Better evidence for a better world

Campbell evidence and gap maps

Coming soon – Campbell EGMs are a new evidence synthesis product. Plain language summaries of our EGMs will be published on this website. The interactive EGMs and full EGM reports will be available in our journal on the Wiley Online Library platform: click here.



Learn more about Campbell EGMs

Campbell-partnered EGMs

Campbell has produced maps on other topics, sometimes in partnership with other organisations.



See the Campbell-partnered EGMs
Search Result: 30 Records found
Page 1 of 3

K2_THE_LATEST

The impact of care farms on quality of life, depression and anxiety among different population groups
  • Authors Jenni Murray, Nyantara Wickramasekera, Marjolein Elings, Rachel Bragg, Cathy Brennan, Zoe Richardson, Judy Wright, Marina G. Llorente, Janet Cade, Darren Shickle, Sandy Tubeuf, Helen Elsey
  • Published date 2019-11-27
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title The impact of care farms on quality of life, depression and anxiety among different population groups
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/full/10.1002/cl2.1061
  • English

    PLAIN LANGUAGE SUMMARY

    More evidence needed on the effectiveness of care farms

    Care farming is the therapeutic use of agricultural and farming practices. People value the farms, but the evidence on their effectiveness is limited.

    What is this review about?

    Care farming (also called social farming) is the therapeutic use of agricultural and farming practices. Service users and communities supported through care farming include people with learning disabilities, mental and physical health problems, substance misuse, adult offenders, disaffected youth, socially isolated older people, and the long-term unemployed.

    This review aims to understand the impact of care farming on quality of life, depression and anxiety, on a range of service user groups. It also aims to explore and explain the way in which care farming might work for different groups.

    What is the aim of this review?

    This Campbell systematic review examines the impact of care farming on quality of life, depression and anxiety, on a range of service user groups. It also aims to explore and explain the way in which care farming might work for different groups.

    What studies are included?

    The review included randomised and quasi-randomised controlled trials; interrupted time series and non-randomised controlled observational studies; uncontrolled before and after studies and qualitative studies. Study participants were those who typically receive support at a care farm. Studies conducted in a setting that met the accepted definition of a care farm were included, but farming interventions that were carried out in a hospital or prison setting were excluded.

    The total number of included studies in this review are 18 qualitative studies and 13 quantitative studies, one of which was a mixed-methods study.

    What are the findings of this review?

    The qualitative interview studies showed that people valued, amongst other things, being in contact with each other, and feeling a sense of achievement, fulfilment, and belonging.

    Some groups seemed to appreciate different things, indicating that different groups may benefit in different ways but, it is unclear if this is due to a difference in the types of activities or the way in which people value different things from the same activity.

    There is a lack of quantitative evidence that care farms improve people’s quality of life, but some evidence that they might improve depression and anxiety.

    Larger studies involving single service user groups and fully validated outcome measures are needed to prove more conclusive evidence about the benefits of care farming.

    What do the findings of the review mean?

    There is a lack of evidence to determine whether or not care farming is effective in improving quality of life, depression and anxiety. More evidence is available for those with mental ill-health, but firm conclusions cannot be drawn.

    Despite the current lack of robust evidence to support the effectiveness of care farming, there are strong arguments to support a more integrated approach to care farming as a viable alternative or adjunct to mainstream approaches for mental health problems. Lack of choice, gender inequalities, and over-burdened statutory services indicate the need for a credible alternative treatment option.

    There needs to be a concerted effort to increase awareness among commissioners of health care, frontline service providers, and potential service users about care farming, how – and for whom – it might work. Models across Europe that offer a more integrated approach between green care and statutory services could provide valuable learning.

    The evidence for care farming for other service user groups is not as well developed as it is for those with mental health problems, but that is not to say there is not a need. Disaffected youth, adult offenders, and people with dementia represent significantly large vulnerable population groups where current service provision struggles to meet demand.

    The need to continue to improve and provide high quality research in these areas is therefore pressing.

    How up-to-date is this review?

    The review authors searched for studies published up to July 2017.

Effectiveness of continuing professional development training of welfare professionals on outcomes for children and young people
  • Authors Trine Filges, Carole Torgerson, Louise Gascoine, Jens Dietrichson, Chantal Nielsen, Bjørn A. Viinholt
  • Published date 2019-11-07
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title Effectiveness of continuing professional development training of welfare professionals on outcomes for children and young people
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/full/10.1002/cl2.1060
  • English

    PLAIN LANGUAGE SUMMARY

    Little evidence of the effectiveness of continuing professional development (CPD)

    Continuing professional development (CPD) aims to improve outcomes for the children and young people with whom educational and welfare professionals work. There is no clear evidence that CPD in education improves student academic outcomes.

    What is this review about?

    CPD is delivered in a variety of settings by different kinds of ‘trainers’ or educators for differing lengths of time and differing intensity. There are many methods of delivery such as coaching sessions, feedback based on observations or videotapes of classroom practice, and feedback and reflection workshops.

    This review looked at the effects of CPD approaches for education and welfare practitioners (pre-school teachers, pedagogues, school teachers, social workers, psychologists, police officers) on educational, social, crime and justice outcomes for children and young people; and – as secondary outcomes – any effects on the professional practice of practitioners in these fields. For the purposes of this review, the CPD must involve the development of core professional skills.

    What is the aim of this review?

    This Campbell systematic review examines the effects of continuing professional development (CPD) approaches for education and welfare practitioners on: educational and social outcomes for children and young people; and outcomes for practitioners. The review summarizes evidence from 51 moderate-quality studies, including 48 randomized controlled trials and three quasi-experiments.

    What studies are included?

    This review includes studies that evaluate the effects of CPD on children’s or young people’s and professionals’ outcomes. Fifty-one studies were identified, all related to education. No eligible studies were identified for social welfare or crime and justice.

    The 51 education studies were grouped into three sub-topic areas: 12 studies (reporting 10 trials) considered CPD in social and emotional development interventions (in daycare, kindergarten, pre-school and school settings); 38 studies (reporting 33 trials) dealt with CPD in language and literacy development interventions; one study looked at CPD in stress reduction. Most (48) studies used experimental designs with random assignment.

    Only 26 of the 51 studies were included in the meta-analyses. The reduction was caused by studies reporting on the same trial (five studies), insufficient reporting of outcomes to calculate an effect size (four studies) and studies being rated to have too high risk of bias. In total 16 studies were assessed not to be of sufficient methodological quality to be included in the meta-analyses.

    The studies spanned the period 1999 to 2018. Thirty-three trials were undertaken in the USA, two in the UK, and one in each of the following countries: Denmark, Ireland, the Netherlands, New Zealand, Portugal, Australia, Chile and Germany.

    What are the main findings of this review?

