No evidence of whole population mental health impact of the Triple P parenting programme: findings from a routine dataset

Marryat, Louise; Thompson, Lucy; Wilson, Philip

doi:10.1186/s12887-017-0800-5

Cited by 21 publications

(18 citation statements)

References 41 publications

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“…Unlike efficacy trials which typically have substantial involvement from the research team to optimise retention, effectiveness studies in community settings depend on the implementation of the data gathering from parents to be conducted by the programme implementation staff, in this case Parent Gym coaches, supported by the administration of the main programme team. The level of post-course responses was similar to other large scale effectiveness studies such as the Parenting Early Intervention Programme (Lindsay and Strand, 2013;Lindsay et al, 2011-see also Fives et al (2014 and Marryat et al (2017)). The response rate for the comparison group at 33.5% was lower: unlike a waiting list control group, this was a non-intervention group which had no possibility of benefitting from the study later.…”

Section: Methodssupporting

confidence: 82%

“…The post-course response rate for the Parent Gym sample was 55.0%. Although higher than the response rate in the comparison population sample, the response rate is overall rather low but at levels comparable to other large scale effectiveness trials in community samples (Fives et al, 2014;Marryat et al, 2017). We therefore examined the patterns of missing data.…”

Section: Methodsmentioning

confidence: 88%

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Evaluating Parent Gym: a community implemented universal parenting programme

Lindsay

Totsika

Thomas

2019

Journal of Children’s Services

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BackgroundThere is growing evidence of the efficacy and effectiveness of targeted parenting programmes but the evidence for universal parenting programmes is much less developed. The purpose of this study is to evaluate the effectiveness of Parent Gym, a parenting programme delivered in schools. Design/methodology/approachIn this paper a quasi-experimental design was utilised. Parents were recruited to the Parent Gym programme comprising six 2-hour weekly sessions. Parents completed measures of their parenting efficacy, parenting satisfaction, interest in parenting, and mental well-being at pre-and post-course.Comparative data were derived from a retrospectively defined randomly selected group of nonparticipant parents at two time points, equivalent to the length of the Parent Gym course. FindingsChanges in the Parent Gym group were compared with the comparison group using repeated measures mixed 2x2 ANOVAs, which accounted for the potential effect of demographic characteristics (parent gender, ethnicity, parent age, parent education level, and single parent status), and their potential interaction with group membership. Parenting satisfaction showed a significantly greater increase for the Parent Gym group with a large effect size (d = 0.80). Regarding parenting efficacy, there was a significant time x group interaction indicating efficacy scores increased in the Parent Gym group but decreased in the comparison group (d = 1.93). Mental wellbeing also improved for the Parent Gym group from below the national norm before the course (d = -0.26) to significantly greater than the national norm at post-course (d = 0.29).Findings from the present study indicate that a universal programme, Parent Gym, was associated with very large improvements in parents' self-efficacy, large improvements in parenting satisfaction and moderate improvements in mental well-being, when delivered in community settings. It is recommended that future studies include a measure of children's behaviour and include a follow up of the programme's effectiveness over time. Practical implicationsThe evidence provides support for the continued use of the Parent Gym programme in the community as universal provision for parents.

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Section: Methodssupporting

confidence: 82%

Section: Methodsmentioning

confidence: 88%

Evaluating Parent Gym: a community implemented universal parenting programme

Lindsay

Totsika

Thomas

2019

Journal of Children’s Services

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“…A recent paper published in BMC Pediatrics [5] reports on a city-wide implementation of Triple P in Glasgow, Scotland. We applaud the authors for conducting an independent evaluation of the Triple P system, and endorse the value of independent evaluations of parenting support interventions.…”

