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Better evidence for a better world
Better evidence for a better world

Better evidence for a better world (173)

Additional Info

  • Authors Hanne Næss Hjetland, Ellen Irén Brinchmann, Ronny Scherer, Monica Melby-Lervåg
  • Published date 2017-12-15
  • Coordinating group(s) Education
  • Type of document Review Plain language summary
  • Title Preschool predictors of later reading comprehension ability
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.14
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Preschool language skills are associated with better reading comprehension at school

    A variety of language skills related to both language comprehension (e.g., vocabulary and grammar) and code-related skills (e.g., phonological awareness and letter knowledge) is important for developing decoding skills and, in turn, reading comprehension in school. Thus, reading comprehension instruction is more likely to be successful if it focuses on a broad set of language skills.

    What is this review about?

    Determining how to provide the best instruction to support children’s reading comprehension requires an understanding of how reading comprehension actually develops. To promote our understanding of this process, this review summarizes evidence from observations of the development of language and reading comprehension from the preschool years into school. The main outcome in this review is reading comprehension skills.

    Understanding the development of reading comprehension and its precursors can help us develop hypotheses about what effective instruction must comprise to facilitate well-functioning reading comprehension skills. These hypotheses can be tested in randomized controlled trials.

    What is the aim of this review?

    This Campbell systematic review examines the relationships between skills in preschool and later reading comprehension. The review summarizes evidence from 64 longitudinal studies that have observed these relationships.

    What studies are included?

    This review includes studies that observe the relationship between preschool language and code-related skills and later reading comprehension. A total of 64 studies were identified, all of which were included in the analysis. However, several of them suffered from considerable attrition, used convenience sampling, included a selected sample and failed to report on important study and sample characteristics.

    The studies spanned 1986 to 2016 and were mostly performed in the USA, Europe and Australia.

    What are the main results in this review?

    Code-related skills in preschool (e.g., phoneme awareness and letter knowledge) are indirectly related to reading comprehension via word decoding. Linguistic comprehension is directly related to reading comprehension skills. Code-related skills and linguistic comprehension were strongly related. Moreover, language comprehension was more important for reading comprehension in older readers than in younger readers.

    What do the findings of this review mean?

    These results show that a broad set of language skills is important in developing reading comprehension. The results also suggest that successful instruction for reading comprehension should target a broad set of language skills.

    In future studies, the effectiveness of instruction that targets such a set must be tested in randomized controlled trials. Additionally, future longitudinal studies should address issues of reliability, missing data and representativeness.

    How up-to-date is this review?

    The review authors searched for studies up to February 2016.

  • Spanish

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Additional Info

  • Authors Giel Ton, Sam Desiere, Wytse Vellema, Sophia Weituschat, Marijke D'Haese
  • Published date 2017-12-12
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title The effectiveness of contract farming for raising income of smallholder farmers in low- and middle-income countries
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.13
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Contract farming improves incomes for better-off farmers

    Contract farming, a sales arrangement between a farmer and a firm, is popular with government and donors. Contract farming can produce substantial income gains for farmers. Moreover, these benefits may well be required for contract farming schemes to survive. Better- off farmers are most likely to participate in contract farming schemes.

    What did the review study?

    Contract farming is a sales arrangement agreed before production begins, which provides the farmer with resources or services. The service package provided by the firm varies per location, and can include transport, certification, input provisioning and credit.

    This systematic review summarises evidence on income effects for smallholders to assess average effects and explore combinations of factors that increase these effects.

    What is the aim of this review?

    This Campbell systematic review examines the impact of contract farming on income and food security of smallholder farmers in low- and middle-income countries. The review summarises findings from 75 reports, of which 22 (covering 26 contract farming interventions) were used for meta-analysis.

    What studies are included?

    Included studies had to examine the impact of contract farming on income and food security of smallholder farmers in low- and middle-income countries. Studies had to use a comparison group with appropriate statistical methods to allow for selection effects.

    Seventy-five studies were identified with quantitative estimates of the impact of contract farming of which 22 studies, covering 7,471 respondents, were of sufficient rigour to include in the meta-analysis of income effects. The meta-analysis covers 26 empirical instances of contract farming in 13 developing countries.

    What are the main results in this review?

