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Triple P Online

Topic Areas
Scientific Rating
Child Welfare Relevance
Parent Training Programs that Address Behavior Problems in Children and Adolescents
2  — Supported by Research Evidence
Medium

About This Program

Target Population: All parents or caregivers of children ages 0-12 years

For parents/caregivers of children ages: 0 – 12

Program Overview

Triple P Online is one of the interventions within the Triple P – Positive Parenting Program® System, which is designed to help parents learn strategies to promote social competence and self-regulation in children as well as decrease problem behavior. There are eight (1-hour) online modules that can be completed using a computer, tablet, or smartphone. Parents are guided to apply simple strategies in specific situations to encourage positive behavior and to prevent and respond assertively when problems occur. Triple P Online is interactive and provides videos, activities, and built-in motivational support including reminder emails and in-program encouragement to reinforce skill development and enhance parental engagement and completion. Parents may download their workbook, a variety of parent tipsheets, and other material for future reference.

Triple P Online was adapted from the in-person version of Triple P - Positive Parenting Program® - Level 4 Standard Triple P.

Program Goals

The goals of Triple P Online are:

  • Improve mental health, including reduce stress, depression, and anger related to parenting children.
  • Reduce behavioral problems in children being parented, including conduct disorders and attention-deficit/hyperactivity disorder (ADHD).
  • Reduce conflict with children being parented.
  • Reduce risk of maltreating children being parented.
  • Prevent development, or worsening, of mental health disorders in children being parented through enhancing the parenting knowledge, skills, and confidence.

Logic Model

View the Logic Model for Triple P Online.

Essential Components

The essential components of Triple P Online include:

  • Uses an explicit self-regulatory framework, including principles of:
    • Self-sufficiency
    • Self-efficacy
    • Self-management
    • Problem-solving
  • Teaches parents how to monitor their own and their child’s behavior and to set specific and observable goals for change
  • Minimal sufficiency to ensure cost effectiveness including the ability to tailor delivery to meet individual family needs:
    • Ability to provide the program directly to parents with little administrative and practitioner contact
    • Ability to provide the program in combination with other strategies, such as telephone calls, to support families requiring more intensive support
  • The use of videos to provide a balance of simplicity and interactivity, including multiple, relevant family examples to create an engaging and practical learning environment
  • Flexibility to meet family needs and preferences as to when and where they access the program, with self-paced learning to progress through course content and revisit the information over a 12-month period to consolidate positive change
  • An online delivery modality to increase the population reach, particularly suited to families with busy schedules, who are geographically isolated, or who have the inability to attend regular parenting courses
  • Parents and caregivers of the same children have flexibility to be able to do the program together or support each other throughout, and are encouraged to share their parenting plans with each other and/or additional supports as they go
  • Core parenting strategies are introduced across eight modules:
    • What is positive parenting? (e.g., creating a safe environment; having realistic expectations)
    • Encouraging behavior you like (e.g., quality time; paying attention)
    • Teaching new skills (e.g., managing their feelings; becoming independent)
    • Managing misbehavior (e.g., ground rules; consequences)
    • Dealing with disobedience (e.g., common parent traps; giving effective instructions)
    • Planning ahead to prevent problems (e.g., Planning for high-risk times; deciding on rules)
    • Making shopping fun (e.g., encouraging good behaviors; dealing with difficult behavior)
    • Raising confident, capable kids (e.g., being considerate; developing good social skills)
  • Each module:
    • Contains brief video clips of families demonstrating Triple P strategies
    • Includes an interactive activity after each clip to reinforce the use of the strategy and to stimulate further thought (e.g., checklist, rating scale, multiple choice quiz)
    • Ends with a ‘get active’ section that asks the user to develop achievable goals and set homework tasks, to consolidate learning, and to encourage between-session practice
    • Provides in-program encouragement, including award of virtual badges for the completion of activities
    • Provides access to a variety of extra resources (e.g., worksheets including monitoring forms and information sheets; podcast audio content; an email with a module summary)
    • Provides access to a Q&A section that contains commonly asked questions
    • Continuously imports a text summary of the content presented in the videos and responses to activities to an individualized workbook that can be printed or emailed

Program Delivery

Parent/Caregiver Services

Triple P Online directly provides services to parents/caregivers and addresses the following:

  • Behavioral, social, emotional, or developmental concerns for a child that are either anticipatory or mild to moderate in nature; also parental behavioral, social, and/or emotional concerns including interparental conflict, anger, depression, anxiety, stress, low parenting confidence, and low sense of self-efficacy

Recommended Intensity:

Eight 1-hour online modules that parents complete independently on their own time

Recommended Duration:

Recommended completion of one module per week for eight weeks, however parents have access to the program for 12 months

Delivery Setting

This program is typically conducted in a(n):

  • Virtual (Online, Telephone, Video, Zoom, etc.)

