儿科综合初级保健对预防和治疗身体和行为健康状况的系统回顾和荟萃分析。

IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Journal of Pediatric Psychology Pub Date : 2024-06-12 DOI:10.1093/jpepsy/jsae038
Cody A Hostutler, Jeffrey D Shahidullah, Jennifer A Mautone, Tiffany M Rybak, Chimereodo Okoroji, Teryn Bruni, Kevin G Stephenson, Leah Vance Utset, Kurt A Freeman, Leah LaLonde, Andrew R Riley
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引用次数: 0

摘要

目的评估儿科综合初级保健模式中提供的行为健康干预对临床结果的影响:我们检索了 Medline、EMBASE、CENTRAL、PsycINFO 和 SCOPUS 中从 1998 年 1 月 1 日至 2023 年 9 月 20 日发表的研究。我们纳入了使用比较条件(常规护理、增强型常规护理或候补名单)对儿科初级护理中的现场行为健康整合进行评估的研究。我们使用 Covidence 软件提取了有关症状变化、功能障碍/生活质量、健康指标和行为变化的结果数据。偏倚风险分析使用 Cochrane 偏倚风险工具进行。我们使用多层次荟萃分析法对研究中嵌套的多个结果进行综合分析。开放科学基金会预注册:#10.17605/OSF.IO/WV7XP.结果:共纳入 33 篇论文,代表 27 项研究,涉及 6879 名儿童和护理人员。其中 24 项研究为随机对照试验,3 项为准实验设计。17篇论文报告了治疗试验,16篇报告了预防试验。我们发现,综合初级护理优于常规护理或增强型常规护理的总体效应较小(SMD = 0.19,95% 置信区间 [0.11, 0.27])。主持人分析表明,同地模式和综合模式之间的效果相似,治疗和预防试验之间没有统计学意义上的显著差异:结论:研究结果表明,在改善行为、生活质量和症状方面,综合初级护理优于常规护理和强化常规护理。综合初级保健研究需要改进报告标准,以促进更好地综合和理解文献。
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A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions.

Objective: To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.

Methods: We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP.

Results: In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.

Conclusions: Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.

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来源期刊
Journal of Pediatric Psychology
Journal of Pediatric Psychology PSYCHOLOGY, DEVELOPMENTAL-
CiteScore
6.00
自引率
11.10%
发文量
89
期刊介绍: The Journal of Pediatric Psychology is the official journal of the Society of Pediatric Psychology, Division 54 of the American Psychological Association. The Journal of Pediatric Psychology publishes articles related to theory, research, and professional practice in pediatric psychology. Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the context of pediatric health. The field aims to promote the health and development of children, adolescents, and their families through use of evidence-based methods.
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