechas por los expertos y ha demostrado su eficacia en el tratamiento de niños con otras enfermedades crónicas, consideramos que es una intervención prometedora

Community organizing and community health:Piloting an innovative approach to community engagement applied to an early intervention project in south London

BACKGROUND: The importance of community engagement in health is widely recognized, and key themes in UK National Institute for Health and Clinical Excellence (NICE) recommendations for enhancing community engagement are co-production and community control. This study reports an innovative approach to community engagement using the community-organizing methodology, applied in an intervention of social support to increase social capital, reduce stress and improve well-being in mothers who were pregnant and/or with infants aged 0–2 years. METHODS: Professional community organizers in Citizens-UK worked with local member civic institutions in south London to facilitate social support to a group of 15 new mothers. Acceptability of the programme, adherence to principles of co-production and community control, and changes in the outcomes of interest were assessed quantitatively in a quasi-experimental design. RESULTS: The programme was found to be feasible and acceptable to participating mothers, and perceived by them to involve co-production and community control. There were no detected changes in subjective well-being, but there were important reductions in distress on a standard self-report measure (GHQ-12). There were increases in social capital of a circumscribed kind associated with the project. CONCLUSIONS: Community organizing provides a promising model and method of facilitating community engagement in health

Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial

Objective To evaluate the effectiveness of a peer led parenting intervention delivered to socially disadvantaged families. Design Randomised controlled trial. Setting Schools and children’s centres in a socially deprived borough of inner London. Participants Parental caregivers seeking help with managing the problem behaviours of 116 index children, aged 2-11 years; 59 families were randomised to the intervention and 57 to a waitlist control condition. Intervention Empowering parents, empowering communities is an eight week (two hours each week), manualised programme delivered to groups of parents by trained peer facilitators from the local community. Main outcome measures Child problems (number and severity), parental stress, and parenting competencies were assessed before and after the intervention using standardised parent reported measures. Results Significantly greater improvements in positive parenting practices and child problems were observed in the intervention group compared with the waitlist group, with no difference in parental stress between the groups. An intention to treat analysis for the primary outcome measure, the intensity subscale of the Eyberg child behaviour inventory, showed an intervention effect size of 0.38 (95% confidence interval 0.01 to 0.75, P=0.01). The intervention group had high rates of treatment retention (91.5%) and user satisfaction. Conclusion The peer led parenting intervention significantly reduced child behaviour problems and improved parenting competencies. This is a promising method for providing effective and acceptable parenting support to families considered hard to reach by mainstream services

Cross-cultural adaptability of parenting interventions designed for childhood behavior problems: A meta-analysis

The dissemination of parenting interventions is one of the advised approaches to globally counteract childhood behavior problems, delinquency, and future criminal careers. Many of these interventions are developed in Anglosphere countries and transported to other contexts with distinct cultural backgrounds. However, there are no meta-analyses evaluating the overall effectiveness of these Anglosphere parenting programs in non-Anglosphere settings. This meta-analysis aimed to examine the effectiveness of parenting interventions developed in Anglosphere countries when transported to non-Anglosphere countries, as well as compare effectiveness levels between Anglosphere and non-Anglosphere trials; and analyze the impact of research and contextual factors in the dissemination of these interventions. Parenting interventions were included if they were: created in an Anglosphere setting; tested in non-Anglosphere countries; focused on reducing childhood behavioral problems; designed for children ranging from two to 12 years old; and tested in an experimental randomized trial. A random-effects model was selected for our meta-analysis. Standardized mean differences, confidence intervals and prediction intervals were also computed. Twenty studies were included, and results suggest that parenting interventions designed for childhood behavior problems can be transported to non-Anglosphere countries and potentially maintain effectiveness. This study is a relevant contribution to the evidence of cross-cultural transportability of parenting interventions

Family partnership model as a framework to address psychosocial needs in pediatric cancer patients

