We would have considered it reasonable to combine the results from both if there was
little heterogeneity between the study designs and the interaction between the
effect of intervention and the choice
of randomisation unit was considered to be unlikely.
In addition,
little knowledge is available on the
effect of parenting support programmes delivered to immigrant parents.24 The few studies available have mostly shown
little or no improvement in the mental health
of immigrant parents25 26 or even poorer outcomes for immigrant families27 and families with low socioeconomic status.28 Scarcity
of studies in this area may simply because few immigrant parents participate in such programmes.24 Several studies have reported difficulties in recruiting and retaining immigrant parents in parenting support programmes.29 30 Factors such as belonging to an ethnic minority, low socioeconomic status, practical aspects or experienced alienation and discrimination all contribute to low participation.28 31 Other studies have demonstrated that low participation and a high dropout rate
of immigrant parents are associated with a lack
of cultural sensitivity in the
intervention, poor information about the parenting programme and lack
of trust towards professionals.24 A qualitative study conducted with Somali - born parents in Sweden showed that Somali parents experienced many societal challenges in the new country and in their parenting behaviours.