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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Systematic review of preventive interventions for children's mental health: what would work in Australian contexts?
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Systematic review of preventive interventions for children's mental health: what would work in Australian contexts?

机译：对儿童心理健康的预防性干预措施的系统评价：在澳大利亚情况下，什么会起作用？

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摘要

In childhood, mental health problems primarily consist of behaviour and emotional problems. These affect one in every seven children (i.e. 200 000 in Australia). Left untreated, up to 50% of preschool problems continue through the childhood years. Because of their high prevalence, population-based approaches will be needed to reduce their associated burden. The aim of the present study was therefore to identify evidence-based preventive interventions for behavioural and emotional problems of children aged 0-8 years. Randomized controlled trials of preventive interventions for behavioural and emotional problems were located by searching standard clinical databases and systematic reviews. The authors determined which programmes were effective and ineffective, dividing the effective programmes into those with high or low risk of trial bias. Among effective programmes, the most promising for delivery in Australian contexts were identified, selected for their strength of evidence, sample comparability to Australia's population, and programme compatibility with Australia's service system. Around 50 preventive interventions have been evaluated in randomized controlled trials. Most targeted children's behavioural problems, and a few targeted emotional problems. Three US programmes have the best balance of evidence: in infancy, the individual Nurse Home Visitation Programme; at preschool age, the individual Family Check Up; at school age, the Good Behaviour Game class programme. Three parenting programmes in England and Australia are also worthy of highlight: the Incredible Years group format, Triple P individual format, and Parent Education Programme group format. Effective preventive interventions exist primarily for behaviour and, to a lesser extent, emotional problems, and could be disseminated from research to mainstream in Australia, ensuring fidelity to original programmes. Future research should develop programmes targeting emotional problems, and replicate effective programmes for behaviour problems in quality population translation trials. Randomized trial methods in staged roll-outs can determine population cost-benefits for children's mental health without delaying dissemination.
机译：在儿童时期，心理健康问题主要包括行为和情绪问题。这影响到每七个孩子中有一个（在澳大利亚为20万）。如果不及时治疗，高达50％的学龄前问题将持续到儿童时期。由于它们的普遍性很高，需要采用基于人群的方法来减轻其相关的负担。因此，本研究的目的是确定0-8岁儿童的行为和情感问题的循证预防干预措施。通过搜索标准临床数据库和系统评价，找到了针对行为和情绪问题的预防干预措施的随机对照试验。作者确定了哪些计划有效和无效，将有效计划分为试验偏倚风险高或低的那些。在有效的计划中，根据其证据强度，与澳大利亚人口的样本可比性以及与澳大利亚服务系统的计划兼容性，确定了在澳大利亚范围内最有希望交付的计划。随机对照试验已评估了约50种预防性干预措施。大多数针对儿童的行为问题，少数针对儿童的情绪问题。美国的三个计划在证据方面具有最佳的平衡：婴儿期，单独的护士家庭探望计划;在学龄前，个人家庭检查;在学龄时，参加“良好行为游戏”课程。英格兰和澳大利亚的三个育儿计划也值得一提：不可思议的年组格式，Triple P个人格式和父母教育计划组格式。有效的预防干预措施主要是针对行为，在较小程度上涉及情绪问题，可以从研究传播到澳大利亚主流，以确保忠于原始计划。未来的研究应该开发针对情绪问题的程序，并在高质量的人口翻译试验中复制针对行为问题的有效程序。分阶段推广的随机试验方法可以确定儿童心理健康的人群成本效益，而不会延迟传播。

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