Better evidence for a better world

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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 Brandy R Maynard, Michael Solis, Veronica Miller, Kristen E. Brendel
  • Published date 2017-03-10
  • Coordinating group(s) Education, Social Welfare
  • Type of document Review Plain language summary
  • Title Mindfulness-based interventions for improving cognition, academic achievement, behavior and socio-emotional functioning of primary and secondary students
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/CSR.2017.5
  • Records available in English, Norwegian, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Mindfulness-based interventions in schools have positive effects on cognitive and socioemotional processes but do not improve behavior and academic achievement

    The use of Mindfulness-based interventions (MBIs) in schools has been on the rise. Schools are using MBIs to reduce student stress and anxiety and improve socioemotional competencies, student behavior and academic achievement.

    MBIs have small, positive effects on cognitive and socioemotional processes but these effects were not seen for behavioral or academic outcomes. The studies are mostly of moderate to low quality. Therefore, further evidence from independent evaluators is needed to be able to evaluate the effectiveness of this type of intervention.

    What did the review study?

    With the diverse application and findings of positive effects of mindfulness practices with adults, as well as the growing popularity with the public, MBIs are increasingly being used with youth. Over the past several years, MBIs have received growing interest for use in schools to support socioemotional development and improve behavior and academic achievement.

    This review examines the effects of school-based MBIs on cognitive, behavioral, socioemotional and academic achievement outcomes with youth in a primary or secondary school setting. MBIs are interventions that use a mindfulness component, broadly defined as “paying attention in a particularly way: on purpose, in the present moment, non-judgmentally”, often with other components, such as yoga, cognitive-behavioral strategies, or relaxation skills training.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of school-based MBIs on cognition, behaviour, socioemotional outcomes and academic achievement. The review summarizes 61 studies and synthesizes 35 studies, with a total of 6,207 student participants.

    What studies are included?

    Included studies used a randomized controlled trial, quasi-experimental, single group pre-post test or single subject design and reported at least one of these outcomes: cognition, academic performance, behaviour, socioemotional, and physiological. Study populations include preschool, primary and secondary school students.

    A total of 61 studies are included in the review, but only the 35 randomized or quasi-experimental studies are used in the meta-analysis. Most of the studies were carried out in North America, and others in Asia, Europe and Canada. All interventions were conducted in a group format. Interventions ranged in duration (4-28 weeks) and number of sessions (6-125 sessions) and frequency of meetings (once every two weeks to 5 times a week).

    What are the main results in this review?

    MBIs have a small, statistically significant positive effect on cognitive and socioemotional outcomes. But there is not a significant effect on behavioural and academic outcomes.

    There was little heterogeneity for all outcomes, besides behavioural outcomes, suggesting that the interventions produced similar results across studies on cognitive, socioemotional, and academic outcomes despite the interventions being quite diverse.

    What do the findings in this review mean?

    Findings from this review indicate mixed effects of MBIs in schools. There is some indication that MBIs can improve cognitive and socioemotional outcomes, but no support for improvement in behavior or academic achievement. Despite the growing support of MBIs for adults, youth may not benefit in the same ways or to the same extent as adults.

    While not well studied, anecdotal evidence indicates costs and adverse effects of these types of interventions that should be better studied and weighed against the small to no effects on different types of outcomes when considering adoption of MBIs in schools.

    These findings should be read with caution given the weakness of the evidence produced by the studies. The high risk of bias present in the studies means that further evidence is needed to evaluate the effectiveness of this type of intervention. The evidence from this review urges caution in the widespread adoption of MBIs and encourages rigorous evaluation of the practice should schools choose to implement it.

    How up-to-date is this review?

    The review authors searched for studies published until May 2015.

  • Norwegian

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  • Spanish

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Additional Info

  • Authors Anke Rohwer, Nkengafac Villyen Motaze, Eva Rehfuess, Taryn Young
  • Published date 2017-03-02
  • Coordinating group(s) Education
  • Type of document Review Plain language summary
  • Title E-learning of evidence-based healthcare (EBHC) to increase EBHC competencies in healthcare professionals
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.4
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Blended learning is most effective in increasing evidence-based health care competencies of health workers

    Evidence-based health care (EBHC) is decision-making for health care, informed by the best research evidence. Doctors, nurses and allied health professionals need to have the necessary knowledge and skills to apply EBHC. The use of electronic learning (e-learning) for EBHC training is increasing.

