Primary Care Interventions for Early Childhood Development: A Systematic Review

Peacock-Chambers, Elizabeth; Ivy, Kathryn S.; Bair-Merritt, Megan

doi:10.1542/peds.2017-1661

Cited by 76 publications

(40 citation statements)

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“…Global efforts to prevent individual and societal human capability losses have galvanised around early childhood policies and services to support all children to achieve their developmental potential. [2][3][4][5][6] Investments in early childhood are backed by evidence that early childhood interventions benefit children, [7][8][9] especially those with multiple disadvantages. 10 Evidence from longitudinal life course studies converges around the strengths and limitations of this study ► The use of data linkage methodology enabled a population-wide cohort to be assembled with minimal selection bias.…”

Section: Introductionmentioning

confidence: 99%

Associations between clusters of early life risk factors and developmental vulnerability at age 5: a retrospective cohort study using population-wide linkage of administrative data in Tasmania, Australia

et al. 2020

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ObjectiveEarly childhood is a critical time to address risk factors associated with developmental vulnerability. This study investigated the associations between clusters of early life risk factors and developmental vulnerability in children’s first year of full-time school at age 5.DesignA retrospective cohort study.SettingPopulation-wide linkage of administrative data records for children born in Tasmania, Australia in 2008–2010.ParticipantsThe cohort comprised 5440 children born in Tasmania in 2008–2010, with a Tasmanian 2015 Australian Early Development Census (AEDC) record and a Tasmanian Perinatal Collection record.Outcome measureThe AEDC is a national measure of child development across five domains: physical health and well-being, social competence, emotional maturity, language and cognitive skills (school-based), and communication skills and general knowledge. Children who scored below the 10th percentile on one or more AEDC domains were classified as developmentally vulnerable. Children with special needs are not included in the AEDC results.ResultsLatent class analysis identified five clusters of risk factors: low risks (65% of children), sociodemographic and health behaviour risks (24%), teenage mother and sociodemographic risks (6%), birth risks (3%), and birth, sociodemographic and health behaviour risks (2%). In this sample population, 20% of children were classified as developmentally vulnerable, but the proportion varied substantially by latent class. Logistic regression showed increased odds of developmental vulnerability associated with sociodemographic and health behaviour risks (OR 2.26, 95% CI 1.91 to 2.68, p<0.001), teenage mother and sociodemographic risks (OR 2.01, 95% CI 1.50 to 2.69, p<0.001), and birth, sociodemographic and health behaviour risks (OR 3.29, 95% CI 2.10 to 5.16. p<0.001), but not birth risks (OR 1.34, 95% CI 0.88 to 2.03, p=0.1649), relative to the reference group.ConclusionsThe patterning of risks across the five groups invites consideration of multisectoral policies and services to address complex clusters of risk factors associated with developmental vulnerability.

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Section: Introductionmentioning

confidence: 99%

Associations between clusters of early life risk factors and developmental vulnerability at age 5: a retrospective cohort study using population-wide linkage of administrative data in Tasmania, Australia

et al. 2020

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“…These two propositions are supported from systematic reviews that conclude that the quality of evidence is sub-optimal to inform a change in practice. This means that policy makers are less likely to prioritise Well-child Care [2728]. Oberklaid has documented these challenges for policy makers in response to the rescindment of a four year-old Healthy Kids Check in Australia because of the mounting evidence that it was not meeting child health outcomes [27].…”

Section: Resultsmentioning

confidence: 99%

“…The modified Oxford Centre for Evidence tool was used to grade study level (Appendix Table 1). As some recently conducted systematic reviews have already evaluated the effectiveness of Well-child Care programs using independent author consensus, the utility of repeating this process for the purposes of this realist synthesis was considered unnecessary [2728].…”

Section: Theory and Methodsmentioning

confidence: 99%

A Realist Synthesis of Literature Informing Programme Theories for Well Child Care in Primary Health Systems of Developed Economies

