Table 1.
Characteristics of Included Studies
| Source | Design; comparison group(s) | Sample size | Parent age M (SD); female, % | Study population | Country | Race/ethnicity majority, % | Child age M (SD) or range; Boys, % |
Intervention name; duration | E-health method | Relevant findings M (SD) or b (p)c |
Study quality ratingb |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Controlled studies (n = 30) | |||||||||||
| Baker et al. (2015) | Controlled; waitlist | 15 | 39; 80 | Parents of adopted children | USA | Caucasian, 73.3 | 3.51a; 60 | Emotional attachment and emotional availability (EA2); 6 weeks | Online video-conferencing |
PSI: I: 225 (26.6) C: 233.6 (30.9) |
50.0 |
| Book et al. (2020) | RCT; active (no video) | 50 | 36.6a; 85 | Parents of children scheduled for inguinal hernia repair | Germany | NR | 2.6; 76 | Video educating parents on hernia repair; NR | Online video |
STAI: I: 50 (10) C: 58 (11) |
57.1 |
| Boyle et al. (2017) | RCT; Standard Care | 200 | 36.05a; 100 | Mothers of children with a food allergy | United Kingdom | “Non-white”, 59 | 4.00a; 61 | Psychoeducation food allergy information; 6 weeks | CBT sessions with phone calls |
STAI-S: I: 31.9 (10.2) C: 34 (10.2) STAI-T: I: 35.9 (10.1) C: 37.2 (9.1) PSS: I: 14.5 (6.5) C:15.3 (6.1) |
42.9 |
| Breitenstein et al. (2016) | RCT; active (health promotion) | 83 | 30–49 (63.3%); 100 | Low-income, ethnic minority parents | USA |
African-American, 64.6 Hispanic, 30.4 |
3.52; 57 | The ezPARENT Program; 12 weeks | App |
PSI-SF: I: 70.2 (19.3) C: 70.95 (21.0) |
57.1 |
| Cernvall et al. (2015) | RCT; waitlist | 58 | 38 (7.2); 67 | Parents of children with cancer | Sweden | NR | Median = 5; 46 | Self-help CBT principles; 10 weeks | Online modules |
BDI-II: I: 12.9 (9.5) C: 19.8 (8.3) BAI: I: 10.1 (10.0) C: 11.3 (9.4) PCL-C I: 35.9 (14.5) C: 45.1 (13.0) |
50.0 |
| David et al. (2017) (Study 1) | RCT; Waitlist | 42 | 32.9 (5.3); 86 | NR | Romania | NR | 5.9 (2.6); NR | Attention Bias Modification (ABM); 1 week | Online sessions |
PSS: I: 34.7 (6.0) C: 35.2 (11.36) |
42.9 |
| David et al. (2017) (Study 2) | RCT; active (no ABT) | 53 | 35.9 (5.3); 91 | NR | Romania | NR | 6.45 (3.3); NR | Rational Positive Parenting program (Rppp) + ABM; 1 week | Online sessions/ modules |
PSS: I: 32.5 (9.1) C: 28.6 (7.86) |
42.9 |
| Ehrensaft et al. (2016) | RCT; waitlist | 52 | 24.37a; 100 | Young post-secondary mothers | USA | NR | 2–6; NR | Triple P Online (TPOL); 12 weeks | Website |
PSI- SF: I: 70.5 (18.6) C: 77.5 (17.67) |
42.9 |
| Farris et al. (2013) | RCT; Active (Face-to-face intervention, booklet) | 133 | 30.7 (5.9); 100 | NR | USA | European-American, 81.6 | 2–3; 47 | Adventures in Parenting; 12 weeks | Booklet with web sessions |
SCL-D: I: 51.01 (5.21) C: 52.1 (6.6) SCL-A I: 44.1 (8.1) C: 43.1 (9.2) SCL-GS: I: 49.4 (6.73) C: 50.2 (8.1) |
42.9 |
| Fortier et al. (2015) | RCT; Standard care | 80 | 32 (5); 92.3 | Parents of children undergoing surgery | USA | Caucasian, 76.9 | 4.35a; 56 | WebTIPS; 7 days | Website |
STAI: I: 32.7 (7.9) C: 36.8 (7.1) |
64.3 |