    E-learning, compared to no learning, improves EBHC knowledge and skills but not attitudes and behaviour. There is no difference in outcomes when comparing e-learning to face-to-face learning. Combining e-learning with face-to-face learning (blended learning) has a positive impact on EBHC knowledge, skills, attitude and behaviour.

    What did the review study?

    Evidence-based health care (EBHC) involves phrasing questions based on a knowledge gap, searching for research that can answer the question, critically appraising and interpreting the research, applying the results and auditing the process. Electronic learning (e-learning) has become an increasingly popular method of teaching EBHC.

    This review assesses the effectiveness of e-learning of EBHC for increasing EBHC competencies in healthcare professionals. The primary outcomes are EBHC knowledge, skills, attitude and behaviour.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of e-learning in improving evidence-based health care knowledge and practice.

    What studies were included?

    Eligible studies were randomised controlled trials (RCTs), cluster RCTs, non-RCTs, controlled before-after studies and interrupted time series of any healthcare professional evaluating any educational intervention on EBHC, and that was delivered fully (pure e-learning) or in part (blended learning) via an electronic platform compared to no learning, face-to-face learning or other forms of e-learning of EBHC.

    The review included 24 trials, comprising 20 RCTs and four non-RCTs, with a total of 3,825 participants. Participants were medical doctors, nurses, physiotherapists, physician assistants, athletic trainers and a combination of professionals at all levels of education. The studies included a variety of interventions.

    What are the main results in this review?

    Compared to no learning, pure e-learning improves EBHC knowledge and skills but not attitudes and behaviour. Pure e-learning is no better than face-to-face learning in improving any of the primary outcomes.

    Blended learning is better than no learning for improving EBHC knowledge, skills, attitude and behaviour; and is better than face-to-face learning in improving attitudes and behaviour. Compared to pure e-learning, blended learning improves EBHC knowledge. It is not clear which e-learning components are most effective in improving outcomes.

    However, the included studies were of moderate to low quality, with a small number of studies included in each analysis, and imprecision and inconsistency of results in all comparisons. These shortcomings need to be taken into consideration when interpreting the results.

    What do the findings in this review mean?

    E-learning of EBHC, whether pure or blended, compared to no learning, improves EBHC knowledge and skills. There is no difference in these outcomes when comparing e-learning to face-to-face learning. Blended learning, which typically comprises multiple interventions, appears more effective than other types of learning in improving EBHC knowledge, skills, attitude and behaviour.

    Future research should focus on the different components of e-learning and should adequately report on all the intervention components, the educational context and implementation strategies.

    How up-to-date is this review?

    The review authors searched for studies published until May 2016.

  • Spanish

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Additional Info

  • Authors Carlos Oya, Florian Schaefer, Dafni Skalidou, Catherine McCosker, Laurenz Langer
  • Published date 2017-03-01
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title Effects of certification schemes for agricultural production on socio-economic outcomes in low- and middle-income countries
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.3
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Certification schemes do not seem to improve household incomes for farmers and wages for workers

    Certification schemes (CS) set and monitor voluntary standards to make agricultural production socially sustainable and agricultural trade fairer for producers and workers. The evidence base is very limited and inconclusive. Certification increases prices and income from produce, but not wages or total household income. Certification agencies should adopt simpler programmes adapted to local context and rigorously test their impact.

    What did the review study?

    Certification sets and monitors voluntary standards, and can encompass systems engaging in a wider range of activities in policy, advocacy, and capacity building, and in building markets and supply chains, to make agricultural production socially sustainable and agricultural trade fairer.

    Certification is meant to affect a wide range of socioeconomic and environmental outcomes, to improve the wellbeing of farmers and agricultural workers employed by corporate plantations or individual producers. Certification schemes use a combination of standard-setting actions, training, different types of market interventions, and the application of adequate labour standards.

