Family‐centred interventions for Indigenous early childhood well‐being by primary healthcare services
Appendices
Appendix 1. Criteria for family‐centredness
Family‐centredness rating score (13 elements)
Rating 0, 1, 2, 3, or 4
| C1: family as a constant | |||||||||||
| Family as a constant in child's life | 2 | 4 | 3 | 2 | 4 | 2 | 4 | 4 | 1 | 4 | 3 |
| Recognising family strengths | 2 | 4 | 2 | 2 | 3 | 2 | 4 | 2 | 1 | 4 | 2 |
| Parent/professional collaboration | 4 | 4 | 4 | 4 | 4 | 4 | 3 | 2 | 4 | 3 | 4 |
| Needs‐based family support | 3 | 4 | 2 | 3 | 3 | 4 | 4 | 4 | 3 | 2 | 4 |
| Flexible provision of health care | 3 | 4 | 2 | 3 | 3 | 4 | 4 | 2 | 3 | 4 | 4 |
| Sharing information with families | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 3 | 4 |
| C2: culturally responsive | |||||||||||
| Culturally competent health care | 3 | 4 | 4 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 |
| Respecting family diversity | 3 | 4 | 2 | 3 | 2 | 2 | 3 | 3 | 2 | 3 | 4 |
| Providing financial support | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C3: supporting family individuality and need for different types of family support | |||||||||||
| Respecting family coping methods | 1 | 3 | 1 | 1 | 1 | 4 | 4 | 1 | 2 | 2 | 2 |
| Providing emotional support | 3 | 4 | 2 | 3 | 0 | 3 | 3 | 2 | 1 | 1 | 4 |
| Family‐to‐family support | 1 | 1 | 0 | 1 | 0 | 2 | 2 | 0 | 0 | 1 | 4 |
| Attending to the developmental needs of children and families | 3 | 4 | 2 | 3 | 3 | 2 | 3 | 0 | 3 | 3 | 4 |
| Total score | 32 (62%) | 44 (85%) | 28 (54%) | 32 (62%) | 30 (58%) | 37 (72%) | 43 (83%) | 28 (54%) | 28 (54%) | 34 (65%) | 43 (83%) |
(Exclude studies with family‐centredness score < 26 or 50%)
0: article included no evidence that the author(s) either implicitly or explicitly addressed, endorsed, or advocated adoption of adherence to the elements of family‐centred care.
1: article included a minimal amount of implicit evidence that the author(s) advanced adoption or support of the elements of family‐centred care.
2: article included numerous instances of implicit evidence that the author(s) advanced adoption or support of the elements of family‐centred care.
3: article included a minimal amount of explicit evidence that the author(s) advanced adoption or support of the elements of family‐centred care.
4: article included numerous instances of explicit evidence that the author(s) advanced adoption or support of the elements of family‐centred care
Explicit evidence = an element was clearly stated and distinctly expressed.
Implicit evidence = If it could be inferred that the author(s) descriptions, arguments, etc. were consistent with the intent of the elements of family‐centred care.
Appendix 2. CENTRAL search strategy
#1(aborigin* or indigen*):ti,ab,kw
#2("first nation*" or "native people*"):ti,ab,kw
#3"oceanic ancestry group":kw
#4("first australian*" or "torres strait* islander*" or tiwi or maori* or "tangata whenua"):ti,ab,kw
#5((american* or canadian) near/2 indian*):ti,ab,kw
#6tribes:kw
#7([mh "united states"] or [mh canada] or [mh "new zealand"] or ("united states" or america* or canad* or alaska* or "new zealand*"):ti,ab,kw) and native*:ti,ab,kw
#8(amerind* or metis or navajo or ojibw* or chippewa or algonquin or cree or arikara or iroquois or cherokee or mohawk or muscogee or choctaw or seminole or zuni or lakota or sioux or hopi or pima or tohono or yaqui):ti,ab,kw
#9(aleut* or eskimo* or inuit* or inupiat* or yupik* or hawai*):ti,ab,kw
#10{or #1‐#9}
#11(family or families or father* or mother* or husband* or wife* or paternal or maternal or grandparent* or guardian* or parent or parents or parental or parenting or "child rearing" or childrearing):ti,ab,kw
#12[mh "health personnel"]
#13(((general or family) next (doctor* or practitioner* or physician*)) or ((health* or medical) near/2 (service* or personnel or organi*ation*)) or nurse* or nursing or provider* or worker* or aide or aides):ti,ab,kw
#14((primary near/2 (care or health*)) or "patient cent*red"):ti,ab,kw
#15#10 and (#11 or #12 or #13 or #14)
#16[mh pregnancy]
#17pregnan*:ti,ab,kw
#18[mh "maternal health services"]
#19"maternal welfare":kw
#20[mh infant]
#21[mh "child development"]
#22"child development":ti,ab,kw
#23(embryo* or fetus* or foetus* or "unborn child*" or prenatal or pre‐natal or perinatal or peri‐natal or postnatal or post‐natal or postpartum or post‐partum or obstetric* or midwife* or baby or babies or newborn or neonat* or neo‐nat* or childbirth or birth or infant* or toddler* or preschool* or pre‐school* or "nursery school*" or kindergarten or "early child*"):ti,ab,kw
#24[mh "pregnancy complications"]
#25[mh "infant newborn diseases"]
#26[mh "neurodevelopmental disorders"]
#27((*developmental* or learning or "child behavio*") next (disorder* or disease* or disab*)):ti,ab,kw
#28[mh "child health services"]
#29(child* and (health* or care or welfare or wellbeing or "well being")) or (family next (centred or centered or based or focused or focussed))
#30"early intervention*":ti,ab,kw
#31((family or families or parent* or mother* or father* or maternal or paternal or guardian*) near/5 (educat* or teach* or instruct* or train* or coach* or counsel* or advis* or advice* or inform* or support* or program* or intervention*)):ti,ab,kw
#32{or #16‐#31}
#33#15 and #32
Appendix 3. MEDLINE search strategy
1. (aborigin* or indigen*).ti,ab,kf.
2. (first nation* or native people*).ti,ab,kf.
3. oceanic ancestry group/
4. (first australian* or torres strait* islander* or tiwi).ti,ab,kf.