| Franke et al. (2020) | RCT; waitlist | 53 | 38.16a; 18.8 | Parents of children with ADHD symptoms | New Zealand | European, 79.2 | 4; 71.7 | TPOL; 16 weeks | Online modules |
DASS-A: I: 3.01 (4.2) C: 5 (6.41) DASS-D: I: 3.53 (4.0) C: 6.96 (7.2) DASS-S: I: 9.65 (7.0) C: 13.9 (8.0) |
57.1 |
| Hemdi and Daley (2017) | RCT; TAU | 62 | 33.64a; 100 | Mothers of children with ASD | Saudi Arabia | NR | 4.89a; N/a | “Models of stress and coping”; NR | App |
HADS-A: I: 7.59 (2.09) C: 7.83 (2.64) HADS-D: I: 3.84 (2.49) C: 11.36 (3.42) PSI-SF: I: 116.18 (12.7) C: 139.4 (13.34) |
85.7 |
| Jones et al. (2017) | RCT; waitlist | 97 | 36.63a; 78 | Parents with a bipolar diagnosis | United Kingdom | Caucasian, 94.8 | 6.64; 2.08 | Integrated bipolar parenting intervention (IBPI); 16 weeks | Online modules |
PSI: I: 82.5 (18.9) C: 94.3 (23.9) |
85.7 |
| Kierfeld et al. (2013) | RCT; waitlist | 48 | NR; NR | Parents of children with externalizing behaviour problems | Germany | German, 83.3 | 5.2 (.8); 50 | “Behavioural family intervention”; 11 weeks | Self-help book with telephone |
DASS: I: 55.3 (8.94) C: 68.9 (20.3) |
64.3 |
| Lefever et al. (2017) | RCT; waitlist | 371 | 28.9 (5.8); 100 | Parents at-risk of child maltreatment | USA | Hispanic, 46 | 4.6 (0.57); 56 | Parent–child interaction (PCI); 1.5–4 weeks | In-person sessions with telephone |
BDI-II: I: 7.45 (6.05) C: 7.66 (6.56) |
64.3 |
| MacKenzie and Hilgedick (2000) | Controlled; No intervention, or Active (booklet) | 46 | 35.7 (5.1); 89.7 | Parents with well-adjusted pre-school children | USA | Caucasian, 82.1 | 4.3 (0.73); 49.1 | Computer-Assisted Parenting Program (CAPP); 4 weeks | Online modules |
PSI: I: 117.19 (22.3) No intervention: C: 123.73 (23.2) Booklet: C: 120.5 (19.6) |
21.4 |
| Mascarenhas et al. (2018) | RCT; Waitlist | 64 | 37, 100 | Exercising for parents | USA | Caucasian, 67 | 2.85a, NR | The Moms Online Video Exercise (MOVE); 8 weeks | Website with video-conferencing and mobile apps |
PROMIS- A: (b = -1.1, p = .50) PROMIS-D: (b = -3.0, p = .05) |
78.6 |
| Mindell et al. (2011) | RCT; No intervention (regular routine) | 264 | 30–39 (59%); 100 | Parents of children with sleep disturbances | USA | NR | 1.61 (.74); 49.6 | Individualized recommendations for child sleep; 3 weeks | Internet |
POMS-D I: 5 (7.9) C: 5.08 (8.7) |
50.0 |
| Monaghan et al. (2011) | RCT; waitlist | 24 | 34.8 (6.2); 88 | Parents of children with Type 1 diabetes | USA | Caucasian, 75 | 4.1 (0.8); 50 | The Supporting Parents Program; 3 weeks | Telephone sessions |
STAI-S: I: 37.4 (11.6) C: 37.5 (11.6) CESD: I: 13.5 (9.0) C: 16.33 (11.5) |
35.7 |
| Patton et al. (2020) | RCT; waitlist | 42 | 35.2 (5); 97.6 | Parents of children with hypoglycemia | USA | Caucasian, 95.20 | 4.4 (1.4); 59.5 | REDCHip; 10 weeks | Online video-conferencing |
HFS-PYC: I: 61.67 (19.27) C: 66.8 (12.8) PIP: I: 72.06 (27.9) C: 68.39 (30.9) |
50.0 |
| Potharst et al. (2019) | RCT; waitlist | 67 | 36.20; 100 | Mothers with elevated stress levels | Netherlands | NR | 3.5; 43 | “Mindful parenting training”; 10 weeks | Online modules |
PHQ-4: I: 3.11 (3.18) C: 3.3 (3.1) PSQ: I: 14.5 (2.8) C: 14.2 (3.3) |
42.9 |