    Social and emotional development interventions (nine studies)
    A very small body of evidence for social and emotional development interventions (in daycare, kindergarten, pre-school and school settings) finds no effect of CPD on student academic outcomes (four studies). Results from only two individual studies could be combined in a single meta-analysis of other student outcomes (i.e. non-academic) and teacher outcomes, precluding any conclusions concerning effectiveness or ineffectiveness of this type of CPD on these outcomes.

    Language and literacy development interventions (17 studies)
    A moderate body of evidence for language and literacy development interventions finds no effect for CPD on student academic outcomes (13 studies). The results from only three individual studies could be combined in a single meta-analysis of teacher outcomes, thus precluding any conclusions concerning effectiveness or ineffectiveness of this type of CPD on teacher outcomes.

    Stress reduction (one study)
    It is not possible to draw conclusions from the one study placed in the sub-topic of stress reduction.

    What do the findings of the review mean?

    There is insufficient evidence for conclusions to be drawn, with the exception of language and literacy development interventions. For this type of CPD, there seems to be no effect on student academic outcomes.

    The dominance of the USA as the main country in which the types of CPD interventions covered by this review have been evaluated clearly limits the generalizability of the findings. Moreover, the limited number of studies means that it was not possible to conduct an analysis of specific CPD-approaches across cultures, professions/service-deliverer types, organizations and service-receiver types.

    Agencies should consider conducting a large randomized controlled trial (or a series of large RCTs) evaluating the effectiveness of a CPD intervention in countries outside the USA.

    How up-to-date is this review?

    The review authors searched for studies up to December 2018.

The promotion of well-being among children exposed to intimate partner violence
  • Authors Natasha E. Latzman, Cecilia Casanueva, Julia Brinton, Valerie L. Forman-Hoffman
  • Published date 2019-09-30
  • Coordinating group(s) Crime and Justice, Social Welfare
  • Type of document Review Plain language summary
  • Title The promotion of well-being among children exposed to intimate partner violence
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/full/10.1002/cl2.1049
  • English

    PLAIN LANGUAGE SUMMARY

    Limited evidence on the effectiveness of psychosocial interventions to promote well-being among children exposed to intimate partner violence

    Children’s exposure to intimate partner violence (IPV) is a significant public health and social justice concern with potentially severe and long-lasting effects. The extent to which psychosocial interventions promote well-being among children exposed to IPV, and under what circumstances, such as the modality and setting, is unclear.

    What is this review about?

    Exposure to IPV in childhood can have both short- and long-term negative impacts to health and well-being that persist across generations. There is therefore an increased interest in the development of intervention strategies to promote well-being following exposure. Over the last two decades, theory-driven psychosocial programmes serving children exposed to violence have been developed and established in a range of venues (e.g., school-based mental health clinics, outpatient psychotherapy settings). This review provides a synthesis of the state of this literature and implications for research and practice.

    Specifically, the effectiveness of psychosocial interventions in improving total problems, externalising distress, internalising distress, interpersonal/social problems, and cognitive functioning are assessed. Variation in effects by intervention modality (e.g., individual, family-based) and setting of the intervention (e.g., home, outpatient clinic) are also examined.

    What is the aim of this review?

    This Campbell systematic review examines the effects of psychosocial interventions to promote well-being among children exposed to intimate partner violence. The review summarizes evidence from eight methodologically rigorous randomized controlled trials.

    What studies are included?

    This review includes eight randomised controlled trials (RCTs), with a total of 924 participants.

    The majority of studies were conducted in the USA, with one study each carried out in the Netherlands and India. The age range of target children varied, although all fell within the age range of 0 to 18 years.

    Three of the studies recruited general populations of parents and/or children who had been exposed to IPV, without stated inclusion criteria around parent or child symptomatology or functioning.

    Four studies had more explicit inclusion requirements such as children with IPV-related post-traumatic stress disorder (PTSD) symptoms and fathers with alcohol dependence. Studies varied widely regarding the nature of IPV experienced by parents and witnessed or heard by children.

    What are the main findings of this review?

    Studies examined following outcomes: total problems, externalising distress, internalising distress, interpersonal/social problems, and cognitive functioning. However, differences in the specific measures used, interventions employed, and comparison groups limit the ability to synthesize findings.

    Evidence from two studies suggests there is preliminary evidence that in-home intensive services (parent training and provision of emotional support to the parent) decreases child externalising behaviour among children who have been exposed to IPV and have clinical levels of behaviour problems. However, support for this evidence was only found immediately post-treatment and at an eight-month follow-up, but not at a four-month follow-up.

    Intervention targeting the non-offending parent (mother) had the largest effect, followed by those that targeted the family together and, finally, the single study that targeted parent and child, separately.

    Interventions conducted in the home had a larger effect compared to those conducted in an outpatient setting. However, these findings should be interpreted with great caution due to the heterogeneity in study characteristics such as the nature of the comparators.

    Overall, it is largely unclear the extent to which psychosocial interventions promote well-being among children exposed to IPV, and under what circumstances.

    What do the findings of the review mean?

    The findings from this systematic review indicate that it is largely unclear the extent to which psychosocial interventions promote well-being among children exposed to IPV, and under what circumstances.

    More rigorous evaluation of psychosocial interventions needs to be conducted using common outcomes across studies in order to draw conclusions. We suggest that in addition to increased rigour in evaluation design (such as efforts to minimise selection bias), researchers assess the nature of child exposure and multiple subtypes of IPV; this will help elucidate whether interventions are more or less effective depending on the IPV exposure context.

    How up-to-date is this review?

    The review authors searched for studies up to April 2018.

Recovery schools for improving behavioral and academic outcomes among students in recovery from substance use disorders
  • Authors Emily A. Hennessy, Emily E. Tanner-Smith, Andrew J. Finch, Nila Sathe, Shannon Kugley
  • Published date 2018-10-04
  • Coordinating group(s) Education, Social Welfare
  • Type of document Review Plain language summary
  • Title Recovery schools for improving behavioral and academic outcomes among students in recovery from substance use disorders
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2018.9
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    There is insufficient evidence to know whether recovery high schools and collegiate recovery communities are effective

    Very limited evidence addresses the effectiveness of recovery high schools (RHSs). There is no rigorous evidence on the effectiveness of collegiate recovery communities (CRCs).

    What is this review about?

    Based on the results of one study, RHSs may reduce high school students’ school absenteeism, marijuana use, and other drug use, and increase abstinence from drugs; but RHSs may be no better or worse than other high schools in improving grades, reducing truancy, or reducing alcohol use.

    It is unclear whether CRCs are effective in promoting academic success and reducing substance use among college students.

    What is the aim of this review?

    This Campbell systematic review examines the effects of recovery schools on student behavioral and academic outcomes, compared to the effects of non-recovery schools. The review summarizes evidence from one quasi-experimental study (with a total of 194 participants) that had potential serious risk of bias due to confounding.

