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

Better evidence for a better world (177)

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

    RESUMEN EN LENGUAJE SENCILLO

    Las intervenciones de monitoreo comunitario pueden disminuir la corrupción y mejorar los servicios

    Las intervenciones de monitoreo comunitario pueden disminuir la corrupción. En algunos casos se producen también efectos positivos en salud y educación. Se requiere mayor investigación para comprender cuáles son los contextos y diseños más adecuados para desarrollar intervenciones eficaces.

    ¿Qué estudió la revisión?

    La corrupción y una asignación ineficiente de los recursos para la prestación de servicios son prácticas comunes en países de ingresos medios y bajos. Las intervenciones de monitoreo comunitario están destinadas a abordar dicho problema. En este sentido, se otorga a la comunidad la oportunidad de participar en el control de la prestación de servicios locales, observando y evaluando el desempeño de los proveedores de servicios con el fin de brindar sus conclusiones a los políticos y a los mismos proveedores.

    La presente revisión evalúa la evidencia existente sobre los efectos producidos por las intervenciones de monitoreo comunitario en la corrupción, en el acceso a los servicios prestados y en su calidad. Esta también considera el mecanismo por medio del cual dichas intervenciones modifican los índices de corrupción y de prestación de servicios, además de posibles factores moderadores tales como la zona geográfica, el nivel de ingresos y el grado de exposición a las intervenciones.

    ¿Cuál es el objetivo de esta revisión?

    La presente revisión sistemática de Campbell evalúa la eficacia de las intervenciones de monitoreo comunitario en la reducción de los índices de corrupción y resume las conclusiones alcanzadas por 15 estudios, de los cuales 7 son de Asia, 6 de África y 2 de América Latina.

    ¿Qué estudios se incluyeron?

    Para evaluar los efectos generados en la corrupción, los estudios incluidos debían contar con un diseño experimental o cuasiexperimental. Se consideraron estudios cualitativos para evaluar mecanismos y moderadores.

    Esta revisión evalúa 15 estudios correspondientes a 23 efectos producidos por diversas intervenciones, los que fueron desarrollados en África (6), Asia (7) y América Latina (2). La mayoría de ellos se dedicaron a programas del sector educacional (9), seguidos de salud (3), infraestructura (2) y promoción del empleo (1).

    ¿Cuáles son los principales resultados obtenidos por esta revisión?

    Las intervenciones de monitoreo comunitario pueden disminuir los niveles de corrupción; también mejoran la utilización de los servicios de salud, aunque no se han hallado resultados significativos en el ámbito educacional en cuanto a matriculación escolar y tasa de deserción. Por otra parte, no se observan mejorías en los tiempos de espera de los servicios de salud ni en la tasa de mortalidad infantil, aunque sí en el índice de peso por edad. Finalmente, existen efectos beneficiosos en los resultados educacionales, según mediciones obtenidas por calificaciones de exámenes.

    Las intervenciones de monitoreo comunitario parecen ser más eficaces en el mejoramiento de los resultados cuando promueven el contacto directo entre los ciudadanos y los políticos o proveedores de servicios y cuando brindan herramientas para el monitoreo del desempeño a los ciudadanos.

    En todos los casos, las conclusiones se basan en una cantidad muy acotada de estudios. Además, existe heterogeneidad en dichas conclusiones con respecto a salud y educación. Por lo tanto, es complejo alcanzar conclusiones generales sólidas sobre la eficacia de la intervención.

    ¿Qué significan los resultados de esta revisión?

    La evidencia indica que las intervenciones de monitoreo comunitario son iniciativas promisorias. Es decir, su eficacia ha sido demostrada. Sin embargo, la evidencia es escasa, las intervenciones no son factibles de aplicar en todos los ámbitos y algunas iniciativas parecen más promisorias que otras.

    Futuros estudios deberán evaluar la eficacia de diversos tipos de intervenciones de monitoreo comunitario en diferentes contextos y sectores y con distintos plazos para establecer cuándo y en qué forma estas pueden ser más efectivas en mejorar los resultados. Es preciso contar con información y herramientas adecuadas para colaborar con los ciudadanos en el proceso de monitoreo. Investigar estos mecanismos y el control que ejercen en la eficacia de las intervenciones de monitoreo comunitario debería ser prioridad para las futuras investigaciones en el área.

