JMIR Publications

ABSTRACT

Background:

Face-to-face co-parenting interventions have been shown to improve outcomes for parents and children after separation or divorce. Online co-parenting interventions are a flexible and scalable alternative for parents navigating multiple other stressors. However, there is little understanding about how their content leads to positive behaviour change.

Objective:

The objective of this systematic review was to explore how behavioural science could be incorporated into the content of online co-parenting interventions by analysing their active ingredients, (or ‘behaviour change techniques – BCTs) and potential mechanisms of action.

Methods:

Eligibility criteria: Studies were included if they evaluated or described interventions for parents who were separating or divorced, were delivered online, and evaluated at least one psychological outcome. Information sources: Five databases - Web of Science, Medline, PubMed, PsychInfo and ProQuest - and grey literature were searched in March 2024. Search results were exported to Covidence, where twenty percent of the results were screened by a second reviewer. Risk of Bias: Risk of bias was evaluated using the Mixed Methods Appraisal Tool by two authors. Synthesis methods: Select items from the Behaviour Change Intervention Ontology (BCIO) and Template for Intervention Description and Replication (TIDieR) checklist were used to extract components of the intervention. Results were synthesised after classifying interventions as very promising, promising, and possibly promising based on the risk of bias and positive outcomes.

Results:

14 interventions represented by 24 studies were included in the review. Positive outcomes were observed for asynchronous and synchronous interventions across different levels of interactivity, dosage and tailoring. Interventions that used behaviour change theories were promising in their effectiveness. Across the 14 interventions, 22 BCTs were identified. BCTs used in promising interventions were “Guide how to perform behaviour” and “Awareness of other peoples thoughts, feelings and actions”. Other frequently coded BCTs were “Goal-directed”, “Increase awareness of consequences”, “Monitoring” , “Social support” and “Suggest different perspective on behaviour” BCTs. The content of the interventions most frequently targeted parents’ motivation to change their behaviours, followed by their psychological capability and social opportunity.

Conclusions:

The most frequent sources of bias were the lack in clarity in how randomisation was being performed and incomplete outcome data due to high drop-out rates in the trials. The studies did not provide evidence for the effectiveness of these interventions for parents from low- and middle-income countries. This review provides evidence to support the role of behavioural science in developing evidence-based online co-parenting interventions. Clinical Trial: The protocol was prospectively registered on PROSPERO (CRD42024511486)