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Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review

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GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges’ g from studies with pretest–posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies.

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Data Availability

All materials including the template data collection form, codebook, a clean dataset used for all analyses, and analytic code in RStudio are available in an Open Science Framework (OSF) repository:


Articles included in the meta-analysis are marked with *

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We thank Dr. Neveen Ali Saleh Darawshy and Dr. Alyssa Pintar Breen for helping with the coding process.


The authors received no financial support for the research.

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Correspondence to Abigail H. Gewirtz.

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Conflict of interest

Dr. Gewirtz is the principal investigator of interventions included here (ADAPT and ADAPT4U). Dr. Gewirtz did not extract or analyze data or perform risk of bias assessments in the review.

Registration and Protocol

This systematic review was registered in the international prospective register of systematic reviews, PROSPERO (ID: CRD42020155106) prior to literature search and data extraction. During the review process, several amendments were made and they can be found in the supplementary materials in the Open Science Framework (OSF) repository:

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Cai, Q., Chan, A.C.Y., Lee, SK. et al. Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review. Clin Child Fam Psychol Rev 25, 702–719 (2022).

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