<br>低收入和中等收入国家早期育儿干预的短期、中期和长期影响：系统评价,BMJ Global Health

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低收入和中等收入国家早期育儿干预的短期、中期和长期影响：系统评价
BMJ Global Health ( IF 7.1 ) Pub Date : 2021-03-01 , DOI: 10.1136/bmjgh-2020-004067
Joshua Jeong ₁ , Helen O Pitchik ₂ , Günther Fink _{3,

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Affiliation

简介众所周知，幼儿时期的育儿干预可以在计划实施后立即改善各种儿童发展成果。然而，对于这些最初的好处是否能随着时间的推移而持续，人们知之甚少。方法我们对低收入和中等收入国家 (LMIC) 在出生后 3 年内实施的育儿干预措施进行了系统的文献回顾，并在初次干预后至少 1 年后完成了对干预队列的后续评估。干预后终点。我们根据儿童层面和家长层面的结果以及短期（项目完成后 1-3 年）、中期（4-9 年）、中期（4-9 年）、后续轮次的时间安排总结了干预效果。和长期（10年以上）。我们还进行了探索性荟萃分析，以比较这些后续轮次亚组对儿童认知和行为发展的影响。结果我们确定了 24 篇文章，报告了 7 项针对幼儿期育儿干预措施的随机对照试验，这些试验在 7 个中低收入国家中至少进行了一项后续研究。大多数后续研究都是短期的。三项试验进行了中期随访评价，只有两项试验进行了长期随访评价。尽管试验一致支持项目完成后立即对儿童早期发展结果产生广泛的益处，但结果显示，随着时间的推移，对儿童结果的影响普遍减弱。短期影响好坏参半，中期和长期影响很大程度上尚无定论。对认知发展的探索性荟萃分析发现，综合效应在干预后和短期内显着（尽管幅度较小），但在中长期内效果并不显着。对于行为发展，随着时间的推移，效果始终为零。结论对于中低收入国家早期育儿干预的长期随访研究很少。需要对纵向干预队列进行更多投资，以便更全面地了解育儿干预措施在整个生命过程中的有效性，并改进未来干预措施的设计，以便随着时间的推移，它们能够具有更大的潜力来实现和维持计划效益。

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Short-term, medium-term and long-term effects of early parenting interventions in low- and middle-income countries: a systematic review

Introduction Parenting interventions during early childhood are known to improve various child development outcomes immediately following programme implementation. However, less is known about whether these initial benefits are sustained over time. Methods We conducted a systematic literature review of parenting interventions in low- and middle-income countries (LMICs) that were delivered during the first 3 years of life and had completed a follow-up evaluation of the intervention cohort at least 1 year after the primary postintervention endpoint. We summarized intervention effects over time by child-level and parent-level outcomes as well as by timing of follow-up rounds in the short-term (1–3 years after programme completion), medium-term (4–9 years), and long-term (10+ years). We also conducted exploratory meta-analyses to compare effects on children’s cognitive and behavioral development by these subgroups of follow-up rounds. Results We identified 24 articles reporting on seven randomised controlled trials of parenting interventions delivered during early childhood that had at least one follow-up study in seven LMICs. The majority of follow-up studies were in the short-term. Three trials conducted a medium-term follow-up evaluation, and only two trials conducted a long-term follow-up evaluation. Although trials consistently supported wide-ranging benefits on early child development outcomes immediately after programme completion, results revealed a general fading of effects on children’s outcomes over time. Short-term effects were mixed, and medium-term and long-term effects were largely inconclusive. The exploratory meta-analysis on cognitive development found that pooled effects were significant at postintervention and in the short-term (albeit smaller in magnitude), but the effects were not significant in the medium-term and long-term. For behavioural development, the effects were consistently null over time. Conclusions There have been few longer-term follow-up studies of early parenting interventions in LMICs. Greater investments in longitudinal intervention cohorts are needed in order to gain a more comprehensive understanding of the effectiveness of parenting interventions over the life course and to improve the design of future interventions so they can have greater potential for achieving and sustaining programme benefits over time.

更新日期：2021-03-05

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