Components of interventions to reduce restrictive practices with children and young people in institutional settings: the Contrast systematic mapping review

J. Baker, Kathryn Berzins, K. Canvin, S. Kendal, Stella Branthonne-Foster, J. Wright, T. McDougall, B. Goldson, I. Kellar, J. Duxbury
{"title":"Components of interventions to reduce restrictive practices with children and young people in institutional settings: the Contrast systematic mapping review","authors":"J. Baker, Kathryn Berzins, K. Canvin, S. Kendal, Stella Branthonne-Foster, J. Wright, T. McDougall, B. Goldson, I. Kellar, J. Duxbury","doi":"10.3310/yvkt5692","DOIUrl":null,"url":null,"abstract":"\n \n Incidents in which children or young people experience severe distress or harm or cause distress or harm to others occur frequently in children and young people’s institutional settings. These incidents are often managed using restrictive practices, such as restraint, seclusion, sedation or constant observation; however, these also present significant risks of physical and psychological harm to children and young people as well as staff. Numerous interventions aim to reduce the use of restrictive techniques, but research is hampered by limited attention to specific intervention components. The behavior change technique taxonomy may improve reporting by providing a common language for specifying the content and mechanisms of behaviour change. This study aimed to identify, standardise and report the effectiveness of components of interventions to reduce restrictive practices in children and young people’s institutional settings.\n \n \n \n To map interventions aimed at reducing restrictive practices in children and young people’s institutional settings internationally, to conduct behaviour change technique analysis of intervention components, to identify process elements, and to explore effectiveness evidence to identify promising behaviour change techniques and compare the results with those found in adult psychiatric inpatient settings in a companion review.\n \n \n \n Systematic mapping review with programme content coding using the behavior change technique taxonomy.\n \n \n \n Eleven relevant English-language health and social care research databases 1989–2019 [including Applied Social Sciences Index (ASSIA), Criminal Justice Abstracts, Educational Resources Information Center (ERIC), MEDLINE and PsycInfo®], grey literature and social media were searched during 2019 (updated January 2020). Data extraction, guided by Workgroup for Intervention Development and Evaluation Research (WIDER), Cochrane Library and theory coding scheme recommendations, included intervention characteristics and study design and reporting. Screening and quality appraisal used the Mixed Methods Appraisal Tool. The behavior change technique taxonomy was applied systematically, and interventions were coded for behaviour change technique components. Outcomes data were then related back to these components.\n \n \n \n There were 121 records, including 76 evaluations. Eighty-two interventions, mostly multicomponent, were identified. Evaluation approaches commonly used a non-randomised design. There were no randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Four clusters (i.e. goals and planning, antecedents, shaping knowledge, and feedback and monitoring) contained the majority of identified behaviour change techniques and were detected in over half of all interventions. Two clusters (i.e. self-belief and covert learning) contained no identified behaviour change techniques. The most common setting in which behaviour change techniques were found was ‘mental health’. The most common procedure focused on staff training. The two most common behaviour change techniques were instruction on how to perform the behaviour and restructuring the social environment. Promising behaviour change techniques included instruction on how to perform the behaviour, restructuring the social environment, feedback on outcomes of behaviour and problem-solving. Compared with the companion review, service user perspectives were more sparse and there was more interest in trauma-informed approaches. Effectiveness evidence, range of interventions and reporting were broadly similar.\n \n \n \n Poor reporting may have prevented detection of some behaviour change techniques. The finding that the evidence was weak restricted the feasibility of examining behaviour change technique effectiveness. Literature searches were restricted to English-language sources.\n \n \n \n This study generated, to our knowledge, the first review of evidence on the content and effectiveness of interventions to reduce restrictive practices in children and young people’s institutional settings. Interventions tend to be complex, reporting is inconsistent and robust evaluation data are limited, but some behaviour change techniques seem promising.\n \n \n \n Promising behaviour change techniques could be further explored. Better evidence could help address the urgent need for effective strategies.\n \n \n \n This study is registered as PROSPERO CRD42019124730.\n \n \n \n This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 8. See the NIHR Journals Library website for further project information.