    What are the main findings of this review?

    Sizable portions of youth are in recovery from substance use disorders, and many youth will return to use after receiving substance use treatment. Youth spend most of their waking hours at school, and thus schools are important social environments for youth in recovery from substance use disorders. Recovery schools have been identified as educational programs that may help support youth in recovery from substance use disorders.

    This review focused on two types of recovery schools: RHSs, which are schools that award secondary school diplomas and offer a range of therapeutic services in addition to standard educational curricula; and CRCs, which offer therapeutic and sober support services on college campuses.

    This review looked at whether recovery schools (RHSs or CRCs) affect academic success and substance use outcomes among students, compared to similar students who are not enrolled in recovery schools.

    What studies are included?

    The included study of recovery high schools used a controlled quasi-experimental pretest-posttest design and reported on the following outcomes: grade point average, truancy, school absenteeism, alcohol use, marijuana use, other drug use, and abstinence from alcohol/drugs. The included study focused on a sample of U.S. high school students. There were no eligible studies of CRCs.

    What do the findings of this review tell us?

    Findings from this review indicate insufficient evidence on the effects of recovery schools on student well-being. Although there is some indication RHSs may improve academic and substance use outcomes, this is based on the findings from a single study. There is no available evidence on the effects of CRCs.

    No strong conclusions can be drawn at this time, given the lack of available evidence on RHSs and CRCs, and the serious risk of bias in the one RHS study included in the review. The evidence from this review suggests there is a clear need for additional rigorous evaluations of recovery school effects prior to widespread implementation.

    How up-to-date is this review?

    The review authors searched for studies until September 2018.

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    No existe evidencia suficiente para saber si las escuelas secundarias de recuperación y las comunidades universitarias de recuperación son efectivas

    Existe muy poca evidencia acerca de la efectividad de las escuelas secundarias de recuperación (RHS, por su sigla en inglés). No existe evidencia rigurosa acerca de la efectividad de las comunidades universitarias de recuperación (CRC, por su sigla en inglés).

    ¿De qué trata esta revisión?

    Según los resultados de un estudio, las RHS pueden reducir el ausentismo de estudiantes de secundaria, el consumo de marihuana y otras drogas, y aumentar la abstinencia; pero las RHS pueden no ser mejores o peores que otras escuelas secundarias en lo que respecta el desempeño académico, inasistencias escolares injustificadas o la reducción del consumo de alcohol.

    No está claro si las CRC promueven el éxito académico ni una disminución en el consumo de sustancias en los estudiantes universitarios.

    ¿Cuáles son los principales hallazgos de esta revisión?

    Un número considerable de jóvenes está en programas de recuperación de trastornos por consumo de sustancias, y muchos de ellos volverán a consumirlos incluso después de recibir rehabilitación. Los jóvenes pasan la mayor parte de sus horas del día en la escuela y, por lo tanto, las escuelas constituyen entornos sociales importantes para los jóvenes que se encuentran en recuperación por el consumo de sustancias. Las escuelas de recuperación han sido identificadas como programas educativos que pueden ayudar a los jóvenes a recuperarse de trastornos por consumo de sustancias.

    Esta revisión se centró en dos tipos de escuelas de recuperación: las RHS, que otorgan diplomas de secundaria y ofrecen una gama de servicios terapéuticos además de los planes de estudio estándar; y las CRC, que ofrecen servicios de apoyo terapéutico y de abstinencia en los campus universitarios.

    Esta revisión analizó si las escuelas de recuperación (RHS o CRC) afectan el desempeño académico y el nivel de consumo de sustancias entre los estudiantes, en comparación con estudiantes similares que no están inscritos en escuelas de recuperación.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión sistemática Campbell examina los efectos de las escuelas de recuperación en el desempeño académico y el comportamiento de los estudiantes, en comparación con los efectos de escuelas sin programas de recuperación. La revisión resume la evidencia de un estudio cuasi experimental (con un total de 194 participantes) que tuvo un riesgo potencialmente grave de sesgo por la omisión de variables relevantes que afectan la asociación real entre una variable dependiente e independiente (Confounding en inglés).

    ¿Qué estudios se incluyeron?

    Se incluyó un estudio de escuelas secundarias de recuperación que utilizó un diseño controlado cuasi experimental (pre-post test), que reportó los siguientes resultados: promedio de calificaciones, inasistencias injustificadas, ausentismo escolar, consumo de alcohol, consumo de marihuana, consumo de otras drogas y abstinencia de alcohol/ drogas. Dicho estudio se centró en una muestra de estudiantes de secundaria de EE.UU. No hubo estudios elegibles acerca de las CRC.

    ¿Qué significan los resultados de esta revisión?

    Los hallazgos de esta revisión indican que no existe evidencia suficiente acerca de los efectos que las escuelas de recuperación tienen en el bienestar de los estudiantes. Aunque existen algunos indicios de que las RHS pueden mejorar los resultados académicos y de consumo de sustancias, estos se basan en las conclusiones de un solo estudio. No existe evidencia disponible acerca de los efectos de las CRC.

    Dada la falta de evidencia disponible acerca de las RHS y CRC, y el riesgo grave de sesgo en el único estudio de RHS incluido en esta revisión, no se pueden extraer conclusiones sólidas en la actualidad. La evidencia de esta revisión sugiere que existe una clara necesidad de evaluaciones rigurosas adicionales de los efectos de las escuelas de recuperación antes de que se generalice su implementación.

    ¿Cuán actualizada es esta revisión?

    Los revisores buscaron estudios hasta septiembre de 2018. Esta revisión sistemática Campbell se publicó en octubre de 2018.

Deployment of personnel to military operations: impact on mental health and social functioning
  • Authors Martin Bøg, Trine Filges, Anne Marie Klint Jørgensen
  • Published date 2018-06-01
  • Coordinating group(s) Education, Social Welfare
  • Type of document Review Plain language summary
  • Title Deployment of personnel to military operations: impact on mental health and social functioning
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2018.6
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Deployment to military operations negatively affects the mental health functioning of deployed military personnel

    While additional research is needed, the current evidence strongly supports the notion that deployment negatively affects mental health functioning of deployed military personnel.

    What is this review about?

    When military personnel are deployed to military operations abroad they face an increased risk of physical harm, and an increased risk of adverse shocks to their mental health.

    The primary condition under consideration is deployment to an international military operation. Deployment to a military operation is not a uniform condition; rather, it covers a range of scenarios. Military deployment is defined as performing military service in an operation at a location outside the home country for a limited time period, pursuant to orders.

    The review included studies that reported outcomes for individuals who had been deployed. This review looked at the effect of deployment on mental health outcomes. The mental health outcomes are: post-traumatic stress disorder (PTSD), major depressive disorder (MDD), common mental disorders (depression, anxiety and somatisation disorders) and substance-related disorders.

