Transporting Evidence-Based Parenting Programs for Child Problem Behavior (Age 3-10) Between Countries: Systematic Review and Meta-Analysis.

There has been rapid global dissemination of parenting interventions, yet little is known about their effectiveness when transported to countries different from where they originated, or about factors influencing success. This is the first systematic attempt to address this issue, focusing on interventions for reducing child behavior problems. Stage 1 identified evidence-based parenting interventions showing robust effects in systematic reviews; Stage 2 identified trials of these interventions in a new country. Systematic review/meta-analysis of transported programs was followed by subgroup analyses by trial- and country-level cultural, resource, and policy factors. We found 17 transported trials of 4 interventions, originating in United States or Australia, tested in 10 countries in 5 regions, (n = 1,558 children). Effects on child behavior were substantial (SMD -.71) in the (14) randomized trials, but nonsignificant in the (3) nonrandomized trials. Subgroup analyses of randomized trials found no association between effect size and participant or intervention factors (e.g., program brand, staffing). Interventions transported to "western" countries showed comparable effects to trials in origin countries; however, effects were stronger when interventions were transported to culturally more distant regions. Effects were higher in countries with survival-focused family/childrearing values than those ranked more individualistic. There were no differences in effects by country-level policy or resource factors. Contrary to common belief, parenting interventions appear to be at least as effective when transported to countries that are more different culturally, and in service provision, than those in which they were developed. Extensive adaptation did not appear necessary for successful transportation.