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  • Vashti Berry
    Exeter University
  • G.J. Melendez-Torres
    Exeter University
  • Nick Axford
    Social Research Unit, Darlington, UK
  • Ulf Axberg
    VID Specialized University, Oslo
  • Bram Orobio de Castro
    University of Amsterdam
  • Frances Gardner
    Oxford University
  • Maria Gaspar
    Universidade de Coimbra
  • Bjorn Handegard
    UiT - The Arctic University of Norway, Tromsø
  • Judy Hutchings
  • Ankie Menting
    Utrecht University
  • Sinead McGilloway
    Maynooth University
  • Stephen Scott
    King's College London
  • Patty Leijten
    University of Amsterdam
: There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.
Original languageEnglish
Pages (from-to)1447-1458
Number of pages12
JournalPrevention Science
Volume24
Issue number8
Early online date23 Jul 2023
DOIs
Publication statusPublished - Nov 2023

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