Abstract
OBJECTIVES: This systematic review (PROSPERO ID: CRD42022356654, AMNR junior research grant) evaluated the effectiveness of parenting interventions in pediatric type 1 diabetes, designed to enhance supportive parenting behaviors, in improving family dynamics, parent-, child-, and diabetes-related outcomes. METHODS: We systematically searched PubMed, EMBASE, Cochrane, CINAHL, and PsycINFO for studies from 1980 to February 25, 2025. We included reports of controlled and uncontrolled studies describing quantitative change. Data were synthesized narratively, and intervention content was coded according to a behavioral taxonomy. Risk of bias was assessed using Cochrane's Risk of Bias (2.0) tool and the ROBINS-I tool for controlled and uncontrolled studies, respectively. RESULTS: After screening 12,654 reports, we included 51 studies (across 72 reports) describing findings of 37 unique interventions. Most studies and outcomes had an increased risk of bias. Whereas overall effects were mixed, intensive, targeted interventions had the most impact on psychosocial and diabetes outcomes. Some preventive interventions and, notably, control groups also showed effects, with most promising effects in subgroups. Many preventive intervention studies were underpowered. A diabetes-specific focus seemed necessary, although not sufficient, to affect diabetes outcomes. Several strategies were used to stimulate parents toward changing their own and-ultimately-their children's behavior, although individual components could not be uniquely related to intervention effectiveness. CONCLUSIONS: Targeted and preventive parenting interventions serve as a potential, although not exclusive, approach to improve psychosocial and diabetes outcomes. Future research should elucidate which families benefit from parenting interventions compared to other educational or supporting interventions, thereby delineating their essential intervention components.