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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 sub-optimal. OBJECTIVE This review aimed to describe and appraise the efficacy of strategies used to engage parents in technology-assisted parenting programs targeting ACEs, on behavioural and subjective outcomes of engagement. METHODS Using the PRISMA method, we conducted a systematic review of peer-reviewed papers which described the use of at least one engagement strategy in a technology-assisted parenting program targeting ACEs that are within a parent’s capacity to modify. Eight inter-disciplinary bibliographic databases and grey literature were searched. Use of engagement strategies and measures was narratively synthesised. Associations between specific engagement strategies and engagement outcomes were quantitatively synthesised using Stouffer’s method of combining p values. RESULTS We identified 156 articles that were eligible for inclusion, 29 of which were associated with another article, hence 127 studies were analysed. Preliminary evidence for a reliable association between five engagement strategies (involving parents in a program’s design, delivering a program online compared to face-to-face, the use of personalisation/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 behaviour 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 current evidence with preliminary quantitative findings. Heterogeneous definition and measurement of engagement, and insufficient engagement outcome data, were caveats to this synthesis. Future research can use integrated definitions and measures of engagement to support robust systematic evaluation of engagement in this context. CLINICALTRIAL PROSPERO registration number: CRD42020209819 |
