Three variants of a behavioral family intervention (BFI) program known as Triple P were compared using 305 preschoolers at high risk of developing conduct problems. Families were randomly assigned to enhanced BFI (EBFI), standard BFI (SBFI), self-directed BFI (SDBFI), or wait list (WL). At postintervention, the 2 practitioner-assisted conditions were associated with lower levels of parent-reported disruptive child behavior, lower levels of dysfunctional parenting, greater parental competence, and higher consumer satisfaction than the SDBFI and WL conditions. Overall, children in EBFI showed greater reliable improvement than children in SBFI, SDBFI, and WL. By 1-year follow-up, children in all 3 conditions achieved similar levels of clinically reliable change in observed disruptive behavior. However, the EBFI and SBFI conditions showed greater reliable improvement on parent-observed disruptive child behavior.
Twenty-four parents of oppositional preschoolers were randomly assigned to either a self-directed behavioral family intervention condition (SD) or to a waitlist control group (WL). The self-directed parent training program, based on self-regulation principles, consisted of a written information package and weekly telephone consultations for 10 weeks. At posttest, in comparison to the WL group, children in the SD group had lower levels of behavior problems on parent report measures of child behavior. At posttreatment, parents in the SD condition reported increased levels of parenting competence and lower levels of dysfunctional parenting practices as compared to parents in the WL condition. In addition, mothers reported lower levels of anxiety, depression, and stress as compared to mothers in the WL condition at posttreatment. Using mother's reports, gains in child behavior and parenting practices achieved at posttreatment were maintained at 4-month follow-up.
This paper describes the theoretical and empirical basis of a unique multilevel system of parenting and family support known as the Triple P-Positive Parenting Program. The program incorporates five levels of intervention on a tiered continuum of increasing strength and narrowing population reach. The self-regulation framework of the program is discussed and an ecological or systems-contextual approach to dissemination of the program to service providers is highlighted. Implementation issues to consider in effective program dissemination are discussed including managing the "politics" of family support, strategies for coping with changes in government, maintaining quality, balancing cost and sustainability, and remaining data responsive. Future research directions are identified.
The Triple P-Positive Parenting Programme is described as an example of an evidence-based universal parenting initiative that provides a tiered continuum of interventions of increasing strength but narrowing reach in an effort to make parenting programmes more accessible to parents. Interventions within the system range from the use of the media and brief messages to intensive family interventions for parents where parenting problems are complicated by multiple additional sources of family adversity. Several issues concerning the role of training and organizational factors that influence the successful uptake and implementation of the programme are discussed.Key Words: positive parenting; prevention; child abuse; population approach In the prevention of child abuse, it is important to reorient our focus from treatment outcomes to develop and evaluate a population perspective to family problems. We suggest that a populationbased strategy to enhance parental competence, prevent dysfunctional parenting practices, change parental attributions and promote teamwork between partners would reduce family risk factors associated with child maltreatment. For this to be effective, several criteria need to be met (Taylor, 1999;: knowledge of the prevalence and incidence of child outcomes being targeted; knowledge of the prevalence and incidence of family risk factors; knowledge that changing specific family risk and protective factors leads to a reduction in the incidence and prevalence of the target problem; use of effective family interventions; family interventions must be culturally appropriate; and interventions need to be widely available.
Two variants of a behavioral family intervention (BFI) program known as Triple P were compared using 87 preschoolers with co-occurring disruptive behavior and attentional/hyperactive difficulties. Families were randomly allocated to enhanced BFI (EBFI), standard BFI (SBFI), or a waitlist (WL) control group. At postintervention both BFI programs were associated with significantly lower levels of parent-reported child behavior problems, lower levels of dysfunctional parenting, and greater parental competence than the WL condition. The EBFI condition was also associated with significantly less observed child negative behavior in comparison to the WL. The gains achieved at postintervention were maintained at 1-year follow-up. Contrary to predictions, the enhanced program was not shown to be superior to the standard program using any of the outcome measures at either postintervention or follow-up. Each of the programs produced significant reductions in children's co-occurring disruptive behavior and attentional/hyperactive difficulties with 80% of the children showing clinically reliable improvement in observed negative behavior from preintervention to follow-up.
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