5. (maori* or tangata whenua).ti,ab,kf.
6. american native continental ancestry group/
7. indians north american/
8. ((american* or canadian) adj2 indian*).ti,ab,kf.
9. (exp united states/ or exp canada/ or exp new zealand/ or (america* or canad* or alaska* or new zealand*).ti,ab,kw.) and native*.ti,ab,kf.
10. (amerind* or metis or navajo or ojibw* or chippewa or algonquin or cree or arikara or iroquois or cherokee or mohawk or muscogee or choctaw or seminole or zuni or lakota or sioux or hopi or pima or tohono or yaqui).ti,ab,kf.
11. inuits/
12. (aleut* or eskimo* or inuit* or inupiat* or yupik* or hawai*).ti,ab,kf.
13. or/1‐12
14. (family or families).mp.
15. (father* or mother* or husband* or wife* or paternal or maternal or grandparent* or guardian*).mp.
16. parenting/
17. exp child rearing/
18. (parent or parents or parental or parenting or child rearing or childrearing).ti,ab,kf.
19. exp health personnel/
20. (((general or family) adj (doctor* or practitioner* or physician*)) or ((health* or medical) adj2 (service* or personnel or organi#ation*)) or nurse* or nursing or provider* or worker* or aide or aides).ti,ab,kf.
21. ((primary adj2 (care or health*)) or patient cent?red).mp.
22. or/14‐21
23. 13 and 22
24. exp pregnancy/
25. pregnan*.mp.
26. exp maternal health services/
27. exp "embryonic and fetal development"/
28. exp fetus/
29. exp infant/
30. child preschool/
31. exp child development/
32. (embryo* or fetus or foetus or "unborn child*" or prenatal or pre‐natal or perinatal or peri‐natal or postnatal or post‐natal or postpartum or post‐patum or baby or babies or newborn or neonat* or neo‐nat* or childbirth or birth or obstetric* or midwife* or infant* or toddler* or preschool* or pre‐school* or "nursery school*" or kindergarten or "early child*").mp.
33. exp pregnancy complications/
34. exp infant newborn diseases/
35. exp neurodevelopmental disorders/
36. ((developmental* or learning or child behavio*) adj (disorder* or disease* or disab*)).ti,ab,kf.
37. "early intervention (education)"/
38. exp child health services/
39. child health/
40. child welfare/
41. ((child* and (health* or care or welfare or wellbeing or well being)) or (family adj (cent?red or based or focus?ed))).mp.
42. ((family or families or parent* or mother* or father* or maternal or paternal or guardian*) adj5 (educat* or teach* or instruct* or train* or coach* or counsel* or advis* or advice* or inform* or support* or program* or intervention*)).ti,ab,kf.
43. or/24‐42
44. 23 and 43
45. randomized controlled trial.pt.
46. controlled clinical trial.pt.
47. random*.tw.
48. placebo*.tw.
49. trial.tw.
50. groups.ab.
51. clinical trial.pt.
52. evaluation studies.pt.
53. research design/
54. follow up studies/
55. prospective studies/
56. cross over studies/
57. comparative study.pt.
58. controlled before after studies/
59. interrupted time series analysis/
60. (experiment* or intervention*).tw.
61. (pre test or pretest or post test or posttest).tw.
62. (preintervention or postintervention).tw.
63. time series.tw.
64. (cross over or crossover or factorial* or latin square).tw.
65. (assign* or allocat* or volunteer*).tw.
66. (control* or compar* or prospectiv*).tw.
67. (impact* or effect? or chang* or evaluat*).tw.
68. or/45‐67
69. 44 and 68
Appendix 4. Embase search strategy
1. exp indigenous people/
2. (aborigin* or indigen*).ti,ab,kw.
3. (first nation* or native people*).ti,ab,kw.
4. oceanic ancestry group/
5. exp australian aborigine/
6. (first australian* or torres strait* islander* or tiwi).ti,ab,kw.
7. "maori (people)"/
8. (maori* or tangata whenua).ti,ab,kw.
9. exp amerind people/
10. ((american* or canadian) adj2 indian*).ti,ab,kw.
11. (exp united states/ or exp canada/ or exp new zealand/ or (america* or canad* or alaska* or new zealand*).ti,ab,kw.) and native*.ti,ab,kw.
12. (amerind* or metis or navajo or ojibw* or chippewa or algonquin or cree or arikara or iroquois or cherokee or mohawk or muscogee or choctaw or seminole or zuni or lakota or sioux or hopi or pima or tohono or yaqui).ti,ab,kw.
13. exp eskimo‐aleut people/
14. native hawaiian/
15. (aleut* or eskimo* or inuit* or inupiat* or yupik* or hawai*).ti,ab,kw.
16. or/1‐15
17. (family or families).mp.
18. (father* or mother* or husband* or wife* or paternal or maternal or grandparent* or guardian*).mp.
19. (parent or parents or parental or parenting or child rearing or childrearing).mp.
20. health care personnel/
21. (((general or family) adj (doctor* or practitioner* or physician*)) or ((health* or medical) adj2 (service* or personnel or organi#ation*)) or nurse* or nursing or provider* or worker* or aide or aides).ti,ab,kw.
22. ((primary adj2 (care or health*)) or patient cent?red).mp.
23. or/17‐22
24. 16 and 23
25. exp pregnancy/
26. pregnan*.mp.
27. exp prenatal development/
28. human embryo/
29. fetus/
30. exp childbirth/
31. exp infant/
32. toddler/
33. preschool child/
34. child development/
35. (embryo* or fetus or foetus or "unborn child*" or prenatal or pre‐natal or perinatal or peri‐natal or postnatal or post‐natal or postpartum or post‐patum or baby or babies or newborn or neonat* or neo‐nat* or childbirth or birth or obstetric* or midwife* or infant* or toddler* or preschool* or pre‐school* or "nursery school*" or kindergarten or "early child*").mp.
36. maternal child health care/
37. exp newborn care/
38. infant welfare/
39. exp pregnancy complication/
40. exp newborn disease/
41. exp infant disease/
42. developmental disorder/
43. exp autism/
44. exp behavior disorder/
45. exp learning disorder/
46. ((developmental* or learning or child behavio*) adj (disorder* or disease* or disab*)).ti,ab,kw.
