Supporting parents to reduce children's anxiety: A meta-analysis of interventions and their theoretical components.

Parent-focused interventions hold promise for reducing child anxiety, but their content varies greatly, and little is known on the intervention content. We estimated the effects of parent-focused interventions on child anxiety and the most effective combinations of theoretical components. We searched PsycINFO, Medline, and Web of Science in October 2022 for randomized trials on parent-focused interventions to reduce children's anxiety. We used robust variance estimation to estimate main effects and differential effects by individual theoretical components, and network meta-analysis to estimate the effects of clusters of components (preregistration: PROSPERO CRD42022362983). We identified 26 studies (k = 157, N = 4098). Parent-focused interventions had a significant medium effect on children's anxiety (d = -0.59; 95% CI [-0.92, -0.26]). Interventions used seven theoretically distinct components. No significant differential effects were found, but all clusters of components that produced significant effects contained a behavioral component. Adding cognitive and emotional components to behavioral components seemed beneficial. This meta-analysis highlights the potential of parent-focused interventions for children's anxiety, and of behavioral components in particular, but is limited by the very low certainty of evidence. More high-quality research is needed to understand the exact potential of parent-focused interventions on children's anxiety, and their most effective components.