Home-visiting interventions for families with complex and multiple problems: A systematic review and meta-analysis of out-of-home placement and child outcomes

Arjen van Assen*, Jana Knot-Dickscheit, Wendy Post, Hans Grietens

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)
132 Downloads (Pure)

Abstract

Children growing up in families experiencing complex and multiple problems (FECMP) are at an increased risk of developing problems in multiple areas of life. A wide array of home-visiting interventions has been developed to address the complex care needs of these families. The aim of this study is to investigate out-of-home placement rates and child outcomes of these home-visiting interventions. A systematic review and meta-analysis was conducted using five scientific databases (PsycInfo, ERIC, SocIndex, MedLine, & Picarta). The systematic search of these databases yielded 8,377 hits. Forty-two publications reporting on 50 studies were included in the review. A random-effects survival curve meta-analysis model was estimated for out-of-home placement and random-effects meta-analysis models were estimated for children's behavioral problems and stressful experiences. Out-of-home placement increased from 7.5% at case closure to 24.3% one year after case closure. On average there was a moderate decrease in emotional and behavioral problems (d = 0.50) and stressful experiences (d = 0.50) during intervention, but considerable problems remained after case closure. More research is needed to investigate family and service characteristics that may explain heterogeneity in outcomes. Furthermore, there is a need to adopt a broader perspective in evaluations of home-visiting services by including outcomes related to the skills, development, and wellbeing of children.

Original languageEnglish
Article number104994
Number of pages14
JournalChildren and Youth Services Review
Volume114
DOIs
Publication statusPublished - Jul-2020

Keywords

  • Intensive home-visiting
  • Families experiencing multiple problems
  • Child outcomes
  • Out-of-home placement
  • Meta-analysis
  • RANDOM-EFFECTS MODELS
  • PRESERVATION SERVICES
  • DIFFICULTIES QUESTIONNAIRE
  • IDENTIFYING FAMILIES
  • PUBLICATION BIAS
  • MENTAL-HEALTH
  • SOCIAL-WORK
  • DRUG-USE
  • PROGRAM
  • CARE

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