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Stress management interventions among socioeconomically disadvantaged parents: A meta-analysis and moderation analysis.

International journal of nursing studies
August 1, 2021
Jiying Ling et al. (3 authors)
Journal ArticleMeta-AnalysisReviewHuman Study
Study Details

Study Goal

The researchers aimed to quantitatively examine the effects of stress management interventions, including mindfulness, on reducing stress, depression, and anxiety among socioeconomically disadvantaged parents, and to explore moderators of these effects.

Results Summary

Mindfulness-based interventions showed a small but significant effect in reducing depression (g = -0.16) compared to other interventions, with short-term benefits for stress and depression but limited long-term effects. The study also found that interventions lasting 1-3 months had greater stress-reducing effects than longer durations.

Population

Socioeconomically disadvantaged parents

Effective Dosage

Not specified

Duration

1-3 months (most effective duration)

Interactions

None mentioned

Extracted Claims (15)
InterventionDirectionEndpointPopulationDosageImpactClaim #
stress management interventions
decrease
parental stress
socioeconomically disadvantaged parents
-0.24 (95% CI: -0.33, -0.15)
had a small effect
#1
stress management interventions
decrease
parental stress
socioeconomically disadvantaged parents
-0.12 (95% CI: -0.27, 0.04)
follow-up effect
#2
stress management interventions
decrease
depression
socioeconomically disadvantaged parents
-0.15 (95% CI: -0.26, -0.04)
pooled effects on reducing
#3
stress management interventions
no change
depression
socioeconomically disadvantaged parents
0.02 (95% CI: -0.21, 0.26)
follow-up effect
#4
stress management interventions
no change
anxiety
socioeconomically disadvantaged parents
-0.03 (95% CI: -0.16, 0.11)
average effects
#5
stress management interventions
decrease
stress
socioeconomically disadvantaged parents in developing countries
g = -0.52
had a significantly larger effect in reducing
#6
stress management interventions
decrease
stress
socioeconomically disadvantaged parents in developed countries
g = -0.19
effect in reducing
#7
stress management interventions
decrease
stress
socioeconomically disadvantaged parents
g = -0.47
resulted in a significantly greater effect in reducing
#8
stress management interventions
decrease
stress
socioeconomically disadvantaged parents
g = -0.12
effect in reducing
#9
stress management interventions
decrease
stress
socioeconomically disadvantaged parents
g = -0.36
had a greater effect in reducing
#10
stress management interventions
decrease
stress
socioeconomically disadvantaged parents
g = -0.11
effect in reducing
#11
stress management interventions
decrease
stress
socioeconomically disadvantaged parents
g = -0.20
effect in reducing
#12
Cognitive behavioral therapy
decrease
depression
socioeconomically disadvantaged parents
g = -0.20
resulted in greater effects in reducing
#13
mindfulness-based interventions
decrease
depression
socioeconomically disadvantaged parents
g = -0.16
resulted in greater effects in reducing
#14
interventions focusing on parenting/life/self-care skills
no change
depression
socioeconomically disadvantaged parents
g = 0.003
effect in reducing
#15
Abstract

BACKGROUND: Socioeconomically disadvantaged parents experience high levels of stress, anxiety, and depression. Many interventions have been tested to reduce parental stress, but no meta-analysis has been conducted to quantitatively summarize the effects and explore the moderators of intervention effects among socioeconomically disadvantaged parents. OBJECTIVE: This meta-analysis aimed to (1) quantitatively examine the intervention effects of prior stress management interventions among socioeconomically disadvantaged parents on reducing stress, depression, and anxiety; and (2) explore the potential moderators of intervention effects. METHODS: Six databases, including CINAHL, PubMed, PsycINFO, Sociological Abstracts, Web of Science, and Cochrane, were searched in February 2021. After a two-step literature screening by two independent reviewers, 45 eligible articles were retained. Two evaluators independently assessed each eligible study's quality using the Evidence Project risk of bias tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guided the report. Meta-analyses (random-effects model) and moderation analyses (mixed-effects model) were performed. RESULTS: Previous stress management interventions had a small effect of -0.24 in reducing parental stress (95% confidence interval [CI]: -0.33, -0.15) with a 7.6-month follow-up effect of -0.12 (95% CI: -0.27, 0.04). The pooled effects on reducing depression were -0.15 (95% CI: -0.26, -0.04) with a 9-month follow-up effect of 0.02 (95% CI: -0.21, 0.26). Two studies measured anxiety, and the average effects were -0.03 (95% CI: -0.16, 0.11). Intervention effects on stress were significantly moderated by country (p = .005), study design (p < .001), and intervention duration (p = .030). Interventions conducted in developing countries (g = -0.52) had a significantly larger effect in reducing stress than those conducted in developed countries (g = -0.19). Studies using a quasi-experimental design (g = -0.47) resulted in a significantly greater effect in reducing stress than RCTs (g = -0.12). Interventions with a duration of 1-3 months (g = -0.36) had a greater effect in reducing stress than those with a longer duration (g = -0.11 for 3-6 months, -0.20 for >6 months). Intervention effects on reducing depression were significantly moderated by intervention component (p = .030). Cognitive behavioral therapy (g = -0.20) and mindfulness-based interventions (g = -0.16) resulted in greater effects in reducing depression than interventions focusing on parenting/life/self-care skills (g  =  0.003). CONCLUSIONS: Previous stress management interventions have short-term beneficial effects on reducing parental stress and depression, but long-term follow-up effects are limited. Short-duration (1-3 months) mindfulness-based interventions and cognitive behavioral therapy in clinical settings are recommended for socioeconomically disadvantaged parents to reduce stress and depression.

Medical Subject Headings (MeSH)
AnxietyHumansParentingParentsPsychotherapyVulnerable Populations
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations8
Citations/Year2.0
Relative Citation Ratio1.23
NIH Percentile57.9%
Research Impact Scores
APT Score0.50
Weight Score2.43
Normalized Score0.62
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