Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents

Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents

Authors
Olson, J. R. Benjamin, P. H. Azman, A. A. Kellogg, M. A. Pullmann, M. D. Suter, J. C. Bruns, E. J.
Year
2021
Journal
Journal of the American Academy of Child & Adolescent Psychiatry
Volume
27
Pages
27
OBJECTIVE: Wraparound is a common method for coordinating care for children and adolescents with serious emotional disorders (SED), with nearly 100,000 youths served annually in the United States. The current systematic review and meta-analysis estimated effects on youth outcomes (symptoms, functioning, school, juvenile justice, and residential placement) and costs. METHOD: A literature search identified 17 peer-reviewed and gray literature studies meeting criteria, which were coded on characteristics of sample, design, implementation, and outcomes. Random effects modeling was conducted using Comprehensive Meta-Analysis Version 3.0. Effect sizes were calculated using Hedges g. Homogeneity of effects were assessed using Q statistics. RESULTS: Medium-sized effects favored Wraparound-enrolled youths for costs (g=0.391, CI=0.282-0.500, p < .001), residential outcomes (g=0.413, CI=0.176-0.650, p=.001), and school functioning (g=0.397, CI=0.106-0.688, p=.007); small effects were found for mental health symptoms (g=0.358, CI=0.030-0.687, p=.033) and functioning (g=0.315, CI=0.086-0.545, p=.007). Larger effects were found for peer-reviewed studies, quasi-experimental designs, samples with a larger percentage of youths of color, and Wraparound conditions with higher fidelity. CONCLUSION: Results indicate positive effects for Wraparound, especially for maintaining youths with SED in the home and community. However, many studies showed methodological weaknesses, and fidelity measurement was largely absent, suggesting a need for additional research. Nonetheless, the results should aid decisions around resource allocation, referral practices, and system partnerships among child psychiatrists and other behavioral health professionals.

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Topic

Mental Health Problems and Disorders

Behavior Problems

Externalizing Behaviors / Challenging Behaviors

Antisocial Behaviors

Development and Life Coping Skills

School Performance

Intervention

The organization of interventions

Home-based Interventions

Public Health Interventions

Community-Based Interventions / Local Area

Age group

Preschool Aged Children (3-5 years)

School Aged Children (6-12 years)

Adolescents (13-18 years)

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