Every Family: A Population Approach to Reducing Behavioral and Emotional Problems in Children Making the Transition to School

Abstract

A large-scale population trial using the Triple P-Positive Parenting Program (TPS) was evaluated. The target population was all parents of 4- to 7-year-old children residing in ten geographical catchment areas in Brisbane (intervention communities) and ten sociodemographically matched catchment areas from Sydney (5) and Melbourne (5), care as usual (CAU) comparison communities. All five levels of the Triple P multilevel system of intervention were employed; including a local mass media strategy, a primary care strategy, and three more intensive levels of parenting intervention delivered by a range of service providers (e.g., health, education, and welfare sectors). Program outcomes were assessed through a computer-assisted telephone interview of a random sample of households (N = 3000) in each community at pre-intervention and again at two years post-intervention. At post-intervention there were significantly greater reductions in the TPS communities in the number of children with clinically elevated and borderline behavioral and emotional problems compared to the CAU communities. Similarly parents reported a greater reduction in the prevalence of depression, stress and coercive parenting. Findings show the feasibility of targeting dysfunctional parenting practices in a cost-effective manner and the public acceptance of an approach that blends universal and targeted program elements. Editors' Strategic Implications: This is the first positive parenting program to demonstrate longitudinal, population-level effects for parents and children. The authors provide an excellent example of multilevel prevention planning, coordination, execution, and evaluation.

Literatur-Review zur Validität des präventiven Elterntrainings Stepping Stones Triple P

“…Um eine hohe Qualität der elternbezogenen Interventionen zu garantieren, wird ein universitär verankertes, interdisziplinäres Ausbildungs-und Lizensierungssystem für erforderlich gehalten, wie es etwa in Australien bereits für Fachkräte aus Medizin, Psychologie, Erziehung und Sozialarbeit geschafen wurde (Sanders et al, 2004a(Sanders et al, , 2008 und im deutschsprachigen Raum bereits für das Elternprogramm StandardTripleP umgesetzt worden ist (Heinrichs, 2006a Die Kritik an der Auszeit-Komponente des SSTP richtet sich (a) auf die Verwendung einer aversiven Maßnahme in einem Programm für behinderte Menschen als solche (Wiese et al, 2005); (b) auf den Mangel an strengen Indikationskriterien, den Einsatz von Auszeitstrategien bei Problemen, die nicht erkennbar gravierend sind sowie die Nichtbeachtung von möglichen schädlichen Nebenwirkungen (Probst u. Spreitz, 2008); (d) auf die zu geringe Berücksichtigung behinderungsspeziischer Bedingungshintergründe des Problemverhaltens (Eltern Fokus-Gruppe von Kindern mit autistischen Störungen, Whittingham et al, 2006).…”

“…Diese bisherigen positiven Befunde sind weitgehend konsistent mit den Ergebnissen mehrerer Evaluationsstudien zur internen Validität des Standard-Triple-P-Programms (Sanders, 2008). Als einschränkende Faktoren der internen Validität sind anzuführen: (a) ausstehende Untersuchungen an diagnostischen Subgruppen innerhalb der diagnostischen Schirm-Kategorie "Entwicklungsbehinderungen" (b) die noch mit Unsicherheit behateten Schätzungen der Outcome-Efektstärken auf Basis der Evaluationsstudien-Stichprobe von n = 2 sowie der moderaten Probanden-Stichprobengrößen (c) ausstehende Replikationsstudien aus dem deutschsprachigen Raum; (d) Mangel an Efektivitätsstudien außerhalb der Forscher-Community um M. R. Sanders.…”

A systematic review of universal campaigns targeting child physical abuse prevention

“…Only three studies examined child abuse outcomes specifically and found a reduction in the incidence of abusive head injuries [49], child maltreatment injuries [56] and child maltreatment cases [52,56]; though one was not statistically significant [52]. However, some measure of behavior change was assessed in more than half (58.8%) of the studies [46,47,[49][50][51][52][53][56][57][58][59]. Significant decreases were seen in child behavior problems [47,[57][58][59] and in dysfunctional or coercive parenting behaviors [47,51,57,59].…”

“…However, some measure of behavior change was assessed in more than half (58.8%) of the studies [46,47,[49][50][51][52][53][56][57][58][59]. Significant decreases were seen in child behavior problems [47,[57][58][59] and in dysfunctional or coercive parenting behaviors [47,51,57,59]. Two studies reported increases in calls to helplines to report child abuse cases [46,52].…”

Broadening the reach of evidence-based parenting interventions: Evaluation of a brief online version of the Triple P – Positive Parenting Program

“…The most comprehensive meta-analysis conducted to date (Sanders, Kirby, et al, 2014) revealed significant short-and long-term improvements for children's social, emotional and behavioural outcomes (medium effect), parenting practices (medium effect), parenting satisfaction and efficacy (medium effect), parental adjustment (small-medium effect) and parental relationship (small effect). Several studies have also investigated the effects of Triple P as a public-health intervention and recorded significant population-level impact across a range of outcomes including behavioural and emotional problems in children, parent-child relationship, coercive parenting, and parental depression and stress (Fives, Pursell, Heary, Nic Gabhainn, & Canavan, 2014;Sanders et al, 2008;Sarkadi, Sampaio, Kelly, & Feldman, 2014), as well as reduced incidence of child abuse, and hospitalisations, injuries and outof-home placements due to maltreatment (Prinz, Sanders, Shapiro, Whitaker, & Lutzker, 2009). …”