Online Parent Support Programs for Children’s Behavioral Problems: A Meta-Analytic Review of Effects and Program Components Associated with Effects

Background: There is a rapid increase in the development of online prevention strategies. This call for the need to understand how effective these strategies are for improving mental health, and which components (e.g., adding therapist contact) contribute to their effectiveness. This study is the first to systematically review and meta-analyze the effectiveness of online parenting support programs on children’s behavioral problems, as well as on emotional problems and parental mental health. In addition, we tested whether online programs are more effective if they include therapist contact, and explored with specific combinations of program components are associated with stronger program effects.

Method: We identified randomized controlled trials comparing an online parent support program to a control through a systematic literature search in four databases (e.g., PubMed/MEDLINE). Twelve studies (84 effect sizes) met inclusion criteria. We used multi-level meta-analysis to summarize the program effects and to test therapist involvement as a putative moderator of these program effects. We used Qualitative Comparative Analysis (QCA) to identify the content and delivery components that seem sufficient or necessary for program effectiveness.

Results: parent support programs had small but significant effects on behavioral problems (β = -0.32; 95% CI -0.473 to -0.169), emotional problems (β = -0.22; 95% CI, -0.306 − -0.129), and parental mental health (β = -0.30; 95% CI, -0.426 − -0.171). Parent support programs with therapist involvements seemed more effective than those without therapist involvement (β = -0.29 vs -0.24), but therapist involvement was not a significant moderator of program effects (β = -0.29; 95% CI, -0.609 − 0.031. In the QCA, sending parents reminders was the only delivery component sufficient for effectiveness.

Conclusion: There is evidence to support the effectiveness of online parent support programs for reducing children’s emotional and behavioral problems, and improving parental mental health. Therapist involvement not necessarily yields stronger effects; including parent reminders seems sufficient to yield stronger effects. It should be taken into account that our findings relied on an emerging field that currently includes only a limited number of studies (12 studies), a limited numbers of different programs (10 programs), and reliance on parent-reported effects only.