    This review assesses whether certification schemes work for the wellbeing of agricultural producers and workers in low- and middle-income countries.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of certification schemes in improving the welfare of farmers and workers. The review summarises findings from 43 quantitative studies, and 136 qualitative studies.

    What studies are included?

    Included studies evaluate the effects of CS on socioeconomic outcomes for agricultural producers and workers. Eligible CS are based on second- (industry-level) or third-party certifications, and exclude own-company standards. For the effectiveness review, studies must use experimental or non-experimental methods demonstrating control for selection bias. Qualitative studies are included to answer questions about barriers, facilitators and contextual factors; these report on relevant outcomes, have sufficient reporting on methods, and provide substantive evidence on relevant themes. The review includes 43 studies used for analysing quantitative effects, and 136 qualitative studies for synthesizing barriers, enablers and other contextual factors.

    What are the main results in this review?

    There is not enough evidence on the effects of CS on a range of intermediate and final socio-economic outcomes for agricultural producers and wage workers. There are positive effects on prices. But workers’ wages do not seem to benefit from the presence of CS. Income from the sale of produce is higher for certified farmers, but overall household income is not. Context matters substantially for the causal chain between interventions of certification schemes and the wellbeing of producers and workers.

    Generally, the quality of the studies is mixed, with a significant number of studies that are weak on a number of methodological fronts.

    What do the findings in this review mean?

    For farmers and workers the results show there is no guarantee that living standards improve through certification. To have a positive impact, CS need favourable conditions and the support of other factors. Some of these conditions depend on deeply rooted socioeconomic factors that, in the short to medium run, will not likely be altered substantially by certification.

    For CS practitioners and businesses, there are several lessons to learn. Claims about impact should match what is achievable and verifiable. Standards and interventions could be revised, away from multiple standards with fewer overlaps between systems and rationalisation of interventions. Impact evaluation standards should be given more attention. CS need to develop a deeper understanding of context, and adapt and pre-test the type and range of interventions.

    Researchers and evaluators should consider using a range of methods for different kinds of research questions, and have a clear understanding of what kind of design is more appropriate for each question. They should also use a more consistent, rigorous approach in reporting methods and results.

    How up-to-date is this review?

    The review authors searched for studies published until July 2016.

  • Spanish

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Additional Info

  • Authors Martin Bøg, Trine Filges, Lars Brännström, Anne-Marie Klint Jørgensen, Maja Karrman Fredriksson
  • Published date 2017-02-15
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title 12-step programs for reducing illicit drug use
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.2
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    12-step programs for reducing illicit drug use are neither better nor worse than other interventions

    Illicit drug abuse has serious and far-reaching implications for the abuser, their family members, friends, and society as a whole.

    Preferred intervention programs are those that effectively reduce illicit drug use and its negative consequences, and are cost-effective as well. Current evidence shows that overall, 12-step programs are just as effective as alternative, psychosocial interventions. The costs of programs are, therefore, an important consideration. However, the strength of the studies is weak and further evidence regarding the effectiveness of 12-step programs is needed.

    What did the review study?

    Illicit drug abuse is a globally recognised problem leading to high human, social and economic costs.

    The 12-step program, modelled on the approach of Alcoholics Anonymous and adopted by Narcotics Anonymous and others, aims for complete abstinence. The 12-step approach is used both by self-help groups and for professional treatment called Twelve Step Facilitation (TSF). The broad applicability and low cost of the 12-step approach may appeal to policy makers.

    This review examines the effectiveness of 12-step programs in reducing the use of illicit drugs. Secondary outcomes considered are on criminal behaviour, prostitution, psychiatric symptoms, social functioning, employment status, homelessness, and treatment retention.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of 12-step programs in reducing the use of illicit drugs. The review summarises findings from 10 studies, nine of which were conducted in the United States.

    What studies are included?

    Included studies assess 12-step interventions for participants with illicit drug dependence using randomized controlled trials and quasi-experimental studies. Study populations are participants who have used one or more types of illicit drugs, regardless of gender and ethnic background.

    A total of 10 studies consisting of 1,071 participants are included in the final evaluation. Nine of the studies were conducted in the United States, and one in the United Kingdom. The studies compare the 12-step program to alternative interventions. Nine studies were included in meta-analysis.

