Online interventions for the mental health and well-being of parents of children with additional needs: Systematic review and meta-analysis.

The trials disagreed with each other far more than is comfortable in a pooled analysis (I² between 80% and 96% depending on the outcome). The authors had planned to test whether the type of programme, how it was delivered or how long it ran explained the differences, and there were too few studies to do it. The authors themselves say the results should be interpreted cautiously. Quality was mixed. Eight of the 30 studies were rated weak overall, and only three blinded the person scoring the outcomes. Every outcome was self-report, so parents always knew which programme they had received. Nine studies excluded parents who already had a mental health condition or were already receiving care for one, so the parents with the greatest need are largely missing from this evidence. Most participants were mothers. No intervention was designed for, or delivered only to, fathers. Results could only be compared straight after the programme ended, because too few studies reported follow-up. The wellbeing result rests on just three studies. Grey literature was not searched and only English-language papers were included.

All four authors declare that they have no conflict of interest, and the review was registered in advance with PROSPERO (CRD42022357326). No funding source is stated in the text supplied. All four authors identify as female and as mothers, three are trained in occupational therapy and one in psychology and statistics, which they state in a positionality statement.

Do not read the pooled stress result of 1.27 as the improvement you would expect for the next parent you enrol. The 13 trials differed so much in their results that pooling them was of limited use, and the authors themselves say the findings should be interpreted cautiously. Do not assume these are occupational therapy interventions either. Only three of the 30 studies used an occupational therapy approach.