    ¿Cuán actual es esta revisión?

    Sus autores revisaron estudios publicados hasta noviembre de 2013 y este trabajo fue publicado en noviembre de 2016.

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

    RESUMEN EN LENGUAJE SENCILLO

    Los programas de desparasitación masiva producen efectos marginales o ningún efecto en la mayoría de los resultados sobre temas de bienestar

    Este análisis independiente refuerza el argumento esgrimido en contra de las desparasitaciones masivas al descubrir muy pocos efectos o ningún efecto en la mayoría de los resultados relacionados con temas de bienestar.

    ¿De qué se trata esta revisión?

    La helmintiasis y la esquistosomiasis transmitidas por el suelo afectan a más de un tercio de la población mundial. En este sentido, existe debate sobre la eficacia, por un lado, y qué tan efectivas en función de costos son las desparasitaciones masivas de niños.

    La presente revisión evalúa los efectos producidos por desparasitaciones masivas de helmintos transmitidos por el suelo en el crecimiento, los logros educacionales, la cognición, la asistencia a la escuela y la calidad de vida, además de ciertos efectos adversos en niños que habitan zonas endémicas.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión sistemática de Campbell estudia la eficacia de la desparasitación masiva a la hora de mejorar la salud, la nutrición y otros resultados conseguidos en países de ingresos medios y bajos. La revisión examina 65 estudios que cubren más de un millón de niños en 24 países.

    ¿Qué estudios se incluyeron?

    Los estudios incluidos analizan la desparasitación masiva de helmintos transmitidos por el suelo (aisladamente o en combinación con otras intervenciones relacionadas con drogas o la salud infantil) de niños entre 6 meses y 16 años e informan sobre consecuencias en al menos uno de los siguientes índices: crecimiento, asistencia a la escuela, desempeño escolar, procesamiento o desarrollo cognitivo y bienestar, o de ciertos acontecimientos adversos. Entre los tipos de estudios incluidos se encuentran ensayos controlados aleatorizados, series temporales interrumpidas y estudios no experimentales que emplearon métodos estadísticos de análisis para emparejar participantes con no participantes o métodos estadísticos para explicar los factores de confusión y el sesgo en la selección de la muestra.

    Con una duración de tratamiento de entre cuatro meses y cinco años, se estudiaron 1.092.120 niños, incluidos cinco estudios de largo plazo de hasta 8 a 10 años después de finalizados los programas de desparasitación con más de 90.000 niños. Estos estudios fueron desarrollados en 24 países de ingresos medios y bajos. La mayor parte de los programas estudiados lleva a cabo desparasitaciones un mínimo de dos veces al año; solo dos de ellos lo hacen una vez al año.

    ¿La desparasitación mejora la salud de los niños y otros indicadores de bienestar?

    La desparasitación masiva de helmintos transmitidos por el suelo probablemente genera pocos o ningún efecto en el peso, la talla, la asistencia a la escuela, la cognición medida a través de la atención a corto plazo o la tasa de mortalidad.

    La desparasitación masiva para combatir solo la esquistosomiasis tal vez aumente levemente el peso, pero genera escaso impacto en la talla y la cognición.

    Dos estudios a largo plazo de mediana calidad muestran un aumento de la productividad económica (horas trabajadas) y un aumento en la matriculación escolar 10 años después de efectuada la desparasitación. Pero no existe certeza de que tales efectos se deban precisamente a la desparasitación o a una combinación de intervenciones de saneamiento e higiene.

    Los resultados encontrados son consistentes para diversos grupos de población según edad, sexo, prevalencia del parásito, estado nutricional de referencia, nivel de cumplimiento, impacto en el parásito, gravedad de la infección, tipos de parásitos, riesgo de sesgo y características del estudio. La desparasitación de niños que han arrojado resultados positivos en casos de esquistosomiasis o de helmintos transmitidos por el suelo deriva en mayor aumento de peso, pero no se observan diferencias en talla, cognición o tasa de asistencia a la escuela.

    ¿En qué forma incide esta revisión en los encargados de formular políticas públicas y tomar decisiones?

    Este análisis independiente refuerza el argumento en contra de la desparasitación masiva. Además de reconsiderar los programas de desparasitación masiva con sus actuales características, es preciso explorar políticas adicionales con el fin de mejorar la salud y la nutrición de los niños en zonas endémicas. Específicamente en cuanto a la esquistosomiasis, las consecuencias para las políticas públicas es que la desparasitación masiva puede ser eficaz en términos de aumento de peso.

