A Living Scoping Review of Universal Interventions for Promoting Relational Health in Childhood, Adolescence and Young Adulthood.

Investing in relational health across childhood, adolescence and young adulthood not only promotes health and development within a generation, but may have cascading benefits to the next generation. Here we review the literature on universal interventions designed to promote relational health from childhood to young adulthood (4-24 years), just prior to the normative transition to parenthood and raising next generation offspring. This review was conducted in accordance with the JBI methodology for scoping reviews. Electronic databases (MEDLINE [EBSCOhost], PsycINFO [EBSCOhost], and Embase [EBSCOhost] databases) were searched using terms that combined concepts: (1) outcomes pertaining to child, family and community relational ecology; (2) childhood, adolescence, and young adulthood; (3) RCT study design; (4) universal prevention approach. This yielded 3,396 articles, of which 113 were eligible for inclusion. A further 12 articles were identified via expert knowledge resulting in 125 articles reporting on 85 universal interventions (including nine population interventions). Most (90%) interventions were designed for children and adolescents, and most (97%) targeted family, school and community microsystems including aggressive/disruptive behaviour, parenting, peer relationships, and social competence using mostly classroom/school and parenting/family interventions. The few mesosystem interventions focused mostly on family-school connections. Only nine made changes to exosystems, for instance through community coalitions. Key features of population trials included: (1) multiple components; (2) involvement of the community, and; (3) integration into existing service systems. Efforts to promote relational health could be strengthened by a focus on improving the the interlocking social infrastructure which enables relational health to flourish at the microsystem level.