Barriers to and facilitators of engagement with early-intervention services by pregnant people at risk of child removal: a mixed methods systematic review protocol

Objective: The objective of this review is to synthesize existing qualitative, quantitative, and mixed methods evidence in order to identify and examine the barriers to and facilitators of engagement with early-intervention services by pregnant people at risk of child removal. 

Introduction: Early intervention and prevention is key to reducing the risk of child abuse, neglect, and removal. Prenatal screening and referral to appropriate treatment and supports underpins best practice early-intervention responses. However, research suggests that pregnant people most in need of support services are often those least likely to engage with them. For early intervention to work, the barriers and facilitators of prenatal engagement must be identified and addressed within service and practice approaches with this group. 

Inclusion criteria: This mixed methods systematic review will consider qualitative, quantitative, and mixed methods studies of pregnant people at risk of child removal. Studies will be considered if they report on barriers to or facilitators of engagement in early-intervention services that address risk factors for child removal. 

Methods: The systematic review will be conducted in accordance with JBI methodology for mixed methods systematic reviews. A range of databases will be searched, including Informit online, MEDLINE (Ovid), ProQuest Central and Social Sciences Premium, PsycINFO (Ovid), and Scopus (Elsevier). Critical appraisal and data extraction for studies meeting the inclusion criteria will be performed by two reviewers using standardized JBI tools. Data synthesis will follow the convergent integrated approach to mixed methods systematic reviews.