Individual Participant Data Meta-Analysis: Individual Differences in Mediators of Parenting Program Effects on Disruptive Behavior

Abstract

OBJECTIVE: Although parenting programs are the most widely used approach to reduce disruptive behavior in children, there is a notable lack of understanding of the exact changes in parenting that underlie their effects. Challenges include the frequent use of composite measures of parenting behavior and insufficient power to detect mediation effects and individual differences in these in individual trials. METHOD: Individual participant data from 14 European randomized controlled trials of social learning-based parenting programs were pooled to examine which specific parenting behaviors best explain program effects. Participants included 3,252 families with children ages 1 to 13 years. Parental use of praise, tangible rewards, physical discipline, harsh verbal discipline, and not following through on discipline were included as putative mediators. Additionally, the study explored whether subgroups of families showing different mediational pathways exist. RESULTS: Changes in parenting partially mediated program effects, with all included parenting behaviors except parental use of praise serving as unique mediators. Less harsh verbal discipline and increased following through on discipline were the strongest mediators. The study identified 3 subgroups with distinct responses to parenting programs. Most families benefited, partly through increased following through on discipline; families with the least or most difficulties were more likely to benefit less or not at all. CONCLUSION: These findings offer insight into the specific parenting behavior changes key to reducing disruptive child behavior, while highlighting the need for innovative research methodologies to gain a deeper understanding of individual differences in parenting program benefits and mechanisms. PLAIN LANGUAGE SUMMARY: Parenting programs are the most widely used strategy to reduce children's disruptive behavior. In this analysis of individual data of 3,252 families that participated in 14 European randomized controlled trials, the authors examined which specific changes in parenting behaviors best explain the effects of parenting programs on children's behavior, and whether these changes might differ across different types of families. The authors found that changes in parenting behavior partially explained program effects on disruptive behavior. Reduced harsh verbal discipline and increased following through on discipline seemed the most important parenting behaviors. While most families benefited from parenting programs, those facing the most or the least difficulties benefited less. STUDY PREREGISTRATION INFORMATION: Study Preregistration: Individual Participant Data Meta-analysis: Individual Differences in Mediators of Parenting Program Effects on Disruptive Behavior; https://doi.org/10.1016/j.jaac.2023.11.005.