    What are the main results in this review?

    There is no difference in the effectiveness of 12-step interventions compared to alternative psychosocial interventions in reducing drug use during treatment, post treatment, and at 6- and 12-month follow-ups. 12-step programmes combined with additional treatment did have a significant effect at 6-month follow-up, but this finding is based on few studies and is not found at 12-month follow-up.

    There is some evidence that 12-step programmes retain fewer of their participants than other programmes, but the evidence has shortcomings. No effect was found on other secondary outcomes.

    What do the findings in this review mean?

    The main evidence presented in this review suggests that 12-step programs for reducing illicit drug use are neither better nor worse than other interventions.

    This conclusion should be read with caution given the weakness of the evidence produced by the studies.

    The power to detect a difference between the 12-step interventions and alternative psychosocial interventions was low and the estimated effect sizes were small. Many studies failed to adjust for the fact that the intervention is administered to groups, and so may overestimate effects. Given all these shortcomings, further evidence regarding the effectiveness of this type of intervention, especially in self-help groups, is needed.

    How up-to-date is this review?

    The review authors searched for studies published until September 2016.

  • Spanish

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Additional Info

  • Authors Matthew Manning, Susanne Garvis, Christopher Fleming, Gabriel T. W. Wong
  • Published date 2017-01-20
  • Coordinating group(s) Education
  • Type of document Review Plain language summary
  • Title The relationship between teacher qualification and the quality of the early childhood care and learning environment
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2017.1
  • Records available in English, Norwegian, Spanish, Turkish
  • English

    PLAIN LANGUAGE SUMMARY

    Higher teacher qualifications are associated with higher quality early childhood education and care

    This review examines the empirical evidence on the relationship between teacher qualifications and the quality of the early childhood learning environment. Higher teacher qualifications are positively associated with higher quality in early childhood education and care.

    What is this review about?

    Poor quality early childhood education and care (ECEC) can be detrimental to the development of children as it could potentially lead to poor social, emotional, educational, health, economic and behavioural outcomes. The lack of consensus as to the strength of the relationship between teacher qualification and the quality of the early childhood learning environment has made it difficult for policy makers and educational practitioners alike, to settle on strategies that would enhance the learning outcomes for children in their early stages of education.

    This review examines the current empirical evidence on the correlation between teacher qualifications and the quality of early childhood learning environments.

    What is the aim of this review?

    This Campbell systematic review examines the current empirical evidence on the correlation between teacher qualifications and the quality of the early childhood learning environments. The review summarises findings from 48 studies with 82 independent samples. Studies included children from pre-kindergarten and kindergarteners prior to elementary/primary school and centre-based providers.

    What studies are included?

    Included studies must have examined the relationship between teacher qualification and quality of the ECEC environment from 1980 to 2014, as well as permit the identification of the education program received by the lead teacher and provide a comparison between two or more groups of teachers with different educational qualifications. Furthermore, the studies had to have comparative designs and report either an overall quality scale or an environment rating scale.

    A total of 48 studies conducted with 82 independent samples were included in the review.

    What are the main results in this review?

    Overall, the results show that higher teacher qualifications are significantly correlated with higher quality early childhood education and care. The education level of the teachers or caregivers is positively correlated to overall ECEC qualities measured by the environment rating scale. There is also a positive correlation between teacher qualification and subscale ratings including program structure, language and reasoning.

    What do the findings in this review mean?

    The review shows a positive statistically significant association between teacher qualification and the quality of early childhood learning environment. This finding is not dependent on culture and context given that the evidence is from several countries.

    Mandating qualified teachers, i.e. with tertiary education, may lead to significant improvement for both process and structural quality within centre-based and home-based ECEC settings. However, the evidence is from correlational studies, so evidence is needed from studies with designs which can assess causal effects. Further research should also assess specific knowledge and skills teachers with higher qualifications have learned that enable them to complete their roles effectively.

    How up-to-date is this review?

    The review authors searched for studies published until January 2015. This Campbell Systematic Review was published in January 2017.

  • Norwegian

    Click on 'Download PDF' in the right column to view the Norwegian translation of this plain language summary.

