Virtual and digital (V&D) interventions can be effective in supporting vulnerable children but generally no more and often less than face-to-face approaches, according to a new report.
The Early Intervention Foundation (EIF) charity has published the findings of research carried out in response to the Covid-19 crisis and concerns about the effect of social isolation on children’s services.
It says this will require new models that could harness V&D, and that service providers are taking steps to deliver remotely delivered interventions. These include one-to-one and group based therapy, support by phone, messaging and video conferencing, and self-guided measure through online quizzes, apps and games. They focus on areas including physical health, maltreatment, mental health and wellbeing, antisocial behaviour and substance misuse.
But of 116 existing options identified, only 22% come with robust evidence that they have been effective. The EIF said that, while this does not mean others will not provide benefits for children, they have to be used with a significant note of caution.
The evidence also points to face-to-face often being more effective, and highlights that children may be more inclined to drop out of V&D programmes, reducing the likelihood that the intervention will work.
Core component priority
One of the major problems is that when an intervention is adapted for the technology the core components, such as a strong relationship and regular contact with a practitioner, can be lost. The research found that just 3% of remote programmes were delivered on a one-on-one basis, with most having no direct practitioner input or contact and relaying heavily on self-guided or unguided content.
The report also highlights the need for a change in approach due to the Covid-19 outbreak. The survey found that 76% of intervention providers need to make major adaptations in their approach, with only 32% having delivered their programmes predominantly through remote methods.
Jack Martin, lead author of the report and senior research officer at the EIF, said: “We conducted this research to support the sector during this period of unprecedented change, and to help ensure that vulnerable children and young people – and their families – continue to receive services that are grounded in the evidence.
“Providers are making a massive effort to keep vital support coming to those who need it most. The study highlights some of the challenges that exist in trying to make this transformation happen quickly, and some of the pitfalls to be avoided. We hope the recommendations in the report provide useful and actionable insights for those who are making important decisions about new and adapted services right across the country.”
The report makes a number of recommendations on how V&D interventions can be made more effective. They include frequent contact with a trained practitioner when developing the measures, and ensuring there is sufficient engagement in place to detect if they are not reaching the children who need support.
There is also a need for providers to work with experts in digital delivery to ensure the content is appropriate and engaging, and when adapting existing interventions to V&D they need to maintain a focus on the core components.
In addition, they should work with researchers on evaluations that will improve the evidence base on whether the approaches are effective.
The research was based on a rapid review 33 UK and international evidence clearing houses to identify programmes delivered remotely, existing evidence reviews and a short online survey of early intervention programme providers and developers in the UK, conducted early this month. It prompted 88 responses.
Image by Inaki Perez de Albeniz, CC BY 2.0 through flickr