Barriers to and facilitators of engagement with early-intervention services by pregnant people at risk of child removal: a mixed methods systematic review protocol.

OBJECTIVE: The objective of this review is to synthesize existing qualitative, quantitative, and mixed methods evidence in order to identify and examine the barriers to and facilitators of engagement with early-intervention services by pregnant people at risk of child removal. INTRODUCTION: Early intervention and prevention is key to reducing the risk of child abuse, neglect, and removal. Prenatal screening and referral to appropriate treatment and supports underpins best practice early-intervention responses. However, research suggests that pregnant people most in need of support services are often those least likely to engage with them. For early intervention to work, the barriers and facilitators of prenatal engagement must be identified and addressed within service and practice approaches with this group. INCLUSION CRITERIA: This mixed methods systematic review will consider qualitative, quantitative, and mixed methods studies of pregnant people at risk of child removal. Studies will be considered if they report on barriers to or facilitators of engagement in early-intervention services that address risk factors for child removal. METHODS: The systematic review will be conducted in accordance with JBI methodology for mixed methods systematic reviews. A range of databases will be searched, including Informit online, MEDLINE (Ovid), ProQuest Central and Social Sciences Premium, PsycINFO (Ovid), and Scopus (Elsevier). Critical appraisal and data extraction for studies meeting the inclusion criteria will be performed by two reviewers using standardized JBI tools. Data synthesis will follow the convergent integrated approach to mixed methods systematic reviews. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021254794.

Parental engagement in preventive parenting programs for child mental health: a systematic review of predictors and strategies to increase engagement.

BACKGROUND: Child mental health problems are now recognised as a key public health concern. Parenting programs have been developed as one solution to reduce children's risk of developing mental health problems. However, their potential for widespread dissemination is hindered by low parental engagement, which includes intent to enrol, enrolment, and attendance. To increase parental engagement in preventive parenting programs, we need a better understanding of the predictors of engagement, and the strategies that can be used to enhance engagement. METHOD: Employing a PRISMA method, we conducted a systematic review of the predictors of parent engagement and engagement enhancement strategies in preventive parenting programs. Key inclusion criteria included: (1) the intervention is directed primarily at the parent, (2) parent age >18 years, the article is (3) written in English and (4) published between 2004-2016. Stouffer's method of combining p-values was used to determine whether associations between variables were reliable. RESULTS: Twenty-three articles reported a variety of predictors of parental engagement and engagement enhancement strategies. Only one of eleven predictors (child mental health symptoms) demonstrated a reliable association with enrolment (Stouffer's p < .01). DISCUSSION: There was a lack of consistent evidence for predictors of parental engagement. Nonetheless, preliminary evidence suggests that engagement enhancement strategies modelled on theories, such as the Health Belief Model and Theory of Planned Behaviour, may increase parents' engagement. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42014013664.