The Effectiveness of Parenting Interventions on Psychosocial Adjustment in Parents of Children and Adolescents with Type 1 Diabetes: A Meta-Analysis

Aims: Parenting interventions in this review refer to supportive parenting training provided for parents or primary caregivers of children and adolescents with type 1 diabetes mellitus (T1DM). The review aimed to synthesize evidence about parenting interventions in parents or caregivers of children and adolescents with T1DM, and to evaluate the effect of interventions in reducing parents' or caregivers' psychological distress, helping them share diabetes management responsibility, seek social support, and improve their quality of life.

Methods: We searched PubMed, MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science from January 1978 to October 2018. Randomized controlled trials (RCTs) comparing an intervention group of parenting programs with a control group of usual care were included. The primary outcomes were stress, family responsibility and conflict, and social support. Secondary outcomes included other psychological index and quality of life. Pooled effect sizes of weighted mean difference (WMD) were calculated.

Results: A total of 17 RCTs with 962 participants met the inclusion criteria. Findings of the meta-analysis showed parenting interventions could significantly reduce parents' depression (WMD = -5.78, 95% CI: -6.23 to -5.33, I 2  = 0%) and distress (WMD = -5.28, 95% CI: -10.31 to -.25, I 2  = 0%), and help them ask for positive social support (WMD = .83, 95% CI: .03 to 1.64, I 2  = 0%). No beneficial changes of other outcomes were found.

Linking Evidence to Action: Parents of children and adolescents with T1DM need support from the multidisciplinary team in health care, especially in mental health, family management of childhood diabetes, and social support. Parenting interventions may help parents reduce psychological distress and depression and assist them to ask for social support. Future research should include well-designed RCTs with large samples, appropriate measures with clear definitions, objective assessment, and separation of effects on mothers and fathers.