Primary Care–Based Interventions to Promote Positive Parenting Behaviors: A Meta-analysis

医学 心理干预 心理信息 背景(考古学) 荟萃分析 严格标准化平均差 优势比 随机对照试验 数据提取 置信区间 梅德林 幼儿 家庭医学 临床心理学 儿科 护理部 发展心理学 心理学 病理 法学 古生物学 外科 内科学 生物 政治学
作者
Reshma Shah,Sarah Kennedy,Maureen D. Clark,Sarah Corey Bauer,Alan Schwartz
出处
期刊:Pediatrics [American Academy of Pediatrics]
卷期号:137 (5) 被引量:111
标识
DOI:10.1542/peds.2015-3393
摘要

CONTEXT: Utilization of primary care settings offers a promising approach to enhance parenting practices that are critical for promoting early childhood development. Determining the impact of existing primary care interventions on key parenting behaviors will aid providers and policy makers as they seek strategies to improve early child outcomes. OBJECTIVE: To evaluate the efficacy of primary care–based interventions on parenting practices that promote early child development among children younger than 36 months. DATA SOURCES: PubMed, Excerpta Medica dataBASE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature databases were searched electronically. STUDY SELECTION: English-language articles that were quasi-randomized or randomized controlled trials, included parents of children <36 months of age, and reported outcomes related to parenting behaviors that promote early child development. DATA EXTRACTION: Two reviewers independently extracted data regarding participants, interventions, and outcomes. Quantitative meta-analyses were conducted with random effects for study and fitted with restricted maximum likelihood methods. RESULTS: The review included 13 studies reporting parenting outcomes in 2 categories: participation in cognitively stimulating activities and positive parent-child interactions. We found a statistically significant positive effect of primary care–delivered interventions and parent-child interactions (summary standardized mean difference 0.29, 95% confidence interval [CI] 0.06–0.52, P < .0001) and participation in cognitively stimulating activities (summary standardized mean difference 0.34, 95% CI 0.03–0.54; summary odds ratio 0.13, 95% CI 0.01–0.25, P < .0001). LIMITATIONS: Limitations included heterogeneity in measures used, outcomes, and timing of assessments. CONCLUSIONS: Primary care–based interventions modestly affect positive parenting behaviors important for early childhood development. Randomized controlled trials with comparable outcome measures using standardized assessments are needed to assess further beneficial impacts.
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