Table 1.

Characteristics and quality assessment of studies included

Author(s)/Date	Setting	Aim	Design	Sample	Intervention	Main outcomes	Quality assessment*
Qualitative studies
Kai 199432	Health visitor and general practitioner baby clinics (UK)	To explore disadvantaged parents’ perceptions and use of the Baby Check booklet	Qualitative interview and records of consultations	Parents of 34 babies <6 months attending weekly baby clinic in GP in disadvantaged area	Parents were given a copy of Baby Check. Unstructured 30–90-min interviews with parents until baby was 6 months	Perceptions, use of the booklet and consultations for illness among disadvantage parents	**
Krantz 200138	Parent Resource Centre. Children's Hospital Ontario (Canada)	To describe the development of, and pilot, a fever anticipatory guidance tool for parents	Qualitative interview	15 first-time parents with children aged 2 months to 4 years from inner city Parent Resource Centre	The Fever Anticipatory Guidance Tool	Views on, and use of, the booklet	*
Randomised controlled trials
Baker et al 200918	ED (USA)	Effect of a brief educational video during ED visit for minor febrile illnesses	RCT	280 parents of children aged 3 months to 3 years presenting to with febrile illness	Intervention: 11-min video on home management of fever. Control: 8-min video on home and automobile safety	Knowledge, attitudes, and return ED visits for minor febrile illnesses within 2 years	***
Broome et al 200319	6 clinics in 6 states (USA)	Effect of a structured education programme on parents’/grandparents’ knowledge, confidence, and satisfaction in assessing and managing a child's fever	RCT	216 children from 3/12 to 6 years of age and their parents/grandparents. 183 followed up at 3 months and 145 at 6 months	Intervention 1: video and brochure on childhood fever in clinic; Intervention 2: brochure and video in clinic, plus health professional reinforced content and answered parents’ questions during consultation; Control: ‘usual’ care	Knowledge, confidence, and satisfaction in assessing and managing child’s fever at 48 h, 1, 3, and 6 months postintervention	*
Chande et al 199620	Urban paediatric ED (USA)	Effect of educational intervention on common childhood illness on ED visits	RCT	130 parents of children with minor illnesses in ED	Intervention: 10-min video on paediatric healthcare issues plus information booklet on common paediatric ailments Control: standard ED discharge instructions	Return visits to ED over 6 months	*
Francis et al 200925	General practice (UK)	Effect of interactive booklet on respiratory tract infections on reconsultation for same illness episode, antibiotic use, future consultation intentions, and parental satisfaction	Cluster RCT	61 practices in Wales and England. 558 parents of children (6 months to 14 years) with a respiratory tract infection	Intervention: Eight page booklet on childhood respiratory tract infections within consultations and as a take home resource. Control: ‘usual’ consultation	Reconsultation within 2 weeks, antibiotic prescribing and consumption, future consultation intentions, parent satisfaction and usefulness of information received, reassurance and enablement	****
Hansen 199026	General practice (Denmark)	Effect of booklet on families’ minor illness-behaviour for children <8 years	RCT	100 young families with min. one child <8 years in one practice	Intervention: Booklet on common childhood problems, presented by GP. Parent recorded illnesses. Control: Unclear. ?‘usual care’ plus diary completion	Consultation frequency and anxiety over 6 months	**
McCarthy et al 199023	US Private practice and primary care centre	Effect of Acute Illness Observation Scales (AIOS) on mother's judgements about acute illness in children under 24 months	RCT	369 mothers with 2-week-old baby	Intervention: AIOS film plus fever scenario scoring. Film shown again at 6 and 15 months. AIOS used to score illness prior to and with doctor during consultation. Control: Routine advice about fever. Illness scored on 3-point scale	Reliability, specificity and sensitivity of mother's judgements compared to clinician assessment from 2 weeks of age, for 32 months	*
Robbins et al 200312	Primary care (UK)	Effect of home visit and infant minor illness booklet on parent's illness management and consultation rates	RCT	Single GP practice: 103 parents of babies born in 6-month birth cohort	Intervention: Postal booklet on common childhood illnesses. Research nurse visit when baby 6 weeks old. Control: Routine health visiting service	Confidence, knowledge, home care activities and desire to contact professionals. Prescription and consultation rates tracked for 6 months	***
Thomson et al 199933	General Practice (UK)	Effect of Baby Check, an illness scoring system for babies ≤6/12, on parents’ use of health services for their baby	RCT	997 mothers with new babies	Intervention: Baby Check plus an accident prevention leaflet Control: accident prevention leaflet alone	Consultation behaviour tracked for 6 months	***
Usherwood 199135	General practice (UK)	Effect of a children's symptom booklet on GP consultations	RCT	419 households with 634 children born 1975 to 1984 registered with one practice	Intervention: Postal booklet on cough, fever, sore throat, diarrhoea and vomiting Control: No intervention. Baseline data gathered for 2 months prior to intervention	Consultation rates for 12 months postintervention	*
Non-randomised trials
Herman and Jackson 201029	Head Start agencies (USA)	Effect of educational intervention on health utilisation for acute illness in children ≤5 years	Cohort study (prospective)	9240 parents with one child enrolled in Head Start 7281 completed the training 581 tracked annually for 2 years	Health training programmes using reference guide ‘What to Do When Your Child Gets Sick’ by Mayer and Kuklierus (2007) in 55 Head Start agencies in 35 states. Tracked for 3 months, trained in 4th month, follow-up for 6 months. Annual visits for 581 parents	ED and primary care consultation rates for 3-year period	***