47. child health/
48. child health care/
49. ((child* and (health* or care or welfare or wellbeing or well being)) or (family adj (cent?red or based or focus?ed))).mp.
50. early childhood intervention/
51. early intervention/
52. parent counseling/
53. ((family or families or parent* or mother* or father* or maternal or paternal or guardian*) adj5 (educat* or teach* or instruct* or train* or coach* or counsel* or advis* or advice* inform* or support* or program* or intervention*)).ti,ab,kw.
54. or/25‐53
55. 24 and 54
56. randomized controlled trial/
57. controlled clinical trial/
58. single blind procedure/ or double blind procedure/
59. crossover procedure/
60. random*.tw.
61. trial.tw.
62. placebo*.tw.
63. ((singl* or doubl*) adj (blind* or mask*)).tw.
64. (experiment* or intervention*).tw.
65. epidemiology/
66. controlled study/
67. (pre test or pretest or post test or posttest).tw.
68. (preintervention or postintervention).tw.
69. (cross over or crossover or factorial* or latin square).tw.
70. (assign* or allocat* or volunteer*).tw.
71. (control* or compar* or prospectiv*).tw.
72. (impact* or effect? or chang* or evaluat*).tw.
73. time series analysis/
74. time series.tw.
75. or/56‐74
76. 55 and 75
77. limit 76 to embase
78. limit 76 to conference abstracts
79. or/77‐78
Appendix 5. PsycINFO search strategy
1. exp indigenous populations/
2. (aborigin* or indigen*).ti,ab,id.
3. (first nation* or native people*).ti,ab,id.
4. (first australian* or torres strait* islander* or tiwi).ti,ab,id.
5. (maori* or tangata whenua).ti,ab,id.
6. ((american* or canadian) adj2 indian*).ti,ab,id.
7. tribes/
8. ((america* or canad* or alaska* or new zealand*) and native*).ti,ab,id.
9. (amerind* or metis or navajo or ojibw* or chippewa or algonquin or cree or arikara or iroquois or cherokee or mohawk or muscogee or choctaw or seminole or zuni or lakota or sioux or hopi or pima or tohono or yaqui).ti,ab,id.
10. (aleut* or eskimo* or inuit* or inupiat* or yupik*).ti,ab,id.
11. hawai*.ti,ab,hw,id.
12. or/1‐11
13. (family or families).ti,ab,hw,id.
14. (father* or mother* or husband* or wife* or paternal or maternal or grandparent* or guardian*).ti,ab,hw,id.
15. (parent or parents or parental or parenting or child rearing or childrearing).ti,ab,hw,id.
16. health personnel/
17. (((general or family) adj (doctor* or practitioner* or physician*)) or ((health* or medical) adj2 (service* or personnel or organi#ation*)) or nurse* or nursing or provider* or worker* or aide or aides).ti,ab,id.
18. ((primary adj2 (care or health*)) or patient cent?red or client cent?red).ti,ab,hw,id.
19. or/13‐18
20. 12 and 19
21. ("120" or "140" or "160").ag.
22. exp pregnancy/
23. pregnan*.ti,ab,hw,id.
24. exp prenatal development/
25. exp prenatal care/
26. exp birth/
27. exp early childhood development/
28. exp preschool students/
29. kindergarten students/
30. (embryo* or fetus* or foetus* or unborn child* or prenatal or pre‐natal or perinatal or peri‐natal or postnatal or post‐natal or postpartum or post‐patum or baby or babies or newborn or neonat* or neo‐nat* or childbirth or birth or obstetric* or midwife* or infant? or toddler* or preschool* or pre‐school* or nursery school* or kindergarten or early child*).ti,ab,hw,id.
31. exp obstetrical complications/
32. exp neonatal disorders/
33. exp developmental disabilities/
34. ((developmental* or neurodevelopmental* or learning or child behavio*) adj (disorder* or disease* or disab*)).ti,ab,hw,id.
35. early intervention/
36. ((child* and (health* or care or welfare or wellbeing or well being)) or (family adj (cent?red or based or focus?ed))).ti,ab,hw,id.
37. family life education/
38. parent training/
39. ((family or families or parent* or mother* or father* or maternal or paternal or guardian*) adj5 (educat* or teach* or instruct* or train* or coach* or counsel* or advis* or advice* or inform* or support* or program* or interven*)).ti,ab,id.
40. or/21‐39
41. 20 and 40
42. random*.ti,ab,hw,id.
43. (experiment* or intervention*).ti,ab,hw,id.
44. trial*.ti,ab,hw,id.
45. placebo*.ti,ab,hw,id.
46. ((singl* or doubl* or trebl* or tripl*) and (blind* or mask*)).ti,ab,hw,id.
47. treatment effectiveness evaluation/
48. mental health program evaluation/
49. (pre test or pretest or post test or posttest).ti,ab,hw,id.
50. (preintervention or postintervention).ti,ab,hw,id.
51. (cross over or crossover or factorial* or latin square).ti,ab,hw,id.
52. (assign* or allocat* or volunteer*).ti,ab,hw,id.
53. (control* or compar* or prospectiv*).ti,ab,hw,id.
54. (impact* or effect? or chang* or evaluat*).ti,ab,hw,id.
55. time series.ti,ab,hw,id.
56. exp experimental design/
57. ("0430" or "0450" or "0451" or "1800" or "2100").md.
