Integrating health and social services into the environment of childhood growth from birth to starting school: the systematic review of effective cooperation interventions

INTRODUCTION: The increasing need for support services and the fragmented nature of the service system challenge us to develop services for children and their families. Child and family services are provided by the public, private and third sectors, which according to research have little or no reciprocal co-operation. As many practices have moved towards family-centrality, the need for personnel and families to work collaboratively has become increasingly apparent. There is a need to understand how to promote this collaboration. AIMS: The aim of this review was to investigate and summarize studies that included an effective intervention as a specific component for the promotion of collaboration among child service professionals or between families with 0–8 years old children. METHODS: Search strategy: We searched the electronic databases (Cochrane Library, CINAHL, MEDLINE, EBSCOhost Academic Search Elite, ERIC, PsycINFO, Social Services Abstracts, Sociological Abstracts, Sigle, Social Care Online, Soc Index, Assia, Mbased, Arto, Linda, Medic, Pro Quest, Science Direct, Wiley, Sage and Springerlink) from 2000 through May 2008. Selection criteria: two authors assessed identified studies for intervention studies (experimental studies, observational studies with or without control group, qualitative studies, meta-analyses and systematic reviews) that describe interventions to promote collaboration among child service professionals or between child rearing families. Studies also had to meet criteria for cultural adequacy and methodological quality. Data collection and analysis: methodological quality was independently assessed by two review authors using the quality criteria checklist. Levels of evidence were used to determine the strength of the evidence available. It was not possible to perform meta-analyses because of the heterogeneity of the selected studies. MAIN RESULTS: Of the 1205 titles initially indentified through the search strategy, 88 studies met the inclusion criteria. In 31 of these studies the co-operation intervention was targeted at community settings or service-system level. In 23 of studies the co-operation intervention was between professionals and in 49 studies the intervention was conducted in children and families. The studies were very heterogeneous in terms of interventions, participants, and measuring instruments. In only 12 of the 88 studies the methodological quality was good. We found little evidence in effectiveness of interventions to promote collaboration among professionals and families with 0–8 years old children. CONCLUSIONS: The review produced information on co-operation interventions used by service providers in the field of health care, social care, and education. Most of the interventions were targeted at different problem situations, and only five were identified as interventions aimed at maintaining health. The current evidence base is although too heterogeneous and sparse to draw conclusions on the overall effectiveness of the interventions to co-operation. Further, high quality studies examining the effectiveness of co-operation interventions are required.