  • Spanish

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  • Turkish

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Additional Info

  • Authors Roy Carr-Hill, Caine Rolleston, Rebecca Schendel
  • Published date 2016-12-07
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title The effects of school-based decision-making on educational outcomes in low- and middle-income contexts
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.9
  • Records available in English, Hindi, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    School-based decision-making has positive effects on education outcomes – but not in low-income countries

    Decentralizing decision-making to schools has small to moderate positive effects in reducing repetition, dropouts and increasing test scores. These effects are restricted to middle-income countries, with no positive effects found in low-income countries or in disadvantaged communities.

    What did the review study?

    Many governments have addressed the low quality of education by devolving decision-making authority to schools. It is assumed that locating decision-making authority within schools will increase accountability, efficiency and responsiveness to local needs.

    But there is limited evidence of the effectiveness of these reforms, especially from low-income countries. Existing reviews on school-based decision- making have tended to focus on proximal outcomes and offer very little information about why school-based decision- making has positive or negative effects in different circumstances.

    This review addresses two questions: (1) What is the impact of school-based decision-making on educational outcomes in low- and middle-income countries (L&MICs); and (2) What are the barriers to, and enablers of, effective models of school-based decision-making?

    What is the aim of this review?

    This Campbell systematic review assesses the effectiveness of school-based decision-making. The review summarises findings from 17 impact studies and nine studies of barriers and enablers.

    What studies are included?

    Included studies for the analysis of impact evaluated the change in decision-making authority from a higher level of decision-making authority to the level of the school on educational outcomes. Outcomes were either proximal – e.g. attrition, equality of access, increased enrolment – or final, e.g. test scores, psychosocial and non-cognitive skills. Included studies had to have a comparison group and data which were collected since 1990.

    Twenty-six studies, covering 17 interventions, were included in the analysis of impact. Nine studies were identified to assess barriers and enablers of school-based decision-making.

    What are the main results in this review?

    School-based decision-making has small effects in reducing dropouts and repetition. There is a moderate positive effect on average test scores, though the effects are smaller for language and maths. The effects are not large, but comparable to those found in many other effective educational interventions.

    The positive impact is found in middle-income countries, with no significant effect in low-income countries. School-based decision-making reforms appear to have a stronger impact on wealthier students having more educated parents, and for children in younger grade levels. School-based decision-making reforms appear to be less effective in disadvantaged communities, particularly if parents and community members have low levels of education and low status relative to school personnel.

    What do the findings in this review mean?

    1. School-based decision-making reforms in highly disadvantaged communities are less likely to be successful. Parental participation seems to be the key to the success of such reforms.
    2. The involvement of school management committees in personnel decisions appears to play a role in improving proximal outcomes, such as teacher attendance, but success is also likely to be linked to the overall teacher job market and the prospects of long-term employment.
    3. The specifics of programme design appear to be crucial. Given the limited evidence, we cannot conclude with certainty that incorporating certain elements into school-based management reforms are generally beneficial. However, it appears that the details of such supplementary elements may be important.

    There needs to be further robust analysis of the impact of large- scale school-based decision-making, as well as further analysis of the conditions that mitigate their impact. There is also a clear need to examine the potentially negative impacts of these reforms, given widespread adoption of such policies.

    How up-to-date is this review?

    The review authors searched for studies published until January 2015.

  • Spanish

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  • Hindi

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Additional Info

  • Authors Ezequiel Molina, Laura Carella, Ana Pacheco, Guillermo Cruces, Leonardo Gasparini
  • Published date 2016-11-15
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title Community monitoring interventions to curb corruption and increase access and quality of service delivery in low- and middle-income countries
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.8
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Community monitoring interventions can reduce corruption and may improve services

    Community monitoring interventions can reduce corruption. In some cases, but not all, there are positive effects on health and education outcomes. Further research is needed to understand contexts and designs for effective interventions.

    What did the review study?

    Corruption and inefficient allocation of resources in service delivery are widespread in low- and middle-income countries. Community monitoring interventions (CMIs) are intended to address this problem. The community is given the opportunity to participate in monitoring service delivery: observing and assessing providers’ performance to provide feedback to providers and politicians.