58. or/42‐57
59. 41 and 58
Appendix 6. CINAHL search strategy
S26 s25 Limiters ‐ Exclude MEDLINE records
S25 s9 and s24
S24 s10 or s11 or s12 or s13 or s14 or s15 or s16 or s17 or s18 or s19 or s20 or s21 or s22 or s23
S23 "early intervention*" or ((family or families or parent* or mother* or father* or maternal or paternal or guardian*) N5 (educat* or teach* or instruct* or train* or coach* or counsel* or advis* or advice* or inform* or support* or program* or intervention*))
S22 (child* and (health* or care or welfare or wellbeing or "well being")) or (family N1 (cent#red or based or focus#ed))
S21 MH child health services+
S20 (developmental* or learning or "child behavio*") N1 (disorder* or diasease* or disab*)
S19 MH mental disorders diagnosed in childhood+
S18 MH infant, newborn, diseases+
S17 MH pregnancy complications+
S16 embryo* or fetus* or foetus* or "unborn child*" or prenatal or pre‐natal or perinatal or peri‐natal or postnatal or post‐natal or postpartum or post‐patum or baby or babies or newborn or neonat* or neo‐nat* or childbirth or birth or obstetric* or midwife* or infant* or toddler* or preschool* or pre‐school* or "nursery school*" or kindergarten or "early child*"
S15 "child development*"
S14 MH infant+
S13 MH (maternal health services+ or maternal‐child care+ or maternal‐child welfare+)
S12 MH fetus+
S11 MH embryo+
S10 (MH pregnancy+) or pregnan*
S9 s7 and s8
S8 family or families or father* or mother* or husband* or wife* or paternal or maternal or grandparent* or guardian* or parent or parents or parental or parenting or "child rearing" or childrearing or ((general or family) N1 (doctor* or practitioner* or physician*)) or ((health* or medical) N2 (service* or personnel or organi?ation*)) or nurse* or nursing or provider* or worker* or aide or aides or (primary N2 (care or health*)) or "patient centred" or "patient centered" or MH health personnel+
S7 s1 or s2 or s3 or s4 or s5 or s6
S6 aleut* or eskimo* or inuit* or inupiat* or yupik* or hawai*
S5 amerind* or metis or navajo or ojibw* or chippewa or algonquin or cree or arikara or iroquois or cherokee or mohawk or muscogee or choctaw or seminole or zuni or lakota or sioux or hopi or pima or tohono or yaqui
S4 ((MH (united states+ or canada+)) or ("united states" or america* or canad* or alaska* or "new zealand*")) and native*
S3 ((american* or canadian*) N2 indian*) or tribes
S2 "first australian*" or "torres strait* islander*" or tiwi or maori* or "tangata whenua"
S1 aborigin* or indigen* or "first nation*" or "native people*"
Appendix 7. Informit search strategy
Indigenous Collection 14 databases: A+Education, AGIS Plus Text, Asia Collection, Australian Public Affairs (APAFT), Business Collection, EduTV, Engineering Collection, Families & Society Collection, Health Collection, Humanities & Social Sciences Collection, Indigenous Collection, Literature & Culture Collection, New Zealand Collection, TVNews
(family OR families OR father* OR mother* OR husband* OR wife* OR paternal OR maternal OR grandparent* OR guardian* OR parent*)
AND
(pregnan* OR embryo* OR fetus* OR foetus* OR "unborn child*" OR prenatal OR "pre‐natal" OR perinatal OR "peri‐natal" OR postnatal OR "post‐natal" OR postpartum OR "post‐partum" OR obstetric* OR midwife* OR baby OR babies OR newborn OR neonat* OR "neo‐nat*" OR childbirth OR birth OR infant* OR toddler* OR preschool* OR "pre‐school*" OR "nursery school*" OR kindergarten OR "early child*" OR "child develoment" OR "newborn disease*" OR "infant disease*" OR "early childhood disease*" OR developmental OR "learning disorder*" OR "child behavio*" OR "early intervention*" OR (child* AND (health* OR care OR welfare OR wellbeing OR "well being")))
AND
(random* OR control* OR trial OR assign* OR allocat* OR volunteer* OR experiment* OR intervention* OR compar* OR prospectiv* OR assess* OR impact* OR effect* OR chang* OR evaluat* OR blind* OR "cross over" OR crossover OR factorial OR "latin square" OR "time series")
Appendix 8. CENTRAL search strategy (scoping)
#1(aborigin* or indigen*):ti,ab,kw (Word variations have been searched)
#2(first nation* or native people*):ti,ab,kw (Word variations have been searched)
#3MeSH descriptor: [Oceanic Ancestry Group] explode all trees
#4(first australian* or torres strait* islander*):ti,ab,kw (Word variations have been searched)
#5maori*:ti,ab,kw (Word variations have been searched)
#6MeSH descriptor: [American Native Continental Ancestry Group] explode all trees
#7MeSH descriptor: [Indians, North American] explode all trees
#8((american* or canadian) near/1 indian*)
#9MeSH descriptor: [United States] explode all trees
#10MeSH descriptor: [Canada] explode all trees
#11MeSH descriptor: [New Zealand] explode all trees
#12(america* or canad* or alaska* or new zealand*):ti,ab,kw (Word variations have been searched)
#13native*:ti,ab,kw (Word variations have been searched)
#14(#9 or #10 or #11 or #12) and #13
#15(metis or cherokee* or chippewa* or choctaw* or navajo* or sioux):ti,ab,kw (Word variations have been searched)
#16MeSH descriptor: [Inuits] explode all trees
#17(inuit* or eskimo* or inupiat* or yupik*):ti,ab,kw (Word variations have been searched)
#18hawai*:ti,ab,kw (Word variations have been searched)
#19#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #14 or #15 or #16 or #17 or #18
#20(family or families):ti,ab,kw (Word variations have been searched)
#21(father* or mother* or husband* or wife* or paternal or maternal or grandparent* or guardian*):ti,ab,kw (Word variations have been searched)
#22MeSH descriptor: [Parenting] explode all trees
#23(parent or parents or parental or parenting):ti,ab,kw (Word variations have been searched)
#24MeSH descriptor: [Maternal Health Services] explode all trees
#25(prenatal or perinatal or postnatal or postpartum):ti,ab,kw (Word variations have been searched)
#26#20 or #21 or #22 or #23 or #24 or #25
#27#19 and #26
#28MeSH descriptor: [Pregnancy] explode all trees
#29pregnan*:ti,ab,kw (Word variations have been searched)
#30MeSH descriptor: [Embryonic and Fetal Development] explode all trees
#31MeSH descriptor: [Fetus] explode all trees
#32MeSH descriptor: [Infant] explode all trees
#33MeSH descriptor: [Child, Preschool] explode all trees
#34(fetus* or foetus* or unborn child* or baby or babies or newborn or neonat* or infant? or toddler* or preschool* or preschool* or kindergarten or early child*):ti,ab,kw (Word variations have been searched)
#35MeSH descriptor: [Pregnancy Complications] explode all trees
#36MeSH descriptor: [Infant, Newborn, Diseases] explode all trees
#37MeSH descriptor: [Neurodevelopmental Disorders] explode all trees
#38MeSH descriptor: [Early Intervention (Education)] explode all trees
#39#28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38
#40#27 and #39
Study flow diagram.