    Contract farming may substantially increase farmer income with an average effect in the range of 23 to 54 per cent. There is upward bias in the estimate because of survivor bias in individual studies (no data on farmers who drop out of schemes) and in the body of evidence (no studies on contract farming arrangements that collapsed in their initial years), and publication bias in the literature (under-reporting of insignificant outcomes). Therefore, some caution is needed in interpreting the findings.

    For farmers to give up their autonomy in marketing and prevent side-selling, substantial income gains need to be offered. This is especially so for annual crops and when firms have contracts directly with farmers rather than through a cooperative.

    Poorer farmers are not usually part of contract farming schemes. In 61% of the cases, contract farmers had significantly larger landholdings or more assets than the average farmers in the region.

    What do the findings in this review mean?

    Contract farming covers a wide range of contractual arrangements. This heterogeneity makes it difficult to draw general conclusions from the literature published on this topic. The lack of studies on ‘failed treatments’ leads to an overestimation of the effectiveness of contract farming.

    Moreover, the analysis suggests a marked publication bias; all studies report on at least one case of contract farming that has a positive and statistical significant income effect.

    Relatively larger or richer farmers can cope better with these risks and are, therefore, more likely to take part in a contractual arrangement. This implies that contract farming is more suited to the relatively better-off segment of the farming population.

    Further research should: (1) improve reporting of the intervention; (2) document the less-successful instances of contract farming, and report inconclusive results (insignificant effects); and (3) capture other outcomes of contract farming such as (sector-wide) innovation, and livelihood resilience.

    How up-to-date is this review?

    The review authors searched for studies published up to October 2015.

  • Spanish

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Additional Info

  • Authors Jochen Kluve, Susana Puerto, David Robalino, Jose Manuel Romero, Friederike Rother, Jonathan Stöterau, Felix Weidenkaff, Marc Witte
  • Published date 2017-12-04
  • Coordinating group(s) Education, International Development, Social Welfare
  • Type of document Review Plain language summary
  • Title Interventions to improve the labour market outcomes of youth: a systematic review of training, entrepreneurship promotion, employment services and subsidized employment interventions
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.12
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Active labour market programmes for youth increase employment and earnings but effects vary between programmes and context

    Youth are disproportionately victims of unemployment and low-quality jobs. Active labour market programmes increase earnings and employment. But the effects vary greatly between programmes’ type, design and context.

    What did the review study?

    Youth unemployment is much greater than the average unemployment rate for adults, in some cases over three times as high. Today, over 73 million young people are unemployed worldwide. Moreover, two out of five young people in the labour force are either working but poor or are unemployed. The youth employment challenge is not only about job creation, but especially about enhancing the quality of jobs for youth.

    This systematic review assesses the impact of youth employment interventions on the labour market outcomes of young people. The included interventions are training and skills development, entrepreneurship promotion, employment services and subsidized employment. Outcomes of interest include employment, earnings and business performance outcomes.

    What is the aim of this review?

    This Campbell systematic review examines the impact of youth employment interventions on the labour market outcomes of young people and business performance. The review summarises findings from 113 reports of 107 interventions in 31 countries.

    What studies are included?

    Included studies had to: (1) evaluate an active labour market programme (ALMP) which was designed for – or targeted primarily – young women and men aged between 15 and 35; (2) have an experimental and quasi-experimental design; and (3) report at least one eligible outcome variable measuring employment, earnings, or business performance.

    The evidence base covers 107 interventions in 31 countries, including 55 using skills training, 15 with entrepreneurship promotion, ten using employment services and 21 using subsidized employment.

    What are the main results in this review?

    Overall, youth employment interventions increase the employment and earnings of those youth who participate in them. But the effect is small with a lot of variation between programmes. There are significant effects for entrepreneurship promotion and skills training, but not for employment services and subsidised employment.

    Impacts on earnings were also positive but small and highly variable across programmes. Entrepreneurship promotion and skills training were effective in increasing earnings, while effects of employment services and subsidised employment were negligible or statistically insignificant. There is limited evidence of the effects of youth employment programmes on business performance outcomes, and the effect size was not statistically significant.

    In addition to the variation in impact across different types of programmes, some variation can be explained by country context, intervention design, and profile and characteristics of programme beneficiaries. The impacts of ALMPs are greater in magnitude in low- or middle-income countries than in high-income countries. Programmes targeting the most disadvantaged youth were associated with bigger programme effects, particularly for earnings outcomes, and effects were slightly larger for women than for men.

