31 January 2024
Virtual and digital interventions
A rapid review of interventions for children aged 0-5 and their families.
We conducted this rapid review to supplement an earlier review by the Early Intervention Foundation (now Foundations) and to help local authorities consider evidence-based options for their Family Hubs digital offer.
The purpose of this review was to identify specific virtual and digital interventions for children aged 0-5 and their families that local authorities might include as part of their Family Hubs offer within four priority areas:
- Parenting support
- Parent–infant relationships and perinatal mental health
- Support for children’s early language and the home learning environment
- Infant feeding
Given the limited timeframe, this rapid review does not provide sufficient evidence to suggest that virtual interventions are superior to face-to-face interventions in supporting families with children under the age of five years.
Of the seven studies which were deemed to meet the inclusion criteria, only two articles showed statistically significant evidence of impact. Both studies aligned with the Family Hub priority area on parenting support, demonstrating positive impacts on parenting practice:
- Van Leishout et al., 2021 highlighted positive impacts on parent-infant relationships through a one-day interactive workshop that led to significant mean reductions in Edinburgh Postnatal Depression Scale scores for mothers. Despite more research being needed to compare this brief intervention with longer programmes, the article showed potential for virtual and digital delivery interventions to perhaps complement face-to-face support for parents with depression.
- Helle et al., 2019 ‘Early Food for Future Health’ intervention demonstrated that 80% of mothers preferred accessing information on infant nutrition online. The intervention showed positive outcomes in children’s diet and eating habits by for example children being served more fruit and vegetables and having beneficial mealtime routines such as not watching TV/playing on tables during mealtimes.
Whilst two of the interventions did have rigorous evidence of positive impact, the evidence base is small, and as they were not based in the UK it is not possible to examine differences amongst participants across socio-economic groups or a range of protected characteristics such as ethnicity. It is also important to mention that the interventions identified in the review were compared to ‘usual care’ within the country, which varied markedly between studies making it hard to measure value-added.
Many of the included studies that did not show any statistically significant improvements in outcomes often discussed virtual and digital delivery of interventions as cost-effective and could increase reach to populations if used as accompanying tools to business-as-usual interventions. It is however worth mentioning that there was no evidence presented in this rapid review to support these claims.
Despite limited impacts on outcome measures, the review gathered that parents seem to enjoy the virtual and digital interventions as the acceptability, feasibility, and engagement were reported high and parents noted that they found them relatively easy to use.
Implications for policy
This review found limited evidence to support the use of virtual and digital interventions for families of children under the age of five, nor did it find evidence to support the suggestion that they are superior to face-to-face interventions. However, the review did find some promising findings that a virtual or digital component can increase the efficacy of face-to-face support. This may suggest that services and interventions can be strengthened by including both face-to-face and virtual components to serve different community needs.
However, these findings are preliminary and further rigorous research is required before clear policy implications can be identified. Further reviews are necessary to establish ‘what works for whom’ and in what circumstances, especially as the current findings do not reflect the demographic in the UK.