    This review assesses the evidence on the effects of community monitoring interventions on corruption and access and quality of service delivery outcomes. The review also considers the mechanism through which CMIs effect a change in corruption and service delivery outcomes, and possible moderating factors such as geographic region, income level or length of exposure to interventions.

    What is the aim of this review?

    This Campbell systematic review assesses the effectiveness of community monitoring interventions in reducing corruption. The review summarises findings from 15 studies, of which seven are from Asia, six from Africa and two from Latin America.

    What studies are included?

    To assess the effect on corruption included studies had to have either an experimental or a quasi-experimental design. Qualitative studies were included to assess mechanisms and moderators.

    The review assesses 15 studies of 23 different programmes’ intervention effects. The studies were conducted in Africa (6), Asia (7) and Latin America (2). Most studies focused on programmes in the education sector (9), followed by health (3), infrastructure (2) and employment promotion (1).

    What are the main results in this review?

    Community monitoring interventions can reduce corruption. They also improve utilization of health services, but no significant effect is found on school enrolments or dropouts. There is no improvement in health service waiting times, but there is an improvement in weight for age, though not child mortality. There are beneficial effects on education outcomes as measured by test scores.

    Community monitoring interventions appear to be more effective in improving outcomes when they promote direct contact between citizens and providers or politicians, and when they include tools for citizens to monitor the performance of providers and politicians.

    In all cases, findings are based on a small number of studies. There is heterogeneity in the findings with respect to health and education. Hence it is difficult to provide any strong, overall conclusions about intervention effectiveness.

    What do the findings in this review mean?

    The evidence identifies community monitoring interventions as promising. That is, there is evidence that they are effective. But the evidence base is thin, the interventions do no work in all contexts, and some approaches appear more promising than others.

    Future studies should assess the effectiveness of different types of community monitoring interventions in different contexts, sectors and time frames to identify when and how such programmes may be most effective in improving outcomes. There is a need for adequate information and tools to assist citizens in the process of monitoring. Research about these mechanisms and their moderation of the effectiveness of CMIs should be a priority for further research in the area.

    How up-to-date is this review?

    The review authors searched for studies published until November 2013.

  • Spanish

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Additional Info

  • Authors Vivian Andrea Welch, Shally Awasthi, Chisa Cumberbatch, Robert Fletcher, Jessie McGowan, Katelyn Merritt, Shari Krishnaratne, Salim Sohani, Peter Tugwell, Howard White, George A. Wells
  • Published date 2016-09-27
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title Deworming and adjuvant interventions for improving the developmental health and well-being of children in low- and middle-income countries
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.7
  • Records available in English, Spanish, French
  • English

    PLAIN LANGUAGE SUMMARY

    Mass deworming programmes have little or no effect on most welfare outcomes

    The effectiveness and cost-effectiveness of mass deworming of children to improve child health and other outcomes is debated. This independent analysis reinforces the case against mass deworming, finding little or no effect on most welfare outcomes.

    What is this review about?

    Soil-transmitted helminthiasis and schistosomiasis affect more than a third of the world’s population. There is debate about the effectiveness and cost-effectiveness of mass deworming of children to improve child health and other outcomes in endemic areas.

    This review evaluates the effects of mass deworming for soil-transmitted helminths on growth, educational achievement, cognition, school attendance, quality of life and adverse effects in children in endemic helminth areas.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of mass deworming to improve health, nutrition and other outcomes in low- and middle-income countries. The review analyses 65 studies covering over one million children in 24 countries.

    What studies are included?

    Included studies examine out mass deworming for soil-transmitted helminths (alone or in combination with other drugs or child health interventions) for children aged 6 months to 16 years, and report at least one of the following outcomes: growth, school attendance, school performance, cognitive processing or development, well-being, or adverse events. Included study designs are randomized trials, interrupted time series and non-experimental studies that used statistical methods of analysis to match participants with non-participants, or statistical methods to account for confounding and sample selection bias.

    Sixty-five studies are analyzed in the review, with a treatment duration from 4 months to 5 years, covering 1,092,120 children, including five long-term studies 8-10 years after mass deworming programs with over 90,000 children. These studies were conducted in 24 low and middle income countries. Most programmes studied conduct deworming twice per year or more frequently, with only two studies of programmes deworming just once per year.

