BACKGROUND Interventions supporting parents of young children often target parenting or parental mental health separately. Multi-component parenting and parental mental health interventions have the potential to improve parenting practices, mental health, and early childhood development. We aimed to examine their impact on child and parent outcomes. METHODS In this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science Core Collection, APA PsycINFO, CINAHL Complete, the Cochrane Central Register of Controlled Trials, and the Global Health Database from inception to Jan 23, 2024. Eligible studies were randomised controlled trials of interventions explicitly targeting parenting behaviours and parental mental health antenatally or in children's first 3 years of life. Screening, extraction, and quality assessment were done independently by two authors. Primary outcomes were cognitive and social-emotional functioning in children and depressive symptoms in parents, meta-analysed as standardised mean differences (SMDs), relative to control. This study is registered with PROSPERO, CRD42022302848. FINDINGS We found 5843 records. After screening 2636 (45·1%) titles and abstracts, we manually identified and screened three additional articles and excluded 2177 records. After screening 462 full-length articles, 25 articles, representing a sample size of 8520 children and caregivers, were included. At baseline, mean caregiver age was 27·7 years (SD 5·9) and mean child age (excluding those enrolled during pregnancy) was 14·4 months (8·0). Interventions lasted a mean of 14 months (SD 11) and used a mean of 3·7 behaviour change techniques (2·0). Most interventions dedicated more time to parenting behaviours than to parental mental health. We found significant intervention effects on children's cognitive (SMD 0·19 [95% CI 0·04 to 0·34]; I2=69%) and social-emotional (0·26 [0·17 to 0·34]; I2=47%) outcomes but not on depressive symptoms in female caregivers (-0·18 [-0·36 to 0·002]; I2=86%) relative to control conditions. Risk of bias across studies was moderate, and we found heterogeneity across results. INTERPRETATION Multi-component parenting and mental health interventions had a positive effect on child cognitive and social-emotional outcomes, but not on depressive symptoms in parents, suggesting that other factors might contribute to positive ECD outcomes. Interventions might lack adequate focus on mental health to make a discernible impact, highlighting a need for future studies to differentiate and assess contributions of parenting and mental health components to understand independent and collective effects on family outcomes. FUNDING Canadian Institutes of Health Research.

中文翻译：

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多成分养育和父母心理健康干预对儿童早期发展和父母结果的影响：系统评价和荟萃分析。


背景技术支持幼儿父母的干预措施通常单独针对养育子女或父母心理健康。多方面的育儿和家长心理健康干预措施有可能改善育儿实践、心理健康和儿童早期发展。我们的目的是研究它们对儿童和家长结果的影响。方法 在本次系统评价和荟萃分析中，我们检索了 MEDLINE、Embase、Web of Science Core Collection、APA PsycINFO、CINAHL Complete、Cochrane 对照试验中央注册库和全球健康数据库，时间范围从开始到 2024 年 1 月 23 日。这些研究是随机对照试验，针对明确针对产前或儿童出生前 3 年内的养育行为和父母心理健康的干预措施进行随机对照试验。筛选、提取和质量评估由两位作者独立完成。主要结果是儿童的认知和社会情感功能以及父母的抑郁症状，通过相对于对照的标准化平均差（SMD）进行荟萃分析。本研究已在 PROSPERO 注册，CRD42022302848。调查结果 我们找到 5843 条记录。在筛选了 2636 (45·1%) 篇标题和摘要后，我们手动识别并筛选了另外三篇文章，并排除了 2177 条记录。在筛选了 462 篇全文文章后，纳入了 25 篇文章，代表了 8520 名儿童和看护者的样本量。基线时，看护者平均年龄为 27·7 岁 (SD 5·9)，平均儿童年龄（不包括怀孕期间登记的儿童）为 14·4 个月 (8·0)。干预措施平均持续 14 个月 (SD 11)，平均使用 3·7 次行为改变技术 (2·0)。大多数干预措施将更多的时间花在养育行为上，而不是父母的心理健康上。 我们发现对儿童认知（SMD 0·19 [95% CI 0·04 至 0·34]；I2=69%）和社交情感（0·26 [0·17 至 0·34]；I2 =47%）结果，但不影响女性照顾者的抑郁症状（-0·18 [-0·36 至 0·002]；I2=86%）（相对于对照条件）。研究之间的偏倚风险是中等的，我们发现结果之间存在异质性。解释 多成分育儿和心理健康干预措施对儿童认知和社会情感结果有积极影响，但对父母的抑郁症状没有影响，这表明其他因素可能有助于积极的 ECD 结果。干预措施可能缺乏对心理健康的足够关注，无法产生明显的影响，这凸显出未来的研究需要区分和评估养育和心理健康因素的贡献，以了解对家庭结果的独立和集体影响。资助加拿大健康研究所。