Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data

Vashti Berry; G. J. Melendez-Torres; Nick Axford; Ulf Axberg; Bram Orobio de Castro; Frances Gardner; Maria Filomena Gaspar; Bjørn Helge Handegård; Judy Hutchings; Ankie Menting; Sinéad McGilloway; Stephen Scott; Patty Leijten

doi:10.1007/s11121-022-01404-1

Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data

Vashti Berry^*, G. J. Melendez-Torres, Nick Axford, Ulf Axberg, Bram Orobio de Castro, Frances Gardner, Maria Filomena Gaspar, Bjørn Helge Handegård, Judy Hutchings, Ankie Menting, Sinéad McGilloway, Stephen Scott, Patty Leijten

^*Corresponding author for this work

Child & Adolescent Psychiatry

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.

Original language	English
Journal	PREVENTION SCIENCE
DOIs	https://doi.org/10.1007/s11121-022-01404-1
Publication status	Accepted/In press - 2022

Keywords

Engagement
IPD meta-analysis
Parenting programs
Social disadvantage
Socioeconomic status

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s11121-022-01404-1

Cite this

Berry, V., Melendez-Torres, G. J., Axford, N., Axberg, U., de Castro, B. O., Gardner, F., Gaspar, M. F., Handegård, B. H., Hutchings, J., Menting, A., McGilloway, S., Scott, S., & Leijten, P. (Accepted/In press). Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data. PREVENTION SCIENCE. https://doi.org/10.1007/s11121-022-01404-1

@article{cd882ed467bd4e3f95de14b2e4a79977,

title = "Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data",

abstract = "There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.",

keywords = "Engagement, IPD meta-analysis, Parenting programs, Social disadvantage, Socioeconomic status",

author = "Vashti Berry and Melendez-Torres, {G. J.} and Nick Axford and Ulf Axberg and {de Castro}, {Bram Orobio} and Frances Gardner and Gaspar, {Maria Filomena} and Handeg{\aa}rd, {Bj{\o}rn Helge} and Judy Hutchings and Ankie Menting and Sin{\'e}ad McGilloway and Stephen Scott and Patty Leijten",

note = "Funding Information: This study was partly funded by the National Institute of Health Research (NIHR) Public Health Research Program (PI Gardner). In addition, Vashti Berry, G. J. Melendez-Torres, and Nick Axford{\textquoteright}s time is supported by the NIHR Applied Research Collaboration South West Peninsula (NIHR PenARC). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Patty Leijten{\textquoteright}s time is supported by a ZonMw Fellowship (#636320007). Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

doi = "10.1007/s11121-022-01404-1",

language = "English",

journal = "PREVENTION SCIENCE",

issn = "1389-4986",

publisher = "Springer Verlag",

}

Berry, V, Melendez-Torres, GJ, Axford, N, Axberg, U, de Castro, BO, Gardner, F, Gaspar, MF, Handegård, BH, Hutchings, J, Menting, A, McGilloway, S, Scott, S & Leijten, P 2022, 'Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data', PREVENTION SCIENCE. https://doi.org/10.1007/s11121-022-01404-1

TY - JOUR

T1 - Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data

AU - Berry, Vashti

AU - Melendez-Torres, G. J.

AU - Axford, Nick

AU - Axberg, Ulf

AU - de Castro, Bram Orobio

AU - Gardner, Frances

AU - Gaspar, Maria Filomena

AU - Handegård, Bjørn Helge

AU - Hutchings, Judy

AU - Menting, Ankie

AU - McGilloway, Sinéad

AU - Scott, Stephen

AU - Leijten, Patty

N1 - Funding Information: This study was partly funded by the National Institute of Health Research (NIHR) Public Health Research Program (PI Gardner). In addition, Vashti Berry, G. J. Melendez-Torres, and Nick Axford’s time is supported by the NIHR Applied Research Collaboration South West Peninsula (NIHR PenARC). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Patty Leijten’s time is supported by a ZonMw Fellowship (#636320007). Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.

AB - There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.

KW - Engagement

KW - IPD meta-analysis

KW - Parenting programs

KW - Social disadvantage

KW - Socioeconomic status

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U2 - 10.1007/s11121-022-01404-1

DO - 10.1007/s11121-022-01404-1

M3 - Article

AN - SCOPUS:85135100443

SN - 1389-4986

JO - PREVENTION SCIENCE

JF - PREVENTION SCIENCE

ER -

Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data

Abstract

Keywords

UN SDGs

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