Université de Lorraine, EA4360 APEMAC, Vandoeuvre-lès-Nancy, France.
Luxembourg Institute of Health, Department of Population Health, 1 A-B Rue Thomas Edison, Strassen, 1445, Luxembourg.
BMC Public Health. 2018 Aug 31;18(1):1087. doi: 10.1186/s12889-018-5915-6.
In 2009, the World Health Organization's Commission on Social Determinants of Health set out its recommendations for action, which included establishing equity from early childhood onwards by enabling all children and their mothers to benefit from a comprehensive package of quality programmes. In order to address social inequalities in health, it is recommended that action be taken from early childhood, and actions providing support for parenting are an effective lever in this respect. The aim of this review of systematic reviews is to analyse, on the one hand, the components and characteristics of effective interventions in parenting support and, on the other, the extent to which the reviews took into account social inequalities in health.
A total of 796 reviews were selected from peer-reviewed journals published between 2009 and 2016 in French or English. Of these, 21 reviews responding to the AMSTAR and selected ROBIS criteria were retained. These were analysed in relation to the consideration they gave to social inequalities in health according to PRISMA-equity.
The reviews confirmed that parenting support programmes improved infants' sleep, increased mothers' self-esteem and reduced mothers' anger, anxiety and stress levels. The mainly authors noted that the contexts in which the interventions had taken place were described either scantly or not at all, making it difficult to evaluate them. Only half of the reviews had addressed the question of social inequalities in health. In particular, there had been little research conducted on the relational aspect and the social link.
In terms of addressing social inequalities in perinatal health, the approach remains both modest and reductive. Understanding how, for whom and in what conditions interventions operate is one way of optimising their results. Further research is needed to study the interactions between the interventions and their contexts.
2009 年，世界卫生组织社会决定因素健康委员会提出了行动建议，其中包括通过使所有儿童及其母亲都能受益于全面的优质方案，从儿童早期开始实现公平。为了解决健康方面的社会不平等问题，建议从儿童早期开始采取行动，为育儿提供支持的行动是这方面的有效手段。本次对系统评价的综述旨在一方面分析育儿支持方面有效干预措施的组成部分和特征，另一方面分析这些综述在多大程度上考虑了健康方面的社会不平等。
从 2009 年至 2016 年期间在法国或英语期刊上发表的同行评审期刊中，共选择了 796 篇综述。其中，有 21 篇符合 AMSTAR 和选定的 ROBIS 标准的综述被保留下来。根据 PRISMA-Equity，对这些综述进行了分析，以了解它们对健康方面社会不平等的考虑程度。
这些综述证实，育儿支持方案改善了婴儿的睡眠，提高了母亲的自尊心，降低了母亲的愤怒、焦虑和压力水平。主要作者指出，干预措施所发生的背景要么描述得很少，要么根本没有描述，因此难以进行评估。只有一半的综述探讨了健康方面社会不平等的问题。特别是，对于关系方面和社会联系方面的研究很少。
在处理围产期健康方面的社会不平等问题方面，方法仍然既适度又具有局限性。了解干预措施如何、为谁以及在何种条件下运作是优化其结果的一种方法。需要进一步研究来研究干预措施及其背景之间的相互作用。