    Does deworming improve child health and other welfare outcomes?

    Mass deworming for soil-transmitted helminths probably has little to no effect on weight, height, school attendance, cognition measured by short-term attention, or mortality. There are no data on short-term quality of life and little evidence of adverse effects.

    Mass deworming for schistosomiasis alone may slightly increase weight but probably has little to no effect on height and cognition. The evidence does not support indirect benefits for untreated children from being exposed to treated children.

    Two moderate quality long term studies show an increase in economic productivity (hours worked) and increase in educational enrollment 10 years after deworming. But it is uncertain whether these effects are due to deworming or the combined sanitation and hygiene intervention.

    Findings are consistent for various groups of the population by age, sex, worm prevalence, baseline nutritional status, compliance, impact on worms, infection intensity, types of worms, risk of bias, and study characteristics. Deworming for children who screened positive for schistosomiasis or soil-transmitted helminths results in larger gains in weight but no difference in effect on height, cognition or school attendance.

    What are the implications of this review for policy makers and decision makers?

    This independent analysis reinforces the case against mass deworming. In addition to a reconsideration of mass deworming programs in their current form, additional policy options need to be explored to improve child health and nutrition in worm-endemic areas. For schistosomiasis, policy implications are that mass deworming may be effective at improving weight.

    What are the research implications of this review?

    Future research should assess which subset of children benefit from mass deworming using individual level meta-analysis. This analysis could explore whether it is feasible to develop a case-finding tool to identify children and settings which will benefit from treatment.

    How up-to-date is this review?

    The search was completed in January 2016.

  • Spanish

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  • French

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Additional Info

  • Authors Carolyn Graham, Michael West, Jessica Bourdon, Katherine J. Inge
  • Published date 2016-09-01
  • Coordinating group(s) Education
  • Type of document Review Plain language summary
  • Title Employment interventions for return-to-work in working-age adults following traumatic brain injury
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.6
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Interventions for adults with traumatic brain injury may improve employment status

    Programs for adults who have suffered traumatic brain injury may improve employment status. All programs lead to employment, although no single program was more effective than the other programs.

    What is this review about?

    The unemployment rate in the USA for people who have suffered traumatic brain injury (TBI) was around 60% for 2001-10, compared to a national average of around 7%.

    Post-acute rehabilitation services – such as residential community reintegration programs, comprehensive day treatment programs, and community re-entry programs - focus on helping individuals adjust to ongoing impairments and to re-enter their communities, workplaces, and education. This review assesses the most effective type of intervention for returning individuals with TBI to work.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of vocational rehabilitation interventions to help adults with traumatic brain injury get competitive employment. Three randomized controlled trials are included: two of military populations in the USA and one of the civilian population in China (Hong Kong).

    What studies are included?

    Studies are included which assess interventions focused on assisting helping working-aged adults with TBI return to competitive employment, including self-employment. Participants must have been between 18 and 65 years of age, experienced a non-penetrating TBI, been engaged in either full-time or part-time employment at time of injury, and been unemployed or on medical leave at time of receipt of the intervention.The studies must have competitive employment as an outcome.

    Three randomized controlled trials (RCT) are included in the analysis, two studying US military personnel and one of civilians in China (Hong Kong). All three studies compared alternative programmes. One compared an intensive in-hospital program versus an at-home program. The second study compared the CogSMART program plus supported employment with supported employment alone. And in the third study the control group received psycho-educational training with the treatment group receiving the same content via a virtual reality-based training platform.

    How effective are the programmes?

    None of the programs were better at improving employment outcomes than the comparator program to which it was compared. The intensive in-hospital program was no better than the at-home alternative, CogSMART added no value to supported employment alone, and virtual reality-based training was no better than psycho-educational training. Comparison of employment before and after the interventions showed the interventions in the United States improved employment status. The intervention in China did not improve employment status.

    None of the studies reported secondary employment outcomes: hours worked and wages earned.

    It was not possible to conduct analysis of the relative effectiveness of different types of programme because of the small number of included studies.

