Enhancing Initial Parental Engagement in Interventions for Parents of Young Children: A Systematic Review of Experimental Studies
Low rates of participation in parenting interventions may undermine their effectiveness. Although a wide range of strategies to engage parents in interventions are described in the literature, little is known about which engagement strategies are most effective in enhancing parental engagement. This systematic review explores effective engagement strategies to encourage initial parental engagement (recruitment, enrolment, and first attendance) in parenting interventions for parents of children aged 2–8 years old. This review was conducted based on the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions (Higgins and Green 2011) and the Preferred Reporting Items for Systematic Review and Meta-Analysis (Moher et al. 2009). Electronic systematic searches from January 1996 to August 2017 were conducted in PsycINFO, Scopus, ProQuest Social Sciences Journals, CINAHL, and PubMed databases. Eight studies met the inclusion criteria representing 1952 parents from four different countries. Of the engagement strategies tested in included studies (monetary incentive, setting, testimonial, advertisement, and engagement package), three strategies (advertisement, incentive, and engagement package) showed a significant effect on a stage of engagement, but none across stages. The low methodological quality of the selected studies limits their generalisability and thus provides limited evidence regarding effective engagement strategies to increase recruitment, enrolment, and first attendance rates in parenting interventions. There is a need for further, more methodologically rigorous, research evidence regarding how to engage parents more effectively in the early stages of parenting interventions.
KeywordsParental engagement Parenting intervention Engagement strategies Young children Systematic review
We would like to thank Miranda Newell, Librarian from the University of Queensland Library, for her assistance with developing search strategy and protocol. We also thank Bao Yi Tan, who collaborated as the second reviewer for selection of articles by full text.
CG, AM, and DH contributed to the drafting of the protocol. CG ran the searches and retrieved potentially relevant studies. CG was one of the two reviewers for selection by full text. AM was the third reviewer to deal with discrepancies. CG conducted data extraction for selected studies. CG, AM, and DH wrote the review.
CG is supported by a scholarship granted by CONICYT (Comisión Nacional de Investigación Científica y Tecnológica) Becas Chile 72160251. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with Ethical Standards
Conflict of interest
The Parenting and Family Support Centre is partly funded by royalties stemming from published resources of the Triple P—Positive Parenting Program, which is developed and owned by The University of Queensland (UQ). Royalties are also distributed to the Faculty of Health and Behavioural Sciences at UQ and contributory authors of published Triple P resources. Triple P International (TPI) Pty Ltd is a private company licensed by Uniquest Pty Ltd on behalf of UQ, to publish and disseminate Triple P worldwide. The authors of this report have no share or ownership of TPI. Alina Morawka and Divna M. Haslam receive royalties from TPI. TPI had no involvement in the study design, collection, analysis or interpretation of data, or writing of this report. Alina Morawska and Divna M. Haslam are employees at UQ. Carolina Gonzalez is a student at UQ.