| Raj et al. (2015) | RCT; active (web resources) | 37 | 32.66a; 95 | Parents of children hospitalized due to Traumatic brain injury | USA | Caucasian, 62 | 5.4 (2.1); 68 | I-InTERACT; 6 months | Web-based parent program + video-conferencing |
CESD: I: 12.71 (11.35) C: 7.73 (6.4) SCL: I: 50.47 (12.74) C: 52 (9.8) PSI: I: 54.31 (36.4) C: 52.2 (33.8) |
50.0 |
| Sanders et al. (2008) | RCT; delayed intervention | 454 | NR; 94.7 | N/a | Australia | White, 94.7 | 5.5 (2.24); 64.8 | Driving mum and dad mad; 10 weeks | TV series |
DASS-T: I: 23.4 (23.9) C: 29.7 (26.9) |
50.0 |
| Sanders et al. (2014) | RCT; active (booklet) | 193 | 38.18a; NR | Parents of children with of disruptive behaviour problems | New Zealand | European, 90 | 5.63 (1.64); 67 | TPOL; NR | Online modules |
DASS-A: I: 1.65 (2.8) C: 2.04 (3.6) DASS-D: I: 3.52 (5.36) C: 3.86 (5.91) DASS-S: I: 6.9 (5.7) C: 7.7 (6.7) |
42.9 |
| Sheeber et al. (2012) | RCT; TAU | 70 | 31a; 100 | Mothers with depression | USA | Caucasian, 93 | 4.6a; 50 | Mom-Net; 14 weeks | Online modules |
BDI:II: I: 13.4 (10.4) C: 22.5 (11) |
85.7 |
| Sheeber et al. (2017) | RCT; waitlist | 266 | 31.8 (7.2); 100 | Low-income mothers | USA |
Caucasian, 79.3 Hispanic, 11.7 |
4.4 (1.3); 48.8 | Mom-Net; 26 weeks | Online modules |
PHQ-9: I: 6.27 (5) C: 7.9 (5.4) |
71.4 |
| Sourander et al. (2016) | RCT; active (education) | 464 | NR; NR | Parents of children with disruptive behaviour problems | Finland | NR | 4; 61.9 | Strongest families smart website; 11 weeks | Online sessions |
DASS: I: 14.9 (1) C: 17.6 (1) |
50.0 |
| Sveen et al. (2016) | RCT; waitlist | 62 | 37.35a; 68 | Parents of children with severe burns | Sweden | NR | 5.80a; 55 | Caring for a child with burns; 6 weeks | Online modules |
MADRS: I: 4.6 (6.3) C: 6 (6.9) PSS: I: 23.3 (7.3) C: 22.9 (9) PSI: I: 50.7 (10.6) C: 51.1 (20.6) |
50.0 |
| Wang et al. (2018) | Controlled; standard care | 101 | 31–40 (55%); 72 | Parents of children with acute lymphoblastic leukemia | China | Han Nationality, 99 | 3–7 (47%); 64 | Care assistant; 3 months | App |
SDS: I: 49.1 (12.2) C: 49.5 (10.8) SAS: I: 50.6 (12.9) C: 55.9 (13.7) |
35.7 |
| Whitney and Smith (2015) | RCT; waitlist | 120 | 41 (N/a); 100 | Mothers of children with socially disruptive conduct behaviour | USA | Caucasian, 91 | 1.6–5; 72 | NR; 8 weeks | Online journaling |
PSI-SF: I: 36.97 (1.12) C: 35.4 (0.79) |
42.9 |
| Pre-post studies (n = 8) | |||||||||||
| Fidika et al. (2015) | Pre-post | 23 | 37 (6.2); 91.3 | Caregivers of children with cystic fibrosis | Germany | NR | 5.8 (4.8); 53.8 | WEP-CARE; 3.5 months | Writing-therapy |
HADS-A: pre: 11.4 (2.6), post: 6.7 (2.6) HADS-D: pre: 16.96 (6.6), post: 12.09 (7.04) |
81.8 |
| Nicholson et al. (2009) | Pre-post | 22 | 36.59 (8.3); 100 | Mothers with serious mental illness | USA | Caucasian, 77.2 | 0–5 (26.9%); 48.1 | Family options; 6 months | In-person sessions with phone calls |
PSS-FOA: pre: 16.95 (11.45), post: 14.4 (12.86) BSI: pre: 62.86 (10.69), post: 60.9 (11.6) |
72.7 |
| Piotrowska et al. (2020) | Pre-post | 456 | 37.7 (8.7); 62.9 | Parents of children with conduct problems | Australia | NR | 5.8 (3.5); 60.3 | ParentWorks; 6 weeks | Online modules | K6: Pre: 16.39 (6.3), post: 13.15 (6.5) | 63.6 |
