Effects of multi-component parenting and parental mental health interventions on early childhood development and parent outcomes: a systematic review and meta-analysis

Background Interventions supporting parents of young children often target parenting or parental mental health separately. Multi-component parenting and parental mental health interventions have the potential to improve parenting practices, mental health, and early childhood development. We aimed to examine their impact on child and parent outcomes. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science Core Collection, APA PsycINFO, CINAHL Complete, the Cochrane Central Register of Controlled Trials, and the Global Health Database from inception to Jan 23, 2024. Eligible studies were randomised controlled trials of interventions explicitly targeting parenting behaviours and parental mental health antenatally or in children's first 3 years of life. Screening, extraction, and quality assessment were done independently by two authors. Primary outcomes were cognitive and social-emotional functioning in children and depressive symptoms in parents, meta-analysed as standardised mean differences (SMDs), relative to control. This study is registered with PROSPERO, CRD42022302848. Findings We found 5843 records. After screening 2636 (45<middle dot>1%) titles and abstracts, we manually identified and screened three additional articles and excluded 2177 records. After screening 462 full-length articles, 25 articles, representing a sample size of 8520 children and caregivers, were included. At baseline, mean caregiver age was 27<middle dot>7 years (SD 5<middle dot>9) and mean child age (excluding those enrolled during pregnancy) was 14<middle dot>4 months (8<middle dot>0). Interventions lasted a mean of 14 months (SD 11) and used a mean of 3<middle dot>7 behaviour change techniques (2<middle dot>0). Most interventions dedicated more time to parenting behaviours than to parental mental health. We found significant intervention effects on children's cognitive (SMD 0<middle dot>19 [95% CI 0<middle dot>04 to 0<middle dot>34]; I 2 =69%) and social-emotional (0<middle dot>26 [0<middle dot>17 to 0<middle dot>34]; I 2 =47%) outcomes but not on depressive symptoms in female caregivers (-0<middle dot>18 [-0<middle dot>36 to 0<middle dot>002]; I 2 =86%) relative to control conditions. Risk of bias across studies was moderate, and we found heterogeneity across results. Interpretation Multi-component parenting and mental health interventions had a positive effect on child cognitive and social-emotional outcomes, but not on depressive symptoms in parents, suggesting that other factors might contribute to positive ECD outcomes. Interventions might lack adequate focus on mental health to make a discernible impact, highlighting a need for future studies to differentiate and assess contributions of parenting and mental health components to understand independent and collective effects on family outcomes. Funding Canadian Institutes of Health Research. Copyright (c) 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.