    What do the findings in this review mean?

    The evidence suggests that investing in youth through active labour market measures may pay off. Skills training and entrepreneurship promotion interventions appear to yield positive results on average. So, there are potential benefits from combining supply- and demand-side interventions to support youth in the labour market.

    The evidence indicates the need for careful design of youth employment interventions. The “how” seems to be more important than the “what” and, in this regard, targeting disadvantaged youth may act as a key factor for success.

    There is a need to strengthen the evidence base with more studies of promising programmes, especially in sub-Saharan Africa. Further research should investigate intermediate outcomes and soft skills, and should collect cost data.

    How up-to-date is this review?

    The review authors searched for studies published up to January 2015.

  • Spanish

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Additional Info

Additional Info

  • Authors Michael de Vibe, Arild Bjørndal, Sabina Fattah, Gunvor M Dyrdal, Even Halland, Emily E Tanner-Smith
  • Published date 2017-11-01
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.11
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Mindfulness training improves health and quality of life for adults

    Mindfulness-Based Stress Reduction (MBSR) is used to improve health, quality of life and social functioning. MBSR has a positive effect on mental health outcomes measured right after the intervention and at follow up. It also improves personal development, quality of life, and self-reported mindfulness.

    What is this review about?

    Stress and stress-related mental health problems are major causes of illness and disability. Mindfulness Based Stress Reduction is a group-based health promotion intervention to improve health and the way people deal with stress and life’s challenges. The core ingredient is mindfulness training through physical and mental exercises practiced daily for eight weeks. The mindful non-judgmental attitude of being present with what arises is practiced in the formal exercises and in everyday situations. This review assesses the effect of MBSR programs on outcome measures of mental and physical health, quality of life and social functioning in adults.

    What is the aim of this review?

    This review summarizes all studies that compare the effect of a MBSR program to a control group intervention, in which the participants had been randomly allocated to be in either the MBSR group or a control group. The review summarizes the results in two categories. First, where the effect of the MBSR program was compared to an inactive group (either a wait list group or one receiving ordinary care also received by the MSBR group). Second, where MBSR was compared with an alternative active group intervention.

    What studies are included?

    The review summarizes 101 randomized controlled trials with a total of 8,135 participants from USA, Europe, Asia and Australia. Twenty-two trials included persons with mild or moderate psychological problems, 47 targeted people with various somatic conditions and 32 of the studies recruited people from the general population. Seventy-two studies compared MBSR to an inactive control group, while 37 compared MBSR to an active control intervention. Seven studies compared MBSR to both. Ninety-six studies contributed data to the meta-analyses, with data from 7,647 participants.

    Is mindfulness effective?

    MBSR has a moderately large effect on outcome measures of mental health, somatic health, and quality of life including social function at post-intervention when compared to an inactive control. If 100 people go through the MBSR program, 21 more people will have a favourable mental health outcome compared to if they had been put on a wait-list or gotten only the usual treatment.

    These results may be inflated by underreporting of negative trials and moderate heterogeneity (indicating differences between the trials).

    MBSR has a small but significant effect on improving mental health at post-intervention compared to other active treatments. MBSR has the same effect as other active interventions on somatic health, and quality of life (including social function). There was no underreporting of negative trials, and heterogeneity (differences between trials) were small for mental health, moderate for quality of life and large for somatic health.

    The effects were similar across all target groups and were generally maintained at follow-up (1–34 months). The effects were largely independent of gender and study sample. The effects seemed also largely independent of duration and compliance with the MBSR intervention. No studies report results regarding side-effects or costs.

    Effects were strongly correlated to the effects on measures of mindfulness, indicating that the effects may be related to the increase in self-reported mindfulness.

    Two thirds of the included studies showed a considerable risk of bias, which was higher among studies with inactive than active control groups. Studies of higher quality reported lower effects than studies with low quality. The overall quality of the evidence was moderate, indicating moderate confidence in the reported effect sizes. Further research may change the estimate of effect.

    What do the findings of this review mean?

    Based on this review it is reasonable to consider MBSR a moderately well-documented method for helping adults improve their health and cope better with the challenges and stress that life brings. New research should improve the way the trials are conducted addressing the pitfalls in research on mind-body interventions.

    How up-to-date is this review?

    The review authors searched for studies up to November 2015.

