Figure 1
PRISMA Flow diagram of screening results.
Table 1
Characteristics of the four included studies.
| AUTHOR/YEAR/LOCATION | STUDY CHARACTERISTICS | PARTICIPANT CHARACTERISTICS | OUTCOME CHARACTERISTICS | RISK OF BIAS (MEASURE USED) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TOTAL SAMPLE | INTERVENTION GROUP | CONTROL GROUP | STUDY TYPE/DURATION | SETTING | INTERVENTION | AGE MEAN (YEARS) | SEX (%) | ADVERSITY | OUTCOME MEASURES | SIGNIFICANT OUTCOMES | ||
| Briggs et al. 2011 (United States) | 79 with elevated ASQ:SE scores | 41 | 38 | Prospective cohort 5-year duration | Primary care paediatric practice | Children identified with elevated ASQ:SE scores through universal screening were offered evaluation by Infant Toddler Specialists and appropriate treatment or referral in consultation with paediatric provider. Treatment included education and family support. | 47.4% 0-12 months Mean and SD not available (range 6 months -3 years) | 52% Male | Racial minority – Hispanic or African American – 82.1% Receiving Medicaid or other state-sponsored insurance programs – 68.9% | ASQ-SE | ASQ-SE Significant improvement on ASQ:SE scores in intervention children compared with those who declined intervention (p = .01) | Low (ROBINS-I) |
| Molnar et al. 2018 (United States) | 225 | 225 | – | Prospective cohort 12 months | Paediatric medical homes at 3 sites servicing primarily low-income residents | Early Childhood Mental Health clinician and family partner (case manager) provided: case coordination with paediatric medical homes, care planning, referrals as needed and child mental health and or parenting interventions. | 3.26 years (SD 2.01, range 0-8 years) | 62% Male | Racial minority African American – 34% Hispanic – 53% | ASQ-SE for children aged 5 years and younger CBCL for children aged 6-8 years | ASQ – SE Significant declines in social, emotional and behavioural problems for children under 5 years Children who started above the clinical cut-off score on average scored below (in the healthy range) by timepoint 3 (p < 0.0001) CBCL Those who scored above clinical cut-off scores at baseline had a 37% decline at time 3 (p < 0.001). | Low (ROBINS-I) |
| Myers et al. 2010 (United States) | 116 diagnosed with ADHD | 116 | – | Pre/post-intervention Monthly reviews until 14 months or until stable | 2 paediatric clinics (1 rural, 1 urban) | A Care Manager liaised between treating physicians and consulting psychiatrists to develop and implement care plan related to treatment and basic parent education. | 8.84 years (SD 1.99, range 6-12 years) | 73% Male | Racial minority – Hispanic – 95% | VADPRS and VADTRS | VADPRS – ADHD, oppositional defiant disorder, and conduct disorder symptom and performance subscales improved significantly (P < .05). VADTRS – symptom subscales improved (p < 0.001) but performance subscales did not. | Moderate (ROBINS-I) |
| Wansinket al. 2015 (Netherlands) | 99 | 49 | 50 | RCT 18 months | Community mental health centre | The Preventative Basic Care Management (PBCM) program provided parents case management to design a tailored plan for the family, link families to evidence-based parenting strategies, home-based family support, psychoeducation, community health services, social services, services for debt restructuring and financial resources. Also provide care coordination. Control: Parents received a brochure about the impact of parenting problems on children and information about available services. | 6.08 years (SD 2.02, range 2.3–10.7 years) | 56% Male | Parent with a mental illness – (depression 39%, PTSD 15%, anxiety disorder 13%). Single parent – 46% Racial minority – 67% Receiving Medicaid or other state-sponsored insurance programs – 38% | SDQ | SDQ No significant effect on SDQ | Low- Moderate (Risk of Bias) |
[i] ASQ-SE – Ages and Stages Questionnaire – Social and Emotional.
CBCL – Child Behaviour Check List.
VADPRS – Vanderbilt ADHD Parent Rating Scales.
VADTRS – Vanderbilt ADHD Teacher Rating Scales.
SDQ – Strengths and Difficulties Questionnaire.
Table 2
Dimensions of integration incorporated within the four included studies.
| AUTHOR | LEVEL OF INTEGRATION* | DIMENSIONS OF INTEGRATION BASED ON RMIC AND KEY COMPONENTS | EXAMPLES OF INTEGRATION ACROSS THE RMIC WITHIN THE STUDY |
|---|---|---|---|
| Briggs et al. 2011 | 4 | Clinical integration
|
|
Professional integration
|
| ||
Organisational integration
|
| ||
| Molnar et al. 2018 | 4 | Clinical integration
|
|
Professional integration
|
| ||
Organisational integration
|
| ||
Functional integration
|
| ||
| Myers et al. 2010 | 2–3 | Clinical integration
|
|
Organisational integration
|
| ||
| Wansink et al. 2015 | 2 | Clinical integration
|
|
Professional integration
|
|
[i] * Level 1– minimal collaboration; Level 2 – basic collaboration at a distance; Level 3 – Basic collaboration on-site; Level 4 close collaboration on-site with some system integration; Level 5 – Close collaboration approaching an integrated practice; and Level 6 – full collaboration in a transformed/merged integrated practice [39].