Risk of bias summary: review authors' judgement on each risk of bias domain across all included studies.
Risk of bias graph: review authors' judgement on each risk of bias domain as percentages across all included studies.
Comparison 1: Primary outcomes, Outcome 1: Overall health and well‐being
Comparison 1: Primary outcomes, Outcome 2: Psychological health and emotional behaviour of children
Comparison 1: Primary outcomes, Outcome 3: Physical health and developmental health outcomes of children
Comparison 1: Primary outcomes, Outcome 4: Family health‐enhancing lifestyle or behavioural outcomes
Comparison 1: Primary outcomes, Outcome 5: Psychological health of parent/carer
Comparison 2: Secondary outcomes, Outcome 1: Parenting knowledge and awareness
Comparison 2: Secondary outcomes, Outcome 2: Service access and utilisation
Comparison 3: Subgroup analysis, Outcome 1: Overall health and well‐being
Comparison 3: Subgroup analysis, Outcome 2: Physical health and developmental health outcomes of children
Comparison 3: Subgroup analysis, Outcome 3: Family health‐enhancing lifestyle or behavioural outcomes
| Family‐centred care compared to any control for Indigenous children aged < 5 years | |||||
| Patient or population: Indigenous children aged < 5 years Setting: primary health care Intervention: family‐centred care Comparison: usual care or minimal intervention | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | № of participants | Certainty of the evidence | Comments | |
|---|---|---|---|---|---|
| Risk with any control | Risk with family‐centred care | ||||
| Overall health and well‐being Timing: the longest time point available for each study Direction of effect: higher beneficial | — | The mean SMD score in the intervention group was 0.14 SD higher | 2386 | ⊕⊝⊝⊝ | Family‐centred care may improve the overall health and well‐being of Indigenous children and their families, but the evidence is very uncertain. |
| Psychological health and emotional behaviour of children Timing: the longest time point available for each study Direction of effect: higher beneficial | The mean psychological health and emotional behaviour of children ranged from 0.95 to 1.02 points | The mean MD score in the intervention group was 0.04 points higher | 384 | ⊕⊝⊝⊝ | The evidence is very uncertain about the effect of family‐centred care on psychological health and emotional behaviour of children. |
| Physical health and developmental health outcomes of children Timing: the longest time point available for each study Direction of effect: higher beneficial | — | The mean SMD score in the intervention group was 0.13 SD higher | 1961 | ⊕⊝⊝⊝ | The evidence is very uncertain about the effect of family‐centred care on physical health and developmental health outcomes of children. |
| Family health‐enhancing lifestyle or behavioural outcomes Timing: the longest time point available for each study Direction of effect: higher beneficial | — | The mean SMD score in the intervention group was 0.16 SD higher | 1969 | ⊕⊝⊝⊝ | The evidence is very uncertain about the effect of family‐centred care on family health‐enhancing lifestyle or behavioural outcomes. |
| Psychological health of parent/carer Timing: the longest time point available for each study Direction of effect: higher beneficial | The mean psychological health of a parent carer was 48.71. | The mean SMD mental health scores were 0.10 SD higher (0.03 lower to 0.22 higher).e | 975 | ⊕⊝⊝⊝ | The evidence is very uncertain about the effect of family‐centred care on psychological health of parent/carer. |
| Adverse events or harms Direction of effect: lower beneficial | 2 studies reported narrative information on adverse events. 1 study measured adverse events and side effects and reported that no aspect of the intervention including the application of fluoride varnish resulted in any reported adverse events. 1 study reported on emergency department presentations and hospital admissions as adverse events. No adverse events reported were deemed to be the result of the intervention. | Unclear participants (2 RCTs) | ⊕⊝⊝⊝ | The evidence is very uncertain about the effect of family‐centred care on adverse events of harm. | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; SD: standard deviation; SMD: standardised mean difference. | |||||
| GRADE Working Group grades of evidence | |||||
| aCrucial biases on multiple criteria and likely to seriously alter results. This included no blinding of participants and interventionist, people delivering the intervention collected the data, high attrition, and selective outcome reporting. Downgraded two levels. | |||||
| Study | Participants | Indigenous status | Country | Primary focus of intervention | Intervention | Broad category of intervention | Length of intervention | Control |
|---|---|---|---|---|---|---|---|---|
| Pregnant adolescents aged 12–19 years at conception and at ≤ 28 weeks' gestation. | Navajo reservation (New Mexico) and White Mountain Apache reservation (Arizona) | USA | Negative parenting patterns | Home visits covering antenatal care, labour, delivery, breastfeeding, nutrition, parenting, home safety, immunisations, well‐baby care, family planning, sexually transmitted disease prevention, and maternal goal setting for personal and family development. | Education | 9 months: from 28 weeks' gestation to 6 months' postpartum; 25 home visits and 31 discrete lessons | Education: breastfeeding programme delivered in 23 home visits and 20 lessons. | |
| Pregnant women | Maori residing within | New Zealand | Early childhood caries | Participants offered 4 intervention components: 1. provision of dental care during pregnancy; 2. FV application to teeth of children aged 6, 12, and 18 months; 3. MI, and 4. AG. The 3 themes covered by MI and AG are oral health knowledge, oral self‐care and oral health protection and community water fluoridation. | Counselling | 18 months: 1 intervention component delivered during pregnancy and 3 more at age 6, 12, and 18 months. | Minimal dental care: examination, | |
