The global need for developing comprehensive mental healthcare systems for children and adolescents has been increasingly evident. The system-of-care (SOC) model in the USA is among the most studied cases for such a system, which demonstrates how integrated services, encompassing psychiatric care, can effectively support children and adolescents with severe emotional disturbance. Over the past decades, the SOC framework has been widely expanded, with nearly every state in the USA receiving federal funding to implement or expand the SOC initiatives. The number of studies investigating the efficacy of the SOC is increasing, but no systematic review of the instruments for the evaluation of the implementation of the SOC exists today. This protocol paper documents the plan of a systematic review, which aims to identify and synthesise the existing instruments, which are designed and used to evaluate the implementation of the SOC.

This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocol guidelines. To identify relevant studies, we will perform a comprehensive search in five databases: PubMed, PsycINFO, ERIC, Social Work Abstracts and Web of Science. The title and abstracts of all searched articles will be screened independently by two reviewers according to the eligible criteria. Full-text screening of potentially relevant articles will be performed by at least two independent reviewers. A summary of included articles will describe the availability, progress and cultural adaptability of instruments.

The current systematic review will be solely based on previously reported data and will not involve new data collection. There are no concerns that require ethical vetting. Findings of the review will be disseminated through conference presentations and publication in a peer-reviewed journal.

1065693.

Zika virus (ZIKV) infection during pregnancy has been associated with adverse birth outcomes, including congenital Zika syndrome, characterised by features such as microcephaly. However, the broader neurodevelopmental influence of prenatal ZIKV exposure, especially among offspring without congenital anomalies at birth, remains poorly understood. While previous studies, including a review, have explored neurodevelopment in ZIKV-exposed children, comparative pooled estimates between exposed and unexposed groups remain scarce. This systematic review and meta-analysis aims to evaluate the association between prenatal ZIKV exposure and neurodevelopmental outcomes in offspring without congenital anomalies at birth, using data from observational studies with defined control groups.

We will systematically search multiple databases, including PubMed, EMBASE, Scopus, CINAHL, PsycINFO, Cochrane Library and Web of Science, alongside grey literature sources such as Google Scholar and conference proceedings. Eligible studies will include observational designs (cohort and case-control) comparing neurodevelopmental outcomes between children with and without prenatal ZIKV exposure. Primary outcomes will include gross motor, fine motor, communication, problem-solving, social-emotional and cognitive development assessed with validated tools. Three reviewers will independently screen studies, extract data and assess methodological quality using the Newcastle-Ottawa Scale and the Grading of Recommendations, Assessment, Development and Evaluation approach. A meta-analysis will be conducted where appropriate, with heterogeneity assessed using the I² statistic and further explored through subgroup and meta-regression analyses.

Ethical approval is not required, as the study involves secondary analysis of publicly available data. Findings will be disseminated through peer-reviewed publications and conference presentations.

CRD420251011184.