Primary Care Interventions for Early Childhood Development: A Systematic Review

Pediatrics. 2017 Dec;140(6):e20171661. doi: 10.1542/peds.2017-1661. Epub 2017 Nov 14.

Abstract

Context: 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.

Objective: 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.

Data sources: A literature search of PubMed and PsycINFO was conducted from January 1, 1999, to February 14, 2017.

Study selection: 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.

Data extraction: Forty-eight studies in which 24 interventions were described were included. Levels of evidence and specific outcome measures are reported.

Results: 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.

Limitations: Community or home-based interventions were excluded.

Conclusions: 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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Behavior Therapy / methods*
  • Child Behavior Disorders / therapy*
  • Child Development*
  • Child, Preschool
  • Humans
  • Primary Health Care / methods*