Primary Care Interventions for Early Childhood Development: A Systematic Review.

Abstract

The pediatric primary care setting offers a platform to promote positive parenting behaviors and the optimal development of young children. Many new interventions have been developed and tested in this setting over the past 2 decades. To summarize the recent published evidence regarding the impact of primary care-based interventions on parenting behaviors and child development outcomes; to provide recommendations for incorporation of effective interventions into pediatric clinics. A literature search of PubMed and PsycINFO was conducted from January 1, 1999, to February 14, 2017. Publications in which primary care-based interventions and reported outcomes regarding the child's development or parenting behaviors associated with the promotion of optimal child development are described. Forty-eight studies in which 24 interventions were described were included. Levels of evidence and specific outcome measures are reported. Included interventions were categorized as general developmental support, general behavioral development, or topic-specific interventions. Two interventions resulted in reductions in developmental delay, 4 improved cognitive development scores, and 6 resulted in improved behavioral intensity or reduction in behavioral problems. Interventions used a variety of theory-based behavior change strategies such as modeling, group discussion, role play, homework assignment, coaching, and video-recorded interactions. Three interventions report the cost of the intervention. Community or home-based interventions were excluded. Although several interventions resulted in improved child development outcomes for children aged 0 to 3 years, comparison across studies and interventions is limited by use of different outcome measures, time of evaluation, and variability of results.