    What are the implications of this review for policy makers and decision makers?

    These three studies have limited implications for practice and policy. No intervention was found to be more effective than any other. In two of the studies the populations were limited to military subjects, who present with significantly different challenges such as posttraumatic stress disorder.

    The comparator interventions of at-home training and supported employment appear promising.

    What are the research implications of this review?

    There is a need for more RCTs on return-to-work interventions for adults with TBI, preferably separating competitive employment from school attendance. Military interventions should be conducted with civilian samples in order to determine their effectiveness in the civilian population, including on populations outside the United States. A broader range of employment outcomes should be studied, with regular follow up at standard intervals (e.g., six months, 12 months, 18 months, etc.).

    How up-to-date is this review?

    The search was completed in 2015.

  • Spanish

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

Additional Info

  • Authors Esther Coren, Rosa Hossain, Jordi Pardo Pardo, Brittany Bakker
  • Published date 2016-07-01
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Title Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young people
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.5
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Lack of evidence on the effectiveness of interventions to reintegrate street-connected children

    There are a range of interventions to improve the integration and well-being of street-connected children, yet no studies measure integration, education or employment outcomes. There appears to be no effect on and mixed evidence for mental health. There may be reductions in substance abuse.

    What is this review about?

    Millions of street-connected children throughout the world are at risk of exploitation, violence, substance abuse, and health problems, and are not receiving skills-based education. Interventions to promote access to education, healthy and settled lifestyles, and reduction of risks are intended to give this group a better chance in life and prevent marginalization from society.

    What is the aim of this review?

    This review assessed the effectiveness of interventions for improving outcomes among street-connected children and young people, and for reducing some important health-related risks; and to improve access to and integration into society, education, and employment opportunities.

    What does the review study?

    This review investigates the effects of interventions for street-connected children to promote integration to the society, skills-based education, prospects of employment, and health risk education.

    What studies are included?

    Eligible study designs compare outcomes from interventions for street-connected children and young people aimed at reintegration, education, employment, improving health and/or harm reduction, and provision of shelter, versus a comparison group (e.g. shelter/drop-in service as usual). The review identified 13 studies evaluating 19 interventions. All studies were conducted in the USA except one (South Korea).

    What are the main results in this review?

    The outcome for integration was not measured in included studies. The same was the case for education and employment related outcomes - none of the included studies measured literacy, numeracy, or participation in education or skills-based employment. Several studies measured health-related outcomes.

    Five studies investigate the effect of interventions to encourage safe or reduced sexual activity (e.g. numbers of partners, frequency of sex, HIV knowledge, unprotected sex, condom use and rates of abstinence). The results are mixed, lacking enough evidence to support any of the interventions.

    Eight studies report outcomes of interventions promoting safe or reduced substance use. The outcomes used a variety of measures in different studies at various times making it difficult to get a clear overview. The overall effect was mixed; some studies report positive effect and the others reported negative or no effect. Three studies investigate the effect of family therapy on substance abuse and report improvements in some of the measures.

    Eight studies investigate the effect of therapeutic interventions to improve mental health (including self-esteem and depression) in street-connected kids. In general, there is no significant improvement in the intervention group compared to the control group. In some instances, both groups improved from the baseline. Finally, two studies investigate the effect of family-based approaches on family functioning. No differences were found between intervention and control conditions on most of the outcome measures used.

    What was the quality of the evidence?

    The quality of evidence was from low (i.e. for risk reduction in sexual activity and family therapy) to moderate (i.e. mental health improvement, harm reduction in substance abuse).

    What do the findings in this review mean?

    There is a dearth of evidence from controlled trials on interventions to improve integration of street-connected children and young adults into society and providing skills-based education. The evidence from health interventions aimed at

    engaging in safe sexual practices, and at improving mental health vary widely and are inconclusive as to their effectiveness. Some of the interventions aimed at reducing the risk of substance abuse may be effective. Further research in this area will be useful in understanding the effectiveness of these approaches and validating the effect of some of the interventions that are supported by moderate evidence.

    How up-to-date is this review?

    The review authors searched for relevant studies until April 2015.

  • Spanish

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

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