Preventing child maltreatment: a meta-analysis and systematic review of parenting programs

Abstract

Child maltreatment—a serious public health problem—is a global phenomenon. Parenting programs are considered effective approaches to preventing child maltreatment; however, comprehensive understanding is still lacking of the effectiveness of such programs in all areas of outcomes and the way parenting programs work. This thesis consists of two parts: a quantitative synthesis of high-level evidence about program effects and a qualitative integration of program process. The thesis employs two research methods: meta-analytic review and systematic review. I searched 11 electronic databases to identify studies published between 2000 and 2012. Forty-two studies meeting the eligibility criteria were included in the systematic review, and 21 of these were included in the meta-analysis. The total random effect size was 0.338. The research found that parenting programs successfully reduced substantiated child maltreatment reports. The programs also reduced risk factors and enhanced protective factors associated with child maltreatment. However, program effects began to decrease in the first year after program completion. Parenting programs function by remediating parental cognition, thus changing parenting behaviors and enhancing parent-child relationships. The successful program components include teaching child-rearing knowledge, improving parenting skills and changing parents’ inappropriate attitudes towards children. Parenting programs are demonstrated to be effective public health approaches to avoiding child maltreatment. Parenting programs could produce positive effects in both low- and middle-income countries, as well as high-income countries. The study recommends a longer-term intervention beginning prenatally or at an early age of the children and involving more male caregivers. The evidence-based service of parenting programs could be widely adopted in future practices. The research also indicates that parenting programs could be applicable within the Chinese context, where such programs have not been widely used to date.