    By identifying the major effects of deployment on mental health and quantifying these effects, the review can inform policy development on deployment and military activity as well as post-deployment support for veterans. In this way the review enables decision-makers to prioritise key areas.

    What is the aim of this review?

    This Campbell systematic review examines the effects of deployment on mental health. The review summarizes evidence from 185 studies. All studies used observational data to quantify the effect of deployment.

    What studies are included?

    This review includes studies that evaluate the effects of deployment on mental health. A total of 185 studies were identified. However, only 40 of these were assessed to be of sufficient methodological quality to be included in the final analysis. The studies spanned the period from 1993 to 2017 and were mostly carried out in the USA, UK and Australia. The studies all had some important methodological weaknesses. None of the included studies used experimental designs (random assignment).

    What are the main findings of this review?

    Does deployment have an effect on mental health?

    Deployment to military operations negatively affects the mental health functioning of deployed military personnel. For assessments taken more than 24 months since exposure, we consistently found adverse effects of deployment on all mental health domains (PTSD, depression, substance abuse/dependence, and common mental disorders), particularly on PTSD. For assessments taken less than 24 months (or a variable number of months since exposure) the evidence was less consistent and in many instances inconclusive.

    What do the findings of this review mean?

    The odds of screening positive for PTSD and depression were consistently high in the longer term. This suggests that efforts should be increased to detect and treat mental disorders, as effects may be long-lasting.

    Overall the risk of bias in the majority of included studies was high. While it is difficult to imagine a randomised study design to understand how deployment affects mental health, other matters such as changes to personnel policy, or unanticipated shocks to the demand for military personnel, could potentially be a rich source of quasi-experimental variation.

    How up-to-date is this review?

    The review authors searched for studies up to April 2017.

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    El despliegue de operaciones militares afecta negativamente la salud mental del personal militar movilizado

    Si bien se requiere más investigación al respecto, la evidencia actual respalda firmemente la idea de que el despliegue afecta negativamente la salud mental del personal militar movilizado.

    ¿Cuál es el tema que trata esta revisión?

    Cuando se moviliza personal militar a operaciones militares en el extranjero, se enfrentan a mayores riesgos físicos y traumas adversos para su salud mental.

    La condición primordial considerada es el despliegue de una operación militar internacional. El despliegue de una operación militar no es algo uniforme; más bien, cubre varios escenarios. El despliegue militar se define como la prestación del servicio militar en una operación fuera del país de origen y por un período de tiempo limitado, en conformidad con las órdenes entregadas.

    La revisión incluyó estudios que reportaron resultados para individuos que habían sido desplegados. Esta revisión analizó el efecto del despliegue en los resultados de salud mental. Los resultados de salud mental son: trastorno de estrés postraumático, trastorno depresivo mayor, trastornos mentales comunes (trastornos de depresión, ansiedad y somatización) y trastornos relacionados con sustancias.

    Al identificar los efectos principales del despliegue en la salud mental y cuantificar sus efectos, la revisión es capaz de proporcionar información para el desarrollo de políticas relacionadas con el despliegue y la actividad militar, al igual que el apoyo posterior al despliegue para los veteranos. De esta manera, la revisión permite a los tomadores de decisiones priorizar áreas clave.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión sistemática de Campbell examina los efectos del despliegue en la salud mental. La revisión resume la evidencia de 185 estudios. Todos los estudios utilizaron datos de observación para cuantificar el efecto del despliegue.

    ¿Cuáles son los principales hallazgos de esta revisión?

    ¿Qué estudios se incluyen?

    Esta revisión incluye estudios que evalúan los efectos del despliegue sobre la salud mental. Se identificó un total de 185 estudios. Sin embargo, sólo 40 de ellos tenían una calidad metodológica suficiente para ser incluidos en el análisis final. Los estudios abarcaron el período de 1993 a 2017, y se llevaron a cabo principalmente en EE. UU., el Reino Unido y Australia. Todos los estudios presentaron ciertas debilidades metodológicas importantes. Ninguno de los estudios incluidos utilizó diseños experimentales (asignación aleatoria).

    ¿Afecta el despliegue militar la salud mental?

    El despliegue de operaciones tiene un efecto negativo sobre la salud mental del personal militar movilizado. En las evaluaciones realizadas después de 24 meses de la exposición, encontramos consistentemente efectos adversos en todos los aspectos de la salud mental (trastorno de estrés postraumático, depresión, abuso/dependencia de sustancias y trastornos mentales comunes), especialmente en el trastorno de estrés postraumático. En evaluaciones realizadas antes de 24 meses (o un número variable de meses después) desde la exposición, la evidencia fue menos consistente, y en muchos casos no concluyente.

    ¿Qué significan los hallazgos de esta revisión?

    Las probabilidades de obtener resultados positivos en la detección del trastorno de estrés post traumático y la depresión fueron consistentemente altas a largo plazo. Esto sugiere que se deben aumentar los esfuerzos para detectar y tratar los trastornos mentales, ya que sus efectos pueden ser duraderos.

    En general, el riesgo de sesgo en la mayoría de los estudios incluidos fue alto. Si bien resulta difícil concebir un diseño de estudio aleatorizado para entender cómo el despliegue afecta la salud mental, otras cuestiones como los cambios en la política de personal o los impactos imprevistos en la demanda de personal militar podrían constituir una fuente abundante de variaciones cuasi-experimentales.

    ¿Qué tan actualizada es esta revisión?

    Los revisores buscaron estudios hasta abril de 2017. Esta revisión sistemática de Campbell se publicó en junio de 2018.

Reducing unemployment benefit duration to increase job-finding rates
  • Authors Trine Filges, Anders Bruun Jonassen, Anne-Marie Klint Jørgensen
  • Published date 2018-02-28
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title Reducing unemployment benefit duration to increase job-finding rates
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2018.2
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Reducing the maximum duration of unemployment benefits increases the job finding rate of the unemployed

    Reducing the maximum duration of unemployment benefits is one strategy used to reduce unemployment. Evidence from seven studies confirms such an effect. However, the effect is small and more studies of higher quality are needed to give more detailed findings to inform policy.

    What did the review study?

    Policymakers may wish to reduce the generosity of the unemployment benefits system in order to reduce unemployment levels. Reducing benefit levels may be politically more difficult than shortening the length of the unemployment benefit eligibility period to create work incentives for the unemployed.

    This review summarizes studies that measure the effects of shortening the maximum duration of unemployment benefit entitlement on job finding rates.

    What is the aim of this review?

    This Campbell systematic review examines the impact of reducing the maximum duration of unemployment benefits on job-finding rates. Seven studies were included in the review, all of which are from European countries.

    What studies are included?

    Included studies had to examine the effect of a reduction in the maximum duration of entitlement of any kind of unemployment benefits on employment using a well-defined control group.

