背景:支持幼儿父母的干预措施通常分别针对育儿或父母的心理健康。多组分育儿和父母心理健康干预措施有可能改善育儿实践,心理健康,和早期儿童发展。我们旨在研究它们对儿童和父母结局的影响。
方法:在本系统综述和荟萃分析中,我们搜索了MEDLINE,Embase,WebofScience核心合集,APAPsycINFO,CINAHL完成,Cochrane中央受控试验登记册,和全球卫生数据库从成立到2024年1月23日。符合条件的研究是针对父母行为和父母心理健康的干预措施的随机对照试验。筛选,提取,质量评估由两名作者独立完成.主要结果是儿童的认知和社会情绪功能和父母的抑郁症状,荟萃分析为标准化平均差异(SMD),相对于控制。这项研究在PROSPERO注册,CRD42022302848。
结果:我们发现了5843条记录。在筛选2636(45%)标题和摘要后,我们手动识别并筛选了另外3篇文章,排除了2177条记录.在筛选了462篇全长文章后,25条,代表8520名儿童和照顾者的样本量,包括在内。在基线,平均照顾者年龄为27·7岁(SD5·9),平均儿童年龄(不包括怀孕期间登记的儿童)为14·4个月(8·0).干预平均持续14个月(SD11),并使用了3·7种行为改变技术(2·0)。大多数干预措施将更多的时间用于育儿行为,而不是父母的心理健康。我们发现干预对儿童的认知(SMD0·19[95%CI0·04至0·34];I2=69%)和社交情感(0·26[0·17至0·34];I2=47%)结果具有显着的影响,但对女性护理人员的抑郁症状没有影响(-0·18[-0·36至0·002];I2=86%)。所有研究的偏差风险是中等的,我们发现了不同结果的异质性。
结论:多组分育儿和心理健康干预对儿童认知和社会情绪结果有积极影响,但不是父母的抑郁症状,提示其他因素可能有助于积极的ECD结果。干预措施可能缺乏对心理健康的足够关注,无法产生明显的影响,强调需要未来的研究来区分和评估育儿和心理健康组成部分的贡献,以了解对家庭结果的独立和集体影响。
背景:加拿大卫生研究院。
BACKGROUND: Interventions supporting parents of young children often target parenting or parental mental health separately. Multi-component parenting and parental mental health interventions have the potential to improve parenting practices, mental health, and early childhood development. We aimed to examine their impact on child and parent outcomes.
METHODS: In this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science Core Collection, APA PsycINFO, CINAHL Complete, the Cochrane Central Register of Controlled Trials, and the Global Health Database from inception to Jan 23, 2024. Eligible studies were randomised controlled trials of interventions explicitly targeting parenting behaviours and parental mental health antenatally or in children\'s first 3 years of life. Screening, extraction, and quality assessment were done independently by two authors. Primary outcomes were cognitive and social-emotional functioning in children and depressive symptoms in parents, meta-analysed as standardised mean differences (SMDs), relative to control. This study is registered with PROSPERO, CRD42022302848.
RESULTS: We found 5843 records. After screening 2636 (45·1%) titles and abstracts, we manually identified and screened three additional articles and excluded 2177 records. After screening 462 full-length articles, 25 articles, representing a sample size of 8520 children and caregivers, were included. At baseline, mean caregiver age was 27·7 years (SD 5·9) and mean child age (excluding those enrolled during pregnancy) was 14·4 months (8·0). Interventions lasted a mean of 14 months (SD 11) and used a mean of 3·7 behaviour change techniques (2·0). Most interventions dedicated more time to parenting behaviours than to parental mental health. We found significant intervention effects on children\'s cognitive (SMD 0·19 [95% CI 0·04 to 0·34]; I2=69%) and social-emotional (0·26 [0·17 to 0·34]; I2=47%) outcomes but not on depressive symptoms in female caregivers (-0·18 [-0·36 to 0·002]; I2=86%) relative to control conditions. Risk of bias across studies was moderate, and we found heterogeneity across results.
CONCLUSIONS: Multi-component parenting and mental health interventions had a positive effect on child cognitive and social-emotional outcomes, but not on depressive symptoms in parents, suggesting that other factors might contribute to positive ECD outcomes. Interventions might lack adequate focus on mental health to make a discernible impact, highlighting a need for future studies to differentiate and assess contributions of parenting and mental health components to understand independent and collective effects on family outcomes.
BACKGROUND: Canadian Institutes of Health Research.