  • Spanish

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Additional Info

  • Authors Alex Baron, Maria Evangelou, Lars-Erik Malmberg, G.J. Melendez-Torres
  • Published date 2017-10-16
  • Coordinating group(s) Education
  • Type of document Review Plain language summary
  • Title The 'Tools of the Mind' curriculum for improving self-regulation in early childhood
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.10
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    The ‘Tools of the Mind’ curriculum improves self-regulation and academic skills in early childhood

    The ‘Tools of the Mind’ early childhood curriculum appears to improve children’s self-regulation and academic skills. The assessment of the Tools curriculum is hampered by a lack of rigorous evidence and more research is necessary to corroborate this finding.

    What did the review study?

    Tools of the Mind (Tools) is an early childhood education curriculum, which involves structured make-believe play scenarios and a series of other curricular activities.

    Tools aims to promote and improve children’s self-regulation and academic skills by having a dual focus on self-regulation and other social-emotional skills in educational contexts. This review examines the evidence on the effectiveness of tools in promoting children’s self-regulation and academic skills, in order to inform its implementation in schools.

    What is the aim of this review?

    This Campbell systematic review examines the evidence on the effectiveness of the Tools of the Mind curriculum in promoting children’s self-regulation and academic skills, in order to inform its implementation in schools. The participants included students of all ages, gender, ethnicity, special education status, language-learning status, and socio-economic status. The review summarises findings from 14 records across 6 studies conducted in the USA.

    What studies are included?

    Included studies had to have used randomized controlled trials or quasi-experimental studies and reported on one or more quantitative effect sizes regarding Tools’ effectiveness in self-regulatory or academic domains.

    A total of 14 records across 6 studies were included in the review. The participants included students of all ages, gender, ethnicity, special education status, language learning status, and socio-economic status. The studies included measured at least one of four primary outcomes and did not measure any secondary outcome. Studies that compared Tools with a business-as-usual or another intervention were included in the review.

    All included studies were conducted in the USA.

    What are the main results in this review?

    The Tools curriculum significantly improved children’s math skills relative to comparison curricula, but the effect size was small. There are also shortcomings in the quality of evidence.

    Although the average effect sizes for self-regulation and literacy favoured tools compared to other approaches, the effect was not statistically significant. The evidence from the small number of included studies is mostly consistent with the evidence observed for other similar programs, but again the evidence is weak.

    The results for the outcome measures were not statistically significant.

    What do the findings in this review mean?

    Generally, the Tools curriculum seems to improve children’s self-regulation and academic skills. However, given the small number of included studies, as well as other methodological shortcomings, such as the high risk of bias in some of the included studies, this conclusion should be read with caution.

    While there is doubt as to the validity of the findings, Tools’ educational approach seems to be consistent with many child developmental theories and as such, should not be ruled out. There is a need to conduct more high quality research, especially about studies focused on demonstrating Tools’ effectiveness in promoting children’s self-regulation skills.

    How up-to-date is this review?

    The review authors searched for studies published up to December 2016.

  • Spanish

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Additional Info

  • Authors Sarah Krowka, Alexandria Hadd, Robert Marx
  • Published date 2017-08-28
  • Coordinating group(s) Education
  • Type of document Review Plain language summary
  • Title ‘No Excuses’ charter schools for increasing math and literacy achievement in primary and secondary education
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.9
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    ‘No Excuses’ charter schools associated with greater gains in math and literacy than traditional public schools

    The ‘No Excuses’ charter school model focuses heavily on high academic expectations, rigid and consistent discipline, extended instructional time, intensive teacher training, and increased parental involvement. This review examines the effect of No Excuses charter schools on math and literacy achievement. On average, No Excuses charter schools are associated with greater student gains on standardized measures of math and literacy achievement when compared to traditional public schools – with higher gains for math.

    What did the review study?

    Students from low socio-economic backgrounds or traditionally disadvantaged groups often underperform their peers on standardized tests of math and literacy achievement. This “achievement gap” is associated with negative education and career outcomes—both short-term and long-term. No Excuses charter schools are intended to reduce this gap and improve the achievement gains of traditionally disenfranchised groups.

    For the purposes of this review, No Excuses charter schools are those charter schools that highlight the importance of high academic expectations for all students, rigid discipline enforcement, extended time in school, intensive teacher training, and parental involvement.

