Exploring the design and impact of integrated health and social care services for children and young people living in underserved populations: a systematic review.

objectiveTo explore the evidence for interventions that integrate child health and social care and support programmes and the impact they have on child health and wellbeing. DATA SOURCES: The Cochrane Library, Ovid Medline, Ovid Embase, Ovid Emcare, Ovid Health Management Information Consortium (HMIC) database, and Ovid Social Policy and Practice, Proquest Psychinfo and Ebscohost Cinahl. ELIGIBILITY: Peer-reviewed original research that described an intervention integrating health care and social support or care interventions for children and young people (CYP) up to the age of 18 years in high-income countries. All databases were searched from inception to August 2023. DATA EXTRACTION AND SYNTHESIS: 16 studies were identified: 9 quantitative studies including 4 RCTs, 5 qualitative studies and 2 mixed methods studies. Studies were assessed for quality and a narrative review performed. Study heterogeneity meant a meta-analysis could not be completed.

resultsFor the purposes of clarity and understanding we collated the identified studies bv mode of delivery. In doing so we determined three main models of delivering integrated health and social care services: Targeted support for vulnerable groups, where the provision of packages of interventions focussed on target populations, this showed potential for decreasing the need for social support in the long-term but with limited evidence for reducing referrals into other services. These types of service were more successful in meeting specific objectives such as lower rates of smoking, and reducing repeat pregnancies; Collaborative health and social support, which typically collocated health and social care practitioners, demonstrated improved collaborative working but with little impact on workload, job satisfaction, or service delivery; and School centred health and social care, which were based in educational facilities and improved some aspects of CYP wellbeing and physical health but with concerns they added to teacher workload.

conclusionsIntegrated health and social support programmes offer promising solutions to addressing health inequity in children and young people in underserved populations. However, more robust and consistent study designs are needed to guide researchers and policy makers in their implementation and evaluation. PROSPERO REGISTRATION: CRD42023399907.