Scaling Early Parenting Programs to Support Positive Social-Emotional and Mental Health Outcomes in Young Children: A Systematic Review

Background Evidence-based early parenting programs delivered in early childhood can improve children’s social-emotional and mental health outcomes, yet achieving population-level impact requires effective delivery at scale. Despite growing interest in scaling such interventions, no comprehensive review has synthesized lessons from past efforts. Objective This systematic review aimed to synthesize available peer-reviewed literature on scaled ‘early’ parenting programs (defined as programs delivered during pregnancy and up to child age 5 years). Specifically, the review examined (1) which programs have been scaled, (2) frameworks guiding scaling efforts, (3) reported outcomes, and (4) barriers and enablers to successful scaling. Methods Guided by PRISMA-SR, four databases (PsychInfo, EMBASE, SCOPUS, PubMed) were searched for studies published between 2004 and March 2026. Eligible studies reported data on scaling early parenting programs beyond a single site. Data were synthesized narratively, and qualitative thematic analysis was applied to barriers and enablers. Results Sixty-two papers describing 39 distinct scaling efforts were included, spanning 15 unique programs. Scaled programs included attachment-based interventions and behavioral programs. While some initiatives employed implementation frameworks, most did not. Data suggested positive impacts for families in some relevant areas, however most evidence came from descriptive or non-randomized study designs, and there was significant variation in how outcomes were measured. Reported outcomes relating to scaling reach, fidelity, and sustainability were limited. Six key enablers/barriers were identified: implementation approach; local contexts; collaboration; institutionalizing within systems; leadership; and funding and resources. Conclusions In the last two decades, efforts have been made to scale early parenting programs to support child social-emotional and mental health outcomes. To support future scaling, ongoing research is required.