Interventions to Strengthen Parental Self-Efficacy: An Umbrella Review of Systematic Reviews

Background and purpose: There is a significant body of literature regarding parental self-efficacy (PSE), however, this information is dispersed across a number of settings and contexts. Mechanisms underpinning effective interventions to enhance PSE are not widely known, accessible, or routinely implemented in community practice settings. Considering this, the study aimed to systematically review the available literature on interventions to promote parental self-efficacy, using umbrella review methodology. The objective was to identify and summarize efficacious practices and suggest areas for additional research. The specific research questions were: What interventions have been evaluated in a systematic review to promote PSE? In what contexts and how were PSE interventions delivered? What is the evidence base for PSE interventions? And what are the active components of evidence-supported PSE interventions?

Methods: The population of interest were expectant parents, and parents of children up to age 19. Articles were collected from seven electronic databases, APA PsycInfo, The Cochrane Library, The Campbell Collaboration Library, CINAHL, ERIC, Medline, and Scopus by the study librarian. Studies were included if they were a systematic review with or without meta-analysis of interventions to promote and strengthen parental self-efficacy, published on or after January 1, 1990, available in the English language, and peer reviewed. Self-efficacy was recorded as the primary outcomes, with health, mental health, and child/parent/family developmental outcomes associated with parental self-efficacy as secondary outcomes. Studies were excluded if they did not report information regarding the specific intervention mechanisms responsible for PSE outcomes. Data were extracted using a predefined data extraction template, developed following the JBI Appendix 10.3 data extraction tool, and entered into a spreadsheet. Risk of bias was assessed using the JBI appraisal tool. Two independent reviewers conducted abstract screening, study selection, and data extraction, with a third reviewer engaged to solve discrepancies. All three reviewers were involved in the appraisal review process.

Results: Five hundred seventy-eight original studies were screened at title and abstract review. One-hundred twenty-four papers were subject to full-text review. Forty-nine systematic reviews were included in the umbrella review, representing 1073 studies in total. Of these studies, 449 studies were specific to PSE, covering both qualitative and quantitative methods (RCTs- 21, RCTs and Quasi-Experimental- 17, only Quasi-Experimental- 1, and mixed-methods- 10). These papers identified a broad range of topics specific to PSE including breastfeeding (9), behavioral change (4), health conditions (7), mental health (5), autism (5), first-time parents (2), general parenting (2), mixed topics (10), and other topics (5). Analysis revealed interventions that incorporate active education, web-based/technology-integrated interventions, ongoing support, group format, and tailored approaches demonstrate greater effectiveness. Conversely, relying solely on standard care, passive materials, ineffective technological interventions, unstructured interventions, or inadequate coaching may limit the effectiveness of interventions to strengthen PSE.

Conclusions and implications: The reported active and inactive components of PSE interventions, including the mechanism underpinning the change process, have significant implications for social work programs. Programs should prioritize evidence-based approaches that address the diverse needs of caregivers, and promote sustained change and positive outcomes.

Keywords: Parent, Caregiver, Self-Efficacy, Intervention, Umbrella Review.