- Becker, K. D., Boustani, M., Gellatly, R., & Chorpita, B. F. (2017). Forty years of engagement research in children’s mental health services: Multidimensional measurement and practice elements. Journal of Clinical Child and Adolescent Psychology, 47, 1–23. https://doi.org/10.1080/15374416.2017.1326121.CrossRefPubMedGoogle Scholar
- Becker, K. D., Lee, B. R., Daleiden, E. L., Lindsey, M., Brandt, N. E., & Chorpita, B. F. (2015). The common elements of engagement in children’s mental health services: Which elements for which outcomes? Journal of Clinical Child and Adolescent Psychology, 44(1), 30–43. https://doi.org/10.1080/15374416.2013.814543.CrossRefPubMedGoogle Scholar
- Bérubé, A., Lafantaisie, V., Dubeau, D., Coutu, S., Caron, J., & Devault, A. (2014). Using implementation evaluation to uncover a child neglect prevention program. Evaluation and Program Planning, 45, 1–8. https://doi.org/10.1016/j.evalprogplan.2014.03.001.CrossRefPubMedGoogle Scholar
- Bruzzese, J. M., Gallagher, R., McCann-Doyle, S., Reiss, P. T., & Wijetunga, N. A. (2009). Effective methods to improve recruitment and retention in school-based substance use prevention studies. Journal of School Health, 79(9), 400–407. https://doi.org/10.1111/j.1746-1561.2009.00427.x.CrossRefPubMedGoogle Scholar
- Calam, R., Miller, C., Sadhnani, V., Sanders, M. R., & Carmont, S.-A. (2008). Can technology and the media help reduce dysfunctional parenting and increase engagement with preventative parenting interventions? Child Maltreatment, 13(4), 347–361. https://doi.org/10.1177/1077559508321272.CrossRefPubMedGoogle Scholar
- Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimklis, A., Chan, E., et al. (2016). Engagement in behavioral parent training: Review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19(3), 204–215. https://doi.org/10.1007/s10567-016-0205-2.CrossRefPubMedGoogle Scholar
- Chacko, A., Wymbs, B. T., Chimiklis, A., Wymbs, F. A., & Pelham, W. E. (2012). Evaluating a comprehensive strategy to improve engagement to group-based behavioral parent training for high-risk families of children with ADHD. Journal of Abnormal Child Psychology, 40(8), 1351–1362. https://doi.org/10.1007/s10802-012-9666-z.CrossRefPubMedGoogle Scholar
- Chacko, A., Wymbs, B., Rajwan, E., Wymbs, F., & Feirsen, N. (2017). Characteristics of parents of children with ADHD who never attend, drop out, and complete behavioral parent training. Journal of Child and Family Studies, 26(3), 950–960. https://doi.org/10.1007/s10826-016-0618-z.CrossRefGoogle Scholar
- Cowan, P. A., Cowan, C. P., Pruett, K., Pruett, M. K., Wong, J. J., & LaRossa, R. (2009). Promoting fathers’ engagement with children: Preventive interventions for low-income families. Journal of Marriage and Family, 71(3), 663–679. https://doi.org/10.1111/j.1741-3737.2009.00625.x.CrossRefGoogle Scholar
- Dittman, C., Keown, L. J., Sanders, M., Rose, D., Farruggia, S. P., & Sofronoff, K. (2011). An epidemiological examination of parenting and family correlates of emotional problems in young children. American Journal of Orthopsychiatry, 81(3), 360–371. https://doi.org/10.1111/j.1939-0025.2011.01104.x.CrossRefPubMedGoogle Scholar
- Frank, T. J., Keown, L. J., & Sanders, M. R. (2015b). Enhancing father engagement and interparental teamwork in an evidence-based parenting intervention: A randomized-controlled trial of outcomes and processes. Behavior Therapy, 46(6), 749–763. https://doi.org/10.1016/j.beth.2015.05.008.CrossRefPubMedGoogle Scholar
- Gross, D., Johnson, T., Ridge, A., Garvey, C., Julion, W., Treysman, A. B., et al. (2011). Cost-effectiveness of childcare discounts on parent participation in preventive parent training in low-income communities. The Journal of Primary Prevention, 32(5–6), 283–298. https://doi.org/10.1007/s10935-011-0255-7.CrossRefPubMedPubMedCentralGoogle Scholar
- Heinrichs, N., Bertram, H., Kuschel, A., & Hahlweg, K. (2005). Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: Barriers to research and program participation. Prevention Science, 6(4), 275–286. https://doi.org/10.1007/s11121-005-0006-1.CrossRefPubMedGoogle Scholar
