The Triple P System of Evidence-Based Parenting Support: Past, Present, and Future Directions

Triple P is an integrated, multi-level system of evidence-based parenting support designed to promote the well-being of children and families to reduce prevalence rates of social, emotional, and behavioral problems in children and adolescents and to prevent child maltreatment. The system developed gradually over four decades to address the complex needs of parents and children from diverse family, socioeconomic and cultural backgrounds. It blends universal and targeted programs, a focus on developing parental self-regulation capabilities, and adopts a life span perspective with a population health framework. The Triple P system is used as a case example to discuss the past, present and future challenges, and opportunities involved in developing, evaluating, adapting, scaling and maintaining a sustainable system of evidence-based parenting intervention. Seven stages of program development are outlined from initial theory building and development of the core parenting program through to the sustained deployment of the intervention system delivered at scale. The importance of ongoing research and evaluation is highlighted so that different programs within the system evolve and adapt to address the contemporary concerns and priorities of families in diverse cultural contexts. A well-trained workforce is essential to deliver evidence-based programs, in a need-responsive manner that blends both fidelity of delivery and flexibility and is tailored to respond to the needs of individual families and local context. Programs need to be gender-sensitive, culturally informed, and attuned to the local context including relevant policies, resources, cultural factors, funding, workforce availability and their capacity to implement programs.

Scaling Up Parenting Interventions is Critical for Attaining the Sustainable Development Goals

Of all the potentially modifiable influences affecting children's development and mental health across the life course, none is more important than the quality of parenting and family life. In this position paper, we argue that parenting is fundamentally linked to the development of life skills that children need in order to achieve the United Nations Sustainable Development Goals. We discuss key principles that should inform the development of a global research and implementation agenda related to scaling up evidence-based parenting support programs. Research over the past 50 years has shown that parenting support programs of varied intensity and delivery modality can improve a wide range of developmental, emotional, behavioral and health outcomes for parents and their children. Such findings have been replicated across culturally and socioeconomically diverse samples, albeit primarily in studies from Western countries. We highlight the evidence for the relevance of parenting interventions for attaining the SDGs globally, and identify the barriers to and strategies for achieving their scale-up. The implications of the global COVID-19 pandemic for the delivery of evidence-based parenting support are also discussed.

Te Whānau Pou Toru: a Randomized Controlled Trial (RCT) of a Culturally Adapted Low-Intensity Variant of the Triple P-Positive Parenting Program for Indigenous Māori Families in New Zealand

Evidence-based parenting support programs (EBPS) based on social learning and cognitive behavioral principles are effective in reducing conduct-related problems in a diverse range of cultural contexts. However, much less is known about their effects with indigenous families. A Collaborative Participation Adaptation Model (CPAM) was used to culturally adapt a low-intensity, two-session group variant of the Triple P-Positive Parenting Program for Māori parents of young children in New Zealand. CPAM involved collaborating closely with Māori tribal elders, practitioners as end-users, and parents as consumers through a participatory process to identify content and delivery process used in Triple P that would ensure that traditional Māori cultural values were incorporated. The culturally adapted program (Te Whānau Pou Toru) was then evaluated with 70 parents of 3-7-year-old children in a two-arm randomized clinical trial (intervention vs waitlist control). Results showed that parents in the intervention group reported significantly greater improvements in child behavior problems and reduced interparental conflict about child-rearing compared to parents in the control group at immediate post-intervention. These intervention effects were either maintained or improved further at follow-up assessment. At 6-month follow-up intervention-group parents reported significantly greater reductions in overreactive parenting practices and greater confidence in managing a range of difficult child behaviors than control parents. The culturally adapted program was associated with high levels of parental satisfaction. Findings are discussed in terms of making brief, effective, culturally adapted parenting support available to Māori families.

Progress in Nurturing Human Well-Being

Substantial evidence in the behavioral and social sciences has accrued in support of numerous intervention programs and policies bearing on improving the lives of children and families. To this end, Clinical Child and Family Psychology Review features a special journal issue on "Evolving Toward a More Nurturing Society." The field has achieved numerous advances regarding how to create and promote nurturing environments that foster successful development and prevent psychological and behavioral problems in children and youth. Such advances cut across multiple strategies (e.g., programs and interventions, practices, and public policies), settings (e.g., family, school including preschool and K-12, service sectors, community), domains (e.g., behavioral health, parenting, cognitive and academic functioning, nutrition, physical activity, obesity, safety, and many other domains), and developmental periods of childhood. The special journal issue showcases a sampling of strategies and domains relevant to producing optimal conditions of nurturance for children and families.