Effective interventions and practices for parents experiencing complex and multiple needs

Completed Project

This project has now been completed. The linked publication can be viewed here:

Effective interventions and practices for parents experiencing complex and multiple needs

Summary

This protocol summarises plans for a systematic review of interventions, practices and programmes aimed at improving outcomes for vulnerable children and their parents.

Who, what, why and how?

There is strong evidence showing the potential benefits of parenting interventions for the wellbeing of children supported by early help and children’s social care (CSC) services. However, there is a need to identify the interventions and practice elements that are effective in working with families experiencing complex and multiple problems, and to find out what works in different contexts and for different groups of families.

As such, we have commissioned the Centre for Evidence and Implementation (CEI) to conduct a systematic review which aims to identify and describe:

  • Parenting interventions which have been shown to be effective in improving child and parent outcomes within a context relevant to the UK’s early help and CSC practice
  • Practice elements that are shared by effective interventions and observed to contribute to intervention effectiveness, covering both content and delivery characteristics
  • Evidence about for whom, and in which contexts, circumstances, and combinations the identified interventions and practices have the highest likelihood of being effective
  • Information relevant for the successful implementation of interventions, practices and programmes within the UK context.

Research Questions

The research questions for this review are:

  1. Which parenting interventions have strong evidence of their effectiveness in reducing child maltreatment and/or improving child outcomes when delivered to families experiencing multiple and complex needs, within a context relevant to UK early help and CSC practice? What are their pooled effects?
  2. What are the key moderators of effectiveness in parenting interventions for this group, focusing on:
    • Contextual characteristics including family complexity
    • Structural elements of programmes
    • Practice elements: to what extent do programme components contribute to or detract from the effectiveness of interventions? Have any been observed to be superfluous or contraindicated, including for specific subgroups?
  3. What is known about the implementation requirements and feasibility of effective interventions and practice elements, relevant to social care contexts in the UK?

How will we go about it

The review questions will be answered by a meta-analysis.

The review will include studies which focus on parents or carers of children with a mean age of up to 10 years, defined as having more complex and multiple needs. All included studies will be either randomised controlled trials or cluster-randomised controlled trials, and must deliver an intervention where at least 50% of sessions or content is directed at parents aimed at improving knowledge, skills or behaviours. The outcomes of interest are broad but, in summary, focus on child safety, well-being and improving later-life outcomes.

Included literature is not restricted by country, however, the review will place importance on the applicability of findings to the UK context, particularly in relation to an intervention’s ability to be implemented within the UK context.

This project also includes a rapid qualitative synthesis to explore enablers and barriers to intervention engagement and understand user perspectives on intervention delivery and effectiveness.

Delivery Partners

Centre for Evidence and Implementation (CEI), University of Oxford, Monash University, University of Amsterdam

Evaluation partners

Due Date

This project is due to be completed by August 2024.
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Systematic review protocol: Effective interventions and practices for parents experiencing complex and multiple needs

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Qualitative evidence review protocol: Rapid evidence synthesis of perceptions, experiences, and barriers and enablers to successful implementation of interventions for parents experiencing complex & multiple needs

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Cost ratings:

This rating is based on information that programme providers have supplied about the components and requirements of their programme. Based on this information, EIF rates programmes on a scale from 1 to 5, where 1 indicates the least resource-intensive programmes and 5 the most resource-intensive. 

1: A rating of 1 indicates that a programmes has a low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of less than £100.

2: A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £100–£499.

3: A rating of 3 indicates that a programme has a medium cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £500–£999.

4: A rating of 4 indicates that a programme has a medium-high cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £1,000–£2,000.

5: A rating of 5 indicates that a programme has a high cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of more than £2,000.

Child Outcomes:

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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Evidence ratings:

The evidence ratings distinguish five levels of strength of evidence. This is not a rating of the scale of impact but of the degree to which a programme has been shown to have a positive, causal impact on specific child outcomes.

Level 2: Recognises programmes with preliminary evidence of improving a child outcome, but where an assumption of causal impact cannot be drawn.

Level 2+: The programme will have observed a significant positive child outcome in an evaluation meeting all of the criteria for a level 2 evaluation, but also involving a treatment and comparison group. There is baseline equivalence between the treatment and comparison‐group participants on key demographic variables of interest to the study and baseline measures of outcomes (when feasible).

Level 3: Recognises programmes with evidence of a short-term positive impact from at least one rigorous evaluation – that is, where a judgment about causality can be made.

Level 3+: The programme will have obtained evidence of a significant positive child outcome through an efficacy study, but may also have additional consistent positive evidence from other evaluations (occurring under ideal circumstances or real world settings) that do not meet this criteria, thus keeping it from receiving an assessment of 4 or higher.

Level 4: Recognises programmes with evidence of a long-term positive impact through multiple rigorous evaluations. At least one of these studies must have evidence of improving a child outcome lasting a year or longer.