- Heinrichs, N., Krüger, S., & Guse, U. (2006). Der Einfluss von Anreizen auf die Rekrutierung von Eltern und auf die Effektivität eines präventiven Elterntrainings. [The effect of incentives on recruitment of parents and effectiveness of preventive parent training.]. Zeitschrift für Klinische Psychologie und Psychotherapie: Forschung und Praxis, 35(2), 97–108. https://doi.org/10.1026/1616-3422.214.171.124.CrossRefGoogle Scholar
- Higgins, J., & Green, S. (2008). Cochrane handbook for systematic reviews of interventions: Cochrane book series. In J. P. T. Higgins & S. Green (Eds.), Chichester. England: Wiley.Google Scholar
- Higgins, J., & Green, S. (2011). Cochrane handbook for systematic reviews of interventions Version 5.1. 0 [updated March 2011].Google Scholar
- Hofstede, G., Hofstede, G. J., & Minkov, M. (2010). Cultures and organizations: Software of the mind (3rd ed.). New York: McGraw-Hill.Google Scholar
- Lefever, J. B., Bigelow, K. M., Carta, J. J., & Borkowski, J. G. (2013). Prediction of early engagement and completion of a home visitation parenting intervention for preventing child maltreatment. NHSA Dialog, 16(1), 1–19.Google Scholar
- Lindsey, M. A., Brandt, N. E., Becker, K. D., Lee, B. R., Barth, R. P., Daleiden, E. L., et al. (2014). Identifying the common elements of treatment engagement interventions in children’s mental health services. Clinical Child and Family Psychology Review, 17(3), 283–298. https://doi.org/10.1007/s10567-013-0163-x.CrossRefPubMedGoogle Scholar
- Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., et al. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1. https://doi.org/10.1186/2046-4053-4-1.CrossRefPubMedPubMedCentralGoogle Scholar
- Piotrowska, P. J., Tully, L. A., Lenroot, R., Kimonis, E., Hawes, D., Moul, C., et al. (2017). Mothers, fathers, and parental systems: A conceptual model of parental engagement in programmes for child mental health—Connect, Attend, Participate, Enact (CAPE). Clinical Child and Family Psychology Review, 20, 146–161. https://doi.org/10.1007/s10567-016-0219-9.CrossRefPubMedGoogle Scholar
- Sanders, M. R. (2012). Development, evaluation, and multinational dissemination of the Triple P-Positive Parenting Program. Annual Review of Clinical Psychology, 8, 345. https://doi.org/10.1146/annurev-clinpsy-032511-143104.CrossRefPubMedGoogle Scholar
- Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J. (2014). The Triple P-positive parenting program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34(4), 337–357. https://doi.org/10.1016/j.cpr.2014.04.003.CrossRefPubMedGoogle Scholar
- Sanders, M. R., Tully, L. A., Pollard, G. E., Baade, P. D., Heywood, A. H., Lynch, M. E., et al. (1999). A survey of parenting practices in Queensland: Implications for mental health promotion. Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals, 9(2), 105–114.Google Scholar
- The Cochrane Collaboration. (2014). Review Manager (RevMan) [Computer program] (Version 5.3). Copenhagen: The Nordic Cochrane Centre.Google Scholar
- UNESCO Institute of Statistics. (2018). Education dataset. Retrieved from: http://data.uis.unesco.org/. Accessed 12 Jan 2018.
- Winslow, E. B., Braver, S., Cialdini, R., Sandler, I., Betkowski, J., Tein, J. Y., et al. (2017). Video-based approach to engaging parents into a preventive parenting intervention for divorcing families: Results of a randomized controlled trial. Prevention Science. https://doi.org/10.1007/s11121-017-0791-3.Google Scholar
- Winslow, E. B., Poloskov, E., Begay, R., Tein, J.-Y., Sandler, I., & Wolchik, S. (2016). A randomized trial of methods to engage Mexican American parents into a school-based parenting intervention. Journal of Consulting and Clinical Psychology, 84(12), 1094. https://doi.org/10.1037/ccp0000140.CrossRefPubMedPubMedCentralGoogle Scholar
- World Health Organization. (2009). Preventing violence through the development of safe, stable and nurturing relationships between children and their parents and caregivers. Geneva: World Health Organization.Google Scholar
- Wymbs, F. A., Cunningham, C. E., Chen, Y., Rimas, H. M., Deal, K., Waschbusch, D. A., et al. (2015). Examining parents’ preferences for group and individual parent training for children with ADHD symptoms. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1080/15374416.2015.1004678.PubMedPubMedCentralGoogle Scholar