    This review examines whether No Excuses charter schools are associated with greater achievement gains in math and literacy compared to the achievement gains of similar students enrolled in traditional public schools.

    What is the aim of this review?

    This Campbell systematic review examines the effects of No Excuses charter schools on students’ math and literacy achievement gains compared to similar students in public schools. The review summarizes evidence from 18 studies, including 5 randomized controlled trials and 13 quasi-experimental studies.

    What studies are included?

    This review includes studies that evaluate the effects of No Excuses charter schools on students’ literacy and math achievement gains. It includes 18 studies conducted in the United States spanning from 1990-2015.

    What are the main results in this review?

    No Excuses charter schools, on average, produced larger math and literacy achievement gains for their students than their public school peers—with higher gains for math. These benefits increase for three years, at which point the achievement gains stabilized or returned to lower gains.

    What do the findings in this review mean?

    No Excuses charter schools may help underperforming students make larger achievement gains in math and literacy, more so than at traditional public schools. Additional research is needed to examine the effects of this intervention while accounting for significant issues related to sample bias and to determine the scalability of the model.

    What are the limitations in interpretation of this review?

    Readers should take caution when interpreting this review due to several limitations. First, studies were inconsistent in reporting (or failed to report) important sample characteristics such as percentage of students receiving special education services, number of students exiting or expelled after enrollment etc., severely limiting interpretation of the equality of comparison groups and factors impacting differences in outcomes. Second, follow-up years suggest a sustained significant effect on both math and literacy achievement. However, these results must be interpreted with caution as the number of samples decreased substantially at follow-up years with just one study accounting for the majority of the samples. Third, studies included in this review did not report data indicating the degree to which each characteristic of No Excuses charter schools was implemented, prohibiting the interpretation of the presence, absence, or dosage of the individual characteristics of No Excuses charter schools. Fourth, only five of the 18 included studies employed random assignment, limiting interpretation of the equality of the comparison groups due to the small number in independent samples using random assignment. Fifth, a large number of the included studies examine the effects of the schools of a specific charter management organization: Knowledge is Power Program (KIPP). Though informative, the results of this review cannot be considered generalizable to all No Excuses charter schools. Finally, most studies measured effects with only one, annual standardized achievement measure.

    How up-to-date is this review?

    The review authors searched for studies up to June 2016.

  • Spanish

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Additional Info

  • Authors Martin Schmucker, Friedrich Loesel
  • Published date 2017-07-31
  • Coordinating group(s) Crime and Justice
  • Type of document Review Plain language summary
  • Title Sexual offender treatment for reducing recidivism among convicted sex offenders
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.8
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Treatment of sexual offenders reduces reoffending, but more research needed to identify effective interventions

    Treatment can reduce reoffending (recidivism) rates of sexual offenders. But the results of individual studies are too heterogeneous to draw a conclusion on the general effectiveness of sex offender treatment.

    What is this review about?

    Sexual offender treatment programs to reduce reoffending have been implemented in many countries as part of a strategy in managing this offender group. However, there are still controversies regarding their effectiveness.

    This review integrates findings from six experimental and 21 quasi-experimental studies that compare groups of treated sexual offenders with equivalent control groups. These studies tested whether treated sexual offenders differed from the control groups in sexual and other reoffending.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of treatment for sexual offenders to reduce reoffending and the factors that affect treatment success. The review summarises evidence from 27 impact evaluations.

    What studies are included?

    Included studies compare official recidivism rates of treated sexual offenders with a comparable group of sexual offenders that have not been subjected to the respective treatment. Quasi-experimental studies were included only if they applied sound matching procedures, where the incidental assignment would not introduce bias, or where they were statistically controlled for potential biases. The treatment had to explicitly aim at reducing recidivism rates.

    The review summarizes 27 studies containing 29 eligible comparisons of a treated group and a control group, containing data for 4,939 treated and 5,448 untreated sexual offenders. The studies come from seven different countries, but more than half of the studies have been carried out in North America. All eligible comparisons evaluated psychosocial treatment (mainly cognitive behavioral programs). No studies on pharmacological/hormonal treatment were found which meet the inclusion criteria.

    What are the main findings of this review?

    Does treatment of sexual offenders reduce recidivism?

