Systematic review of parenting interventions in European countries aiming to reduce social inequalities in children's health and development

Abstract

Background: Early child development influences many aspects of wellbeing, health, competence in literacy an numeracy, criminality, and social and economic participation throughout the life course. Children fro disadvantaged groups have less possibilities of achieving full development. By providing a positive start for al children across the social gradient, improved developmental outcomes will be seen during later childhood an throughout their lives. The objective of this systematic review was to identify interventions during early childhoo in countries from the World Health Organisation European Region in 1999-2013 which reduced inequalities i children's health and development Methods: A systematic review was carried out adhering to the PRISMA guidelines. The review examined universal targeted and proportionate universalism interventions, programs and services using an electronic search strategy i PubMed and the International Bibliography of the Social Sciences [IBSS] databases. A further search was performe in the grey literature. Interventions were included only if they were aimed at children or their parents and ha been evaluated Results: We identified 23 interventions in total: 6 in the PubMed data base, 5 in IBSS and 12 in grey literature. Al but 1 intervention-delivered in Sweden-were carried out in the United Kingdom and the Republic of Ireland. Thes aimed to improve parenting abilities, however, some had additional components such as: day-care provision improving housing conditions and speech or psychological therapies. Programmes offering intensive support information and home visits using a psycho-educational approach and aimed at developing parent's and children' skills showed more favourable outcomes. These were parenting behaviours, overall children's health and highe level of fine motor skills and cognitive functioning. Child injuries and abuse were also reduced. Two intervention were universally proportionate and all others were aimed at a specific target population Conclusions: Interventions with better outcomes and a higher level of evidence combined workshops an educational programmes for both parents and children beginning during early pregnancy and included home visit by specialised staff. Further evaluation and publication of early years interventions should be carried out also withi a wider range of countries than just the UK and Ireland.