| Rayner et al. (2016) | Pre-post | 11 | 40.2 (6.7); 100 | Parents of seriously ill children | Australia | NR | 3.0 (3.6); 50 | TAB Online; 2 months | Video-conferencing |
DASS-A&D: pre: 7.43 (9.23), post: 6.98 (8.59) DASS-S: pre: 12.4 (8.9), post: 11.89 (8.2) PCL-C: pre: 34.2 (12.3), post: 33.27 (11.7) |
63.6 |
| James Riegler et al. (2020) | Pre-post | 41 | M > 30; “Predominantly men” | Military veterans | USA | NR | 5.95 (1.85) | Online parenting ProTips (OPPT); 14 weeks | Earpiece telehealth with online modules |
CESD: pre: 23.49 (13.1), post: 20.65 (13.06) PSI: pre: 93.37 (25.64), post: 79.1 (26.5) |
72.7 |
| Skranes et al. (2015) | Pre-post | 99 | 33.1 (5.9); 100 | Parents of “sick children” | Norway | NR | 1.6 (1.6); NR |
Sick Child www.syktbarn.no; 6 to 12 months |
Website | PHCS: pre: 12 (3.7), post: 12 (3.9) | 54.5 |
| Wade et al. (2007) | Pre-post | 5 | 38.4 (N/a); 100 | Parents of children with sleep problems | USA | Hispanic, 60; African-American, 40 | 4.9; 20 | “Two-session Group parent training”; 28 days | In-person workshop with telephone |
BDI-II: pre: 3.33 (1.2), post: 1.37 (0.89) PSI-SF: pre: 10.4 (12.7), post: 2.2 (2.7) |
81.8 |
| Wright et al. (2017) | Pre-post | 32 | 35.1 (5.8); 78 | Parents of children receiving surgery | Canada | Caucasian, 81.3 | 5.2 (1.04); 69 | I-PPP; NR | Online modules | STAI-S: pre: 35.32 (10.8), post: 30.87 (10.2) | 72.7 |
M mean; SD standard deviation; b beta regression coefficient, p p value, I intervention group, C control group, NR not reported, RCT randomized controlled trial, TAU treatment as usual, BAI Beck Anxiety Inventory, BDI-II Beck Depression Inventory, CES-D Center for Epidemiologic Studies Depression Scale, DASS Depression Anxiety and Stress Scale, DASS-A DASS anxiety scale, DASS-D DASS depression scale, DASS-S DASS stress scale, HADS Hospital Anxiety and Depression Scale, HADS-A HADS anxiety score, HADS-D HADS depression score, HFS-PYC Hypoglycemia fear survey for parents of young children, K6 K-6 Psychological Distress Scale, MADRS Montgomery-Asberg Depression Scale, PHQ-4 & 9 Patient Health Questionnaire, POMS Profile of Mood States, POMS-D POMS depression score, PROMIS Patient-Reported Outcomes Measurement Information System, PROMOS-A PROMIS anxiety score, PROMIS-D PROMIS depression score, PIP Pediatric Inventory for Parents, PSI Parenting Stress Index, PSI-SF PSI- Short Form, PSS Perceived Stress Scale, PSQ Perceived Stress Questionnaire, PHCS Perceived Health Competence Scale, PCL-C PTSD Checklist-Civilian Version, SCL Symptom Checklist 90-R, SCL-A SCL anxiety score, SCL-D SCL depression score, SCL-GS SCL global severity of symptoms score, SDS Symptom Distress Scale, STAI State-Trait Anxiety Inventory, STAI-S STAI state anxiety scale, STAI-T trait anxiety scale
aWeighted average
bNIH Quality Assessment Tools ratings (total scores converted to percentages)
cOnly one study did not provide means and standard deviations, in this case CMA computed an effect estimate based on sample size and p value