    ¿Cuáles son las consecuencias de la presente revisión para futuras investigaciones?

    Las futuras investigaciones deben evaluar qué subgrupo de niños se beneficia de la desparasitación masiva utilizando metaanálisis a nivel individual. Tal análisis puede explorar si es factible desarrollar una herramienta de detección de casos que permita identificar a los niños y los escenarios que se verán beneficiados con el tratamiento.

    ¿Cuán actual es esta revisión?

    La investigación finalizó en enero de 2016 y esta revisión sistemática de Campbell fue publicada en septiembre de 2016.

  • French

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

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

    RESUMEN EN LENGUAJE SENCILLO

    Las intervenciones dirigidas a adultos con lesión cerebral traumática pueden ayudar a mejorar su situación laboral

    Los programas dirigidos a adultos que han sufrido alguna lesión cerebral traumática pueden ayudar a mejorar su situación laboral. Todos los programas evaluados conducían al empleo, pero ninguno resultó más eficaz que los demás.

    ¿De qué se trata esta revisión?

    La tasa de desempleo en los Estados Unidos para personas que habían sufrido una lesión cerebral traumática (TBI, por sus siglas en inglés) fue de alrededor del 60% para el período 2001-2010, en comparación con el promedio nacional que no superaba el 7%.

    Los servicios de rehabilitación tras el alta médica -tales como programas residenciales de reinserción en la comunidad, programas de tratamiento de día completo y programas de reintegración comunitaria- apuntan a ayudar a las personas a adaptarse a alguna discapacidad y a reinsertarse en sus comunidades, lugares de trabajo y sistemas educativos. Esta revisión evalúa las intervenciones más eficaces para la reinserción de individuos con TBI al trabajo.

    ¿Cuál es el objetivo de esta revisión?

    La presente revisión sistemática de Campbell evalúa la eficacia de intervenciones de readaptación profesional para que adultos que han sufrido una lesión cerebral traumática consigan un empleo competitivo. Se incluyen tres ensayos controlados aleatorios: dos aplicados a población militar de los Estados Unidos y uno a la población civil de Hong Kong.

    ¿Qué estudios se incluyeron?

    Se consideraron estudios que evalúan intervenciones que buscan ayudar a regresar a una situación laboral competitiva -incluido el trabajo autónomo- a los adultos en edad de trabajar que han padecido alguna clase de TBI. Los participantes beneficiados debían tener entre 18 y 65 años, haber experimentado una TBI, haber estado trabajando a tiempo completo o medio tiempo al momento de sufrir la lesión y estar desempleado o con licencia médica al momento de ser objeto de la intervención. Los estudios debían conseguir empleos competitivos para los participantes como resultado.

    Tres ensayos controlados aleatorios se incluyen en el análisis, dos de ellos estudiaron a personal militar estadounidense y uno a la población civil china en Hong Kong. Los tres estudios contrastaron programas alternativos. De estos, uno de ellos comparó un programa intensivo en el hospital con otro programa desarrollado en el domicilio del afectado. El segundo estudio comparó el programa CogSMART en combinación con una iniciativa de empleo, en comparación con la iniciativa de empleo por sí sola. Por último, en el tercer estudio el grupo de control recibió una preparación psicoeducacional y el grupo de tratamiento el mismo contenido, pero por medio de una plataforma de capacitación virtual basada en la realidad.

    ¿Cuán eficaces son los programas?

    Ninguno de los programas del tratamiento tuvo un rendimiento más óptimo, a la hora de intentar mejorar los índices de empleo, que el programa del control utilizado como referente y con el cual se los comparó. El programa intensivo realizado en el hospital no fue mejor que la alternativa realizada en el hogar, CogSMART no aportó nada a la iniciativa de empleo por sí sola y la capacitación virtual basada en la realidad no fue mejor que la capacitación psicoeducacional. Al comparar el empleo antes y después de las intervenciones, se observa que estas mejoraron la situación laboral en Estados Unidos. Sin embargo, en China, la intervención no surtió ningún efecto.

    Ninguno de los estudios demostró efectos secundarios en el empleo, en términos de horas trabajadas y de salario percibido. No fue posible analizar la eficacia relativa de diferentes tipos de programas debido al escaso número de estudios incluidos.

