Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden.
Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
Eur Child Adolesc Psychiatry. 2024 Feb;33(2):323-355. doi: 10.1007/s00787-022-01969-w. Epub 2022 Mar 19.
A comprehensive review of the economic evidence on parenting interventions targeting different aspects of child health is lacking to support decision-making. The aim of this review is to provide an up to date synthesis of the available health economic evidence for parenting interventions aiming to improve child health. A systematic review was conducted with articles identified through Econlit, Medline, PsychINFO, and ERIC databases. Only full economic evaluations comparing two or more options, considering both costs and outcomes were included. We assessed the quality of the studies using the Drummond checklist. We identified 44 studies of varying quality that met inclusion criteria; 22 targeting externalizing behaviors, five targeting internalizing problems, and five targeting other mental health problems including autism and alcohol abuse. The remaining studies targeted child abuse (n = 5), obesity (n = 3), and general health (n = 4). Studies varied considerably and many suffered from methodological limitations, such as limited costing perspectives, challenges with outcome measurement and short-time horizons. Parenting interventions showed good value for money in particular for preventing child externalizing and internalizing behaviors. For the prevention of child abuse, some programs had the potential of being cost-saving over the longer-term. Interventions were not cost-effective for the treatment of autism and obesity. Future research should include a broader spectrum of societal costs and quality-of-life impacts on both children and their caregivers.
针对儿童健康不同方面的养育干预措施的经济证据缺乏全面审查，无法为决策提供支持。本综述旨在提供最新的养育干预措施改善儿童健康的现有健康经济证据综合分析。通过 Econlit、Medline、PsychINFO 和 ERIC 数据库，我们进行了系统综述，确定了文章。仅纳入了比较两种或多种方案，同时考虑成本和结果的全经济评估。我们使用 Drummond 清单评估了研究的质量。我们确定了 44 项符合纳入标准的研究，其中 22 项针对外化行为，5 项针对内化问题，5 项针对其他心理健康问题，包括自闭症和酗酒。其余的研究针对儿童虐待（n=5）、肥胖（n=3）和一般健康（n=4）。研究差异很大，许多研究存在方法学限制，例如成本视角有限、结果测量挑战和短期视野。养育干预措施在预防儿童外化和内化行为方面具有良好的成本效益。对于预防儿童虐待，一些项目从长远来看有节省成本的潜力。对于自闭症和肥胖的治疗，干预措施没有成本效益。未来的研究应包括更广泛的社会成本和对儿童及其照顾者的生活质量影响。
