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Psychosocial interventions for disruptive behaviour problems in children in low- and middle-income countries: a systematic review and meta-analysis.
- Source :
-
Journal of child psychology and psychiatry, and allied disciplines [J Child Psychol Psychiatry] 2018 Sep; Vol. 59 (9), pp. 982-993. Date of Electronic Publication: 2018 Apr 06. - Publication Year :
- 2018
-
Abstract
- Background: Most of the evidence for psychosocial interventions for disruptive behaviour problems comes from Western, high-income countries. The transferability of this evidence to culturally diverse, low-resource settings with few mental health specialists is unknown.<br />Methods: We conducted a systematic review with random-effects meta-analysis of randomized controlled trials examining the effects of psychosocial interventions on reducing behaviour problems among children (under 18) living in low- and middle-income countries (LMIC).<br />Results: Twenty-six randomized controlled trials (representing 28 psychosocial interventions), evaluating 4,441 subjects, met selection criteria. Fifteen (54%) prevention interventions targeted general or at-risk populations, whereas 13 (46%) treatment interventions targeted children selected for elevated behaviour problems. Most interventions were delivered in group settings (96%) and half (50%) were administered by non-specialist providers. The overall effect (standardized mean difference, SMD) of prevention studies was -0.25 (95% confidence interval (CI): -0.41 to -0.09; I <superscript>2</superscript> : 78%) and of treatment studies was -0.56 (95% CI: -0.51 to -0.24; I <superscript>2</superscript> : 74%). Subgroup analyses demonstrated effectiveness for child-focused (SMD: -0.35; 95% CI: -0.57 to -0.14) and behavioural parenting interventions (SMD: -0.43; 95% CI: -0.66 to -0.20), and that interventions were effective across age ranges.<br />Conclusions: Our meta-analysis supports the use of psychosocial interventions as a feasible and effective way to reduce disruptive behaviour problems among children in LMIC. Our study provides strong evidence for child-focused and behavioural parenting interventions, interventions across age ranges and interventions delivered in groups. Additional research is needed on training and supervision of non-specialists and on implementation of effective interventions in LMIC settings.<br /> (© 2018 Association for Child and Adolescent Mental Health.)
Details
- Language :
- English
- ISSN :
- 1469-7610
- Volume :
- 59
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of child psychology and psychiatry, and allied disciplines
- Publication Type :
- Academic Journal
- Accession number :
- 29633271
- Full Text :
- https://doi.org/10.1111/jcpp.12894