    ¿En qué forma incide esta revisión en los responsables de formular políticas públicas y tomar decisiones?

    Estos tres estudios inciden muy acotadamente en prácticas y políticas públicas. Por ende, ninguna intervención puede considerarse como superior al resto. En dos de los estudios, el universo de la muestra se limitó a personal militar que presentó desafíos significativamente distintos a los esperados, tales como el trastorno por estrés postraumático.

    Sin embargo, las intervenciones comparativas de capacitaciones en casa y de empleo con apoyo parecen prometedoras.

    ¿Cuáles son las consecuencias de la presente revisión para futuras investigaciones?

    Se necesitan más ensayos controlados aleatorios sobre intervenciones de retorno al trabajo para adultos con TBI que, de preferencia, independicen el empleo competitivo de la asistencia a la escuela. Además, las intervenciones efectuadas en el campo militar debieran realizarse con poblaciones de civiles con el fin de determinar su eficacia entre dicha población, incluida aquella que vive fuera de los Estados Unidos. Por último, debería estudiarse una amplia gama de índices de empleo con seguimiento regular y estándar (por ejemplo: a los 6, 12 y 18 meses).

    ¿Cuán actual es esta revisión?

    La investigación finalizó el año 2015 y este trabajo fue publicado en julio de 2016.

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

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Additional Info

  • Authors Jane Barlow
  • Published date 2016-06-20
  • Type of document Policy brief
  • Title Policy brief 1: Effects of parenting programmes
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  • Records available in English, Spanish
  • English

    Parenting programmes are provided to parents to enhance their knowledge, skills and understanding, and so improve both child and parent behavioural and psychological outcomes.

    These programmes are typically offered over eight to 12 weeks, for about one to two hours each week, although the range varies from as few as two sessions to as many as 20.

    Professor Barlow summarises evidence from six Campbell systematic reviews.

  • Spanish

    Efectos de programas de capacitación para padres: Una revisión de seis revisiones sistemáticas Campbell.

Additional Info

  • Authors Gary Ritter
  • Published date 2016-06-20
  • Type of document Policy brief
  • Title Policy brief 2: Effects of school-based interventions to improve student behavior
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  • Records available in English, Spanish
  • English

    This policy brief summarizes evidence from six Campbell systematic reviews of the effects of school-based interventions to improve student behavior. The interventions examined include cognitive behavioral therapy, counseling with at-risk students, and school-wide campaigns targeting destructive mind-sets.

    To access the six included systematic reviews in full, click here.
  • Spanish

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Additional Info

  • Authors Hugh Waddington
  • Published date 2016-06-08
  • Type of document Policy brief
  • Title Policy brief 3: Programs promoting sustainable agriculture for smallholders
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  • Records available in English, Spanish
  • English

    This Campbell policy brief summarizes evidence from five Campbell  systematic reviews which examine agricultural interventions including technology, skills and the regulatory environment. The impact of the following interventions is presented: land titling, training and technology, farmer field schools, payment for environmental services and decentralized forest management.

  • Spanish

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Additional Info

  • Authors Elizabeth Spier, Pia Britto, Terri Pigott, Eugene Roehlkapartain, Michael McCarthy, Yael Kidron, Mengli Song, Peter Scales, Dan Wagner, Julia Lane, Janis Glover
  • Published date 2016-03-23
  • Coordinating group(s) Education, International Development
  • Type of document Review Plain language summary
  • Title Parental, community and familial support interventions to improve children’s literacy in developing countries
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.4
  • Records available in English, Hindi, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Limited evidence of effectiveness for home- or community-based child literacy programmes yet some approaches improve outcomes

    There is a wide range of models for out-of-school interventions to improve children’s literacy. Most of these models have not been subject to rigorous evaluation. Support to parents and peers has been largely ineffective in improving literacy, though it has worked in some places. Educational TV has positive effects.

    What did the review study?

    For a majority of the world’s children academic learning is neither occurring at expected rates nor supplying the basic foundational skills necessary to succeed in the 21st century. This review examines the availability of evidence and its findings about the effectiveness of interventions to improve parental, familial, and community support for children’s literacy development in developing countries.

    What is the aim of this review?