    Whilst 41 studies were identified, after allowing for study quality and data issues, only seven studies were included in the review. The included studies covered Austria (2 studies), France, Germany (3 studies) and Slovenia. Maximum entitlement ranged between 26 and 209 weeks. The studies analyzed reductions between 9 and 179 weeks, with an average of 43 weeks. The studies analyze data from 1,154,090 unemployment spells.

    What are the main results of this review?

    Reducing the duration of unemployment benefits increases the exit rate from unemployment.

    Data from seven studies show that the exit rate from unemployment for those with reduced duration of benefit entitlement on average is 10 per cent. This corresponds to a 52% chance that those with reduced duration will find a job before an unemployed person with the existing, longer duration (no effect corresponds to a 50% chance).

    There is not enough evidence to determine effects on the exit rate from re-employment or on the wage rate in the job found. There are insufficient high-quality studies to allow an examination of variation of effects.

    What do the findings in this review mean?

    On the basis of this limited number of studies, shortening the maximum duration of unemployment benefit entitlement has a small effect on the job finding rate of the unemployed. Whether unemployed workers responding to a shorter potential benefit entitlement may be worse off, in the sense that they accept “lower quality” jobs, has not yet been fully investigated.

    But the review finds a surprisingly low number of studies with a sufficiently low risk of bias to be used for synthesis to determine the effect size of shortening the maximum duration of unemployment benefit entitlement. Many studies had to be excluded as they had a high risk of bias. This is a finding in its own right.

    There is a need for future studies to more thoroughly discuss the assumptions of the study design and justify the choice of method by considering and reporting all relevant data and tests. Future studies should also use data with all relevant information, in particular, information on whether eligible individuals actually received unemployment benefits and information on individual maximum entitlement duration.

    How up-to-date is this review?

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

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    La reducción en la duración de los beneficios por desempleo aumenta la tasa de salida del mismo

    La reducción en la duración máxima de los beneficios de desempleo es una de las estrategias utilizadas para reducir el mismo. La evidencia de siete estudios confirma dicho efecto. No obstante, el efecto es pequeño y se necesitan más estudios de mayor calidad para obtener resultados más detallados que orienten las políticas.

    ¿Qué estudió la revisión?

    Con el fin de reducir los niveles de desempleo, los formuladores de políticas pueden reducir la generosidad del sistema de beneficios de desempleo. Sin embargo, en la búsqueda de crear incentivos laborales para los desempleados, reducir los beneficios puede ser políticamente más difícil que acortar la duración del período de elegibilidad de los mismos.

    Esta revisión resume los estudios que miden los efectos de acortar la duración máxima del derecho a optar por beneficios de desempleo en las tasas para encontrar empleo de esta población.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión sistemática Campbell examina el impacto de reducir la duración máxima de los beneficios de desempleo sobre la tasa para encontrar empleo. En la revisión se incluyeron siete estudios, todos provenientes de países europeos.

    ¿Qué estudios se incluyen?

    Los estudios incluidos debían examinar el efecto de una reducción en la duración máxima del derecho a cualquier tipo de beneficio de desempleo sobre la tasa de empleo, utilizando un grupo de control bien definido.

    Si bien inicialmente se identificaron 41 estudios, tras la fase de análisis de datos y posibles problemas de calidad, se decidió incluir en la revisión solo siete investigaciones. Los estudios incluidos fueron realizados en Austria (2), Francia (1), Alemania (3) y Eslovenia (1). El periodo máximo de derecho a beneficios de desempleo varió de entre 26 a 209 semanas. Además, estos estudios analizaron reducciones de entre 9 y 179 semanas, con un promedio de 43 semanas, y analizan datos provenientes de 1.154.090 fases de desempleo.

    ¿Cuáles son los principales hallazgos de esta revisión?

    La reducción en la duración de los beneficios de desempleo aumenta la tasa de salida del mismo. Los datos de siete estudios muestran que la tasa promedio de salida del desempleo de aquellos a quienes se les reduce la duración de su derecho a beneficios es del 10%. Esto corresponde al 52% de probabilidad de que aquellos a quienes se les reduce la duración de los beneficios encuentren trabajo antes que una persona desempleada que goza de la duración actual de los mismos (más prolongada).

    No existe evidencia suficiente como para determinar los efectos sobre la tasa de salida del reempleo o la tasa salarial en el trabajo encontrado. Adicionalmente, no existen suficientes estudios de alta calidad que permitan examinar la variación de los efectos.

    ¿Qué significan los resultados de esta revisión?

    Sobre la base de este número limitado de estudios, la reducción de la duración máxima del derecho a beneficios por desempleo tiene un efecto pequeño sobre la tasa para encontrar empleo en los desempleados. La posibilidad de que los trabajadores desempleados, que poseen un potencial beneficio más breve, puedan estar dispuestos a aceptar trabajos de “menor calidad”, aún no se ha investigado lo suficiente.

    Sin embargo, la revisión encontró un número sorprendentemente bajo de estudios con un riesgo de sesgo que fuese lo suficientemente bajo como para generar una conclusión que permita determinar el tamaño del efecto de la reducción de la duración máxima del derecho a beneficios por desempleo. Por ende, se debió excluir muchos estudios que tenían un alto riesgo de sesgo, lo cual, en sí mismo, ya se puede considerar un resultado.

    Es necesario que los estudios futuros debatan más a fondo sobre los supuestos del diseño metodológico, y justifiquen la elección del método al considerar e informar todos los datos y pruebas pertinentes. Asimismo, los estudios futuros también deben usar datos que contengan toda la información oportuna, especialmente, sobre si los individuos elegibles recibieron efectivamente beneficios de desempleo y sobre la duración máxima de los mismos.

    ¿Cuán actualizada es esta revisión?

    Los autores de la revisión buscaron estudios publicados hasta diciembre de 2016. Esta Revisión Sistemática Campbell fue publicada en febrero de 2018.

Effectiveness of interventions to reduce homelessness
  • Authors Heather Menzies Munthe-Kaas, Rigmor C Berg, Nora Blaasvær
  • Published date 2018-02-28
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Title Effectiveness of interventions to reduce homelessness
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2018.3
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Interventions to reduce homelessness and improve housing stability are effective

    There are large numbers of homeless people around the world. Interventions to address homelessness seem to be effective, though better quality evidence is required.

    What did the review study?

    There are large numbers of homeless people around the world. Efforts to combat homelessness have been made on national levels as well as at local government levels.

    This review assesses the effectiveness of interventions combining housing programmes with or without case management as a means to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of interventions to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless. Forty-three studies were included in the review, 37 of which are from the USA.

    What studies are included?

    Included studies were randomized controlled trials of interventions for individuals who were already, or at-risk of becoming, homeless, and which measured impact on homelessness or housing stability with follow-up of at least one year.

