Evaluation Of Interventions For Children Research Articles

Views, obstacles, and uncertainties around the inclusion of children and young people's time in economic evaluations: Findings from an international survey of health economists

People's time is a limited resource and, in economic evaluations that adopt a societal perspective, it is important that it is valued and accounted for. Yet, in economic evaluations of interventions for children and young people (CYP), attempts to take into account the opportunity cost of their time are rare. To understand why this is the case, we need to first understand what views health economists hold in relation to CYP time, and what challenges they face in incorporating this in their evaluations.We planned and carried out an international survey of health economists. We used a combination of approaches to identify potential survey respondents (the survey's sampling frame), we developed a questionnaire that sought to capture respondents' views and practice through close- and open-ended questions, we piloted the questionnaire through a series of cognitive interviews, and we e-mailed unique links to the final version of the questionnaire to 1956 individuals in the sampling frame. We analysed data using quantitative (descriptive and inferential statistics) and qualitative (thematic analysis) methods.We received 274 complete responses. Most respondents (87%) believe CYP time should be considered for inclusion in economic evaluations conducted from a societal perspective. However, they identify a number of obstacles to doing so, most prominently uncertainties around appropriate practice (e.g., when CYP's time should or should not be included in calculations), methodological gaps (e.g., what value to attach to CYP's time), and practical difficulties in measuring displaced time in CYP. Reporting on their own practice, most respondents found it challenging to consider CYP time in their studies, and stressed the need for clear guidance on when, and further research on how, to appropriately account for CYP's time in economic evaluations. We offer our views on how to move the topic forwards and make suggestions further research.

Using the RE-AIM Framework to Guide the implementation and Evaluation of interventions for Children with Communication Disorders

Using the RE-AIM Framework to Guide the implementation and Evaluation of interventions for Children with Communication Disorders

Parents Suggest Which Indicators of Progress and Outcomes Should be Measured in Young Children with Autism Spectrum Disorder

Evaluation of interventions for children with autism spectrum disorder (ASD) is hampered by the multitude of outcomes measured and tools used. Measurement in research with young children tends to focus on core impairments in ASD. We conducted a systematic review of qualitative studies of what matters to parents. Parent advisory groups completed structured activities to explore their perceptions of the relative importance of a wide range of outcome constructs. Their highest ranked outcomes impacted directly on everyday life and functioning (anxiety, distress, hypersensitivity, sleep problems, happiness, relationships with brothers and sisters, and parent stress). Collaboration between professionals, researchers and parents/carers is required to determine an agreed core set of outcomes to use across evaluation research.

Economic Evaluation of Interventions for Children with Neurodevelopmental Disorders: Opportunities and Challenges.

Economic evaluation is a tool used to inform decision makers on the efficiency of comparative healthcare interventions and inform resource allocation decisions. There is a growing need for the use of economic evaluations to assess the value of interventions for children with neurodevelopmental disorders (NDDs), a population that has increasing demands for healthcare services. Unfortunately, few evaluations have been conducted to date, perhaps stemming from challenges in applying existing economic evaluation methodologies in this heterogeneous population. Opportunities exist to innovate methods to address key challenges in conducting economic evaluations of interventions for children with NDDs. In this paper, we discuss important considerations and highlight areas for future work. This includes the paucity of appropriate instruments for measuring outcomes meaningful to children with NDDs and their families, difficulties in the measurement of costs due to service utilization in a wide variety of sectors, complexities in the measurement of caregiver and family effects and considerations in estimating long-term productivity costs. Innovation and application of evaluation approaches in these areas will help inform decisions around whether the resources currently spent on interventions for children with NDDs represent good value for money, or whether greater benefits for children could be generated by spending money in other ways.

Systematic review of the properties of tools used to measure outcomes in anxiety intervention studies for children with autism spectrum disorders.