    This Campbell systematic review assesses the effectiveness of parental, familial, and community support for children’s literacy development in developing countries. The review summarises findings from 13 studies, of which 10 were used for meta-analysis.

    What studies are included?

    Included studies were published since 2003 with a test of an intervention involving parents, families, or community members with the goal of improving the literacy of children aged 3 to 12 years. The study design had to have a comparison group, and report literacy-related outcomes.

    Thirteen studies are included in the review, covering educational television, interventions that help parents learn how to support their children’s school readiness, and tutoring interventions delivered by peers.

    What were the main findings of the review?

    What models of reading and literacy learning programs have been implemented in homes and communities?

    Many models are widely used in low- and middle-income countries. These include the provision of libraries (standing or mobile) in many countries including Zimbabwe, Kenya, India and Venezuela; local-language publishing in, for example, Cambodia, Sri Lanka, and Zambia; literacy instruction outside schools including the teaching of literacy through religious instruction; the distribution e-readers in countries such as Ghana and Uganda; educational TV and radio; and supporting community members to educate children.

    What models of reading and literacy learning programs implemented in homes and communities in LMICs have empirical evidence regarding their level of effectiveness?

    There is no rigorous evidence of the effectiveness of most of the models being used by governments and NGOs around the world. The exceptions are educational TV and radio, and supporting community members to educate children.

    How effective are these models in improving children’s literacy outcomes?

    Overall, interventions for parent training and of child-to-child tutoring are not effective. Eight out of nine reported outcomes show no significant effects. However, there is considerable variation in the findings, so some approaches may be effective in some contexts.

    Educational television appears to improve literacy with frequent viewing, i.e. three to five times a week, over several months.

    What do the findings in this review mean?

    There are serious gaps in our knowledge. Programs that have worked in some settings should be replicated elsewhere so the contextual factors for success can be identified and understood. There is no evidence for most models used by governments and NGOs, none from one Latin America, and just one study presenting evidence of effects on children aged over seven.

    How up-to-date is this review?

    The review authors searched for studies published until July 2013.

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  • Hindi

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Additional Info

  • Authors David Wilson, Charlotte Gill, Ajima Olaghere, Dave McClure
  • Published date 2016-03-23
  • Coordinating group(s) Crime and Justice
  • Type of document Review Plain language summary
  • Title Juvenile curfew effects on criminal behavior and victimization
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.3
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Juvenile curfews are not effective in reducing crime and victimization

    The evidence suggests that juvenile curfews do not reduce crime or victimization.

    What is this review about?

    Curfews restrict youth below a certain age – usually 17 or 18 – from public places during night time. For example, the Prince George’s County, Maryland curfew ordinance restricts youth younger than 17 from public places between 10 p.m. and 5 a.m. on weekdays and between midnight and 5 a.m. on weekends. Sanctions range from a fine that increases with each offense, community service, and restrictions on a youth’s driver’s license. Close to three quarters of US cities have curfews, which are also used in Iceland.

    A juvenile curfew has common sense appeal: keep youth at home during the late night and early morning hours and you will prevent them from committing a crime or being a victim of a crime. In addition, the potential for fines or other sanctions deter youth from being out in a public place during curfew hours.

    This review synthesizes the evidence on the effectiveness of juvenile curfews in reducing criminal behavior and victimization among youth.

    What is the aim of this review?

    This Campbell systematic review assesses the effects of juvenile curfews on crime and victimization. The review summarizes findings from 12 studies.

    What are the main findings of this review?

    What studies are included?

    Included studies test the effect of an official state or local policy intended to restrict or otherwise penalize a juvenile’s presence outside the home during certain times of day. This must have been a general preventive measure directed at all youth within a certain age range and not a sanction imposed on a specific youth.

    Twelve quantitative evaluations of the effects of curfews on youth criminal behavior or victimization are included in the review.

    Do curfews reduce crime and victimization?

    The pattern of evidence suggests that juvenile curfews are ineffective at reducing crime and victimization. The average effect on juvenile crime during curfew hours was slightly positive - that is a slight increase in crime - and close to zero for crime during all hours. Similarly, juvenile victimization also appeared unaffected by the imposition of a curfew ordinance.

    However, all the studies in the review suffer from some limitations that make it difficult to draw firm conclusions. Nonetheless, the lack of any credible evidence in their favor suggests that any effect is likely to be small at best and that curfews are unlikely to be a meaningful solution to juvenile crime and disorder.