Isaacman et al 199227	Paediatric ED (USA)	Effect of two standardised simplified discharge instructions on parents information recall	CT (Non-randomised control)	197 parents of children discharged with otitis media (OM)	Intervention 1: standardised verbal discharge information on OM from HCPs in ED Intervention 2: as above+typewritten information from health professionals in ED.Control: ‘usual’ discharge information	Knowledge and management of OM before leaving ED, at 24 and 72 h postintervention Return visits to ED and parent reported physician contact within 72 h	**
Kelly et al 199636	Private paediatrician's office, 4 Primary care centres (USA)	Effect of educational intervention on knowledge and management of fever	Pretest post-test cohort study	86 caretakers of children 2 months to 5 years presenting for routine healthcare or acute minor illness 50 follow-up interviews	Printed fever management sheet at end of initial interview Identified knowledge deficits addressed	Questionnaire on fever knowledge and management before and 2–4 weeks after intervention	**
O’Neill Murphy et al 200130	Urban ED Children's Hospital of Philadelphia (USA)	Effects of educational programme on parents’ anxiety about fever, home management and consultation behaviour	Quasi-experimental, pretest post-test pilot study	87 parents with children aged 3 months to 5 years with fever >38.4	Intervention: Interactive Fever programme Control: Standard Fever Education Programme	Anxiety, consultation behaviour, home management before and after HCP consultation, 2 and 8 weeks after the intervention	*
Rosenberg and Pless 199321	Montreal Children's hospital ED (Canada)	Effect of ED-based parent education on future ED visit rates	Non-randomised CT	300 parents of children >6 months in ED	Intervention: educational pamphlet on common childhood illness plus video in waiting room. Control: ‘usual’ care. (Sequential recruitment to intervention then control)	Consultation behaviour 4 and 12 months postintervention
Steelman et al 199922	Military Paediatric Clinic (USA)	Effect of educational intervention on parent's childhood fever knowledge and consultation rates	Pretest post-test CT	93 parents attending 2, 4, and 6 month well-infant visits	Intervention: standardised slide presentation on well-infant care+10 min presentation on fever and mail out at 1 and 3 months Control: standardised slide presentation on well-infant care	Knowledge of fever, clinic and ED usage at enrolment, 2 and 4 months postintervention
Wassmer and Hanlon 199928	Worcester Royal Infirmary DGH (UK)	Effect of information for parents on febrile convulsions on parent's knowledge	Non-Randomised CT	Intervention: 50 parents of children with 1st febrile convulsion May to Dec 1996. Control: 50 parents of children at community health clinic with no febrile convulsion	Intervention: verbal and written information on febrile convulsions during consultation Control: no information provided. Assume ‘usual care’	Parental knowledge of febrile convulsion 1 year postintervention
Yoffe et al 201134	Primary care clinic (USA)	Effect of parent-focused educational intervention on non-urgent ED visits	Realistic evaluation	Parents of all children ≤10 years attending 3 primary care clinics Number receiving the booklet was not provided	Intervention: booklet on common childhood illness to the parents with children registered with one primary care clinic Control: Parents of children registered with two other clinics not receiving the booklet	ED consultation rates Nov 2007 to Apr 2009
Qualitative descriptive studies
Thornton et al 199124	Conducted in the home (UK)	Use of Baby Check (BC), an illness scoring system for babies ≤6/12, by mothers at home	Two field trails	Study A: 104 mothers of term babies, randomly selected from the birth register Study B: 70 mothers of term babies born on selected days	Study A: Mothers used BC daily for a week and recorded contacts with HCPs. Research nurse visit to grade mother's competence in booklet use Study B: Mothers used BC when wanted to until baby was 6 months. Research nurse visit when babies 8 and 16 weeks. Questionnaire about BC at 6 months	Views and use of the booklet	****
Anhang et al 201337	Two Children's EDs (USA)	Usability and safety of a web-based decision support tool for parents of children with flu-like illnesses	Pilot feasibility study	294 parents/carers of children ≤18 years who had presented to an emergency department for an influenza-like illness	Intervention: Strategy for Off-site Rapid Triage (SORT) for Kids tool web-based parent survey and severity scoring tool	Caregiver ratings of usability of tool, sensitivity and specificity of SORT for Kids for identifying children needing ED	*
Mixed methods studies
Stockwell et al 201031	Early Head Start Agency at Columbia University (USA)	Pilot evaluation of a community-based, culturally competent health literacy intervention on care of URI, with Latino Early Head Start parents	Pretest post-test pilot evaluation	11 parents of children 6 months to 3 years in full evaluation 17 in interviews and 33 postclass evaluations	Three education modules delivered in children's centre	Parental knowledge, attitudes and care of URI before and 2 weeks after final module using Knowledge, Attitude, Practices instrument	**

*Quality assessment rating, between zero stars (lowest quality) and 4 stars (****, highest quality).

DGH, District General Hospital; ED, emergency department; GP, general practitioner; RCT/CT, randomised controlled trial/controlled trial; URI, upper respiratory infection.