2019

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Introduction: Well-child Care is the provision of preventative health care services for children and their families. The approach, however, to the universal provision of those services is contentious. Methods: We undertook a realist synthesis to enhance understanding of the theoretical mechanisms driving Well-child Care by searching for published and grey literature from multiple databases. Findings: Well-child Care is re-conceptualised as an integrated program delivered in the continuum of pregnancy, infancy and childhood. Depending on the context, Well-child Care can be a policy, a strategy, or an actual clinical practice that promotes child and family health. The main mechanisms include: role, training and continuity of health providers; administrators’ views of the return of investment on achieved outcomes; access to services by families; and the adaptation of programs to meet the dynamic needs of stakeholders. Evidence indicates that for most outcomes, Well-child Care is best delivered in partnerships between community health, social care, and early childhood education sectors. Conclusions: We conclude that Well-child Care policy and program leaders should shift their focus to the integration of: human and physical resources; policy instruments; and shared agreement on outcomes measures across health, social and education sectors. In addition, countries should work towards strengthening universal early education programs and parents’ health literacy regarding child development, health and safety.

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“…Parenting programs often are not built on a theoretical model [52]. Almost all pediatric parenting programs provide for focus groups, face-to-face sessions, and/ or advice offered in the clinical setting [52,53] or provide home visits and group or individual sessions [9]. Few programs provide age-paced written advice sent by mail to support parenting [45,49].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an intervention aimed at supporting new parents: the Baby Newsletter project

et al. 2020

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Background: Anticipatory guidance for parents is commonly used to improve parenting skills. The objective of this pre/post-intervention controlled study was to evaluate the effectiveness of a periodic newsletter with advice on childcare and development in improving parenting self-efficacy. Methods: This was a non-randomized pre/post-intervention controlled study. All the parents of children born between September 2014 and December 2015 resident in the S. Ilario d'Enza municipality (Italy) received eight Baby Newsletters. Parents resident in other municipalities of the same Health District were the control. Parents with linguistic barriers or with preterm or hospitalized children were excluded. Improvement in parenting self-efficacy was measured through the TOPSE (Tool to Measure Parenting Self-Efficacy) questionnaire during the first week (t0) after delivery and at 5 (t1) and 12 months (t2) of life at two vaccination appointments. A score ranging from 0 to 60 was computed for each of the eight domains investigated by the TOPSE. Variations of each TOPSE score between delivery and 12 months in the two groups were compared, adjusting for parity, education, age of parents, and child's sex, and stratifying by parity and education. Results /findings: One hundred thirty-six families accepted to participate in the study. Scores at 12 months were higher than 1 week after delivery in both groups for all TOPSE domains. The improvement was slightly stronger in the Newsletter group for almost all the skills except learning and knowledge [difference in the mean of variation:-0.48 (95% CI: − 3.17; 2.21)]; the difference was significant only for play and enjoyment [2.18 (95% CI: 0.12; 4.25)]. The increase in scores in almost all domains was more pronounced for parents with high education level at first child. Conclusions: The intervention was effective in improving parents' ability to play. However, it risks worsening existing differences between parents with high and with low education levels. Trial registration: Clinical trial registration: NCT03268408.

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Primary Care Interventions for Early Childhood Development: A Systematic Review

Abstract: Although several interventions resulted in improved child development outcomes for children aged 0 to 3 years, comparison across studies and interventions is limited by use of different outcome measures, time of evaluation, and variability of results.

Cited by 76 publications

References 76 publications

Associations between clusters of early life risk factors and developmental vulnerability at age 5: a retrospective cohort study using population-wide linkage of administrative data in Tasmania, Australia

Associations between clusters of early life risk factors and developmental vulnerability at age 5: a retrospective cohort study using population-wide linkage of administrative data in Tasmania, Australia

A Realist Synthesis of Literature Informing Programme Theories for Well Child Care in Primary Health Systems of Developed Economies

Evaluation of an intervention aimed at supporting new parents: the Baby Newsletter project

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