    On average, there is a significant reduction in recidivism rates in the treated groups. The odds to sexually reoffend were 1.41 lower for treated compared to control groups. This equals a sexual recidivism rate of 10.1 percent for treated offenders compared to 13.7 percent without treatment. The mean rates for general recidivism were higher, but showed a similar reduction of roughly a quarter due to treatment.

    The results from the individual studies were very heterogeneous, that is individual study features had a strong impact on the outcomes. Methodological quality did not significantly influence effect sizes. Cognitive-behavioral as well as studies with small samples, medium to high risk offenders, more individualized treatment, and good descriptive validity revealed better effects. There was no significant difference between various settings. We found significant effects for treatment in the community and in forensic hospitals, but there is not yet sufficient evidence to draw conclusions regarding the effectiveness of sex offender treatment in prisons.

    What do the findings in this review mean?

    Overall, the findings are promising, but there is too much heterogeneity between the results of individual studies to draw a generally positive conclusion about the effectiveness of sex offender treatment. Applied cognitive-behavioral foundation of treatment has relatively good potential, but other features, like the risk of the treated offenders or including individualized treatment, significantly affect treatment success.

    More well documented randomized trials and high-quality quasi-experiments are needed, particularly outside of North America. In addition, there is a clear need of more differentiated process and outcome evaluations.

    How up-to-date is this review?

    The study pool of the present analysis was based on the broad search of 2,039 documents from a review published in 2005, updated to cover studies issued prior to 2010. More recent studies were evaluated in an appendix and mostly showed similar findings as in our review.

  • Spanish

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Additional Info

  • Authors Emmy De Buck, Hans Van Remoortel, Karin Hannes, Thashlin Govender, Selvan Naidoo, Bert Avau, Axel Vande veegaete, Alfred Musekiwa, Vittoria Lutje, Margaret Cargo, Hans-Joachim Mosler, Philippe Vandekerckhove, Taryn Young
  • Published date 2017-05-19
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title Approaches to promote handwashing and sanitation behaviour change in low- and middle-income countries
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.7
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Community-based approaches are most effective in promoting changes in hygiene practices, but sustainability is a challenge

    Community-based approaches to promote handwashing and sanitation efforts seem to work better than social marketing, messaging and interventions based on psychosocial theory. Programs combining hygiene and sanitation measures appears to have a larger impact than either one alone.

    What is this review about?

    Diarrhoeal diseases are very common causes of death in low and middle-income countries. Improved sanitation and hygiene reduce diarrhoea, but adoption remains a challenge.

    This review assesses the evidence for two questions: (1) how effective are different approaches to promote handwashing and sanitation behaviour change; and (2) what factors influence the implementation of these approaches?

    What is the aim of this review?

    This Campbell Systematic Review examines the effectiveness of different approaches for promoting handwashing and sanitation behaviour change, and factors affecting implementation, in low and middle-income countries. The review summarises evidence from 42 impact evaluations, and from 28 qualitative studies.

    What studies are included?

    Studies of effectiveness had to be impact evaluations using an experimental or quasi-experimental design and analytical observational studies. Implementation studies used qualitative designs.

    Forty-two quantitative studies and 28 qualitative studies met the inclusion criteria. The quantitative studies were conducted in LMICs worldwide, with the majority of the studies in South Asia and Sub-Saharan Africa.

    What are the main findings of this review?

    Community-based approaches which include a sanitation component can increase handwashing with soap at key times; use of latrines and safe disposal of faeces; and reduce the frequency of open defecation. Social marketing seems less effective. The approach mainly shows an effect on sanitation outcomes when interventions combine handwashing and sanitation components.

    Sanitation and hygiene messaging with a focus on handwashing with soap has an effect after the intervention has ended, but there is little impact on sanitation outcomes. However, these effects are not sustainable in the long term. Using elements of psychosocial theory in a small-scale handwashing promotion intervention, or adding theory-based elements such as infrastructure promotion or public commitment to an existing promotional approach, seem promising for handwashing with soap.

    None of the approaches described have consistent effects on behavioural factors such as knowledge, skills and attitude. There are no consistent effects on health.

    What factors affect implementation?

    Implementation is affected by length of the intervention; visit frequency; use of short communication messages; availability of training materials; kindness, respect, status and accessibility of the implementer; recipient awareness about costs and benefits and their access to infrastructure and social capital.

    For community-based approaches, involvement of the community, enthusiasm of community leaders, having a sense of ownership, the implementer being part of the community, gender of the implementer, trust, income generating activities, clear communication and developing a culture of cooperation facilitated implementation.

