The provision of parenting support is a key feature of wealthier nations' health and social care services. However, attendance and engagement by the neediest parents remains poor. Barriers experienced by parents include personal life factors (beliefs, lifestyles and limited resources) and programme-specific factors (delivery, content and support arrangements). Here we give consideration to these issues, drawing on published reviews of parenting programme effectiveness identified through a comprehensive search of electronic databases. We suggest ways of improving attendance and engagement, by providing programmes as part of a comprehensive framework of family support.