Intergrerte programmer for rusavhengige mødre og deres barn: Systematisk oversikt over studier som rapporterer utfall hos barna

Integrated programs for mothers with substance abuse issues and their children: A systematic review of studies reporting on child outcomes

Authors
Niccols, A. Milligan, K. Smith, A. Sword, W. Thabane, L. Henderson, J.
Year
2012
Journal
Child Abuse & Neglect
Volume
36
Pages
308-322
Background: Integrated treatment programs (those that include on-site pregnancy-, parenting-, or child-related services with addiction services) were developed to break the intergenerational cycle of addiction, potential child maltreatment, and poor outcomes for children. Objectives: To examine the impact and effects of integrated programs for women with substance abuse issues and their children, we performed a systematic review of studies published from 1990 to 2011. Methods: Literature search strategies included online bibliographic database searches, checking printed sources, and requests to researchers. Studies were included if all participants were mothers with substance abuse problems at baseline; the treatment program included at least 1 specific substance use treatment and at least 1 parenting or child treatment service; the study design was randomized, quasi-experimental, or cohort; and there were quantitative data on child outcomes. We summarized data on child development, growth, and emotional and behavioral outcomes. Results: Thirteen studies (2 randomized trials, 3 quasi-experimental studies, 8 cohort studies; N = 775 children) were included in the review. Most studies using pre-post design indicated improvements in child development (with small to large effects, ds = 0.007-1.132) and emotional and behavioral functioning (with most available effect sizes being large, ds = 0.652-1.132). Comparison group studies revealed higher scores for infants of women in integrated programs than those not in treatment, with regard to development and most growth parameters (length, weight, and head circumference; with all available effect sizes being large, ds = 1.16-2.48). In studies comparing integrated to non-integrated programs, most improvements in emotional and behavioral functioning favored integrated programs and, where available, most effect sizes indicated that this advantage was small (ds = 0.22-0.45). Conclusions: Available evidence supports integrated programs, as findings suggest that they are associated with improvements in child development, growth, and emotional and behavioral functioning. More research is required comparing integrated to non-integrated programs. This review highlights the need for improved methodology, study quality, and reporting to improve our understanding of how best to meet the needs of children of women with substance abuse issues. (C) 2012 Elsevier Ltd. All rights reserved.

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Type of intervention

Treatment and Child Welfare Interventions

Topic

Parenting Skills

Children of parents with serious mental or physical illness

Drugs and Gambling

Illegal Drugs

Intervention

Interventions for Pregnant Women and Postpartum Women

Age group

Infants and Toddlers (0-2 years)

Preschool Aged Children (3-5 years)

School Aged Children (6-12 years)

Adolescents (13-18 years)

Age not specified

More information
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