Teaching Parents to Be Responsive: A Network Meta-analysis

Abstract

CONTEXT: Children who receive more responsive care during their early childhood tend to exhibit stronger cognitive development, mental well-being, and physical health across their life course. OBJECTIVE: Determine how to design effective responsivity training programs for caregivers. DATA SOURCES: We searched seven electronic databases through October 2020. STUDY SELECTION: Randomized trials (k = 120) of programs training parents of children ages 0 to 6 to be more responsive. DATA EXTRACTION: Two reviewers independently extracted data. Data were pooled by using random-effects pairwise and network meta-analyses. RESULTS: Programs had, on average, a medium effect (d = 0.56; 95% confidence interval [CI]: 0.47 to 0.65). The most effective programs included didactic teaching and opportunities for parents to observe models, practice skills, and receive feedback (d = 1.07; 95% CI: 0.37 to 1.77), or all these instructional methods in addition to reflection (d = 0.86; 95% CI: 0.64 to 1.09). Programs that had participants observe examples of responsivity (d = 0.70; 95% CI: 0.57 to 0.83), used researchers as facilitators (d = 0.89; 95% CI: 0.66 to 1.12), assigned homework (d = 0.85; 95% CI: 0.66 to 1.02), and had a narrow scope (d = 0.72; 95% CI: 0.57 to 0.87) were more effective than those that did not. LIMITATIONS: Most samples included only mothers from Western countries and lacked follow-up data. CONCLUSIONS: Having parents observe examples of responsive caregiving and complete home-practice in short, focused programs may be an effective, scalable approach to enhancing responsivity in the general population and reducing inequalities in child development.

Teaching empathy to mental health practitioners and trainees: Pairwise and network meta-analyses.

“…The random-effects model was chosen as study populations were assumed to differ (Borenstein et al, 2009). For studies with more than two functionally nonequivalent interventions, we only used the comparison between the most intensive arm and the control group (Sokolovic et al, 2021). Statistical heterogeneity was assessed with I 2 the statistic and p value and explored using mixed-effects model metaregressions using maximum likelihood estimation (Higgins & Thomas, 2019).…”

“…Program characteristics have important implications for the cost of program delivery. Other moderating factors to consider include the number of instructional components utilized, outcome characteristics (assessment type and the type of empathy measured), and study characteristics (type of control group and risk of bias), as there is some evidence they may also impact the effect size of empathy interventions (de Roten et al, 2013; Fragkos & Crampton, 2020; Kiosses et al, 2016; Sokolovic et al, 2021; Teding van Berkhout & Malouff, 2016).…”

“…Pedagogical research has investigated the differential impact of instructional components for academic outcomes, showing that some components (e.g., feedback, reflective learning practices) are more effective than others (e.g., mentoring, student-directed learning; Hattie, 2008). Instructional components for all types of learning can be grouped into five broad categories: didactic (listening to lectures, reading), rehearsal (practicing the skill), reflection (discussing the skill with others or reflecting on one’s own skill), observation (watching enactments pertaining to the skill), and feedback (receiving personalized feedback; Hattie, 2008; Sokolovic et al, 2021). Such instructional components are present in the teaching of empathy (Davis & Begovic, 2014; Hojat, 2009; Jeffrey & Downie, 2016), but the way in which these specific components impact the teaching of empathy is not yet understood.…”

“…Different types of program characteristics have been found to moderate empathy training effects. Program format (group vs. individual), facilitator type (researcher vs. nonresearcher), and dosage have been found to moderate the effectiveness of empathy training (e.g., Brunero et al, 2010; Sokolovic et al, 2021; Teding van Berkhout & Malouff, 2016; Winter et al, 2020). Program characteristics have important implications for the cost of program delivery.…”

Ridurre i problemi comportamentali nei bambini piccoli attraverso il video-feedback. Trial clinico randomizzato pragmatico

“…Inoltre i programmi più efficaci erano quelli dove: a) i genitori hanno osservato esempi di responsività, b) erano presenti i ricercatori come facilitatori, c) erano assegnati compiti a domicilio, d) il focus di intervento era ristretto. Nelle conclusioni gli autori della metanalisi a rete indicano che le home visit e i video-feedback personalizzati sono interventi efficaci per aumentare la responsività del genitore in situazione di rischio e che interventi brevi focalizzati su uno specifico obiettivo possono essere più efficaci di programmi di intervento prolungati e più costosi [7].…”