Online parenting support Meta-analyses of non-inferiority and additional value to in-person support

Parenting support to enhance parent and child mental health is increasingly offered on websites, apps, and through videocall. This development raises the question of how online parenting support compares to traditional in-person parenting support. Is online support non-inferior to traditional in-person support? Or should online support be used as a supplement to in-person support? In the COST Action EurofamNet (CA18123), we sought to answer these questions by systematically searching for randomized trials comparing online to in-person parenting support (Study 1) and trials comparing in-person parenting support augmented with online support elements to in-person parenting support only (Study 2). We registered our review in PROSPERO (CRD42022354393) and searched PsycINFO, MEDLINE, Web of Science, and Cochrane in May 2022. Our outcomes of interests were children’s mental health, parenting practices, parental mental health, and parents’ satisfaction with the program. For Study 1, multilevel meta-analysis of seven eligible randomized trials (101 effect sizes; N = 957) showed consistent non-inferiority of online support and a trend that parents were more satisfied with online support. For Study 2, narrative synthesis of two eligible trials (N = 279) suggests that adding online support elements to in-person support can improve program satisfaction and short-term benefits, but does not contribute significantly to program benefits above and beyond in-person support. Our findings suggest that, provided appropriate online formats and sufficient guidance from professionals, online parenting support is non-inferior to in-person support. The additive value of online support elements to in-person support seems limited, but may still be meaningful. Future research should identify the circumstances under which parents prefer, and benefit more from, in-person versus online parenting support.