Department of Psychology, Arizona State University, Tempe, AZ, USA.
Department of Family Social Science, University of Minnesota Twin Cities, Minneapolis, MN, USA.
Clin Child Fam Psychol Rev. 2022 Dec;25(4):702-719. doi: 10.1007/s10567-022-00400-9. Epub 2022 Jun 8.
GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges' g from studies with pretest-posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies.
发展性人际关系干预（PMTO）是一个基于理论和证据的行为养育项目，在过去三十年中得到了广泛的应用。本系统评价和荟萃分析检查了在六个国家的 3893 个家庭中进行的 20 项发展性人际关系干预（PMTO）研究在养育和儿童适应方面的效果。使用预测试-后测试对照设计的研究的 Hedges'g 被计算出来，并且使用稳健方差估计（RVE）来处理效应量的依赖性。结果表明，发展性人际关系干预（PMTO）显著促进了养育和儿童适应，具有中等至高度的异质性。具体而言，发展性人际关系干预（PMTO）提高了父母的纪律性、育儿监督、技能鼓励、儿童外化问题和儿童内化问题。亚组分析揭示了几个重要的调节因素，包括对照组的类型、测量、信息来源、偏倚风险等。干预效果在不同国家和多个人口统计学特征中都非常稳健。没有发现研究之间在养育和儿童适应方面存在发表偏倚。使用修订后的 Cochrane 随机试验偏倚风险（RoB 2）程序来评估纳入研究中的偏倚风险。由于随机化过程、缺失数据、低测量质量和报告偏倚等问题，一些研究显示出更高的偏倚风险。由于缺乏数据，我们没有检查干预对父母心理健康或夫妻关系质量的影响。未来的研究应该测试中介模型，以了解变化的机制，并确定调节因素，以便理解发展性人际关系干预（PMTO）研究中的高度异质性。
