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基于证据的预防青少年精神和行为健康的初级保健项目:系统综述。

Evidence-based prevention programs targeting youth mental and behavioral health in primary care: A systematic review.

机构信息

Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1007a, Miami, FL 33136, USA.

Emergency Department, Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL 33136, USA.

出版信息

Prev Med. 2019 Mar;120:85-99. doi: 10.1016/j.ypmed.2018.12.009. Epub 2019 Jan 2.

Abstract

The objectives of this systematic review were to: 1) identify evidence-based youth (i.e., infancy, pre-school age, school age, and adolescence) mental and behavioral health disorder preventive interventions conducted in or offered by primary care settings, and 2) describe these interventions' characteristics, efficacy, and clinical involvement. Randomized controlled trials that targeted the prevention of mental or behavioral health outcomes for youth and had a connection to primary care were included. The PRISMA guidelines were utilized for two phases: 1) searching PubMed, EMBASE, PsycInfo, CINAHL, and Cochrane databases in January 2017; and 2) searching United States Preventive Services Task Force (USPSTF) Systematic Reviews in November 2017. The two phases revealed 504 and 58 potential articles, respectively. After removal of duplicates, screening of abstracts, and full-text reviews, 19 interventions (infancy: n = 2, pre-school age: n = 3, school age: n = 6, adolescence: n = 8) were included: 1) 10 interventions described in 17 articles from the databases, and 2) 9 interventions described in 11 articles from the USPSTF reviews. The included interventions capitalized on primary care settings as a natural entry point to engage youth and families into interventions without requiring a large amount of clinic involvement. Commonalities of efficacious interventions and recommendations for future research are discussed. The authors encourage primary care providers, mental and behavioral health providers, and/or public health researchers to continue developing and testing preventive interventions, or adapting existing interventions, to be implemented in primary care.

摘要

本系统评价的目的是

1)确定在初级保健环境中进行或提供的针对青少年(即婴儿期、学前年龄、学龄期和青春期)精神和行为健康障碍的循证预防干预措施,2)描述这些干预措施的特征、效果和临床参与情况。纳入的随机对照试验针对的是预防青少年的精神或行为健康结果,并与初级保健有关。本研究采用 PRISMA 指南进行了两个阶段的检索:1)2017 年 1 月在 PubMed、EMBASE、PsycInfo、CINAHL 和 Cochrane 数据库中进行检索;2)2017 年 11 月在美国预防服务工作组(USPSTF)系统评价中进行检索。这两个阶段分别显示了 504 篇和 58 篇潜在文章。去除重复项后,对摘要进行筛选,对全文进行审查,共纳入 19 项干预措施(婴儿期:n=2,学前年龄:n=3,学龄期:n=6,青春期:n=8):1)数据库中 17 篇文章描述的 10 项干预措施,2)USPSTF 综述中 11 篇文章描述的 9 项干预措施。纳入的干预措施利用初级保健环境作为一个自然的切入点,让青少年及其家庭参与干预措施,而无需大量的诊所参与。讨论了有效的干预措施的共同点和未来研究的建议。作者鼓励初级保健提供者、精神和行为健康提供者和/或公共卫生研究人员继续开发和测试预防干预措施,或改编现有的干预措施,以便在初级保健中实施。

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