Objectives: To summarize recent scientific literature on the psychosocial needs of pediatric cancer patients and their families and the existing psychological interventions to address these needs. To outline the features of the Family Partnership Model, an intervention that has proven effective in other chronic pediatric problems and may be also helpful in this field. Methods: The most recent papers regarding the psychological needs of children with cancer and the interventions to meet them were reviewed. The principles of the Family Partnership Model as a method to enhance care and meet these children’s needs were discussed. Results and conclusions: Although significant psychopathology in children with cancer is relatively rare, psychological late effects such as subclinical PTSD in the survivors and their parents continue to be concerning. Renowned experts in this field have suggested that intervention frameworks useful for this population should provide tailored psychological support to families of children with cancer. Besides, the importance of interventions that can be delivered by health care professionals outside of mental health (e.g. physicians, nurses and teachers) have been highlighted. The Family Partnership Model is a holistic, family-centered and strengths-based approach that provides effective support specifically tailored to children’s and families’ needs. As it meets the most recent recommendations made by experts and has proven helpful in the treatment of child with other chronic illnesses, we think it is a really promising intervention framework

‘Every day is hard, being outside, but you have to do it for your child’: mixed-methods formative evaluation of a peer-led parenting intervention for homeless families

We conducted a mixed-methods, formative evaluation of a peer-led parenting intervention for homeless families. Participants were parents living in temporary accommodation with self-identified difficulties related to parenting an index child aged 2–11 years. An evidence-based programme (‘Empowering Parents, Empowering Communities’) was adapted for delivery with the target population in London, UK. We assessed feasibility in terms of session attendance rate, intervention completion rate and potential for impact on a range of parent-reported outcomes measures. Acceptability and appropriateness were examined by a user satisfaction measure and qualitative interviews. The intervention was delivered across three group cohorts (N = 15). Thirteen parents completed the programme (including one parent who required two attempts). We found improvements in child behavioural difficulties, parenting knowledge and practices, while parental well-being and social support were unchanged. Participants were highly satisfied overall, with indications that the peer-led model mitigated negative expectancies of services and normalized experiences of parenting in challenging conditions. Parental self-care and ‘the good enough parent’ were strongly endorsed topics, although some content (e.g. timeout) was deemed impractical. These promising findings warrant further testing under controlled conditions

The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app

Background: Health mobile applications (apps) have become very popular, including apps specifically designed to support women during the ante- and postnatal periods. However, there is currently limited evidence for the effectiveness of such apps at improving pregnancy and parenting outcomes. Aim: to assess the effectiveness of a pregnancy and perinatal app, Baby Buddy, in improving maternal self-efficacy at three months post-delivery. Methods: Participants were 16-years and over, first-time pregnant women, 12-16 weeks gestation, recruited from five English study sites. The Tool of Parenting Self-efficacy (TOPSE) (primary outcome) was used to compare mothers at three months post-delivery who had downloaded the Baby Buddy app compared to those who had not downloaded the app, controlling for confounding factors. Results: 488 participants provided valid data at baseline (12-16 weeks gestation), 296 participants provided valid data at 3 months post-birth, 114 (38.5%) of whom reported that they had used the Baby Buddy app. Baby Buddy app users were more likely to use pregnancy or parenting apps (80.7% vs 69.6%, p=.035), more likely to have been introduced to the app by a healthcare professional (p=.005) and have a lower median score for perceived social support (81 vs 83, p=.034) than non-app users. The Baby Buddy app did not illicit a statistically significant change in TOPSE scores from baseline to 3 months post-birth (adjusted OR 1.12, 95%CI 0.59 to 2.13, p=.730). Finding out about the Baby Buddy app from a healthcare professional appeared to grant no additional benefit to app users compared to all other participants in terms of self-efficacy at three months post-birth (adjusted OR 1.16, 95%CI 0.60 to 2.23, p=.666). There were no statistically significant differences in the TOPSE scores for the in-app data between either the type of user who was engaged with the app and non-app users (adjusted OR 0.69, 95%CI 0.22 to 2.16, p=.519) or those who were highly engaged and non-app users (adjusted OR 0.48, 95%CI 0.14t o 1.68, p=.251). Conclusion: This study is one of few, to date, that has investigated the effectiveness of a pregnancy and early parenthood app. No evidence for the effectiveness of the Baby Buddy app was found. New technologies can enhance traditional healthcare services and empower users to take more control over their healthcare but app effectiveness needs to be assessed. Further work is needed to consider, a) how we can best use this new technology to deliver better health outcomes for health service users and, b) methodological issues of evaluating digital health interventions