Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents
- Forfatter(e)
- Olson, J. R. Benjamin, P. H. Azman, A. A. Kellogg, M. A. Pullmann, M. D. Suter, J. C. Bruns, E. J.
- År
- 2021
- Tidsskrift
- Journal of the American Academy of Child & Adolescent Psychiatry
- Sider
- 27
- Kategori(er)
- Atferdsproblemer, antisosial atferd og atferdsforstyrrelser Skoleprestasjoner
- Tiltakstype(r)
- Hjemmebaserte tjenester Tiltak i nærmiljøet/infrastruktur (ungdomsklubber, frivillig arbeid, etterskoletilbud, veier, parker)
- Abstract
OBJECTIVE: : Wraparound is a common method for coordinating care for children and adolescents with serious emotional disorders (SED), with nearly 100,000 youths served annually in the United States. The current systematic review and meta-analysis estimated effects on youth outcomes (symptoms, functioning, school, juvenile justice, and residential placement) and costs.
METHOD: : A literature search identified 17 peer-reviewed and gray literature studies meeting criteria, which were coded on characteristics of sample, design, implementation, and outcomes. Random effects modeling was conducted using Comprehensive Meta-Analysis Version 3.0. Effect sizes were calculated using Hedges g. Homogeneity of effects were assessed using Q statistics.
RESULTS: : Medium-sized effects favored Wraparound-enrolled youths for costs (g=0.391, CI=0.282-0.500, p < .001), residential outcomes (g=0.413, CI=0.176-0.650, p=.001), and school functioning (g=0.397, CI=0.106-0.688, p=.007); small effects were found for mental health symptoms (g=0.358, CI=0.030-0.687, p=.033) and functioning (g=0.315, CI=0.086-0.545, p=.007). Larger effects were found for peer-reviewed studies, quasi-experimental designs, samples with a larger percentage of youths of color, and Wraparound conditions with higher fidelity.
CONCLUSION: : Results indicate positive effects for Wraparound, especially for maintaining youths with SED in the home and community. However, many studies showed methodological weaknesses, and fidelity measurement was largely absent, suggesting a need for additional research. Nonetheless, the results should aid decisions around resource allocation, referral practices, and system partnerships among child psychiatrists and other behavioral health professionals.