    Other studies have suggested curfews may be ineffective as juvenile crime is concentrated in hours before and after school, and that under-resourced police forces focus on more urgent demands than enforcing curfews.

    What do the findings in this review mean?

    Contrary to popular belief, the evidence suggests that juvenile curfews do not produce the expected benefits. The study designs used in this research make it difficult to draw clear conclusions, so more research is needed to replicate the findings. However, many of the biases likely to occur in existing studies would make it more, rather than less, likely that we would conclude curfews are effective. For example, most of these studies were conducted during a time when crime was dropping

    throughout the United States. Therefore, our findings suggest that curfews either don’t have any effect on crime, or the effect is too small to be identified in the research available.

    How up-to-date is this review?

    The search for this review was updated in March 2014.

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Additional Info

  • Authors Carol Rivas, Jean Ramsay, Laura Sadowski, Leslie Davidson, Danielle Dunne, Sandra Eldridge, Kelsey Hegarty, Angela Taft, Gene Feder
  • Published date 2016-01-04
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.2
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Limited evidence and limited effects of advocacy to reduce intimate partner violence

    Intensive advocacy may improve everyday life for women in domestic violence shelters and refuges, and reduce physical abuse. There is no clear evidence that intensive advocacy reduces sexual, emotional, or overall abuse, or that it benefits women’s mental health. It is unclear whether brief advocacy is effective.

    What is the review about?

    Partner abuse or domestic violence includes physical, emotional, and sexual abuse; threats; withholding money; causing injury; and long lasting physical and emotional health problems. Active support by trained people, which is called ‘advocacy’, may help women make safety plans, deal with abuse, and access community resources.

    Advocacy may be a stand-alone service, accepting referrals from healthcare providers, or part of a multi-component, and possibly multi-agency, intervention. It may take place in the community, a shelter, or as part of antenatal or other healthcare, and vary in intensity from less than an hour to 80 hours.

    Advocacy may contribute to reducing abuse, empowering women to improve their situation by providing informal counselling and support for safety planning and increasing access to different services.

    What is the aim of this review?

    This Campbell systematic review assesses the effects of advocacy interventions on intimate partner violence and women’s wellbeing. The review summarizes findings from 13 studies.

    What were the main findings of the review?

    What studies are included?

    This review summarizes evidence from 13 clinical trials comparing advocacy for 1,241 abused women with no care or usual care. Most studies followed up on the women for at least a year.

    Does advocacy reduce intimate partner violence and improve women’s wellbeing?

    Physical abuse: After one year, brief advocacy had no effect in two healthcare studies and one community study, but it reduced minor abuse in one antenatal care study. Another antenatal study showed reduced abuse immediately after brief advocacy, but women were also treated for depression, which may have affected results. Two studies provided weak evidence that intensive advocacy reduces physical abuse up to two years after the intervention.

    Sexual abuse was reported in four studies, which found no effects.

    Emotional abuse: One antenatal care study reported reduced emotional abuse at 12 months after advocacy.

    Depression: Brief advocacy prevented depression in abused women attending healthcare services and pregnant women immediately after advocacy. Intensive advocacy did not reduce depression in shelter women followed up at 12 and 24 months. The moderate-to-low quality evidence came mostly from studies with a low risk of bias.

    Quality of life: Three trials of brief advocacy trials no benefit on quality of life. Intensive advocacy showed a weak benefit in two studies in domestic violence shelters and refuges, and a primary care study showed improved motivation to do daily tasks immediately after advocacy.

    What do the results mean?

    Intensive advocacy may improve everyday life for women in domestic violence shelters and refuges in the short term, and reduce physical abuse one to two years after the intervention. There is no clear evidence that intensive advocacy reduces sexual, emotional, or overall abuse, or that it benefits women’s mental health. It is unclear whether brief advocacy is effective, although it may provide short-term mental health benefits and reduce abuse, particularly in pregnant women and those suffering less severe abuse.

    Several studies summarised in this review are potentially biased because of weak study designs. There was little consistency between studies, with variations for advocacy given, the type of benefits measured, and the lengths of follow-up periods, making it hard to combine their results. So it is not possible to be certain how much or which type of advocacy interventions benefit women.

    How up-to-date is this review?

    The search for this review was updated in April 2015.

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