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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Components associated with home visiting program outcomes: A meta-analysis
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Components associated with home visiting program outcomes: A meta-analysis

机译：与家庭访问计划结果相关的组成部分：荟萃分析

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BACKGROUND: Although several systematic reviews have concluded that home visiting has strong evidence of effectiveness, individual evaluations have produced inconsistent results. We used a componentbased, domain-specific approach to determine which characteristics most strongly predict outcomes. METHODS: Medline and PsycINFO searches were used to identify evaluations of universal and selective home visiting programs implemented in the United States. Coders trained to the study criterion coded characteristics of research design, program content, and service delivery. We conducted random-effects, inverse-variance-weighted linear regressions by using program characteristics to predict effect sizes on 6 outcome domains (birth outcomes, parenting behavior and skills, maternal life course, child cognitive outcomes, child physical health, and child maltreatment). RESULTS: Aggregated to a single effect size per study (k = 51), the mean effect size was 0.20 (95% confidence interval: 0.14 to 0.27), with a range of -0.68 to 3.95. Mean effect sizes were significant and positive for 3 of the 6 outcome domains (maternal life course outcomes, child cognitive outcomes, and parent behaviors and skills), with heterogeneity of effect sizes in all 6 outcome domains. Research design characteristics generally did not predict effect sizes. No consistent pattern of effective components emerged across all outcome domains. CONCLUSIONS: Home visiting programs demonstrated small but significant overall effects, with wide variability in the size of domainspecific effects and in the components that significantly predicted domain-specific effects. Communities may need complementary or alternative strategies to home visiting programs to ensure widespread impact on these 6 important public health outcomes. Pediatrics 2013;132:S100-S109.
机译：背景：尽管一些系统的评估得出结论，家庭访问具有有效的证据，但是个人评估却产生了不一致的结果。我们使用基于组件的特定领域方法来确定哪些特征最能预测结果。方法：Medline和PsycINFO搜索用于确定对美国实施的普遍和选择性家庭访问计划的评估。训练有素的研究人员对研究设计，程序内容和服务提供的特征进行编码。我们通过使用程序特征来预测对6个结果域（出生结局，育儿行为和技能，孕产妇的生命历程，儿童认知结局，儿童身体健康和儿童虐待）的影响大小，进行了随机效应，反方差加权线性回归。 。结果：每项研究的总效应大小（k = 51）合计，平均效应大小为0.20（95％置信区间：0.14至0.27），范围为-0.68至3.95。 6个结果域中的3个（母亲生命历程结果，儿童认知结果以及父母的行为和技能）的平均效应大小显着且为阳性，而所有6个结果域的效应大小均不相同。研究设计特征通常不能预测效果的大小。在所有结果域中均未出现有效成分的一致模式。结论：家庭访问程序显示出很小但很明显的总体效果，特定领域效果的大小以及显着预测特定领域效果的组件的差异很大。社区可能需要家庭访问计划的补充或替代策略，以确保对这6个重要的公共卫生成果产生广泛的影响。儿科2013; 132：S100-S109。

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