Cibralic Sara, Wu Weng Tong, Ahinkorah Bright Opoku, Lam-Cassettari Christa, Woolfenden Susan, Kohlhoff Jane, Grace Rebekah, Kemp Lynn, Johnson Patrice, Murphy Elisabeth, Deering April, Raman Shanti, Eapen Valsamma
University of New South Wales, Sydney, NSW, Australia.
South Western Sydney Local Health District & Ingham Institute, Liverpool, NSW, Australia.
BMC Pediatr. 2025 Apr 22;25(1):314. doi: 10.1186/s12887-025-05580-1.
Numerous systematic reviews have shown home visiting interventions to be effective at improving a variety of parent and child outcomes. No review has, however, examined the impact of home visiting programs targeting child (aged 0-5 years) mental health, socioemotional and/or developmental outcomes in the context of families with high vulnerability and complex needs.
A systematic review and meta-analysis were undertaken to examine and synthesize the literature on home visiting programs administered by professionals/paraprofessionals for families with young children, high vulnerability, and complex needs. PsychInfo, Scopus, Embase, PubMed, and CINAHL were searched through August 2023. A manual review was also undertaken of the reference lists of the articles selected for the review and the Home Visiting Evidence of Effectiveness 2023 review/database. English language studies were included if they were evaluated with a group of participants (case studies were excluded), reported results of home visiting intervention targeted at improving mental health and psychosocial outcomes of caregivers and/or developmental outcomes for children (aged 0-4 years 11 months) of families with high vulnerability and complex needs. Two independent reviewers extracted data and assessed for risk of bias. Qualitative results were consolidated narratively while a meta-analysis was used to synthesize quantitative results.
Initial searches identified 623 articles, of which 22 were included in the final review. Findings showed that 18 different home visiting interventions have been implemented with families with high vulnerability and complex needs, and that these interventions are effective at improving a variety of child outcomes. The meta-analysis showed that the weighted mean standardised effect sizes ranged from -0.31 to 0.20, with only one of the four outcomes (i.e., socioemotional and/or behavioural outcomes) being significantly different from 0 (standardised mean difference -0.31; 95% CI: -0.49, -0.13; z = 3.45, p = 0.00). High intervention variability and missing information meant that it was not possible to determine clear patterns regarding features that led to effective versus non-effective interventions.
Taken together, results indicate that there is some evidence showing that home visiting interventions targeted at families with high vulnerability and complex needs can be effective at improving some child outcomes. More research is required to solidify findings.
The University of York Centre for Reviews and Dissemination (PROSPERO) registration number CRD42023460366.
众多系统评价表明，家访干预措施在改善多种家长和儿童的结局方面是有效的。然而，尚无评价考察了针对高脆弱性和需求复杂家庭中儿童（0至5岁）心理健康、社会情感和/或发育结局的家访项目的影响。
进行了一项系统评价和荟萃分析，以审查和综合关于由专业人员/辅助专业人员为有幼儿、高脆弱性和复杂需求的家庭实施的家访项目的文献。检索了截至2023年8月的PsychInfo、Scopus、Embase、PubMed和CINAHL数据库。还对为该评价所选文章的参考文献列表以及《2023年家访有效性证据》评价/数据库进行了人工检索。纳入的英文研究需满足以一组参与者进行评估（排除案例研究），报告了旨在改善高脆弱性和需求复杂家庭中照顾者心理健康和心理社会结局及/或儿童（0至4岁11个月）发育结局的家访干预结果。两名独立评审员提取数据并评估偏倚风险。定性结果以叙述方式进行汇总，同时使用荟萃分析来综合定量结果。
初步检索识别出623篇文章，其中22篇纳入最终评价。研究结果表明，已对高脆弱性和需求复杂的家庭实施了18种不同的家访干预措施，且这些干预措施在改善多种儿童结局方面是有效的。荟萃分析表明，加权平均标准化效应大小在-0.31至0.20之间，四个结局中只有一个（即社会情感和/或行为结局）与0有显著差异（标准化均数差-0.31；95%可信区间：-0.49，-0.13；z = 3.45，p = 0.00）。干预措施的高度变异性和信息缺失意味着无法确定导致有效与无效干预措施的特征的明确模式。
综合来看，结果表明有一些证据显示，针对高脆弱性和需求复杂家庭的家访干预措施在改善某些儿童结局方面可能是有效的。需要更多研究来巩固研究结果。
约克大学评价与传播中心（PROSPERO）注册号CRD42023460366。
