Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review

Qiyue Cai, Athena C.Y. Chan, Sunkyung Lee, Scott Marsalis, Abigail H. Gewirtz

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges’ g from studies with pretest–posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies.

Original languageEnglish (US)
Pages (from-to)702-719
Number of pages18
JournalClinical Child and Family Psychology Review
Issue number4
StatePublished - Dec 2022

Bibliographical note

Funding Information:
We thank Dr. Neveen Ali Saleh Darawshy and Dr. Alyssa Pintar Breen for helping with the coding process.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Child adjustment
  • GenerationPMTO
  • Meta-analysis
  • Parenting programs

PubMed: MeSH publication types

  • Systematic Review
  • Meta-Analysis
  • Journal Article
  • Review


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