Engaging Parents in Technology-Assisted Interventions for Childhood Adversity: Systematic Review.

BACKGROUND: Youth mental health problems are a major public health concern and are strongly associated with adverse childhood experiences (ACEs). Technology-assisted parenting programs can intervene with ACEs that are within a parent's capacity to modify. However, engagement with such programs is suboptimal. OBJECTIVE: This review aims to describe and appraise the efficacy of strategies used to engage parents in technology-assisted parenting programs targeting ACEs on the behavioral and subjective outcomes of engagement. METHODS: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines, we conducted a systematic review of peer-reviewed papers that described the use of at least 1 engagement strategy in a technology-assisted parenting program targeting ACEs that are within a parent's capacity to modify. A total of 8 interdisciplinary bibliographic databases (CENTRAL, CINAHL, Embase, OVID MEDLINE, OVID PsycINFO, Scopus, ACM, and IEEE Xplore) and gray literature were searched. The use of engagement strategies and measures was narratively synthesized. Associations between specific engagement strategies and engagement outcomes were quantitatively synthesized using the Stouffer method of combining P values. RESULTS: We identified 13,973 articles for screening. Of these, 156 (1.12%) articles were eligible for inclusion, and 29 (18.2%) of the 156 were associated with another article; thus, 127 studies were analyzed. Preliminary evidence for a reliable association between 5 engagement strategies (involving parents in a program's design, delivering a program on the web compared to face-to-face, use of personalization or tailoring features, user control features, and provision of practical support) and greater engagement was found. Three engagement strategies (professional support features, use of videos, and behavior change techniques) were not found to have a reliable association with engagement outcomes. CONCLUSIONS: This review provides a comprehensive assessment and description of the use of engagement strategies and engagement measures in technology-assisted parenting programs targeting parenting-related ACEs and extends the current evidence with preliminary quantitative findings. Heterogeneous definition and measurement of engagement and insufficient engagement outcome data were caveats to this synthesis. Future research could use integrated definitions and measures of engagement to support robust systematic evaluations of engagement in this context. TRIAL REGISTRATION: PROSPERO CRD42020209819; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209819.

Modifiable parental factors in adolescent sleep: A systematic review and meta-analysis.

Sleep problems are prevalent during adolescence, but parents may be able to support adolescents to sleep better. A systematic search of records from six databases from inception up to November 2019, identified 103 peer-reviewed publications that examined behaviourally and cognitively modifiable parental factors associated with sleep in adolescents aged 12-18 years. Although included studies were largely cross-sectional and heterogeneous, with heavy reliance on self-reported measures, associations with sound, convergent levels of evidence were found for: 1) parental rule-setting for bedtimes and parent sleep behaviours with longer sleep duration in adolescents; 2) healthy parent sleep and family functioning with better adolescent sleep quality; and 3) parental warmth with better adolescent daytime functioning. Effect sizes were in the small to moderate range. The identified parental factors are recommended targets for inclusion in parenting programs to support adolescent sleep, however, would require validation in intervention studies. Opportunities for research are outlined for the identified parental factors, sleep domains with limited evidence, and better understanding the mechanisms or possible moderators in the associations between parental factors and sleep outcomes.