| Counselling delayed: intervention sessions were delivered after the infant was 24 months old. | ||||||||
| Women aged ≥ 13 years with infants aged < 14 weeks | Navajo Nation (New Mexico) | USA | Early childhood obesity | Family Spirit Nuture curriculum lessons focus on: optimal infant feeding practices, responsive feeding, avoiding SSBs, optimal complementary feeding practices, and whole family healthy eating practices. | Education | 3 months: 6 lessons delivered from 3 to 6 months' postpartum | Education: 3 injury prevention lessons including childproofing, safe travel and outings with an infant, and strategies to avoid abuse and neglect. | |
| Women between weeks 12 and 34 of pregnancy and | Cree Nation Eeyou Istchee (Quebec) | Canada | Early childhood caries | Mothers received MI aimed at reducing child caries. FV was offered after the infant was 1 year old. | Counselling | 24 months: 1 counselling session during pregnancy and up to 6 more sessions postnatally until their child's second birthday. | Education: mothers received 2 mailed culturally appropriate educational pamphlet describing healthy dental care practices for young children. FV was available to children in control group at local dental clinics. | |
| Infants aged 0–5 weeks | Maori and Australian Aboriginal | New Zealand and Australia | Acute respiratory illness | An 8‐week supply of free nicotine replacement therapy was available to participants and other household members. Counselling and follow‐up was provided. A fax referral to Quitline was offered, with proactive call back by Quitline. Resources were provided to support educational and behavioural coaching. | Education and counselling | 3 months: 3 home visits | Usual care | |
| Children aged 2–5 years | Bad River Band of Lake Superior Chippewa Indians, | USA | Obesity | Year 1: mentor‐led lessons with the primary carer and child, discussions and activities to help the carer and child learn about the topic, behaviour change related to the topic, and goal setting to attempt behaviour change. Families attended 3 mentor‐led group sessions. | Education | 2 years: year 1: 12 toolkit lessons and 3 group lessons; year 2: 12 monthly group lessons | Education: year 1: same 12 lessons by mail + monthly newsletter. | |
| Pregnant adolescents aged 12–19 years at conception and at ≤ 28 weeks' gestation. | White Mountain Apache reservation (Arizona), San Carlos Apache Reservations (Arizona), Fort Defiance communities on the Navajo Reservation (Arizona) | USA | Reduce health and behavioural risks | The Family Spirit curriculum lessons focused on 3 domains: 1. parenting skills across early childhood (0–3 years); 2. maternal drug abuse prevention; and 3. maternal life skills and positive psychosocial development. | Education | 3 years: home visits occurred weekly through the end of pregnancy, biweekly until 4 months' postpartum, monthly between 4 and 12 months' postpartum, and bimonthly between 12 and 36 months' postpartum; 45 home visits and 43 lessons | Optimised standard care: visits include 7 antenatal visits, 9 well‐baby visits during the first 3 years of life, and 4 social support visits between years 2 and 3. | |
| Head Start children aged 3–5 years and their primary carers | Navajo Nation | USA | Early childhood caries | The application of FV for children and oral health promotion activities for children and carers. | Education | 1 year: 4 times for FV; oral health promotion was 5 for children and 4 times for adults. | Usual care: usual oral health care made available by dental providers usually the Indian Health Service. FV was available at clinics. | |
| Women booking for antenatal care | Maori | New Zealand | Sudden unexpected death in infancy | The provision of the wahakura a traditional sleeping device. | Environment | Single provision | A portable standing bassinet | |
| American Indian children aged 2–5 years and their primary carers | American Indian/Alaska Native | USA | Obesity | 12 monthly mailed healthy lifestyle lessons, items, and children's books addressing 6 intervention targets. Adults were supported by social media engagement via 2 weekly text messages and invitation to an optional, site‐specific Facebook group | Education | 1 year: 12 monthly mail outs; 2 weekly text messages | Education: child safety curriculum delivered in 12 mailed safety newsletters and related materials | |
| Pregnant adolescents aged 12–22 years at conception and at ≤ 28 weeks' gestation | Navajo reservation (New Mexico) and White Mountain Apache reservation (Arizona) | USA | Behavioural health problems | Home visits providing developmentally timed antenatal and infant‐care parenting lessons, as well as family planning, substance abuse prevention, and problem‐solving and coping‐skills lessons. | Education | 9 months: from 28 weeks' gestation to 6 months' postpartum; 25 home visits | Education: breastfeeding and nutrition programme delivered in 23 home visits. | |
| AG: anticipatory guidance; FV: fluoride varnish; MI: motivational interviewing; SSB: sugar sweetened beverage. | ||||||||
| Study | Control group | Family‐centred care intervention category | Type of outcome | Name of outcome | Outcome measured on | Name of validated survey, questionnaire, or instrument? | Short term | Medium term | Long term | Included in a meta‐analysis |
|---|---|---|---|---|---|---|---|---|---|---|
| Primary outcomes | ||||||||||
| Overall health and well‐being | ||||||||||
| Minimal education | Education | Continuous | Competence domain | Child | ITSEA | — | X | — | X | |
| Usual care | Education | Continuous | Competence domain | Child | ITSEA | — | X | — | X | |
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | — | X | — | X | |
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | — | X | — | X | |
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | — | X | — | X | |
| Usual care | Education | Continuous | Caries: decayed, missing, or filled spaces | Child | NA | — | X | — | X | |
| Minimal education | Education | Continuous | Depression | Mother | CES‐D | — | X | — | X | |
