Article type
Year
Abstract
Background:
Preventive child health services should promote health and prevent disease in children irrespective of their social standing. Since interventions may have differential effects according to social stratification variables, the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-Equity Extension recommends that review authors report and analyze results related to equity questions.
Objectives:
To identify and summarize results of systematic reviews (SR) examining the effect of interventions in preventive health care for pre-school children adapted for the needs of families with low socioeconomic status, ethnic minorities or specified at-risk groups.
Methods:
We searched for SRs in 13 databases up to October 2013. Of 7148 abstracts initially screened, 24 fulfilled the inclusion criteria. Twelve 12 SRs of high quality, six of which were Cochrane reviews, were included.
Results:
Only four of the 12 SRs specifically addressed interventions targeted at disadvantaged parent groups with pre-school children: mothers/families with low socioeconomic status (two SRs), teenage parents and mothers with postnatal depression. We identified five relevant protocols for SRs. Eight SRs presented results from disadvantaged parent groups by incidence. None addressed interventions adapted for the needs of ethnic minority and immigrant parents. We excluded several high quality SRs because results from interventions targeted at disadvantaged groups, other population groups and universal interventions were inseparable in the analyses. Some SRs had poor descriptions of population characteristics related to equity questions; we did not identify the number of these SRs. Pooling of different interventions may have contributed to greater heterogeneity in effect estimates.
Conclusions:
The evidence regarding how to make preventive child health services more equitable is still sparse. However, reanalysis of existing SRs according to established reporting guidelines, with separate analyses for targeted interventions and disadvantaged groups, may improve the knowledge base for public health decision makers.
Preventive child health services should promote health and prevent disease in children irrespective of their social standing. Since interventions may have differential effects according to social stratification variables, the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-Equity Extension recommends that review authors report and analyze results related to equity questions.
Objectives:
To identify and summarize results of systematic reviews (SR) examining the effect of interventions in preventive health care for pre-school children adapted for the needs of families with low socioeconomic status, ethnic minorities or specified at-risk groups.
Methods:
We searched for SRs in 13 databases up to October 2013. Of 7148 abstracts initially screened, 24 fulfilled the inclusion criteria. Twelve 12 SRs of high quality, six of which were Cochrane reviews, were included.
Results:
Only four of the 12 SRs specifically addressed interventions targeted at disadvantaged parent groups with pre-school children: mothers/families with low socioeconomic status (two SRs), teenage parents and mothers with postnatal depression. We identified five relevant protocols for SRs. Eight SRs presented results from disadvantaged parent groups by incidence. None addressed interventions adapted for the needs of ethnic minority and immigrant parents. We excluded several high quality SRs because results from interventions targeted at disadvantaged groups, other population groups and universal interventions were inseparable in the analyses. Some SRs had poor descriptions of population characteristics related to equity questions; we did not identify the number of these SRs. Pooling of different interventions may have contributed to greater heterogeneity in effect estimates.
Conclusions:
The evidence regarding how to make preventive child health services more equitable is still sparse. However, reanalysis of existing SRs according to established reporting guidelines, with separate analyses for targeted interventions and disadvantaged groups, may improve the knowledge base for public health decision makers.