Modelling the potential for parenting skills interventions to reduce inequalities and population prevalence of children’s mental health problems: evidence from the Millennium Cohort Study

Hope, S., Pearce, A. , Cortina-Borja, M., Chittleborough, C., Barlow, J. and Law, C. (2021) Modelling the potential for parenting skills interventions to reduce inequalities and population prevalence of children’s mental health problems: evidence from the Millennium Cohort Study. SSM - Population Health, 14, 100817. (doi: 10.1016/j.ssmph.2021.100817) (PMID:34169135) (PMCID:PMC8209401)

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Parenting programmes can improve parenting quality and, in turn, children's mental health. If scaled-up, they have the potential to reduce population inequalities and prevalence in child mental health problems (MHP). However, this cannot be investigated with trials. Using data from the UK Millennium Cohort Study (18,000 children born 2000–2002), we simulated population impact of scale-up of seven parenting programmes. Predicted probabilities of child MHP (Strengths and Difficulties Questionnaire) by household income quintile (Risk ratios [RRs] and differences [RDs], 95% confidence intervals [CI]) were estimated from logistic marginal structural models, adjusting for parenting quality scores (Child-Parent Relationship Scale at 3 years) and confounders. The impact of scaling-up parenting programmes was simulated by re-estimating predicted probabilities of child MHP after increasing parenting scores according to intervention intensity, targeting mechanisms and programme uptake levels. Analyses included data from 14,399 children, with survey weights and multiple imputation addressing sampling design, attrition and item missingness. Prevalence of child MHP at 5 years was 11.3% (11.4% unadjusted), with relative and absolute income inequalities (RR = 4.8[95%CI:3.6–5.9]; RD = 15.8%[13.4–18.2]). In simulations, universal, non-intensive parenting programmes reduced prevalence (9.4%) and absolute inequalities (RR = 5.0[95%CI:3.8–6.2]; RD = 13.6%[11.5–15.7]). Intensive programmes, targeting a range of potential risk criteria (e.g. receipt of means-tested benefits), reduced inequalities (RR = 4.0[95%CI:3.0–4.9]; RD = 12.4%[10.3–14.6] and, to a lesser extent, prevalence (10.3%). By simulating implementation of parenting programmes, we show that universal non-intensive and targeted intensive approaches have the potential to reduce child MHP at population level, and to reduce but not eliminate inequalities, with important implications for future policy and practice.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Pearce, Dr Anna
Creator Roles:
Pearce, A.Conceptualization, Methodology, Writing – original draft, Writing – review and editing
Authors: Hope, S., Pearce, A., Cortina-Borja, M., Chittleborough, C., Barlow, J., and Law, C.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:SSM - Population Health
ISSN (Online):2352-8273
Published Online:13 May 2021
Copyright Holders:Copyright © 2021 Elsevier
First Published:First published in SSM - Population Health 14: 100817
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174091Improving life chances & reducing child health inequalities: harnessing the untapped potential of existing dataAnna PearceWellcome Trust (WELLCOTR)205412/Z/16/ZHW - MRC/CSO Social and Public Health Sciences Unit
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU13