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Review
. 2016 May;137(5):e20153393.
doi: 10.1542/peds.2015-3393. Epub 2016 Apr 19.

Primary Care-Based Interventions to Promote Positive Parenting Behaviors: A Meta-analysis

Reshma Shah  1 , Sarah Kennedy  2 , Maureen D Clark  3 , Sarah C Bauer  4 , Alan Schwartz  5
Affiliations
Review

Primary Care-Based Interventions to Promote Positive Parenting Behaviors: A Meta-analysis

Reshma Shah et al. Pediatrics. 2016 May.

Abstract

Context: Utilization of primary care settings offers a promising approach to enhance parenting practices that are critical for promoting early childhood development. Determining the impact of existing primary care interventions on key parenting behaviors will aid providers and policy makers as they seek strategies to improve early child outcomes.

Objective: To evaluate the efficacy of primary care-based interventions on parenting practices that promote early child development among children younger than 36 months.

Data sources: PubMed, Excerpta Medica dataBASE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature databases were searched electronically.

Study selection: English-language articles that were quasi-randomized or randomized controlled trials, included parents of children <36 months of age, and reported outcomes related to parenting behaviors that promote early child development.

Data extraction: Two reviewers independently extracted data regarding participants, interventions, and outcomes. Quantitative meta-analyses were conducted with random effects for study and fitted with restricted maximum likelihood methods.

Results: The review included 13 studies reporting parenting outcomes in 2 categories: participation in cognitively stimulating activities and positive parent-child interactions. We found a statistically significant positive effect of primary care-delivered interventions and parent-child interactions (summary standardized mean difference 0.29, 95% confidence interval [CI] 0.06-0.52, P < .0001) and participation in cognitively stimulating activities (summary standardized mean difference 0.34, 95% CI 0.03-0.54; summary odds ratio 0.13, 95% CI 0.01-0.25, P < .0001).

Limitations: Limitations included heterogeneity in measures used, outcomes, and timing of assessments.

Conclusions: Primary care-based interventions modestly affect positive parenting behaviors important for early childhood development. Randomized controlled trials with comparable outcome measures using standardized assessments are needed to assess further beneficial impacts.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Study identification, exclusion, and inclusion. EMBASE, Excerpta Medica database.
FIGURE 2
FIGURE 2
The effect of primary care–based parenting interventions on parent-child interactions. The squares represent individual studies, with the size of the square representing the weight given to each study in the meta-analysis. Error bars represent 95% CIs. The diamond represents the combined result. NCATS, Nursing Child Assessment Teaching Scale.
FIGURE 3
FIGURE 3
The effect of primary care–based parenting interventions and cognitively stimulating activities (reading) by using continuous outcomes. The squares represent individual studies, with the size of the square representing the weight given to each study in the meta-analysis. Error bars represent 95% CIs. The diamond represents the combined result.
FIGURE 4
FIGURE 4
The effect of primary care–based parenting interventions and cognitively stimulating activities (reading) by using dichotomous outcomes. The squares represent individual studies, with the size of the square representing the weight given to each study in the meta-analysis. Error bars represent 95% CIs. The diamond represents the combined result. CCLO, Child Centered Literacy Orientation.
See this image and copyright information in PMC

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