\n","PeriodicalId":73204,"journal":{"name":"Health and social care delivery research","volume":"1 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health and social care delivery research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3310/yvkt5692","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Incidents in which children or young people experience severe distress or harm or cause distress or harm to others occur frequently in children and young people’s institutional settings. These incidents are often managed using restrictive practices, such as restraint, seclusion, sedation or constant observation; however, these also present significant risks of physical and psychological harm to children and young people as well as staff. Numerous interventions aim to reduce the use of restrictive techniques, but research is hampered by limited attention to specific intervention components. The behavior change technique taxonomy may improve reporting by providing a common language for specifying the content and mechanisms of behaviour change. This study aimed to identify, standardise and report the effectiveness of components of interventions to reduce restrictive practices in children and young people’s institutional settings. To map interventions aimed at reducing restrictive practices in children and young people’s institutional settings internationally, to conduct behaviour change technique analysis of intervention components, to identify process elements, and to explore effectiveness evidence to identify promising behaviour change techniques and compare the results with those found in adult psychiatric inpatient settings in a companion review. Systematic mapping review with programme content coding using the behavior change technique taxonomy. Eleven relevant English-language health and social care research databases 1989–2019 [including Applied Social Sciences Index (ASSIA), Criminal Justice Abstracts, Educational Resources Information Center (ERIC), MEDLINE and PsycInfo®], grey literature and social media were searched during 2019 (updated January 2020). Data extraction, guided by Workgroup for Intervention Development and Evaluation Research (WIDER), Cochrane Library and theory coding scheme recommendations, included intervention characteristics and study design and reporting. Screening and quality appraisal used the Mixed Methods Appraisal Tool. The behavior change technique taxonomy was applied systematically, and interventions were coded for behaviour change technique components. Outcomes data were then related back to these components. There were 121 records, including 76 evaluations. Eighty-two interventions, mostly multicomponent, were identified. Evaluation approaches commonly used a non-randomised design. There were no randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Four clusters (i.e. goals and planning, antecedents, shaping knowledge, and feedback and monitoring) contained the majority of identified behaviour change techniques and were detected in over half of all interventions. Two clusters (i.e. self-belief and covert learning) contained no identified behaviour change techniques. The most common setting in which behaviour change techniques were found was ‘mental health’. The most common procedure focused on staff training. The two most common behaviour change techniques were instruction on how to perform the behaviour and restructuring the social environment. Promising behaviour change techniques included instruction on how to perform the behaviour, restructuring the social environment, feedback on outcomes of behaviour and problem-solving. Compared with the companion review, service user perspectives were more sparse and there was more interest in trauma-informed approaches. Effectiveness evidence, range of interventions and reporting were broadly similar. Poor reporting may have prevented detection of some behaviour change techniques. The finding that the evidence was weak restricted the feasibility of examining behaviour change technique effectiveness. Literature searches were restricted to English-language sources. This study generated, to our knowledge, the first review of evidence on the content and effectiveness of interventions to reduce restrictive practices in children and young people’s institutional settings. Interventions tend to be complex, reporting is inconsistent and robust evaluation data are limited, but some behaviour change techniques seem promising. Promising behaviour change techniques could be further explored. Better evidence could help address the urgent need for effective strategies. This study is registered as PROSPERO CRD42019124730. This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 8. See the NIHR Journals Library website for further project information.
减少机构环境中针对儿童和青少年的限制性做法的干预措施的组成部分:对比系统制图审查
儿童或青少年遭受严重痛苦或伤害或对他人造成痛苦或伤害的事件经常发生在儿童和青少年的机构环境中。这些事件通常使用限制性做法进行管理,如约束、隔离、镇静或持续观察;然而,这些也给儿童、年轻人以及工作人员带来了身体和心理伤害的重大风险。许多干预措施旨在减少限制性技术的使用,但由于对具体干预措施的关注有限,研究受到阻碍。行为改变技术分类法可以通过提供用于指定行为改变的内容和机制的通用语言来改进报告。这项研究旨在确定、标准化和报告干预措施的有效性,以减少儿童和年轻人机构环境中的限制性做法。制定旨在减少国际儿童和青年机构环境中限制性做法的干预措施,对干预措施的组成部分进行行为改变技术分析,确定过程要素,并探索有效性证据,以确定有前景的行为改变技术,并将结果与成人精神病住院患者的结果进行比较。使用行为改变技术分类法对节目内容编码进行系统映射审查。2019年期间搜索了11个相关的英语健康和社会护理研究数据库1989–2019[包括应用社会科学索引(ASSIA)、刑事司法摘要、教育资源信息中心(ERIC)、MEDLINE和PsycInfo®]、灰色文献和社交媒体(2020年1月更新)。在干预发展与评估研究工作组(WIDER)、Cochrane图书馆和理论编码方案建议的指导下,数据提取包括干预特征、研究设计和报告。筛选和质量评估使用混合方法评估工具。系统地应用了行为改变技术分类法,并对行为改变技术组成部分的干预措施进行了编码。然后将结果数据与这些组成部分联系起来。共有121项记录,包括76项评价。确定了82项干预措施,其中大部分是多方面的。评估方法通常采用非随机设计。没有随机对照试验。在可能的16个集群中,有14个集群的行为改变技术被检测到。四个集群(即目标和规划、前因、形成知识以及反馈和监测)包含了大多数已确定的行为改变技术,并在一半以上的干预措施中被检测到。两个集群(即自信和隐蔽学习)不包含已确定的行为改变技术。行为改变技术最常见的环境是“心理健康”。最常见的程序侧重于工作人员培训。两种最常见的行为改变技巧是指导如何进行行为和重组社会环境。有希望的行为改变技术包括如何进行行为的指导、重组社会环境、对行为结果的反馈和解决问题。与同行评审相比,服务用户的观点更为稀疏,对创伤知情方法更感兴趣。有效性证据、干预措施的范围和报告大体相似。糟糕的报告可能阻止了某些行为改变技术的检测。证据不足的发现限制了检验行为改变技术有效性的可行性。文献检索仅限于英文来源。据我们所知,这项研究首次审查了有关减少儿童和年轻人机构环境中限制性做法的干预措施的内容和有效性的证据。干预措施往往很复杂,报告不一致,可靠的评估数据有限,但一些行为改变技术似乎很有前景。可以进一步探索有前景的行为改变技术。更好的证据可以帮助解决对有效战略的迫切需要。本研究注册为PROSPERO CRD42019124730。该项目由国家卫生与护理研究所(NIHR)卫生与社会护理提供研究计划资助,并将在《卫生与社会保健提供研究》上全文发表;第10卷,第8期。有关更多项目信息,请访问NIHR期刊图书馆网站。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.00
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信