Nina Sokolovic1, Michelle Rodrigues2, Andrea C Tricco3,4, Roksana Dobrina2, Jennifer M Jenkins2. 1. Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario; nina.sokolovic@mail.utoronto.ca. 2. Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario. 3. Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario; and. 4. Division of Epidemiology and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.
Abstract
CONTEXT: Children who receive more responsive care during their early childhood tend to exhibit stronger cognitive development, mental well-being, and physical health across their life course. OBJECTIVE: Determine how to design effective responsivity training programs for caregivers. DATA SOURCES: We searched seven electronic databases through October 2020. STUDY SELECTION: Randomized trials (k = 120) of programs training parents of children ages 0 to 6 to be more responsive. DATA EXTRACTION: Two reviewers independently extracted data. Data were pooled by using random-effects pairwise and network meta-analyses. RESULTS: Programs had, on average, a medium effect (d = 0.56; 95% confidence interval [CI]: 0.47 to 0.65). The most effective programs included didactic teaching and opportunities for parents to observe models, practice skills, and receive feedback (d = 1.07; 95% CI: 0.37 to 1.77), or all these instructional methods in addition to reflection (d = 0.86; 95% CI: 0.64 to 1.09). Programs that had participants observe examples of responsivity (d = 0.70; 95% CI: 0.57 to 0.83), used researchers as facilitators (d = 0.89; 95% CI: 0.66 to 1.12), assigned homework (d = 0.85; 95% CI: 0.66 to 1.02), and had a narrow scope (d = 0.72; 95% CI: 0.57 to 0.87) were more effective than those that did not. LIMITATIONS: Most samples included only mothers from Western countries and lacked follow-up data. CONCLUSIONS: Having parents observe examples of responsive caregiving and complete home-practice in short, focused programs may be an effective, scalable approach to enhancing responsivity in the general population and reducing inequalities in child development.
CONTEXT: Children who receive more responsive care during their early childhood tend to exhibit stronger cognitive development, mental well-being, and physical health across their life course. OBJECTIVE: Determine how to design effective responsivity training programs for caregivers. DATA SOURCES: We searched seven electronic databases through October 2020. STUDY SELECTION: Randomized trials (k = 120) of programs training parents of children ages 0 to 6 to be more responsive. DATA EXTRACTION: Two reviewers independently extracted data. Data were pooled by using random-effects pairwise and network meta-analyses. RESULTS: Programs had, on average, a medium effect (d = 0.56; 95% confidence interval [CI]: 0.47 to 0.65). The most effective programs included didactic teaching and opportunities for parents to observe models, practice skills, and receive feedback (d = 1.07; 95% CI: 0.37 to 1.77), or all these instructional methods in addition to reflection (d = 0.86; 95% CI: 0.64 to 1.09). Programs that had participants observe examples of responsivity (d = 0.70; 95% CI: 0.57 to 0.83), used researchers as facilitators (d = 0.89; 95% CI: 0.66 to 1.12), assigned homework (d = 0.85; 95% CI: 0.66 to 1.02), and had a narrow scope (d = 0.72; 95% CI: 0.57 to 0.87) were more effective than those that did not. LIMITATIONS: Most samples included only mothers from Western countries and lacked follow-up data. CONCLUSIONS: Having parents observe examples of responsive caregiving and complete home-practice in short, focused programs may be an effective, scalable approach to enhancing responsivity in the general population and reducing inequalities in child development.