Article type
Abstract
BACKGROUND: Parental substance misuse is a pervasive risk factor for a range of detrimental outcomes for children across the life course. While a variety of interventions have been developed for this population, the existing evidence-base requires consolidation to facilitate evidence-informed decisions between different intervention approaches.
OBJECTIVES: This Campbell review aimed to use network meta-analysis to synthesise the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. Another aim was to examine potential moderators of the effects, yet this was also not possible due to data limitations. A secondary objective was to qualitatively synthesise economic, treatment completion, and treatment acceptability information for included studies.
METHODS: Standard methodological procedures were followed across all stages of the review, as guided by the published protocol for the review. Due to the inability to conduct network meta-analyses, pairwise meta-analyses and single effect sizes were used to synthesise effects. Sensitivity analyses are used to explore possible sources of heterogeneity in the absence of sufficient studies to conduct subgroup analyses. Framework synthesis is used to synthesise economic, treatment completion, and treatment acceptability information for included studies.
RESULTS: 99 studies met review inclusion criteria, encompassing 22,213 participants. Interventions were evaluated using a large range of child psychosocial outcomes which broadly fell under: (a) child welfare; (b) child development; (c) child emotional and behavioural; and (d) educational domains. Thirty-six meta-analyses and 215 single effect sizes are used to appraise the effectiveness of included interventions. The size and direction of the effects varied across interventions, type of outcomes, and time-point of measurement. Just over 10% of included studies reported on economic, treatment completion, and treatment acceptability information.
CONCLUSION: Despite a large body of evaluation evidence, disparate outcomes, and missing data precluded formal examination of the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. Review findings suggest that interventions for families affected by parental substance misuse can be effective when they holistically address multiple domains such as parent wellbeing, parenting, children's wellbeing, and/or other factors impacting family wellbeing (e.g., housing).
OBJECTIVES: This Campbell review aimed to use network meta-analysis to synthesise the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. Another aim was to examine potential moderators of the effects, yet this was also not possible due to data limitations. A secondary objective was to qualitatively synthesise economic, treatment completion, and treatment acceptability information for included studies.
METHODS: Standard methodological procedures were followed across all stages of the review, as guided by the published protocol for the review. Due to the inability to conduct network meta-analyses, pairwise meta-analyses and single effect sizes were used to synthesise effects. Sensitivity analyses are used to explore possible sources of heterogeneity in the absence of sufficient studies to conduct subgroup analyses. Framework synthesis is used to synthesise economic, treatment completion, and treatment acceptability information for included studies.
RESULTS: 99 studies met review inclusion criteria, encompassing 22,213 participants. Interventions were evaluated using a large range of child psychosocial outcomes which broadly fell under: (a) child welfare; (b) child development; (c) child emotional and behavioural; and (d) educational domains. Thirty-six meta-analyses and 215 single effect sizes are used to appraise the effectiveness of included interventions. The size and direction of the effects varied across interventions, type of outcomes, and time-point of measurement. Just over 10% of included studies reported on economic, treatment completion, and treatment acceptability information.
CONCLUSION: Despite a large body of evaluation evidence, disparate outcomes, and missing data precluded formal examination of the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. Review findings suggest that interventions for families affected by parental substance misuse can be effective when they holistically address multiple domains such as parent wellbeing, parenting, children's wellbeing, and/or other factors impacting family wellbeing (e.g., housing).