Parental engagement in preventive parenting programs for child mental health: a systematic review of predictors and strategies to increase engagement

Abstract

BackgroundChild mental health problems are now recognised as a key public health concern. Parenting programs have been developed as one solution to reduce children’s risk of developing mental health problems. However, their potential for widespread dissemination is hindered by low parental engagement, which includes intent to enrol, enrolment, and attendance. To increase parental engagement in preventive parenting programs, we need a better understanding of the predictors of engagement, and the strategies that can be used to enhance engagement.MethodEmploying a PRISMA method, we conducted a systematic review of the predictors of parent engagement and engagement enhancement strategies in preventive parenting programs. Key inclusion criteria included: (1) the intervention is directed primarily at the parent, (2) parent age >18 years, the article is (3) written in English and (4) published between 2004–2016. Stouffer’s method of combining p-values was used to determine whether associations between variables were reliable.ResultsTwenty-three articles reported a variety of predictors of parental engagement and engagement enhancement strategies. Only one of eleven predictors (child mental health symptoms) demonstrated a reliable association with enrolment (Stouffer’s p < .01).DiscussionThere was a lack of consistent evidence for predictors of parental engagement. Nonetheless, preliminary evidence suggests that engagement enhancement strategies modelled on theories, such as the Health Belief Model and Theory of Planned Behaviour, may increase parents’ engagement.Systematic review registrationPROSPERO CRD42014013664.

A systematic review of technology‐assisted parenting programs for mental health problems in youth aged 0–18 years: Applicability to underserved Australian communities

“…An additional aim of this review was to explore strategies used to increase engagement, particularly among underserved parent populations. Concordant with previous reviews (Chacko et al, ; Finan et al, ), measures of engagement outcomes varied substantially between studies, with program adherence measures including the mean number of completed modules or sessions for the entire sample, the percentage of the sample that were compliant with a protocol, or the percentage of the sample that completed a certain number of modules or sessions. Upon inspection, no clear connections between engagement outcomes and participant demographic characteristics such as educational attainment or ethnicity were observed.…”

“…Thus, prior to program implementation, focus groups should be conducted with these populations to identify and remove barriers that disproportionately hinder them from enrolling in and completing programs. These strategies may include increasing accessibility to internet and technological devices, designing programs that are compatible across different platforms and devices so that they can be accessed by lower‐SEP populations via smartphones, providing additional practitioner support sessions, or tailoring program content to under‐engaged parent populations (Fernando et al, ; Finan et al, ; Ingoldsby, ).…”

“…Despite substantial progress in the development of effective parenting interventions for youth mental disorders, the positive impact of these interventions is often undermined by low engagement with programs and research assessments (Dumas, Moreland, Gitter, Pearl, & Nordstrom, ; Finan, Swierzbiolek, Priest, Warren, & Yap, ; Ingoldsby, ). Studies indicate that only 10–31% of eligible parents enrol to participate in face‐to‐face parenting programs, the most common form of parenting intervention (Garvey, Julion, Fogg, Kratovil, & Gross, ; Heinrichs, Bertram, Kuschel, & Hahlweg, ; Thornton & Calam, ).…”

Limited access to family-based addiction prevention services for socio-economically deprived families in Switzerland: a grounded theory study

“…Previous studies -not restricted to socio-economically deprived groups -have already identi ed that engagement in preventive parenting programmes is heavily in uenced by parents' awareness of a child's problematic behaviour or symptoms in the child. Children's mental health symptoms, for example, were found to be the only reliable factor in increasing parents' enrolment in preventive parenting programs for child mental health [31]. Spoth and Redmond [32] concluded that parents' rating of the severity of teenage problems in general (smoking, drinking, getting in trouble, etc.)…”

“…Along with these general models and health literacy research, the research on parental engagement in preventive parenting programmes is limited [6,[31][32][33]. Speci cally for FAPS, Laging compiled the factors that in uence willingness to participate in these programmes [6], differentiating between intra-family and programme organizational factors.…”