| Usual care | Environment | Binary | Fully breastfed: yes | Child | No | — | X | — | X | |
| Usual care | Education and counselling | Count | New episodes of acute respiratory illness | Child | Yes | — | X | — | X | |
| Minimal education | Counselling | Continuous | Caries: tooth level caries prevalence (d2‐4efs > 0) | Child | NA | — | — | X | X | |
| Minimal dental care | Counselling (not delayed) | Continuous | Caries: decayed, missing, or filled spaces | Child | NA | — | — | X | X | |
| Psychological health and emotional behaviour of children | ||||||||||
| Minimal education | Education | Continuous | Competence domain | Child | ITSEA | — | X | — | X | |
| Usual care | Education | Continuous | Competence domain | Child | ITSEA | — | X | — | X | |
| Minimal education | Counselling | Binary | Parent reported 'dental caries‐related' child quality of life. Answered "yes" to > 1 quality of life question. | Child | Yes: in‐house with a previous survey involving 301 children | — | — | X | — | |
| Usual care | Education | Continuous | Competence | Child | ITSEA | — | — | X | — | |
| Physical health and developmental outcomes of children | ||||||||||
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | X | — | — | — | |
| Usual care | Environment | Binary | Fully breastfed: yes | Child | No | X | — | — | — | |
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | — | X | — | X | |
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | — | X | — | X | |
| Minimal education | Education | Continuous | BMI z‐score | Child | BMI; scale and measure | — | X | — | X | |
| Usual care | Education | Continuous | Caries: decayed, missing, or filled spaces | Child | NA | — | X | — | X | |
| Usual care | Environment | Binary | Fully breastfeeding: yes | Child | No | — | X | — | X | |
| Usual care | Education and counselling | Count | New episodes of acute respiratory illness | Child | Yes | — | X | — | X | |
| Minimal education | Counselling | Continuous | Caries: tooth level caries prevalence (d2‐4efs > 0) | Child | NA | — | — | X | X | |
| Minimal dental care | Counselling (not delayed) | Continuous | Caries: decayed, missing, or filled spaces | Child | NA | — | — | X | X | |
| Counselling (delayed)a | Counselling (not delayed) | Continuous | Caries: decayed, missing, or filled spaces | Child | NA | — | — | X | — | |
| Family enhancing lifestyle or behaviour outcomes | ||||||||||
| Minimal education | Education | Continuous | Cohesion | Family | Not reported | X | — | — | — | |
| Usual care | Environment | Binary | Maternal sleep quality: good | Mother | No | X | — | — | — | |
| Usual care | Environment | Binary | Infants sleep position: back position | Child | No | X | — | — | — | |
| Minimal education | Education | Continuous | SF‐12: Physical Health component | Carer | SF‐12 | — | X | — | X | |
| Minimal education | Education | Continuous | SF‐12: Physical Health component | Carer | SF‐12 | — | X | — | X | |
| Minimal education | Education | Continuous | HOME | Mother | HOME | — | X | — | X | |
| Minimal education | Education | Continuous | Cohesion | Family | Not reported | — | X | — | X | |
| Usual Care | Education | Continuous | HOME | Mother | HOME | — | X | — | X | |
| Minimal education | Education | Continuous | Infant SSB consumption | Child | Adapted Pre‐School Beverage Intake Questionnaire | — | X | — | X | |
| Usual care | Education | Continuous | Oral health behaviour | Carer | Not reported | — | X | — | X | |
| Usual care | Environment | Binary | Maternal sleep quality: good | Mother | No | — | X | — | X | |
| Usual care | Environment | Binary | Infants sleep position: back position | Child | No | — | X | — | — | |
| Usual care | Education and counselling | Binary | Full smoking ban in home | Family | No | — | X | — | X | |
| Usual care | Education and counselling | Binary | In last 7 days, infant has been around tobacco smoke | Child | No | — | X | — | — | |
| Usual care | Education | Continuous | HOME | Mother | HOME | — | — | X | — | |
| Psychological health of parent/carer | ||||||||||
| Minimal education | Education | Continuous | Depression | Mother | CES‐D | X | — | — | — | |
| Minimal education | Education | Continuous | Depression | Mother | CES‐D | X | — | — | — | |
| Usual care | Education | Continuous | Depression | Mother | CES‐D | X | — | — | — | |
| Minimal education | Education | Continuous | Depression | Mother | CES‐D | — | X | — | X | |
| Minimal education | Education | Continuous | Depression | Mother | CES‐D | — | X | — | X | |
| Minimal education | Education | Continuous | SF‐12: Mental Health component | Carer | SF‐12 | — | X | — | X | |
| Minimal education | Education | Continuous | SF‐12: Mental health component | Carer | SF‐12 | — | X | — | X | |
| Usual care | Education | Continuous | Depression | Mother | CES‐D | — | X | — | X | |
| Usual care | Education | Continuous | Depression | Mother | CES‐D | — | — | X | — | |
| Adverse events | ||||||||||
| Minimal education | Counselling | Unclear | Adverse events related to the intervention. Unclear what specific events were included | Child | NA | — | — | X | — | |
| Minimal education | Education | Unclear | Emergency department presentations and hospital admissions were recorded as potential adverse events | Child | NA | — | — | X | — | |
| Secondary outcomes | ||||||||||
| Parenting knowledge and awareness | ||||||||||
| Minimal education | Education | Continuous | Skills | Mother | No | X | — | — | — | |
| Minimal education | Education | Continuous | Skills | Mother | No | — | X | — | X | |
| Minimal education | Education | Continuous | Involvement | Mother | Parent Involvement Scale from the Substance Abuse and Mental Health Services Administration measure | — | X | — | — | |
| Usual care | Education | Continuous | Home safety practices | Mother | No | — | X | — | X | |
| Minimal education | Education | Continuous | Maternal SSB knowledge index | Mother | No | — | X | — | — | |
| Usual care | Education | Continuous | Knowledge | Mother | No | — | — | X | X | |
| Service access and utilisation | ||||||||||
