Categories associated with best practice:
Determinants of Health: Personal health practices and coping skills, Education, literacy and life-long learning, Physical environment, Social environments, Social support networks, Access to health services, Healthy child development, Other
Triple P – Positive Parenting Program is a multi-level parenting and family support strategy. It aims to prevent severe behavioural, emotional and developmental problems in children by enhancing the knowledge, skills and confidence of parents.
The program is formed on the basis of five core positive-parenting principles that address specific risk and protective factors known to predict positive developmental and mental health outcomes in children:
- ensuring a safe and engaging environment
- creating a positive learning environment
- using assertive discipline
- having realistic expectations
- taking care of oneself as a parent
These five principles translate into 35 specific strategies and parenting skills that can be grouped into several major categories: parent-child relationship enhancement, encouraging desirable behaviour, teaching new skills and behaviours, managing misbehaviours, preventing problems in high-risk situations, self-regulation skills, parental mood-management and coping skills, and partner support and communication skills.
The program has five levels of intervention of increasing strength and narrowing reach. Level 1 targets the entire population through information-based strategies using the media. Selected Triple P (Level 2) is a l- to 2-session brief consultation program for parents with a specific concern about their child’s behaviour or development. Selected Triple P comprises three 120-minute seminars that can be delivered as either a stand-alone intervention whereby parents participate in only one seminar at a time (without necessarily undertaking any more than one seminar), or as part of an integrated series whereby parents undertake all three seminars across a period of several weeks. Primary Care Triple P (Level 3) is a 4-session brief consultation model for use in a primary care setting, such as child health services and family medicine, meant for parents who have a specific concern about their child and who require consultations or active skills training. Level 4 interventions are intensive 8- to 10-session parenting skills programs that can be delivered in group, individual, and self-help formats. Enhanced Triple P (Level 5) provides adjunctive interventions for families in which parenting concerns occur in the context of other major adult adjustment problems, such as marital conflict and depression. In addition to the 5 levels of the system, a number of empirically validated derivative programs have been developed.
There have been a large number of evaluations completed on the Triple P intervention, focusing on the different levels of the intervention, as well as different modes of delivery. The evaluations tend to report large effect sizes in treatment outcomes, with good maintenance of treatment gains, and high levels of participant satisfaction. Evaluations of the Triple P have consistently shown positive effects on observed and parent-reported child behaviour problems, parenting practices, and parents’ adjustment across sites, investigators, family characteristics, cultures and countries.
Primary Source Document
Sanders MR, The Triple P - Positive Parenting Program as a public health approach to strengthening parenting Journal of Family Psychology; 22(3): 506-517
Contact information of developer(s) and/or implementer(s)
University of Queensland
Triple P America
Telephone: (803) 451-2278
|Intervention Goal / Objective||Level(s) Targeted||Equity Focus|
|Put evidence-based parenting into the hands of parents across the world.||People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.|
|Normalise the concept of parenting programs so parents feel comfortable asking for help.||People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.|
|Deliver the exact amount of support a parent needs – enough but not too much.||People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.|
|Provide communities with population-level early intervention to prevent child abuse, mental illness and anti-social behaviour.|
|Give parents the confidence and skills to be self-sufficient - to manage problems independently.|
Health Issue(s) that is/are addressed by the Intervention
- Mental Health
Specific Activities of the Intervention
- Counselling sessions to those who are at high risk for a chronic disease
- Educational health information offered
- Information sessions offered about a risk factor or condition
- Media advocacy
- Group process/program
- Provision of planning tools and evaluation tools
Priority/Target Population for Intervention Delivery
- Infancy (birth to 2 years)
- Early childhood (age 3-5 years)
- Children (age 6-12 years)
- Youth (age 13-18 years)
- Young adult (age 19-24 years)
- Adults (age 25-64 years)
- Early learning environment (ages 0-5)
- Secondary/Middle school
- Before/after school childcare (ages 5-12)
- Elementary school
- Health care setting
|Outcomes and Impact Chart|
|Level of Impact||Description of Outcome||Equity Focus|
|Interpersonal Level||Teachers at the intervention schools reported a significantly greater improvement in children’s behaviour than did teachers at control schools. While the number of student behaviour problems (problems with teachers, peers or self) reported by teachers in the control group remained the same over time, students in the intervention group became significantly less problematic. And with respect to the intensity of problem behaviours, while students at the intervention schools improved slightly from pre- to post-assessment the behaviour of the students in the control group became significantly more disruptive at post intervention. The improved school behaviour in intervention schools was sustained at 6-month follow-up.||Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.|
- Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.
Expertise Required for Implementation within the Context of the Intervention
- No specialized skills required - The Intervention was designed for use/implementation by individuals or groups without highly specialized training. It can be implemented by volunteers, program staff, themselves, etc.
Are there supports available for implementation
Yes. In addition to training for implementers, Triple P International has an implementation and sustainability framework that helps and supports agencies and communities as they deliver the program. The Implementation Framework (the Framework) is adapted from current evidence-based implementation models including RE-AIM and the National Implementation Research Network (NIRN). The Framework is flexible and follows two key principles of Triple P – self-regulation and minimal sufficiency. That means it's a guide to support those implementing Triple P, but the level of support is tailored to match the needs and resources of the agency. The Framework draws on the emerging field of research into the implementation of evidence-based practices (EBPs), with a specific focus on the growing body of research on the implementation of Triple P. Triple P implementation experts in a region always work closely with the implementing organisation or collaborative to help ensure the Framework supports the delivery, as best it can. The Framework supports the full range of implementation possibilities – from small, single organisation implementation to complex, multi-sector public health approaches.
Are there resources and/or products associated with the interventions
Yes. Each intervention within a level has its own facilitator's kit, which is given to practitioners during training. The kits may include professionally-produced videos, PowerPoint presentations, flipcharts, manuals and workbooks. Some practitioner resources have been translated into other languages, including Spanish, Dutch, German, Japanese, French and Swedish. Parent resources are designed to be practical and are tailored to each level and each intervention. They are professionally produced and clinically tested, and are variously available in 18 languages. Parent workbooks, DVDs and tip sheets provide enough information for the parent to remember the strategies and practise them at home, without overloading them with unnecessary details or theories.