    For sanitation and hygiene messaging, text messages should be short and culturally appropriate, passive teaching methods in schools and reminders should be frequent and over a long period. Barriers include illiteracy and a lack of interest and involvement from the family in case of a school intervention. For the social marketing approach barriers were mainly about the use of sanitation loans such as lack of communication to latrine business owners about which area to cover, loan processing times and sanitation loans not reaching poor people.

    What do the findings in this review mean?

    Promotional approaches aimed at handwashing and sanitation behaviour change can be effective in terms of handwashing with soap, latrine use, safe faeces disposal and open defecation. A combination of different promotional elements is probably the most effective strategy. Identifying and tackling the different barriers and facilitators that influence the implementation of these promotional approaches can increase effectiveness.

    An important implication for research is that there is a need for a more uniform method of measuring and reporting on handwashing, latrine use, safe faeces disposal, and open defecation.

    How up-to-date is this review?

    The review authors searched for studies published until March 2016.

  • Spanish

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Additional Info

  • Authors Geir Smedslund, Sabine Wollscheid, Lin Fang, Wendy Nilsen, Asbjørn Steiro, Lillebeth Larun
  • Published date 2017-04-07
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title Effect of early, brief computerized interventions on risky alcohol and cannabis use among young people
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.6
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Computerized brief interventions seem to reduce risky alcohol use among young people; no evidence of effect on cannabis consumption

    Young people who abuse alcohol or cannabis are at risk of immediate and long-term health and legal consequences. There is some evidence of an impact on alcohol use. Findings are hampered by a lack of rigorous evidence, so further research is needed.

    What did the review study?

    Alcohol abuse and use of recreational drugs among young people are significant public health concerns. These should be addressed by effective interventions that provide assistance and counselling to drug and alcohol users.

    A computerized brief intervention is any preventive or therapeutic activity delivered through online or offline electronic devices, such as a mobile phone, and administered within an hour or less, even a few minutes, of the substance abuse. Such interventions aim to reduce alcohol abuse or drug abuse in general. This review assesses research on the effectiveness of early, computerized brief interventions on alcohol and cannabis use by young people who abuse either one or both of these substances.

    What is the aim of this review?

    This Campbell systematic review examines research on the effectiveness of early, computerized brief interventions on alcohol and cannabis use by young people who are high or risky consumers of either one or both of these substances. The review summarises findings from 60 studies from 10 countries. The participants were young people between the ages of 15 and 25, defined as risky consumers of alcohol or cannabis or both. The review included 33,316 participants.

    What studies are included?

    The included studies employed randomized controlled trials and reported on any computerized brief intervention used as a standalone treatment aimed at reducing alcohol and cannabis consumption. The secondary outcome measured was reported adverse outcomes.

    The studies were conducted in the United States, New Zealand, The Netherlands, Sweden, Australia, Germany, Switzerland and Brazil, with one study conducted in several countries (Sweden, Belgium, the Czech Republic and Germany).

    The participants were consumers of alcohol or cannabis or both, and aged 15 to 25 years. A total of 60 studies with a sample size of 33,316 participants were included in the review.

    What are the main results in this review?

    The interventions significantly reduce alcohol consumption in the short-term compared to no intervention, but the effect size is small, and there is no significant effect in the long-term. There are also shortcomings in the quality of the evidence.

    Interventions which provide an assessment of alcohol use with feedback may have a larger effect that those which do not, but again, the evidence is weak.

    The few studies on cannabis did not show significant effects in the reduction of cannabis consumption.

    There was no evidence of adverse effects.

    What do the findings in this review mean?

    Generally, the alcohol interventions seem to work. However, all the studies included in the review had methodological shortcomings. Given the lack of rigorous evidence, this conclusion should be read with caution.

    Only a few studies focused on cannabis, thus hampering any firm conclusion as to the intervention effectiveness.

    While there is doubt as to the validity of the findings, computerized brief interventions should not be completely ruled out as they are easy to administer, low cost and have no adverse effects.

    There is a need to conduct more high quality research, especially with regard to studies focused on cannabis use.

    How up-to-date is this review?

    The review authors searched for studies published until April 2016.

  • Spanish

    Click on 'Download PDF' on the right to view the plain language summary in Spanish.

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