Homework

Triple P Online includes a homework component:

Each Triple P Online module ends with a ‘get active’ section that asks the user to develop achievable goals and set homework tasks, to consolidate learning, and to encourage between-session practice. Homework could include monitoring of parent behavior, implementation of positive parenting strategies (e.g., behavior charts) and discipline routines, practice sessions with child, and planned discussion with parenting partner.

Languages

Triple P Online has materials available in languages other than English:

Arabic, Dutch, Flemish, French, German, Japanese, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Parents receive a Triple P Online access code and will require access to a web-enabled device, such as a computer, tablet, or smartphone. If Triple P Online is being paired with practitioner support, both practitioners and parents will need access to a phone and a secure phone or video conferencing line. Agencies can either purchase access codes in bulk and provide these to parents, or parents can purchase an access code directly from the Triple P parent website. Access codes are valid for 12 months.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

A practitioner is not required to deliver Triple P Online unless telephone support is to be provided to families. Telephone support is an optional service that agencies can provide to parents. Telephone support time can be estimated at one hour per family requiring support (up to four 15-minute telephone calls). Practitioners providing clinical support for Triple P Online need to be familiar with Triple P and Triple P Online.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

As is it an online program, a support handbook is available in lieu of a manual:

  • Triple P International. (2020). Triple P Online support handbook. Author.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

If there is no practitioner involvement in delivery, there will not be the need for Triple P training. However, if the implementing organization wishes practitioners to provide support to parents completing the program, various training options are available depending on the scope of the initiative. A Triple P Implementation Consultant will discuss with the organization what will be the most appropriate training and/or practitioner support options based on the goals of the organization.

Training can be provided onsite with an agency or organization hosting the training or delivered remotely via videoconference.

Number of days/hours:

Times will vary based on the implementation plan for Triple P Online for the organization (e.g., how parents are referred, whether practitioner support will be an option for parents).

Webinars and workshops are available for organizations and practitioners that will refer and support families completing Triple P Online. Triple P training and accreditation is available for practitioners that will provide clinical support to families. A Triple P Implementation Consultant will work with each organization to determine the best training plan for the organization’s goals for Triple P Online.

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Triple P Online as listed below:

Support using the Triple P Implementation Framework includes several pre-implementation materials to measure organizational or provider readiness and additional tools designed to support agencies in the successful adoption of Triple P. Examples of these documents include:

  • Implementation Workbook
  • Implementation Preparation Form
  • Organizational Readiness Checklist
  • Quality Assurance Considerations
  • Evaluation Checklist
  • Sustainability Considerations
  • Shared Learning Networks

Triple P Implementation Tools are provided with support from an Implementation Consultant for agencies adopting Triple P.

Please contact Triple P America for further information: contact.us@triplep.net.

Formal Support for Implementation

There is formal support available for implementation of Triple P Online as listed below:

Triple P America employs Implementation Consultants who are available from point of interest through the implementation process, providing technical support, coaching, and consultation. Implementation Consultants provide support through a mix of onsite, teleconferencing, webinar, and email support. Implementation Consultants support organizations in the implementation planning process and sharing of Triple P implementation tools for agencies/jurisdictions adopting Triple P. This support is available throughout an initiative; often more intensive at first and tapering off as sites/jurisdictions develop effective plans for maintenance.

Triple P America provides consultation, resources and tools related to evaluation and fidelity monitoring. Implementation Consultants use the tools from the Triple P Implementation Framework to foster local ownership of the intended outcomes and processes for evaluation. Sites are supported in fostering effective leadership and following best practices for workforce development, service delivery, and quality improvement cycles. The Triple P Online Management System is a platform available to support organizational monitoring and reporting to enhance the adoption and sustainability of Triple P.

Implementation Consultants provide support for administrators and managers of initiatives and, along with Triple P Trainers, are an available resource to sites seeking additional consultation and support for practitioners through developed workshops, tailored support days, and/or consultation calls at an additional cost.

Fidelity Measures

There are fidelity measures for Triple P Online as listed below:

Fidelity measures for Triple P Online include The Triple P Online Support Session Checklist. This checklist is used by practitioners when providing support to parents completing Triple P Online, to assist in implementing the service as intended. Practitioners/organizations are also able to track the progress of parents to ensure the completion of relevant modules the Triple P Online Management System. Organizations have the flexibility to utilize these instruments as self-assessments or in more formal quality assurance procedures.

Implementation Guides or Manuals

There are implementation guides or manuals for Triple P Online as listed below:

There are a range of documents and guides available to agency leadership and managers to provide guidance on organizational and systems level factors. Implementation Consultants use the tools and processes in the Triple P Implementation Framework to support organizations to develop their own handbook of implementing Triple P. This handbook provides a context-specific guide for those responsible for coordinating the implementation of Triple P within that organization or region.

