scholarly journals Experiences of interventions aiming to improve the mental health and well‐being of children and young people with a long‐term physical condition: A systematic review and meta‐ethnography

2019 ◽  
Vol 45 (6) ◽  
pp. 832-849 ◽  
Author(s):  
Liz Shaw ◽  
Darren Moore ◽  
Michael Nunns ◽  
Jo Thompson Coon ◽  
Tamsin Ford ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young People ◽  
Physical Condition ◽  
Well Being ◽  
Children And Young People ◽  
Health And Well Being

scholarly journals Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes: Systematic review (CHIMES) protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042815
Author(s):  
Rhiannon Evans ◽  
Maria Boffey ◽  
Sarah MacDonald ◽  
Jane Noyes ◽  
G.J. Melendez-Torres ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young People ◽  
Well Being ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Subjective Well Being ◽  
Programme Theory ◽  
Children And Young People ◽  
Health And Well Being

IntroductionThe mental health and well-being of children and young people who have been in care (ie, care-experienced) are a priority. There are a range of interventions aimed at addressing these outcomes, but the international evidence-base remains ambiguous. There is a paucity of methodologically robust systematic reviews of intervention effectiveness, with few considering the contextual conditions under which evaluations were conducted. This is important in understanding the potential transferability of the evidence-base across contexts. The present systematic review will adopt a complex systems perspective to synthesise evidence reporting evaluations of mental health and well-being interventions for care-experienced children and young people. It will address impact, equity, cost-effectiveness, context, implementation and acceptability. Stakeholder consultation will prioritise a programme theory, and associated intervention, that may progress to further development and evaluation in the UK.Methods and analysisWe will search 16 bibliographic databases from 1990 to June 2020. Supplementary searching will include citation tracking, author recommendation, and identification of evidence clusters relevant to included evaluations. The eligible population is children and young people (aged ≤25 years) with experience of being in care. Outcomes are (1) mental, behavioural or neurodevelopmental disorders; (2) subjective well-being; (3) self-harm; suicidal ideation; suicide. Study quality will be appraised with methodologically appropriate tools. We will construct a taxonomy of programme theories and intervention types. Thematic synthesis will be used for qualitative data reporting context, implementation and acceptability. If appropriate, meta-analysis will be conducted with outcome and economic data. Convergent synthesis will be used to integrate syntheses of qualitative and quantitative data.Ethics and disseminationWe have a comprehensive strategy for engagement with care-experienced children and young people, carers and social care professionals. Dissemination will include academic and non-academic publications and conference presentations. Ethical approval from Cardiff University’s School of Social Sciences REC will be obtained if necessary.PROSPERO registration numberCRD42020177478.

scholarly journals Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses

2019 ◽  
Vol 23 (22) ◽  
pp. 1-164 ◽  
Author(s):  
Darren A Moore ◽  
Michael Nunns ◽  
Liz Shaw ◽  
Morwenna Rogers ◽  
Erin Walker ◽  
...  
Keyword(s):  
Mental Health ◽  
User Involvement ◽  
Well Being ◽  
Future Research ◽  
Economic Evaluations ◽  
Children And Young People ◽  
Physical Conditions ◽  
End User Involvement ◽  
Health And Well Being

Background Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. Objectives To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). Data sources For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. Review methods The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen’s d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. Results Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive–behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention–LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. Limitations Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. Conclusions There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. Study registration This study is registered as PROSPERO CRD42011001716. Funding The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.

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