住房支持对孕期和幼儿期社会福利成果影响的系统性审查

Kathleen Brew , Jessica Heerde , Anna Price , Karen McLean
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摘要

背景孕期和幼儿期无家可归与亲生父母及其子女较差的社会福利结果有关。对于这些客户来说,接触儿童保护系统是很常见的。目标系统回顾已发表的文献,调查孕期和幼儿期住房支持对儿童保护结果的影响:在高收入国家中,为怀孕或养育幼儿(0-7 岁)期间无家可归的客户提供住房支持。方法在 CINAHL 和 SocIndex 数据库中系统检索同行评审的研究,对检索到的研究进行独立的双重筛选,并对符合条件的研究进行全文审阅。这两项研究的规模都很小,没有对照组,其中一项是定性研究。没有令人信服的影响证据,因此无法进行荟萃分析。在事后审查中,除儿童保护结果外,另有五项研究符合所有标准。这些研究结果表明,与对照组相比,住房干预措施能更快地改善住房状况,减少酗酒,并减少儿童的内化和外化行为。但是,目前还缺乏具有可靠干预设计的高质量纵向研究,这很可能是由于对此类计划进行评估的嵌入式研究本身就存在挑战。鉴于怀孕和幼儿期对儿童发展的重要性,应优先考虑现有的住房支持和政策实施评估。
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A systematic review of the effects of housing support on social welfare outcomes in pregnancy and early childhood

Background

Homelessness during pregnancy and early childhood is associated with poorer social welfare outcomes for birth parents and their children. For these clients, contact with the child protection system is common. In some cases, children are removed.

Objective

To systematically review published literature investigating the impact of housing support during pregnancy and early childhood on child protection outcomes.

Participants

and setting: Provision of housing support for clients experiencing homelessness while pregnant or parenting young children (0–7 years) in high-income countries.

Methods

A systematic search of databases CINAHL and SocIndex for peer reviewed studies, with independent double-screening of retrieved studies and full-text review of eligible studies.

Findings

Of 793 screens and 37 studies with full-text review, two were eligible. Both were small, without a control group, and one was qualitative. There was no convincing evidence for impacts, and meta-analysis was not possible. In post-hoc reviews, five additional studies met all criteria except child protection outcomes. These studies’ findings suggested that, compared with controls, housing interventions led to faster initial improvements in housing status and decreased alcohol use, as well as decreases in child internalising and externalising behaviours.

Conclusions

There are promising indications that housing interventions generate benefits for clients experiencing homelessness while pregnant or parenting young children. However, high-quality longitudinal studies with robust intervention designs are lacking, likely due to the challenges inherent in embedding research to evaluate such programs. Given the importance of pregnancy and early childhood on children's development, existing housing support and policy implementation evaluations should be prioritised.

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