    A total of 43 studies were included. The majority of the studies (37) were conducted in the United States, with three from the United Kingdom and one each from Australia, Canada, and Denmark.

    What are the main results in this review?

    Included interventions perform better than the usual services at reducing homelessness or improving housing stability in all comparisons.

    These interventions are:

    • High- and low-intensity case management
    • Housing First
    • Critical time intervention
    • Abstinence-contingent housing
    • Non-abstinence-contingent housing with high-intensity case management
    • Housing vouchers
    • Residential treatment

    These interventions seem to have similar beneficial effects, so it is unclear which of these is best with respect to reducing homelessness and increasing housing stability. Evidence with moderate certainty is available for high-intensity case management and housing first compared to usual services.

    What do the findings in this review mean?

    A range of housing programs and case management interventions appear to reduce homelessness and improve housing stability, compared to usual services.

    However, there is uncertainty in this finding as most the studies have risk of bias due to poor reporting, lack of blinding, or poor randomization or allocation concealment of participants. In addition to the general need for better conducted and reported studies, there are specific gaps in the research with respect to: 1) disadvantaged youth; 2) abstinence-contingent housing with case management or day treatment; 3) non-abstinence contingent housing comparing group vs independent living; 4) Housing First compared to interventions other than usual services, and; 5) studies outside of the USA.

    How up-to-date is this review?

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

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    Las intervenciones para reducir el número de personas sin hogar y mejorar la estabilidad de la vivienda son eficaces

    Existe un gran número de personas sin hogar en todo el mundo. Las intervenciones para abordar la falta de hogar parecen ser eficaces, aunque se requiere evidencia de mejor calidad.

    ¿Qué estudió esta revisión?

    Existe un gran número de personas sin hogar en todo el mundo. Se han realizado esfuerzos para combatir la falta de hogar tanto a nivel nacional como desde los gobiernos locales.

    Esta revisión evalúa la efectividad de las intervenciones que combinan programas de vivienda, con o sin manejo de casos, como un medio para reducir la falta de hogar y aumentar la estabilidad residencial para personas sin hogar, o en riesgo de quedarse sin hogar.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión sistemática Campbell examina la efectividad de las intervenciones para reducir la falta de hogar y aumentar la estabilidad residencial para las personas sin hogar o en riesgo de quedarse sin hogar. Cuarenta y tres estudios fueron incluidos en la revisión, 37 de los cuales provienen de EE.UU.

    ¿Qué estudios se incluyen?

    Los estudios incluidos fueron ensayos controlados aleatorios de intervenciones para individuos que ya estaban, o corrían el riesgo de quedar sin hogar, y que midieron el impacto sobre la falta de hogar o la estabilidad de la vivienda con un seguimiento de al menos un año.

    Se incluyeron un total de 43 estudios. La mayoría de los estudios (37) se realizaron en EE.UU., sumados a tres realizados en el Reino Unido, y uno en Australia, Canadá y Dinamarca respectivamente.

    ¿Cuáles son los principales hallazgos de esta revisión?

    Las intervenciones incluidas presentan mejor desempeño que los servicios habituales para reducir la falta de hogar o mejorar la estabilidad de la vivienda en todas las comparaciones.

    Estas intervenciones son:

    • Manejo de casos de alta y baja intensidad
    • Housing First (“Vivienda Primero”)
    • Intervención de tiempo crítico
    • Vivienda contingente a la abstinencia
    • Vivienda no contingente a la abstinencia con manejo de casos de alta intensidad
    • Vales de vivienda
    • Tratamiento residencial

    Estas intervenciones parecieran tener efectos beneficiosos similares, por lo que no está claro cuál de ellas es más efectiva en reducir la falta de hogar y aumentar la estabilidad en términos de vivienda. Existe evidencia con certeza moderada para el manejo de casos de alta intensidad y de Housing First en comparación con los servicios habituales.

    ¿Qué significan los resultados de esta revisión?

    Una variedad de programas de vivienda e intervenciones de manejo de casos parecen reducir la falta de hogar y mejorar la estabilidad de la vivienda, en comparación con los servicios habituales.

    Sin embargo, aún hay incertidumbre con respecto a este hallazgo, ya que la mayoría de los estudios presentan riesgos debido a la falta de reporte de información, incumplimiento o una asignación aleatoria deficiente. Además de haber una necesidad general de estudios mejor dirigidos e informados, existen oportunidades de aprendizaje en la investigación con respecto a: 1) jóvenes en situación de riesgo; 2) vivienda contingente a la abstinencia con manejo de casos o tratamiento diurno; 3) vivienda contingente sin abstinencia comparando la convivencia individual contra la vida independiente; 4) la comparación del modelo Housing First comparada con las intervenciones distintas de los servicios habituales y; 5) estudios realizados fuera de EE.UU.

    ¿Cuán actualizada es esta revisión?

    Los revisores buscaron estudios publicados hasta enero de 2016. Esta revisión sistemática Campbell se publicó en febrero de 2018.

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

    PLAIN LANGUAGE SUMMARY

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

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

    What did the review study?

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

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

    What is the aim of this review?

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

    What studies are included?

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

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

    What are the main results in this review?

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

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

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

    What do the findings in this review mean?

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

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

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

    How up-to-date is this review?

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

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    Los programas activos en el mercado laboral para jóvenes aumentan el empleo y los ingresos, pero los efectos varían entre programas y contextos

    Los jóvenes son víctimas de forma desproporcionada en cuanto a desempleo y trabajos de baja calidad se refiere. Los programas activos en el mercado laboral aumentan los ingresos y el empleo. Aun así, los efectos varían mucho entre el tipo de programa, el diseño y el contexto.

    ¿Qué estudió la revisión?

    El desempleo juvenil es mucho mayor que la tasa de desempleo promedio para los adultos; en algunos casos, es hasta más de tres veces mayor. Hoy, más de 73 millones de jóvenes están en situación de desempleo en todo el mundo. Además, dos de cada cinco jóvenes en la fuerza laboral trabajan, pero son pobres o están desempleados. Por ello, el desafío del empleo juvenil no solo se trata de la creación de empleos, sino especialmente de mejorar la calidad de los mismos para los jóvenes.

    Esta revisión sistemática evalúa el impacto de las intervenciones de empleo juvenil en los resultados del mercado laboral de los jóvenes. Las intervenciones que se incluyen son la capacitación y desarrollo de habilidades, la promoción de la iniciativa empresarial, servicios de empleo y empleo subsidiado. Los resultados de interés incluyen empleo, ingresos y resultados de desempeño empresarial.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión sistemática Campbell examina el impacto de la intervenciones de empleo juvenil en los resultados del mercado laboral de los jóvenes y el desempeño empresarial. La revisión resume los resultados de 113 estudios con 107 intervenciones en 31 países.

    ¿Qué estudios se incluyen?

