A systematic review of participation in prevention family programs

One of the main reasons for the failure of family interventions is related to the low participation and retention of families. Difficulty in promoting adequate engagement and retention of participants is one of the most powerful obstacles and challenges to the implementation and dissemination of evidence-based family interventions. Although a wide range of strategies to involve parents in interventions is described in the literature, little is known as to what strategies are most effective in improving parental involvement. We conducted a systematic review of the predictors of parent participation and enhancement strategies in preventive parenting programs. Key inclusion criteria included: 1) evidence-based studies with a family intervention component, theoretical and empirical reviews of the literature, and systematic reviews; 2) articles published in Portuguese, English, and Spanish; 3) published between 2000 to 2018. Thirty-nine articles reported a variety of predictors of family participation and effective methods to engage families in preventive activities. Four basic dimensions emerged: 1) predictors of participation; 2) characteristics associated with the program; 3) obstacles to participation; and 4) strategies to minimize barriers to participation. Four distinct groups of participation predictors were identified: 1) patterns of family interaction; 2) parents' cognitions and attributions regarding their child's behavioral problems; 3) psychological variables related to parents; and 4) parental perception of intervention. A variety of intrinsic and extrinsic intervention attributes were associated with involvement in family programs. Some obstacles to participation included several logistical issues and circumstances within the family’s social environment. Strategies to minimize barriers to participation included the use of different extrinsic incentives, the role of the trainer, and adjusting parental expectations and motivations throughout the intervention.