Examining Empowerment Interventions With Families and Preschool Children: Systematic Review of Randomized Controlled Trials

Abstract

Empowerment is a core construct in health behavior and an emerging trend in pediatrics. Although it has been suggested as an approach that may promote the person’s participation in health care decisions and positive outcomes, little is known about the nature and effectiveness of interventions to support empowerment in families and preschool-age children. The aim of this review is to identify, appraise, and synthesize the evidence on health interventions explicitly using empowerment as an orienting concept with families and their preschool-age children. We identified randomized controlled trials (RCTs) through systematic searches of eight databases for articles published between 1986 and January 2019 and included RCTs that addressed empowerment as a health intervention approach or outcome and that studied families with 3- to 5-year-old children. The application of empowerment theory, the family and child involvement, and the use of behavior change techniques (BCTs) were assessed through appropriate frameworks. Ten interventions were identified, and 50% of them showed positive outcomes. Most studies claimed a theoretical base. However, the studies provided limited details on theory application in intervention planning, implementation, and evaluation, and the children’s involvement in the interventions was generally scarce. The most commonly applied BCT was “instruction in how to perform the behavior.” We identified 16 potentially effective BCTs. The evidence was not sufficiently robust to determine the effectiveness of empowerment interventions with families and preschool-age children. Additional high-quality studies are needed to produce clearer conclusions. Our results are useful for the design and evaluation of future interventions.

Health Education Intervention Programs in Early Childhood Education: A Systematic Review

“…Due to the complexity of health education and the age characteristics of the age group examined, it is difficult to measure the effectiveness of health education interventions in an institutional environment; therefore, many studies are carried out mainly with the involvement of parents and teachers. So, it is not surprising that in the field of early childhood health education, previous systematic reviews focused primarily on parents or teachers [29][30][31][32], possibly on a specific health education area (oral health, obesity) [33][34][35][36][37][38] or on a specific type of disease [39,40]. A comprehensive review of health interventions for the 3-6-year-old age group within an institutional setting has not been carried out so far.…”

Development and validation of a quantitative measure for parent empowerment via transformative learning

“…Finally, for future research related to program evaluation, as a valid and reliable scale, the PETLQ can also be used to evaluate the effectiveness of parent empowerment informed by transformative learning. Based on a systematic review on empowerment interventions with families, Borges Rodrigues et al (2021) pointed out that current studies lack details regarding how to operationalize key theoretical constructs of empowerment, noting that few studies present a theoretical application at the evaluation stage. Thus, the PETLQ could be used to address this knowledge gap by enabling researchers and practitioners to conduct post-intervention assessment by measuring empowerment constructs informed by transformative learning.…”