Section: Introductionmentioning

confidence: 99%

Comparing apples and pears: misleading conclusions about the population mental health impact of a parenting programme, a commentary on Marryat, Thompson and Wilson (2017)

et al. 2019

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Background The article by Marryat, Thompson and Wilson (2017) in BMC Pediatrics presents an evaluation of the implementation of the Triple P system as a public health intervention conducted by the Glasgow City Council and NHS Greater Glasgow and Clyde. Discussion Unfortunately, the conclusions drawn are questionable for multiple reasons. The lack of a controlled design precludes defensible conclusions about intervention effects free from routine threats to internal validity. There was a substantial mismatch between the intervention sample and the population sample assessed. The article’s title and abstract leave readers with the mistaken impression that the children assessed for outcome were suitably representative of intervention families, when in fact many of the children in the intervention families were missing from the teacher-report outcome assessment (a single questionnaire), and many or most of the children in the teacher-report outcome assessment belonged to families who had never received the intervention. Although Triple P targets parent-child relations and child behavioural and emotional problems at home, Marryat et al. narrowly defined mental health impact as child difficulties in nursery or preschool, while not reporting data from practitioners and parents in the same evaluation that did not support the authors’ conclusion. The paper was further diminished by a number of misleading statements and factual errors related for example to other research on Triple P. Summary Studying the extent to which child mental health functioning at home can generalise to school settings is an important topic of inquiry in relation to parenting support interventions, but unfortunately the Marryat et al. article did not move this area forward.

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“…While several studies have evaluated interventions aiming at improving children’s’ mental health in terms of effectiveness 36 and cost-effectiveness, 37–39 evidence over a lifetime horizon is limited 40 41 and non-health costs and consequences are rarely considered. 9 …”

Section: Methods and Analysismentioning

confidence: 99%

Protocol for the economic evaluation of a complex intervention to improve the mental health of maltreated infants and children in foster care in the UK (The BeST? services trial)

et al. 2018

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IntroductionChildren who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited. This protocol describes the first economic evaluation of its kind in the UK.Methods and analysisAn economic evaluation alongside the Best Services Trial (BeST?) has been prospectively designed to identify, measure and value key resource and outcome impacts arising from the New Orleans intervention model (NIM) (an infant mental health service) compared with case management (CM) (enhanced social work services as usual). A within-trial economic evaluation and long-term model from a National Health Service/Personal Social Service and a broader societal perspective will be undertaken alongside the National Institute for Health Research (NIHR)–Public Health Research Unit (PHRU)-funded randomised multicentre BeST?. BeST? aims to evaluate NIM compared with CM for maltreated children entering foster care in a UK context. Collection of Paediatric Quality of Life Inventory (PedsQL) and the recent mapping of PedsQL to EuroQol-5-Dimensions (EQ-5D) will facilitate the estimation of quality-adjusted life years specific to the infant population for a cost–utility analysis. Other effectiveness outcomes will be incorporated into a cost-effectiveness analysis (CEA) and cost-consequences analysis (CCA). A long-term economic model and multiple economic evaluation frameworks will provide decision-makers with a comprehensive, multiperspective guide regarding cost-effectiveness of NIM. The long-term population health economic model will be developed to synthesise trial data with routine linked data and key government sector parameters informed by literature. Methods guidance for population health economic evaluation will be adopted (lifetime horizon, 1.5% discount rate for costs and benefits, CCA framework, multisector perspective).Ethics and disseminationEthics approval was obtained by the West of Scotland Ethics Committee. Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal as well as published in the peer-reviewed NIHR journals library (Public Health Research Programme).Trial registration numberNCT02653716; Pre-results.

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No evidence of whole population mental health impact of the Triple P parenting programme: findings from a routine dataset

Cited by 21 publications

References 41 publications

Evaluating Parent Gym: a community implemented universal parenting programme

Evaluating Parent Gym: a community implemented universal parenting programme

Comparing apples and pears: misleading conclusions about the population mental health impact of a parenting programme, a commentary on Marryat, Thompson and Wilson (2017)

Protocol for the economic evaluation of a complex intervention to improve the mental health of maltreated infants and children in foster care in the UK (The BeST? services trial)

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