A Meta-Analysis on Parenting Programs Implemented in Rural Areas

Children and families in rural areas experience geographic, financial, and social factors that differentiate them from families in urban areas, yet parenting interventions, which are a first-line treatment for a number of childhood behavioral health problems, have rarely been evaluated with rural samples.

We conducted a meta-analysis (PROSPERO ID: CRD42022283577) to assess 1) the efficacy of parenting programs implemented in rural areas and 2) the program content and delivery characteristics that are associated with outcomes for families in rural areas. Eligible studies assessed the efficacy of parenting programs implemented in a rural area. Of the 838 studies reviewed, 32 were eligible for inclusion.

Pooled estimates of effect sizes revealed that parenting programs had a small but significant effect on parenting (g = 0.33, 95% CI [0.21, 0.44], p < .001) and child (g = 0.43, 95% CI [0.27, 0.459], p < .001) outcomes. Rural programs that taught parents how to communicate with children about consequences, establish effective consequences, and consistently follow through with these consequences showed larger improvements in parent functioning. Programs that taught parents and children problem solving skills, cognitive skills, and social skills showed larger improvements in child functioning. A program's explicit use of homework, in-session role plays, and discussion of parents' attitudes toward limit-setting strategies significantly contributed to the overall effects. Program completion rates appeared to be higher when compared to rates reported in the literature for non-rural implementation.

Findings suggest that rural parenting program implementation appears to be adequately addressing factors that affect program engagement, but more efforts are needed to improve and maintain program outcomes.