Examples of Triple P Implementation Framework tools and guides include:

  • Implementation Workbook
  • Implementation Preparation Form
  • Organizational Readiness Checklist
  • Quality Assurance Considerations
  • Evaluation Checklist
  • Sustainability Considerations
  • Shared Learning Networks

Please contact Triple P America for further information: contact.us@triplep.net.

Implementation Cost

There have been studies of the costs of implementing Triple P Online which are listed below:

There have been studies evaluating the cost effectiveness of the Triple P System, of which Triple P Online is a part of, as listed below:

Research on How to Implement the Program

Research has been conducted on how to implement Triple P Online as listed below:

Research has been conducted on implementation of the Triple P System, of which Triple P Online is a part of, as listed below:

  • Aldridge, W. A., II, Murray, D. W., Prinz, R. J., & Veazey, C. A. (2016). Final report and recommendations: The Triple P implementation evaluation, Cabarrus and Mecklenburg counties, NC. Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill. https://fpg.unc.edu/publications/final-report-and-recommendations-triple-p-implementation-evaluation-cabarrus-and
  • Asgary-Eden, V., & Lee, C. M. (2012). Implementing an evidence-based parenting program in community agencies: What helps and what gets in the way? Administration and Policy in Mental Health and Mental Health Services Research, 39(6), 478–488. https://doi.org/10.1007/s10488-011-0371-y
  • Breitkreuz, R., McConnell, D., Savage, A., & Hamilton, A. (2011). Integrating triple P into existing family support services: A case study on program implementation. Prevention Science, 12(4), 411–422. https://doi.org/10.1007/s11121-011-0233-6
  • Fawley-King, K., Trask, E., Calderon, N. E., Aarons, G. A., & Garland, A. F. (2014). Implementation of an evidence-based parenting programme with a Latina population: feasibility and preliminary outcomes. Journal of Children's Services, 9, 295–306. https://doi.org/10.1108/JCS-04-2014-0024
  • Fives, A., Pursell, L., Heary, C., Nic Gabhainn, S., & Canavan, J. (2014). Parenting support for every parent: A population-level evaluation of Triple P in Longford Westmeath. Final report. Longford Westmeath Parenting Partnership. https://www.researchgate.net/publication/283903988_Parenting_support_for_every_parent_A_population-level_evaluation_of_Triple_P_in_Longford_Westmeath_Final_Report
  • Mazzucchelli, T. G. & Sanders, M. R. (2010). Facilitating practitioner flexibility within evidence-based practice: Lessons from a system of parenting support. Clinical Psychology: Science and Practice, 17(3), 238–252. https://doi.org/10.1111/j.1468-2850.2010.01215.x
  • McPherson, K. E., Sanders, M. R., Schroeter, B., Troy, V., & Wiseman, K. (2016). Acceptability and feasibility of Peer Assisted Supervision and Support for intervention practitioners: A Q-methodology evaluation. Journal of Child and Family Studies, 25(3), 720–732. https://link.springer.com/article/10.1007%2Fs10826-015-0281-9
  • McWilliam, J., Brown, J., Sanders, M. R., & Jones, L. (2016). The Triple P implementation framework: The role of purveyors in the implementation and sustainability of evidence-based programs. Prevention Science, 17, 636–645. https://doi.org/10.1007/s11121-016-0661-4
  • Morawska, A., Sanders, M., Goadby, E., Headly, C., Hodge, L., McAuliffe, C., Page, S., & Anderson, E. (2011). Is the Triple P-Positive Parenting Program acceptable to parents from culturally diverse backgrounds? Journal of Child and Family Studies, 20, 614–622. https://doi.org/10.1007/s10826-010-9436-x
  • Romney, S., Israel, N., & Zlatevski, D. (2014). Exploration-stage implementation variation: Its effect on the cost-effectiveness of an evidence-based parenting program. Zeitschrift für Psychologie, 22, 37–48. https://doi.org/10.1027/2151-2604/a000164
  • Sanders, M. R., Prinz, R. J., & Shapiro, C. J. (2009). Predicting utilization of evidence-based parenting interventions with organizational, service-provider and client variables. Administration and Policy in Mental Health and Mental Health Services Research, 36(2), 133–143. https://doi.org/10.1007/s10488-009-0205-3
  • Seng, A. C., Prinz, R. J., & Sanders, M. R. (2006). The role of training variables in effective dissemination of evidence-based parenting interventions. The International Journal of Mental Health Promotion, 8, 20–28. https://www.tandfonline.com/doi/abs/10.1080/14623730.2006.9721748
  • Shapiro, C. J., Prinz, R. J., & Sanders, M. R. (2012). Facilitators and barriers to implementation of an evidence-based parenting intervention to prevent child maltreatment the Triple P-Positive Parenting Program. Child Maltreatment, 17(1), 86–95. https://doi.org/10.1177/1077559511424774
  • Shapiro, C. J., Prinz, R. J., & Sanders, M. R. (2015). Sustaining use of an evidence-based parenting intervention: Practitioner perspectives. Journal of Child and Family Studies, 24, 1615–1624. https://doi.org/10.1007/s10826-014-9965-9
  • Van Mourik, K., Crone, M. R., & Reis, R. (2018). Relevance of the intervention module "Coping with stress and unhelpful emotions" for parents living in multi-ethnic deprived neighborhoods. Children and Youth Services Review, 88, 426–433. https://doi.org/10.1016/j.childyouth.2018.03.036