    Los estudios incluidos debían: (1) evaluar un programa activo en el mercado laboral (ALMP, por su sigla en inglés) que estuviese diseñado para, o dirigido principalmente a, mujeres y hombres jóvenes entre 15 y 35 años; (2) tener un diseño experimental o cuasi-experimental; e (3) informar al menos una variable de resultado elegible que midiera empleo, ingresos o desempeño empresarial.

    La estudios investigados abarcan 107 intervenciones en 31 países, incluidas 55 que utilizaron capacitación profesional, 15 que promovieron iniciativas empresariales, diez que utilizaron servicios de empleo y 21 que utilizaron empleo subsidiado.

    ¿Cuáles son los principales hallazgos de esta revisión?

    En general, las intervenciones de empleo juvenil aumentan el empleo y los ingresos de los jóvenes que participan en ellas. No obstante, el efecto es pequeño y presenta mucha variación entre los programas. Existen efectos significativos para la promoción de la iniciativa empresarial y la capacitación profesional, pero no para los servicios de empleo y el empleo subsidiado.

    Los impactos en los ingresos también fueron positivos, pero pequeños y muy variables a través de los programas. La promoción de la iniciativa empresarial y la capacitación profesional fueron eficaces para aumentar los ingresos, mientras que los efectos de los servicios de empleo y el empleo subsidiado fueron nulos, o estadísticamente insignificantes. Existe evidencia limitada acerca de los efectos de los programas de empleo juvenil sobre los resultados del desempeño empresarial, y el tamaño del efecto no fue estadísticamente significativo.

    Además de la variación en el impacto entre distintos tipos de programas, algunas variaciones pueden explicarse por el contexto del país, el diseño de la intervención y el perfil y características de los beneficiarios del programa. Los impactos de estos programas son de mayor magnitud en los países de ingresos medios o bajos que en los países de ingresos altos. Los programas dirigidos a los jóvenes en situación de más desventaja se asociaron con mayores efectos del programa, en particular con respecto a los resultados de los ingresos y los efectos fueron ligeramente mayores para las mujeres que para los hombres.

    ¿Qué significan los resultados de este estudio?

    La evidencia sugiere que invertir en los jóvenes a través de medidas activas en el mercado laboral puede rendir frutos. Las intervenciones de capacitación profesional y de promoción de la iniciativa empresarial parecen brindar, en promedio, resultados positivos. Por lo tanto, existen beneficios potenciales de combinar intervenciones de oferta y demanda para apoyar a los jóvenes en el mercado laboral.

    La evidencia señala la necesidad de un diseño cuidadoso de las intervenciones de empleo juvenil. El “cómo” parece ser más importante que el “qué” y, en este sentido, la focalización hacia los jóvenes en situación de desventaja puede actuar como un factor clave para el éxito.

    Es necesario fortalecer la evidencia con más estudios de programas prometedores, especialmente en el África subsahariana. Las investigaciones futuras deben estudiar los resultados intermedios y las habilidades interpersonales, así como deben recopilar los datos de costos.

    ¿Cuán actualizada es esta revisión?

    Los revisores buscaron estudios publicados hasta enero de 2015. Esta revisión sistemática Campbell se publicó en diciembre de 2017.

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

    PLAIN LANGUAGE SUMMARY

    Mindfulness training improves health and quality of life for adults

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

    What is this review about?

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

    What is the aim of this review?

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

    What studies are included?

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

    Is mindfulness effective?

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

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

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

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

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

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

    What do the findings of this review mean?

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

    How up-to-date is this review?

    The review authors searched for studies up to November 2015.

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    La práctica del Mindfulness o Atención Plena mejora la salud y la calidad de vida en adultos

    El programa Mindfulness de Reducción de Estrés (MBSR) se usa para mejorar la salud, la calidad de vida y el funcionamiento social. Este programa tiene un efecto positivo en los resultados de salud mental medidos inmediatamente después de la intervención y durante el seguimiento. Además, mejora el desarrollo personal, la calidad de vida y la atención plena.

    ¿Cuál es el tema que trata esta revisión?

    El estrés y los problemas de salud mental relacionados con este, constituyen algunas de las causas principales de enfermedad y discapacidad. El programa Mindfulness de Reducción de Estrés es una intervención grupal de promoción de la salud para mejorar la forma en que las personas lidian con el estrés y los desafíos de la vida. El componente esencial es el entrenamiento de la atención plena mediante ejercicios físicos y mentales practicados a diario por un periodo de ocho semanas. La actitud consciente y no crítica de estar presente en lo que surge, se practica mediante ejercicios formales, así como en situaciones cotidianas. Esta revisión evalúa el efecto de los programas de Mindfulness en las variables de resultado para la salud mental y física, la calidad de vida y el funcionamiento social en adultos.

    ¿Cuál es el objetivo de esta revisión?

    Esta revisión resume todos aquellos estudios que comparan el efecto de un programa de Mindfulness, en que los participantes habían sido asignados aleatoriamente, con el grupo de control. La revisión resume los resultados en dos categorías. En primer lugar, el efecto del programa se comparó con un grupo inactivo (a un grupo de lista de espera, o bien, a uno que recibió atención normal también recibida por el tratamiento). En segundo lugar, el programa se comparó con una intervención de control activa alternativa.

    ¿Qué estudios se incluyen?

    La revisión resume 101 ensayos controlados aleatorios, con un total de 8.135 participantes de Estados Unidos, Europa, Asia y Australia. Veintidós ensayos incluyeron a personas que presentaban problemas psicológicos leves o moderados, 47 seleccionaron individuos con diversas condiciones somáticas, y 32 de los estudios incorporaron a personas de la población general. Setenta y dos estudios compararon el Mindfulness con un grupo de control puro, mientras que 37 de ellos lo compararon con una intervención de control activo, y siete estudios con ambos. Por último, noventa y seis estudios aportaron datos a los metaanálisis, con datos recogidos de 7.647 participantes.

    ¿La atención plena es efectiva?

    El Mindfulness tiene un efecto medianamente importante sobre las variables de resultado de salud mental, salud somática, y calidad de vida, incluida la función social en forma posterior a la intervención, en comparación con un control puro.

    Los resultados indican que si 100 personas pasan por el programa de Mindfulness, 21 personas tendrán un resultado favorable de salud mental, a diferencia de si se les hubiera asignado a una lista de espera o que solo hubieran recibido el tratamiento común y corriente.

    Estos resultados pueden ser más elevados de lo normal debido al subregistro de ensayos negativos, y a una heterogeneidad moderada (lo que indica diferencias entre los ensayos).

    El Mindfulness presenta un efecto pequeño pero significativo en la mejora de la salud mental posterior a la intervención, en comparación con otros tratamientos. Adicionalmente, la intervención tiene el mismo efecto sobre la salud somática y la calidad de vida (incluida la función social) que otros tratamientos. No hubo subregistro de ensayos negativos, y la heterogeneidad (diferencias entre ensayos) fue pequeña para la salud mental, moderada para la calidad de vida, e importante para la salud somática.

