Mental health and wellbeing interventions for care-experienced children and young people: Systematic review and synthesis of process evaluations

MacDonald, Sarah ORCID: https://orcid.org/0000-0002-8245-2347, Trubey, Rob, Noyes, Jane, Vinnicombe, Soo, Morgan, Helen E., Willis, Simone ORCID: https://orcid.org/0000-0003-3949-7651, Boffey, Maria, Melendez-Torres, G.J., Robling, Michael, Wooders, Charlotte and Evans, Rhiannon 2024. Mental health and wellbeing interventions for care-experienced children and young people: Systematic review and synthesis of process evaluations. Children and Youth Services Review 156 , 107266. 10.1016/j.childyouth.2023.107266

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Abstract

Background The mental health and well-being of care-experienced children and young people remains a concern. Despite a range of interventions, the existing evidence base is limited in scope, with a reliance on standalone outcome evaluations which limits understanding of how contextual factors influence implementation and acceptability. The Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise evidence of intervention theory, outcome, process and economic effectiveness. This paper reports the process evaluation synthesis, exploring how system factors facilitate and inhibit implementation and acceptability of mental health and wellbeing interventions for care-experienced children and young people. Methods Sixteen databases and 22 websites were searched between 2020 and 2022 for studies published from 1990 and May 2022. This was supplemented with contacting experts in the field, citation tracking, screening of relevant systematic reviews and stakeholder consultations. We drew on framework synthesis of qualitative data and incorporated a systems lens, taking account of contextual influences across socio-ecological domains. Quality appraisal assessed reliability and usefulness. Confidence in synthesised findings was assessed with the GRADE-CERQual tool. We report the review in accordance with relevant elements of both the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) checklist. Results Searches retrieved 15,068 unique study reports, and 23 of these were eligible for process evaluation synthesis, reporting on sixteen interventions. Studies were published between 2003 and 2021. Nine interventions were from the UK and Ireland, six interventions were from the USA, and one was from Australia. They were largely classified as interpersonal, where the aim was to modify carer-child relationships. Five key context factors were identified that supported and prohibited intervention delivery: (1) lack of system resources; (2) intervention burden, which encompasses the time, cognitive, and emotional burden associated with implementation and participation; (3) interprofessional relationships between health and social care professionals; (4) care-experienced young people’s identity; and (5) carer identity. Conclusion We identified several supportive and restrictive factors across social and health care systems that may impact intervention implementation and acceptability. Key implications include: the importance of involving diverse stakeholders in intervention development and delivery; the need to better resource and support those involved in interventions, particularly training and support for carers; and ensuring future evaluations integrate process evaluations in order to optimise interventions.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Social Sciences (Includes Criminology and Education) Academic & Student Support Service Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) Centre for Trials Research (CNTRR)
Publisher:	Elsevier
ISSN:	0190-7409
Funders:	NIHR
Date of First Compliant Deposit:	15 November 2023
Date of Acceptance:	22 October 2023
Last Modified:	05 Jan 2024 03:18
URI:	https://orca.cardiff.ac.uk/id/eprint/163840

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