What are the Optimal Combinations of Parenting Intervention Components to Reduce Physical Child Abuse Recurrence? Reanalysis of a Systematic Review using Qualitative Comparative Analysis

Abstract

Parenting interventions are widely used to reduce physical child abuse, but evidence for their effectiveness is mixed, partly because standard methods for synthesising the effectiveness of interventions do not address complex causation. We addressed this by using qualitative comparative analysis to understand pathways to effectiveness in social learning theory‐based parenting interventions. After a systematic search of nine databases and independent and duplicate study selection, we included 14 interventions from ten evaluations. We categorised nine as most effective and five as least effective. We labelled interventions as to the presence or absence of parental self‐management, attachment‐based, alternative punishment or proactive parenting components. We examined how these combined in the most effective and least effective interventions, and identified common pathways to most effectiveness and least effectiveness. The final pathways revealed the importance of two components: alternative punishment strategies and parental self‐management strategies. It was not clear that adding more components to an intervention necessarily translated to more effectiveness; indeed, this could backfire, as many of the least effective interventions combined multiple strategies without teaching parental self‐management. Our findings may be useful to intervention developers and implementers when considering new interventions. Future research should seek to test combinations of components for differential effectiveness between the most effective pathways. Key Practitioner Messages The effectiveness of social learning theory‐based parenting interventions for physical child abuse is variable. We identified two key, but not necessary, components: alternative punishment strategies and parental self‐management strategies. Adding more components did not necessarily lead to high effectiveness, and in some cases this could backfire when parental self‐management was not included.

Design and Implementation of the Irie Homes Toolbox: A Violence Prevention, Early Childhood, Parenting Program

“…Programs reviewed included the Incredible Years Parenting Program ( 30 ), Triple-P Positive Parenting Program ( 31 ), Parent Management Training Oregon Model (PMTO) ( 32 ), Parent-Child Interaction Therapy ( 33 ), Parent Corps ( 34 ), and ACT Raising Safe Kids ( 35 ) from high-income countries and Sinovuyo ( 36 ), Parents Make a Difference ( 15 ), and Projecto Paceria ( 37 ) from low and middle-income countries (LMIC). We also examined reviews and meta-analyses of the common core components of parenting interventions to identify the components that lead to more effective parenting interventions to prevent and reduce children's externalizing behavior ( 38 – 40 ) and to prevent and treat parents' use of violence against children ( 41 – 43 ). As the parenting intervention is planned as a complementary program to the Irie Classroom Toolbox, we also identified components from the Irie Classroom Toolbox that would be applicable to parents.…”

“…For programs targeting child externalizing behavior, building a positive parent-child relationship through nurturing, positive and sensitive interactions, the use of praise and positive reinforcement, emotional communication, and learning appropriate discipline methods such as time-out and consequences have been shown to be important components ( 38 , 40 ). For programs targeting child maltreatment, learning non-violent discipline approaches, daily child-led play, and parental self-management skills have been shown to be most effective ( 41 , 42 ). In terms of the process of delivering the content, the most effective programs are delivered in a non-stigmatizing way, focus on building parents' self-confidence and involve modeling, rehearsal and practice, supportive feedback, homework assignments, and problem-solving activities ( 38 , 42 , 43 ).…”

Evaluation of a Violence-Prevention Programme with Jamaican Primary School Teachers: A Cluster Randomised Trial

“…It is clear that teachers require additional support to further reduce the use of violence against children. A qualitative review of parenting interventions aimed at reducing child abuse found that teaching parental self-management strategies was an important component of effective programmes [42]. Explicit attention to promoting teachers’ self-regulatory capacities may help to further reduce teachers’ use of violence against children [43].…”

From Prevention through to Therapy: Supporting Evidence‐Informed Practice across the Spectrum of Child Maltreatment

“…We start the issue with a reanalysis of a systematic review of parenting interventions to reduce physical child abuse recurrence by G. J. Melendez‐Torres and colleagues (). These authors point out that while parenting interventions are widely used to reduce physical child abuse, the evidence for their effectiveness is mixed.…”