Harnessing Scientific Evidence to Develop Guidelines for Policy Makers and Professionals for Using Parenting Programs

Parenting programs are the primary strategy for increasing parents’ knowledge, and helping parents develop attitudes and behaviors that support children’s mental health. Yet, most families in need of these programs are not reached. This may in part be due to the tension between the time, costs, and training requirements of scaling up evidence-based parenting interventions and the limited resources available in many counties and communities to enhance children’s mental health. This is the case particularly in low and middle income countries. We conducted a series of systematic reviews and meta-analyses to identify the core components of parenting interventions for reducing disruptive child behavior, and translated these findings to a guide for policy makers and professions on the use of evidence-based programs and program components.

Our studies include (1) a meta-analysis (128 randomized trials; 18 countries) of the transportability of parenting programs across countries; (2) a systematic review (212 randomized trials; 20 countries) of the common components of parenting programs, including a specific focus on programs implemented in low and middle income countries; (3) a meta-analysis (151 out of the 212 reviewed trials of study #2) of the program components associated with stronger effects on reduced disruptive child behavior, and (4) meta-analysis (20 microtrials; 2 countries) of the causal effects of individual parenting program components.

Our results show that (1) parenting programs imported from other countries are not less (or more) effective than locally developed programs based on the same theoretical principles; (2) high income countries and low and middle income countries use similar parenting program components. Both have a strong emphasis on positive reinforcement, disciplining skills, and sometimes add parent-child relationship enhancement components or general parental self-management skills (e.g., stress management); (3) few individual components are associated with stronger parenting program effects, although some components (e.g., teaching parents positive reinforcement and limit setting) seem to matter for yielding stronger effects in samples of children with more severe behavior problems; (4) teaching parents only non-violent disciplining behavior yields stronger effects on immediate child compliance than teaching parents only relationship enhancement or positive reinforcement behavior.

The guide includes information about the theoretical background and evidence base of parenting programs and offers advice for real world decisions about which programs to implement, or which components of programs to focus on in case implementation of full-scale programs is not feasible. The guide is developed in collaboration with the WHO and freely available online.