| Usual care | Education and counselling | Count | Hospitalisation for acute respiratory illness | Child | Yes | — | X | — | — | |
| Minimal education | Counselling | Count | Number of visits to dentist for tooth pain | Child | Yes | — | — | X | — | |
| Economic costs | ||||||||||
| Minimal education | Counselling | Cost | Cost‐effectiveness | Health system | NA | — | — | X | — | |
| aWhen control children were aged 24 months, they received the intervention for one year and are called the delayed intervention group. BMI: body mass index; CES‐D: Center for Epidemiologic Studies Depression Scale; HOME: Home Observation for Measurement of the Environment; ITSEA: Infant Toddler Social Emotional Assessment; NA: not applicable; SF‐12: 12‐item Short Form Survey; SSB: sugar‐sweetened beverage. | ||||||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 Overall health and well‐being Show forest plot | 11 | 2386 | Std. Mean Difference (IV, Random, 95% CI) | 0.14 [0.03, 0.24] |
| 1.1.1 Body mass index (BMI) z‐score | 3 | 668 | Std. Mean Difference (IV, Random, 95% CI) | 0.09 [‐0.08, 0.25] |
| 1.1.2 Caries | 3 | 826 | Std. Mean Difference (IV, Random, 95% CI) | 0.20 [0.02, 0.37] |
| 1.1.3 Fully breastfed | 1 | 178 | Std. Mean Difference (IV, Random, 95% CI) | 0.52 [0.05, 0.99] |
| 1.1.4 New episode of acute respiratory illness | 1 | 289 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.10 [‐0.33, 0.13] |
| 1.1.5 Infant‐Toddler Social and Emotional Assessment (ITSEA) | 2 | 384 | Std. Mean Difference (IV, Random, 95% CI) | 0.12 [‐0.08, 0.32] |
| 1.1.6 Maternal mental health | 1 | 41 | Std. Mean Difference (IV, Random, 95% CI) | 0.54 [‐0.09, 1.17] |
| 1.2 Psychological health and emotional behaviour of children Show forest plot | 2 | 384 | Mean Difference (IV, Random, 95% CI) | 0.04 [‐0.03, 0.11] |
| 1.2.1 ITSEA | 2 | 384 | Mean Difference (IV, Random, 95% CI) | 0.04 [‐0.03, 0.11] |
| 1.3 Physical health and developmental health outcomes of children Show forest plot | 8 | 1961 | Std. Mean Difference (IV, Random, 95% CI) | 0.13 [‐0.00, 0.26] |
| 1.3.1 BMI z‐score | 3 | 668 | Std. Mean Difference (IV, Random, 95% CI) | 0.09 [‐0.08, 0.25] |
| 1.3.2 Caries | 3 | 826 | Std. Mean Difference (IV, Random, 95% CI) | 0.19 [0.02, 0.37] |
| 1.3.3 Fully breastfeed | 1 | 178 | Std. Mean Difference (IV, Random, 95% CI) | 0.52 [0.05, 0.99] |
| 1.3.4 New episode of acute respiratory illness | 1 | 289 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.10 [‐0.33, 0.13] |
| 1.4 Family health‐enhancing lifestyle or behavioural outcomes Show forest plot | 9 | 1969 | Std. Mean Difference (IV, Random, 95% CI) | 0.16 [‐0.06, 0.39] |
| 1.4.1 Home environment | 2 | 404 | Std. Mean Difference (IV, Random, 95% CI) | 0.07 [‐0.13, 0.27] |
| 1.4.2 Parent/carer general physical health | 2 | 528 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.03 [‐0.33, 0.27] |
| 1.4.3 Family cohesion | 1 | 41 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.15 [‐0.77, 0.48] |
| 1.4.4 Maternal sleep quality | 1 | 169 | Std. Mean Difference (IV, Random, 95% CI) | 0.34 [‐0.24, 0.93] |
| 1.4.5 Oral health behaviour | 1 | 451 | Std. Mean Difference (IV, Random, 95% CI) | 0.23 [0.02, 0.45] |
| 1.4.6 Full smoking ban in the home | 1 | 254 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.08 [‐0.62, 0.47] |
| 1.4.7 Sugar‐sweetened beverages consumption | 1 | 122 | Std. Mean Difference (IV, Random, 95% CI) | 1.02 [0.64, 1.40] |
| 1.5 Psychological health of parent/carer Show forest plot | 5 | 975 | Std. Mean Difference (IV, Random, 95% CI) | 0.10 [‐0.03, 0.22] |
| 1.5.1 12‐item Short Form Survey (SF‐12) Mental Health | 2 | 530 | Std. Mean Difference (IV, Random, 95% CI) | 0.01 [‐0.16, 0.19] |
| 1.5.2 Center for Epidemiologic Studies Depression Scale (CES‐D) | 3 | 445 | Std. Mean Difference (IV, Random, 95% CI) | 0.20 [0.01, 0.39] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 2.1 Parenting knowledge and awareness Show forest plot | 3 | 445 | Std. Mean Difference (IV, Random, 95% CI) | 0.20 [0.01, 0.38] |
| 2.1.1 Skills | 1 | 41 | Std. Mean Difference (IV, Random, 95% CI) | 0.23 [‐0.38, 0.85] |
| 2.1.2 Involvement | 1 | 82 | Std. Mean Difference (IV, Random, 95% CI) | 0.15 [‐0.29, 0.59] |
| 2.1.3 Home safety practices | 1 | 322 | Std. Mean Difference (IV, Random, 95% CI) | 0.20 [‐0.02, 0.42] |
| 2.2 Service access and utilisation Show forest plot | 2 | 530 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.12 [‐0.54, 0.30] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 3.1 Overall health and well‐being Show forest plot | 11 | 2386 | Std. Mean Difference (IV, Random, 95% CI) | 0.14 [0.03, 0.24] |
| 3.1.1 Family‐centred care (FCC) education | 7 | 1541 | Std. Mean Difference (IV, Random, 95% CI) | 0.13 [0.02, 0.23] |
| 3.1.2 FCC counselling | 2 | 378 | Std. Mean Difference (IV, Random, 95% CI) | 0.19 [‐0.15, 0.53] |
| 3.1.3 FCC environment | 1 | 178 | Std. Mean Difference (IV, Random, 95% CI) | 0.52 [0.05, 0.99] |
| 3.1.4 FCC education and counselling | 1 | 289 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.10 [‐0.33, 0.13] |
| 3.2 Physical health and developmental health outcomes of children Show forest plot | 8 | 1961 | Std. Mean Difference (IV, Random, 95% CI) | 0.13 [‐0.00, 0.26] |
| 3.2.1 FCC education | 4 | 1116 | Std. Mean Difference (IV, Random, 95% CI) | 0.11 [‐0.01, 0.24] |
| 3.2.2 FCC counselling | 2 | 378 | Std. Mean Difference (IV, Random, 95% CI) | 0.19 [‐0.15, 0.53] |
| 3.2.3 FCC environment | 1 | 178 | Std. Mean Difference (IV, Random, 95% CI) | 0.52 [0.05, 0.99] |
| 3.2.4 FCC education and counselling | 1 | 289 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.10 [‐0.33, 0.13] |
| 3.3 Family health‐enhancing lifestyle or behavioural outcomes Show forest plot | 9 | 1969 | Std. Mean Difference (IV, Random, 95% CI) | 0.16 [‐0.06, 0.39] |
| 3.3.1 FCC education | 7 | 1546 | Std. Mean Difference (IV, Random, 95% CI) | 0.17 [‐0.09, 0.43] |
| 3.3.2 FCC environment | 1 | 169 | Std. Mean Difference (IV, Random, 95% CI) | 0.34 [‐0.24, 0.93] |
| 3.3.3 FCC education and counselling | 1 | 254 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.08 [‐0.62, 0.47] |
