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. 2002 Mar;52(476):223–233.

Meta-analysis of the effectiveness of parenting programmes in improving maternal psychosocial health.

Jane Barlow 1, Esther Coren 1, Sarah Stewart-Brown 1
PMCID: PMC1314244  PMID: 12030667

Abstract

The purpose of this study was to determine whether group-based parenting programmes are effective in improving maternal psychosocial health. Data sources used were English and non-English language articles published between January 1970 and July 2000, retrieved using a keyword search of a number of biomedical, social science, educational, and general reference electronic databases. Two independent reviewers selected the relevant abstracts and articles. Only controlled trials were included in which participants had been randomly allocated to an experimental and a control group, the latter being a waiting-list, no-treatment or a placebo control group. Studies had to include at least one group-based parenting programme and one standardised instrument measuring maternal psychosocial health. Means, standard deviations, and information regarding study quality were selected from the included studies by two independent reviewers. The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group, by the pooled standard deviation, to produce an effect size. The results were then combined in a meta-analysis using a fixed-effect model. A total of 23 studies met all the inclusion criteria and 17 of these provided sufficient data with which to calculate effect sizes. Fifteen of these studies provided data on the five main outcomes of interest: depression, anxiety/stress, self-esteem, social support, and relationship with partner. The meta-analyses show statistically significant results favouring the intervention group for depression (-0.3, 95% confidence interval [CI] = -0.4 to -0.1), anxiety/stress (-0.5, 95% CI = -0.7 to -0.3), self-esteem (-0.4, 95% CI = -0.6 to -0.1), and relationship with partner (-0.4, 95% CI = -0.7 to -0.2). However, the meta-analysis of the social support data showed no evidence of effectiveness (-0.04, 95% CI = -0.3 to 0.2). Follow-up data were available for only three of the five outcomes. The results show that there were changes favouring the intervention group for self-esteem (-0.4, 95% CI = -0.7 to -0.2), the mother's relationship with her partner (-0.3, 95% CI = -0.8 to 0.1), and depression (-0.2, 95% CI = -0.4 to 0.002), although the confidence intervals for the mother's relationship with her partner and depression both cross zero. It is concluded that parenting programmes can make a significant contribution to the short-term psychosocial health of mothers. While the limited follow-up data are promising, further evidence of their effectiveness in improving maternal mental health is required. It is also suggested that some caution should be exercised before the results are generalised to parents irrespective of the level of pathology present.

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Selected References

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  1. Anastopoulos A. D., Shelton T. L., DuPaul G. J., Guevremont D. C. Parent training for attention-deficit hyperactivity disorder: its impact on parent functioning. J Abnorm Child Psychol. 1993 Oct;21(5):581–596. doi: 10.1007/BF00916320. [DOI] [PubMed] [Google Scholar]
  2. Barlow J., Stewart-Brown S. Behavior problems and group-based parent education programs. J Dev Behav Pediatr. 2000 Oct;21(5):356–370. doi: 10.1097/00004703-200010000-00007. [DOI] [PubMed] [Google Scholar]
  3. Caplan H. L., Cogill S. R., Alexandra H., Robson K. M., Katz R., Kumar R. Maternal depression and the emotional development of the child. Br J Psychiatry. 1989 Jun;154:818–822. doi: 10.1192/bjp.154.6.818. [DOI] [PubMed] [Google Scholar]
  4. Cogill S. R., Caplan H. L., Alexandra H., Robson K. M., Kumar R. Impact of maternal postnatal depression on cognitive development of young children. Br Med J (Clin Res Ed) 1986 May 3;292(6529):1165–1167. doi: 10.1136/bmj.292.6529.1165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cox J. L., Connor Y., Kendell R. E. Prospective study of the psychiatric disorders of childbirth. Br J Psychiatry. 1982 Feb;140:111–117. doi: 10.1192/bjp.140.2.111. [DOI] [PubMed] [Google Scholar]
  6. Cunningham C. E., Bremner R., Boyle M. Large group community-based parenting programs for families of preschoolers at risk for disruptive behaviour disorders: utilization, cost effectiveness, and outcome. J Child Psychol Psychiatry. 1995 Oct;36(7):1141–1159. doi: 10.1111/j.1469-7610.1995.tb01362.x. [DOI] [PubMed] [Google Scholar]
  7. Cutrona C. E., Troutman B. R. Social support, infant temperament, and parenting self-efficacy: a mediational model of postpartum depression. Child Dev. 1986 Dec;57(6):1507–1518. [PubMed] [Google Scholar]
  8. Ghodsian M., Zajicek E., Wolkind S. A longitudinal study of maternal depression and child behaviour problems. J Child Psychol Psychiatry. 1984 Jan;25(1):91–109. doi: 10.1111/j.1469-7610.1984.tb01721.x. [DOI] [PubMed] [Google Scholar]
  9. Gross D., Fogg L., Tucker S. The efficacy of parent training for promoting positive parent-toddler relationships. Res Nurs Health. 1995 Dec;18(6):489–499. doi: 10.1002/nur.4770180605. [DOI] [PubMed] [Google Scholar]
  10. Guyatt G. H., Sackett D. L., Cook D. J. Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 1993 Dec 1;270(21):2598–2601. doi: 10.1001/jama.270.21.2598. [DOI] [PubMed] [Google Scholar]
  11. Irvine A. B., Biglan A., Smolkowski K., Metzler C. W., Ary D. V. The effectiveness of a parenting skills program for parents of middle school students in small communities. J Consult Clin Psychol. 1999 Dec;67(6):811–825. doi: 10.1037//0022-006x.67.6.811. [DOI] [PubMed] [Google Scholar]
  12. Kumar R., Robson K. M. A prospective study of emotional disorders in childbearing women. Br J Psychiatry. 1984 Jan;144:35–47. doi: 10.1192/bjp.144.1.35. [DOI] [PubMed] [Google Scholar]
  13. Nixon C. D., Singer G. H. Group cognitive-behavioral treatment for excessive parental self-blame and guilt. Am J Ment Retard. 1993 May;97(6):665–672. [PubMed] [Google Scholar]
  14. Odom S. E. Effects of an educational intervention on mothers of male children with attention deficit hyperactivity disorder. J Community Health Nurs. 1996;13(4):207–220. doi: 10.1207/s15327655jchn1304_1. [DOI] [PubMed] [Google Scholar]
  15. Rutter M. Connections between child and adult psychopathology. Eur Child Adolesc Psychiatry. 1996;5 (Suppl 1):4–7. doi: 10.1007/BF00538535. [DOI] [PubMed] [Google Scholar]
  16. Stein A., Gath D. H., Bucher J., Bond A., Day A., Cooper P. J. The relationship between post-natal depression and mother-child interaction. Br J Psychiatry. 1991 Jan;158:46–52. doi: 10.1192/bjp.158.1.46. [DOI] [PubMed] [Google Scholar]
  17. Webster-Stratton C., Kolpacoff M., Hollinsworth T. Self-administered videotape therapy for families with conduct-problem children: comparison with two cost-effective treatments and a control group. J Consult Clin Psychol. 1988 Aug;56(4):558–566. doi: 10.1037//0022-006x.56.4.558. [DOI] [PubMed] [Google Scholar]
  18. Wolfson A., Lacks P., Futterman A. Effects of parent training on infant sleeping patterns, parents' stress, and perceived parental competence. J Consult Clin Psychol. 1992 Feb;60(1):41–48. doi: 10.1037//0022-006x.60.1.41. [DOI] [PubMed] [Google Scholar]

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