BackgroundEvidence about relevant outcomes is required in the evaluation of clinical interventions for children with autism spectrum disorders (ASD). However, to date, the variety of outcome measurement tools being used, and lack of knowledge about the measurement properties of some, compromise conclusions regarding the most effective interventions.ObjectivesThis two-stage systematic review aimed to identify the tools used in studies evaluating interventions for anxiety for high-functioning children with ASD in middle childhood, and then to evaluate the tools for their appropriateness and measurement properties.MethodsElectronic databases including Medline, PsychInfo, Embase, and the Cochrane database and registers were searched for anxiety intervention studies for children with ASD in middle childhood. Articles examining the measurement properties of the tools used were then searched for using a methodological filter in PubMed, and the quality of the papers evaluated using the COSMIN checklist.ResultsTen intervention studies were identified in which six tools measuring anxiety and one of overall symptom change were used as primary outcomes. One further tool was included as it is recommended for standard use in UK children's mental health services. Sixty three articles on the properties of the tools were evaluated for the quality of evidence, and the quality of the measurement properties of each tool was summarised.ConclusionsOverall three questionnaires were found robust in their measurement properties, the Spence Children's Anxiety Scale, its revised version – the Revised Children's Anxiety and Depression Scale, and also the Screen for Child Anxiety Related Emotional Disorders. Crucially the articles on measurement properties provided almost no evidence on responsiveness to change, nor on the validity of use of the tools for evaluation of interventions for children with ASD.PROSPERO Registration numberCRD42012002684.

PREDICTORS OF STUDY RETENTION FROM A MULTISITE STUDY OF INTERVENTIONS FOR CHILDREN AND FAMILIES EXPOSED TO VIOLENCE

Evaluation of interventions for children exposed to violence is critical for informing dissemination of effective services nationally, but retention rates in such studies are typically low, jeopardizing intent-to-treat analytic approaches. We examine predictors of retention (demographics, violence exposure, child mental health, caregiver demographics, and engagement in intervention) in a large multisite national study of interventions for children exposed to violence. Our analyses found that families were more likely to be retained in the study at 6 months if caregivers rated their own physical health as poor or fair, the child experienced higher levels of maltreatment, or the family was assigned to the intervention group within the study. In models limited to those families in the study's intervention group, only receipt of services was significantly related to study retention. Methods with which to increase retention in family therapy programs for at-risk families are discussed.

Oppositional defiant disorder: A systematic review of evidence of intervention effectiveness

This research synthesis examines rigorous evaluations of interventions for children diagnosed with ODD. The primary goal was to identify and synthesize through meta-analysis what is known regarding the effectiveness of various treatments. A secondary goal was to assess the degree to which treatment effectiveness is being evaluated in multiple domains. Seven studies were identified that measured outcomes in six domains. As in prior reviews, interventions demonstrate improvements in the child’s behavior at home and parental stress/strain. Support for improvements in behavior and performance in school is not as strong due in part to a scarcity of attention to the multiple domains of functioning. The interventions reviewed here demonstrate some benefit and no harm; however, there is room to strengthen the research base.

The Essential Role of Theory in the Science of Treating Children: Beyond Empirically Supported Treatments

The central tenet of this article is that theory plays an essential role in the development and evaluation of interventions for children's psychosocial problems. Recent efforts to identify efficacious treatments have paid insufficient attention to the role of psychological theory in intervention development, evaluation, and application. Six principles of developmental psychopathology (defined as a broad framework that incorporates diverse theoretical principles and orientations) are applied to the development, evaluation, and application of interventions for the prevention and treatment of dysfunction in children and adolescents. Specific benefits of incorporating theoretical and empirical findings from developmental psychopathology in school consultation research and practice are delineated. A view of empiricism as equivalent to science and a distrust of theory as a basis for intervention research and practice will hinder the development of a science of treating children.

Economic evaluations and interventions for children and adolescents with mental health problems.

Economic evaluations of interventions for children and adolescents with mental health problems are comparatively rare, although the growing need for them is now quite widely recognized. This review paper first explains how demands for such evaluations have built up, and for what reasons, and then considers the response from evaluators. The various modes of economic evaluation are introduced and illustrated. Previous and current research is discussed by reference to five generic research questions commonly addressed in the wider health economics field: What treatment should be provided? When? Where? To whom? How? The review concludes with recommendations as to how economic evaluations should be taken forward in this increasingly important area of intervention.