Intervention Review

Independent living programmes for improving outcomes for young people leaving the care system

  1. Charles Donkoh1,
  2. Kristen Underhill2,
  3. Paul Montgomery1,*

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 19 JUL 2006

Assessed as up-to-date: 14 JUN 2005

DOI: 10.1002/14651858.CD005558.pub2


How to Cite

Donkoh C, Underhill K, Montgomery P. Independent living programmes for improving outcomes for young people leaving the care system. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD005558. DOI: 10.1002/14651858.CD005558.pub2.

Author Information

  1. 1

    University of Oxford, The Centre for Evidence-Based Intervention, Oxford, UK

  2. 2

    Yale Law School, New Haven, CT, USA

*Paul Montgomery, The Centre for Evidence-Based Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. paul.montgomery@socres.ox.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JUL 2006

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Independent living programmes (ILPs) are designed to provide young people leaving care with skills that will limit their disadvantage and aid in their successful transition into adulthood. Programmes focus on personal development, independent living skills, education, and vocational support.

Objectives

To assess the effectiveness of independent living programmes for young people leaving the care system.

Search methods

The following electronic databases were searched: Cochrane Register of Controlled Trials (CENTRAL) (Issue 3, 2005); MEDLINE (1966 to June 2005); EMBASE (1980 to June 2005); CINAHL (1982 to June 2005); PsycINFO (1887 to June 2005); Sociological Abstracts (1952 - June 2005); Applied Social Science Index and Abstracts (ASSIA) (1987- June 2005) and Dissertation Abstracts (to June 2005). All bibliographies were cross-referenced, and experts were contacted for unpublished or ongoing studies.

Selection criteria

Randomised or quasi-randomised controlled trials comparing ILPs to standard care, another intervention, no intervention, or a wait-list control, for young people leaving care systems at their country's statutory age of discharge.

Data collection and analysis

2196 citations were identified and screened independently by two reviewers. Full text versions were obtained for 54 papers. None met the review's inclusion criteria.

Main results

No study was found that met the inclusion criteria of the review. Eighteen studies using nonrandomised or noncomparative designs were found, which generally reported favourable outcomes for ILP participants; however, reliable inferences cannot be drawn from these studies due to their use of weak methodology.

Authors' conclusions

Results from randomised controlled trials show no evidence of the effectiveness of ILPs in improving or impairing outcomes for young people discharged from care. Further research into ILPs using randomised controlled designs is needed.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Independent living programmes for improving outcomes for young people leaving the care system

This review aimed to evaluate the effectiveness of independent living programmes (ILPs), a widespread and varied group of programmes intended to improve outcomes for foster care (looked-after) youth leaving the care system. There is evidence that of the many thousands of young people who are discharged from care each year, a sizeable number lack the life skills or resources necessary to succeed independently. Compared to the general population, these young adults face much higher rates of homelessness, unemployment, dependency on public assistance, physical and mental health problems, and involvement with the criminal justice system. ILPs, which incorporate independent living skills training, personal development, and educational and vocational support, are one strategy to improve these outcomes.

So as to incorporate only the highest-quality evidence, this review was limited to randomised and quasi-randomised controlled trials that assessed the effectiveness of ILPs for young people leaving the care system. Outcomes of interest included educational attainment, employment, health, housing, and other relevant life skills outcomes.

After an exhaustive search, no study was found that met our criteria. The primary reason for excluding studies was the lack of a randomised or quasi-randomised design. Eighteen studies utilising nonrandom comparisons, one-group longitudinal designs, or qualitative methodology were identified and are detailed in the table of excluded studies. The results of these studies generally favoured ILP participants for the outcomes of interest; however, their weak methodology makes it difficult to draw any firm or reliable inferences for policy and practice. On the whole, adverse effects were rarely observed.

This review is severely limited by the methodological quality of the evidence base for ILPs. Further research incorporating randomised designs is both feasible and necessary.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

年輕人離開照護系統後,輔以獨立生活計畫以改進預後

獨立生活計畫 (ILP) 的設計是為了提供離開照護系統的年輕人技能,以減少劣勢和幫助他們成功成長為成人.這些計畫著重個人發展,獨立生活技能,教育和職業訓練.

目標

評估年輕人離開照護系統後,輔以獨立生活計畫的效果.

搜尋策略

搜尋以下電子資料庫: Cochrane Register of Controlled Trials (CENTRAL) (Issue 3, 2005); MEDLINE (1966 to June 2005); EMBASE (1980 to June 2005); CINAHL (1982 to June 2005); PsycINFO (1887 to June 2005); Sociological Abstracts (1952  June 2005); Applied Social Science Index and Abstracts (ASSIA) (1987June 2005) and Dissertation Abstracts (to June 2005). 再次確認所有參考文獻,也聯絡學者取得未發表或執行中的試驗資料.

選擇標準

隨機或半隨機對照試驗,比較年輕人於法定年齡離開照護系統後,輔以ILP或一般照護,其他介入方式,沒有介入或排進候補名單.

資料收集與分析

兩位獨立檢閱者找到且檢視2196個引用文獻.取得其中54篇文章的全文.沒有任何試驗符合納入條件.

主要結論

沒有試驗符合納入條件.我們找到18個使用非隨機試驗或沒有對照設計的研究,大部分都顯示參加ILP計畫者預後較好。然而,因為方法學的限制,不能由這些試驗得到可靠推論.

作者結論

隨機對照試驗結果顯示:沒有證據顯示ILP可以改進或有害於離開照護系統的年輕人.需要更多進一步使用隨機對照的研究.

翻譯人

本摘要由成功大學附設醫院尹子真翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

本回顧希望評估ILP的效果.很多團體希望在寄養 (照顧) 離開照護體系的年輕人情況,能有更好的成效.每年數千年輕人離開照護體系,其中很多缺少生活技能或能成功獨立生活的資源.和一般人比起來,這些年輕人有比較高的無居住處所比例,失業率,對社會救助的依賴性,身心健康問題和加入犯罪系統機率. ILP包含獨立生活技能訓練,個人發展和職業教育訓練. ILP是一種讓他們之後生活更好的方式.本回顧只採用最高品質的研究,故限定隨機或半隨機對照試驗,比較年輕人離開照護系統後,以ILP輔助的效果.有興趣的結果變項包含:學業成就,就業率,健康,是否有能力負擔住家和其他相關生活技能.經過認真的檢索也沒找到符合條件的試驗.主要原因是缺少隨機或半隨機的設計.我們找到18篇文獻採用非隨機的比較研究,單族群長期追蹤設計,或質性研究,詳列於排除試驗列表.這些試驗結果大部分都顯示,在有興趣的結果變項方面,參與ILP計畫者比較好.然而,這些研究的方法學不夠強,故不能得到確定可靠的推論,提供給政策參考或實務使用.總體來說,很少看到此措施的不良影響.本回顧嚴重受限於ILPs實證的方法學品質。更多隨機設計的研究是有需要且可行的.