What is this?

• This review provides an assessment of 11 web-based parenting interventions in 12 studies. The authors highlight the potential of using the internet to offer parenting support / interventions.
• Web-based parenting programmes can offer a broad spectrum of support for common parenting problems or questions. They can also be used to target specific issues or needs such as illness or for particular stages of development such as infancy or adolescence.
• This review focuses on interventions targeting parenting competencies and/or children’s development.

How is it meant to work?

• Using the internet is a potentially more accessible way to deliver parenting interventions.
• These interventions can take a public health approach, and address broad questions about parenting. Or target specific issues or groups such as social isolation or parents of adolescents.
• They are designed overall to improve parenting capabilities.
• The review offered some detail about the various theories of change used in each of the eleven interventions included in the review. They included, Cognitive Behavioural Therapy (CBT); early intervention theory; parent-child interaction theory and many others. The delivery methods for these mechanisms varied with each intervention, with different uses of media and differing types of intervention used.

What are the evaluated outcomes?

• Parent Outcomes
• Child Outcomes

How effective is it?

Parent Outcomes
Overall, web-based parenting programmes had a medium effect on parent outcomes. This is based on high strength evidence from ten studies. There was not a significant difference on the impact of the interventions on cognitive, attitudinal and behavioural parental outcomes.

Child Outcomes

Overall, web-based parenting programmes had a medium effect on child outcomes. This is based on high strength evidence from four studies. These included behavioural and attitudinal outcomes. For example, alcohol consumption or body esteem.

Ten of the twelve studies included in the review were randomized controlled trials. In the majority of the studies (eleven out of twelve) the evaluated programme had been developed by the researchers, so the evaluation was not independent. Most of the studies also relied on self-report scales.

Where has it been studied?

• Nine out of twelve studies in this review were conducted in the USA. One study was conducted in Australia, Singapore and Taiwan.
• None of the studies included in this review were conducted in the UK, and the authors do not offer any guidance as to whether the specific interventions reviewed could be applicable in different geographical contexts.

Who does it work for?

• The review does not offer specifics regarding the demographics of the participants, or for whom these interventions may be most effective. However, various inclusion criteria had to be met for the review. These included, being a parent whose children were aged from pregnancy (9months) to 21 years old.
• Additionally, four studies focussed on parent characteristics, three on first time or expectant parents, one on parents with low income and babies at risk of poor social-emotional development, and one study focussed on foster carers. Eight programmes targeted specific child characteristics e.g. ADHD and one focused on drug abuse in adolescent girls.

When, where and how does it work?

• The authors suggest that the programmes which were targeting specific health issues, such as parents whose child had experienced a traumatic brain injury, were more effective than the programmes which took a more general ‘public health’ approach. Further to this the interventions which were self-guided showed higher outcomes for parental knowledge. Whereas the guided interventions showed higher outcomes for parental attitude and behaviour.
• All of the studies included in the review examined multiple aspects of parenting. Parent outcomes included attitudinal, behavioural, and knowledge factors. Child outcomes focused on behavioural and attitudinal factors.

What are the costs and benefits?

No economic analysis or discussion of cost-effectiveness of the web-based parenting programmes reviewed was offered by the authors.

Case study

• Infant Net was a web-based parenting intervention delivered to 40 mothers and infants in Oregon, USA. It was developed from an existing intervention PALs, and modified for internet use. Infant Net was designed as an early intervention model, for low income families, to improve parenting behaviours and the child’s social and emotional development.
• It was felt that delivering parenting interventions via the internet may reduce some of the typical barriers to engagement.
• The intervention included 10 video sessions, questions, ‘homework’, skills videos, weekly telephone sessions with a coach and an online ‘bulletin board’ to approximate a peer support group.
• The research found that there was better engagement and higher completion rates, with the web-based programme than with standard home-visit programmes.
• It also showed a positive effect on an infants’ social engagement with their mother.
• Of note, the study had some limitations, the sample size was small and relatively homogeneous.
• Further research is needed in this area.

In summary...

• This is a robust review which suggests that web-based parenting interventions have the potential to enhance parenting competencies.
• A medium effect size was found across parental outcomes including cognitive, behavioural and attitudinal outcomes.
• A medium effect size was found for children’s outcomes, particularly in relation to behavioural measures.
• The review suggests that the interventions targeting a specific problem are more effective than those aimed at parenting more broadly.