    Los efectos fueron similares en todos los grupos objetivo y, en general, se mantuvieron durante el seguimiento (1-34 meses). En su gran mayoría, los efectos no dependieron del género ni de la muestra del estudio y, al parecer, también fueron independientes de la duración y del cumplimiento con los criterios de la intervención. Ningún estudio informa resultados referentes a efectos secundarios o costos.

    Los impactos se correlacionaron fuertemente con los efectos sobre las medidas de atención plena, lo que indica que estos pueden estar relacionados con el aumento de la misma.

    Dos tercios de los estudios incluidos mostraron un riesgo de sesgo significativo, el cual fue mayor entre estudios con grupos de control puro que con grupos activos. Los estudios de mayor calidad informaron menores efectos que los estudios de baja calidad. La calidad general de la evidencia fue moderada, lo que indica cierta confianza en los tamaños de efecto informados. Por ende, investigación adicional podría modificar la estimación del efecto.

    ¿Qué significan los resultados de esta revisión?

    En función de esta revisión, es razonable considerar al Mindfulness como un método moderadamente bien documentado para ayudar a los adultos a mejorar su salud y afrontar de mejor manera los desafíos y el estrés que conlleva la vida. Las nuevas investigaciones deberían mejorar la forma en que se realizan los ensayos, abordando las dificultades presentes en la investigación de intervenciones sobre la relación cuerpo-mente.

    ¿Cuán actualizada es esta revisión?

    Los autores de la revisión buscaron estudios publicados hasta noviembre de 2015. Esta Revisión Sistemática Campbell fue publicada en octubre de 2017.

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

    PLAIN LANGUAGE SUMMARY

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

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

    What did the review study?

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

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

    What is the aim of this review?

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

    What studies are included?

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

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

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

    What are the main results in this review?

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

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

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

    There was no evidence of adverse effects.

    What do the findings in this review mean?

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

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

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

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

    How up-to-date is this review?

    The review authors searched for studies published until April 2016.

  • Spanish

    RESUMEN EN LENGUAJE SENCILLO

    Las intervenciones puntuales automatizadas parecen disminuir el riesgo de alcoholismo entre los jóvenes; pero no existe evidencia sobre los efectos producidos en el consumo de cannabis

    Los jóvenes que abusan del consumo de alcohol o de cannabis corren riesgo de sufrir consecuencias médicas o legales en el plazo inmediato o a largo plazo. Existe cierta evidencia sobre el impacto generado por el consumo excesivo de alcohol. Sin embargo, obtener conclusiones se ha visto obstaculizado por falta de evidencia rigurosa, por lo tanto, se requieren mayores investigaciones.

    ¿Qué estudió la revisión?

    El consumo excesivo de alcohol y de drogas para fines recreativos entre los jóvenes es una importante preocupación de salud pública, que debiera abordarse con intervenciones eficaces que brinden ayuda y orientación. Una intervención puntual automatizada es cualquier clase de actividad preventiva o terapéutica ofrecida a través de medios electrónicos conectados o no conectados a Internet, tales como teléfonos móviles, y que se desarrolla dentro de la hora siguiente o, incluso, tras escasos minutos de ocurrido el abuso de la sustancia. Tales intervenciones buscan disminuir el consumo excesivo de drogas y de alcohol en líneas generales. Esta revisión evalúa las investigaciones realizadas sobre la efectividad de intervenciones puntuales automatizadas y oportunas en cuanto al consumo de alcohol y de cannabis por parte de jóvenes que abusan de uno de ellos o de ambos.

    ¿Cuál es el objetivo de esta revisión?

    La presente revisión sistemática de Campbell evalúa las investigaciones efectuadas sobre la efectividad de intervenciones puntuales automatizadas y oportunas en cuanto al consumo de alcohol y cannabis por parte de jóvenes que abusan de uno de ellos o de ambos o que se encuentran en niveles riesgosos de consumo. La revisión resume las conclusiones de 60 estudios provenientes de 10 países. Los participantes son todos jóvenes de entre 15 y 25 años catalogados en niveles riesgosos de consumo de alcohol o cannabis o ambos. La revisión incluyó a 33.316 participantes.

    ¿Qué estudios se incluyeron?

    Los estudios incluidos emplearon ensayos controlados aleatorios e informaron sobre intervenciones puntuales automatizadas efectuadas como tratamiento específico para disminuir el consumo de alcohol y cannabis. El resultado secundario evaluado arrojó consecuencias adversas.

    Los estudios fueron realizados en Estados Unidos, Nueva Zelandia, los Países Bajos, Suecia, Australia, Alemania, Suiza y Brasil; uno de ellos se realizó en varios países a la vez (Suecia, Bélgica, República Checa y Alemania).

    Los participantes eran consumidores de alcohol o cannabis o ambos de entre 15 y 25 años. Se incluyó en la revisión un total de 60 estudios con una muestra de 33.316 participantes.

    ¿Cuáles son los principales resultados obtenidos por esta revisión?

    Las intervenciones redujeron significativamente el consumo de alcohol en el corto plazo en comparación con la ausencia de intervenciones, aunque la magnitud del efecto fue leve y no se apreciaron efectos significativos a largo plazo. También existen limitaciones en cuanto a la calidad de la evidencia.

    Las intervenciones que abordan el consumo de alcohol con retroalimentación, tal vez generen mayor efecto que aquellas que no lo hacen, aunque se reitera que la evidencia es débil.

    Los pocos estudios revisados sobre el consumo de cannabis no mostraron efectos significativos en la reducción de su consumo. No se presentaron evidencias de efectos adversos.

    ¿Qué significan los resultados de esta revisión?

    En líneas generales, las intervenciones relacionadas con el consumo de alcohol parecieron funcionar bien. Sin embargo, todos los estudios incluidos en la revisión presentaron defectos metodológicos. Dada la falta de evidencia rigurosa, esta conclusión debería ser considerada con cautela.

    Solo unos pocos estudios se dedicaron al cannabis, dificultando así obtener cualquier conclusión definitiva sobre la eficacia de la intervención a este respecto.

    Sin embargo, a pesar de que se duda de la validez de los resultados, las intervenciones puntuales automatizadas no debieran ser del todo descartadas, pues son fáciles de administrar, son económicas y no producen efectos adversos.

    Es necesario llevar a cabo investigaciones de mayor calidad, especialmente con respecto a estudios focalizados en el uso del cannabis.

    ¿Cuán actual es esta revisión?

    Sus autores revisaron estudios publicados hasta abril de 2016 y este trabajo fue publicado en abril de 2017.

Page 1 of 3

Contact us