Inleiding en context
Goede morgen allemaal op deze vrijdag 21 oktober 2022. Het is weer vrijdag, dus het weekeinde is in aantocht. Daarom een mooi weekeindeliedje om mee te beginnen: https://www.youtube.com/watch?v=rI_gT63-w-g The Jam, ik heb ze in 1978 in de Vliegermolen in Voorburg gezien, ik word echt een oude man. Maar goed nu toch echt naar de ´kennisparel´ van vandaag. Daarin wordt een systematisch overzicht gepresenteerd over risicojongeren en de effecten van zogenaamde ´outreach-programma´s om die risico´s te verminderen.
Risicojongeren kunnen worden gedefinieerd als een diverse groep jongeren in onstabiele levensomstandigheden die één of meer ernstige problemen ervaren of dreigen te ontwikkelen. Te denken valt hierbij aan vroegtijdig schoolverlaten, dakloosheid, spijbelen, weglopers, vermogenscriminaliteit en het plegen van serieuze geweldsdelicten. Het is vaak zeer onwaarschijnlijk dat risicojongeren zelf hulp zoeken binnen de gevestigde organisaties. Dit omdat hun ongunstige ontwikkelingstrajecten een gebrek aan vertrouwen hebben veroorzaakt in autoriteiten zoals kinderbeschermingsinstanties en maatschappelijk werkers. Om deze risicojongeren te helpen, is een aantal outreach-programma’s opgezet om de jongeren op ad-hoc basis te helpen. Dat betekent in de regel dat de interventies zijn ontworpen om aan de individuele behoeften van jongeren te voldoen in plaats van one-size-fits- all behandelmodellen. De interventies in bijgesloten ´kennisparel´ zijn gericht op outreach-werk dat uit meerdere componenten kan bestaan waarin die eventueel worden gecombineerd met andere diensten en hulpverleningsmethoden. Wat levert dat allemaal op?
Bron
Filges, Trine, Nina T. Dalgaard & Bjørn C. A. Viinholt (October 2022). Outreach programs to improve life circumstances and prevent further adverse developmental trajectories of at-risk youth in OECD countries: A systematic review. Campbell Systematic Reviews, vol. 18, no. 4, December, pp. 1-28. https://onlinelibrary.wiley.com/doi/full/10.1002/cl2.1282
Samenvatting
At-risk youth may be defined as a diverse group of young people in unstable life circumstances, who are currently experiencing or are at risk of developing one or more serious problems. At-risk youth are often very unlikely to seek out help for themselves within the established venues, as their adverse developmental trajectories have installed a lack of trust in authorities such as child protection agencies and social workers. To help this population, a number of outreach programmes have been established seeking to help the young people on an ad hoc basis, meaning that the interventions are designed to fit the individual needs of each young person rather than as a one-size-fits-all treatment model. The intervention in this review is targeted outreach work which may be (but does not have to be) multicomponent programmes in which outreach may be combined with other services.
The main objective of this review was to answer the following research questions: What are the effects of outreach programmes on problem/high-risk behaviour of young people between 8 and 25 years of age living in OECD countries? Are they less likely to experience an adverse outcome such as school failure or drop-out, runaway and homelessness, substance and/or alcohol abuse, unemployment, long-term poverty, delinquency and more serious criminal behaviour? We identified relevant studies through electronic searches of bibliographic databases, governmental and grey literature repositories, hand search in specific targeted journals, citation tracking, and Internet search engines. The database searches were carried out in September 2020 and other resources were searched in October and November 2021. We searched to identify both published and unpublished literature, and reference lists of included studies and relevant reviews were searched
The intervention was targeted outreach work which may have been combined with other services. Young people between 8 and 25 years of age living in OECD countries, who either have experienced or is at-risk of experiencing an adverse outcome were eligible. Our primary focus was on measures of problem/high-risk behaviour and a secondary focus was on social and emotional outcomes. All study designs that used a well-defined control group were eligible for inclusion. Studies that utilised qualitative approaches were not included. Four of the five studies used for meta-analysis were from the USA and one was from Canada. The timespan in which included studies were carried out was 32 years, from 1985 to 2017; on average the intervention year was 2005. The average number of participants in the analysed interventions was 116, ranging from 30 to 346 and the average number of controls was 81, ranging from 32 to 321. At most, the results from two studies could be pooled in a single meta-analysis. It was only possible to pool the outcomes drug (other than marijuana) use, marijuana use and alcohol use each at two different time points (one and 3 months follow up). At 1 month follow up the weighted averages varied between zero and 0.05 and at 3 months follow up between −0.17 and 0.07. None of them were statistically significant. In addition, a number of other outcomes were reported in a single study only.
Overall, there were too few studies included in any of the meta-analyses in order for us to draw any conclusion concerning the effectiveness of outreach. The vast majority of studies were undertaken in the USA. The dominance of the USA as the main country in which outreach interventions meeting our inclusion criteria have been evaluated using rigorous methods and within our specific parameters clearly limits the generalisability of the findings. None of the studies, however, was considered to be of overall high quality in our risk of bias assessment and the process of excluding studies with critical risk of bias from the meta-analysis applied in this review left us with only five of a total of 16 possible studies to synthesise. Further, because too few studies reported results on the same type of outcome at most two studies could be combined in a particular meta-analysis. Given the limited number of rigorous studies available from countries other than the USA, it would be natural to consider conducting a series of randomised controlled trials evaluating the effectiveness of outreach for at-risk youth in countries outside the USA. The trial(s) should be designed, conducted and reported according to methodological criteria for rigour in respect of internal and external validity to achieve robust results and preferably reporting a larger number of outcomes.
Afsluitend
Tja, ondanks het bestaan van vele initiatieven en bestaande programma´s blijkt het niet mogelijk om uitspraken te doen over de effectiviteit daarvan. Er zijn simpelweg te weinig kwalitatief goede effectevaluatiestudies voorhanden. Dat is op het terrein van interventies en programma´s gericht op het voorkomen van jeugdcriminaliteit een veelvoorkomend probleem. We weten vaak niet wat werkt. Dat blijft toch een grote zwakte, dat gebrek aan kwalitatief goede effectevaluatiestudies.
Ook in Nederland is dat het geval. Naar mijn mening moeten overheden / subsidieverstrekkers standaard vijf tot tien procent van de financiële investeringen in preventieprogramma´s reserveren voor het uitvoeren van kwalitatief goede effectstudies om uiteindelijk uitspraken te kunnen doen wat er met al die investeringen is gebeurd. Dat geldt naar mijn mening trouwens ook bij de aanpak van georganiseerde misdaad in Nederland. Daar is vaak sprake van innovatie maar een schreeuwend gebrek aan evaluative.
