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    Equity effects of parenting interventions for child conduct problems: a pan-European individual participant data meta-analysis


    Gardner, Frances and Leijten, Patty and Harris, Victoria and Mann, Joanna and Hutchings, Judy and Beecham, Jennifer and Bonin, Eva Maria and Berry, Vashti and McGilloway, Sinéad and Gaspar, Maria and João Seabra-Santos, Maria and Orobio de Castro, Bram and Menting, Ankie and Williams, Margiad and Axberg, Ulf and Mørch, Willy Tore and Scott, Stephen and Landau, Sabine (2019) Equity effects of parenting interventions for child conduct problems: a pan-European individual participant data meta-analysis. The Lancet Psychiatry, 6 (6). pp. 518-527. ISSN 2215-0366

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    Abstract

    Background: Childhood conduct problems are a costly public health problem, five times more common in socially disadvantaged groups. Untreated, they have a poor prognosis, with increasing gaps between socio-economic groups, and high rates of subsequent criminality. The Incredible Years (IY) is a high-quality parenting programme as recommended by NICE for reducing conduct problems, and is widely disseminated in Europe. Many trials show IY to be effective, but the potential effects on social inequality of parenting interventions are unknown. This matters since some behavioural interventions (e.g. smoking cessation programmes), while beneficial overall, can widen inequality gaps. Since single trials and aggregate-level meta-analysis are ill-equipped for examining differential intervention (moderator) effects, we pooled individual-level trial data. Method: Individual participant data (IPD) meta-analysis of a near-complete set of randomised trials of European IY parenting programmes (N=1696; 15 trials eligible; 7% [1/15], data unavailable; 7% [1/15] lacked primary outcome). Children were aged 2-10 years (M 5.1; 30% [492/1651] ethnic minority; 58% [931/1614] low-income). Primary outcome was child conduct problems, using Eyberg Child Behavior Inventory (ECBI-I). Moderators were analysed using multilevel modelling with multiple imputation. Findings: IY led to an overall reduction in child conduct problems (13.5 points on ECBI-I, 95% CI 10.9 to 16.1). There was no evidence for differential effects by family disadvantage (poverty, lone/teen parenthood, joblessness; low education), or ethnic minority status. Interpretation: This world-first IPD meta-analysis of parenting trials, the largest pooled data set to date, found no evidence for differential effects by social disadvantage, suggesting IY is unlikely to widen socioeconomic inequalities in conduct problems. Furthermore, the programme may be an important tool for reducing social disparities and improving poor long-term outcomes in disadvantaged families, since follow-up studies indicate that benefits persist. Clinicians and commissioners can be reassured the programme is similarly effective for families from different backgrounds.

    Item Type: Article
    Keywords: Equity; effects; parenting interventions; child conduct problems; pan-European; individual; participant; data meta-analysis;
    Academic Unit: Faculty of Science and Engineering > Psychology
    Item ID: 13902
    Identification Number: https://doi.org/10.1016/S2215-0366(19)30162-2
    Depositing User: Dr. Sinéad McGilloway
    Date Deposited: 01 Feb 2021 13:58
    Journal or Publication Title: The Lancet Psychiatry
    Publisher: Elsevier
    Refereed: Yes
    URI:

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