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Sanders, M. R., Baker, S., & Turner, K. M. T. (2012). A randomized controlled trial evaluating the efficacy of Triple P Online with parents of children with early-onset conduct problems. Behaviour Research and Therapy, 50, 675–684. https://doi.org/10.1016/j.brat.2012.07.004

Type of Study: Randomized controlled trial
Number of Participants: 116 families

Population:

  • Age — Parents: 23–50 years (Mean=37.37 years); Children: 2–9 years (Mean=4.7 years)
  • Race/Ethnicity — Parents: 91% Australian; Children: Not specified
  • Gender — Parents: 91% Female; Children: 67% Male
  • Status — Participants were parents with children displaying early onset disruptive behavior difficulties.

Location/Institution: Australia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Triple P Online for parents of children with early-onset disruptive behavior problems. Participants were randomly assigned to either Triple P Online or an internet use-as-usual control group. Measures utilized include the Family Background Questionnaire (FBQ), Eyberg Child Behavior Inventory (ECBI), Strengths and Difficulties Questionnaire (SDQ), Parenting Scale (PS), Parenting Tasks Checklist (PTC), Depression Anxiety Stress Scales (DASS-21), Parental Anger Inventory (PAI), Parent Problem Checklist (PPC), and Client Satisfaction Questionnaire (CSQ). Results indicate that at postintervention assessment, parents receiving Triple P Online had significantly better outcomes on measures of problem child behavior, dysfunctional parenting styles, parents’ confidence in their parenting role, and parental anger. At the 6-month follow-up assessment intervention gains were generally maintained, and in some cases enhanced. Consumer satisfaction ratings for the program were high. Limitations include small sample size, the underrepresentation of low-income families, generally low base rates of negative behaviors during the observation tasks, and length of follow-up.

Length of controlled postintervention follow-up: 6 months.

Dittman, C. K., Farruggia, S. P., Palmer, M. L., Sanders, M. R., & Keown, L. J. (2014). Predicting success in an online parenting intervention: The role of child, parent, and family factors. Journal of Family Psychology, 28(2), 236–243. https://doi.org/10.1037/a0035991

Type of Study: Randomized controlled trial
Number of Participants: 89 families

Population:

  • Age — Mothers: Mean=37.58 years and Fathers: Mean=39.44 years; Children: 3–8 years (Mean=5.63 years)
  • Race/Ethnicity — Parents: 100% New Zealand; Children: 92% New Zealand European, 4% Maori, and 4% Pacific Islander
  • Gender — Parents: Not specified; Children: 71% Male
  • Status — Participants were parents of children with elevated levels of disruptive behavior problems.

Location/Institution: New Zealand

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the extent to which a wide range of child, parent, family, and program-related factors predicted child behavior and parenting outcomes after participation in an 8-session online version of the Triple P–Positive Parenting Program [now called Triple P Online]. Participants were randomly assigned to receive Triple P Online or the Every Parent’s Workbook. Measures utilized include the Family Background Questionnaire (FBQ), the Eyberg Child Behavior Inventory (ECBI), the Child Abuse Potential Inventory (Brief CAP), the Parenting Scale (PS), the Parenting Tasks Checklist (PTC), the Depression Anxiety Stress Scales (DASS-21), the Parental Anger Inventory (PAI), and the Parent Problem Checklist (PPC). Results indicate that for both mothers and fathers, poorer child behavior outcomes at postintervention were predicted by the number of sessions of Triple P Online completed by the family. For mothers, postintervention child behavior was also predicted by the quality of the mother–child relationship at baseline; for fathers, baseline child behavior severity was an additional predictor. Mothers’ postintervention ineffective parenting was predicted by session completion and preintervention levels of ineffective parenting, whereas the only predictor of fathers’ ineffective parenting at postintervention was preintervention levels of ineffective parenting. Socioeconomic risk, parental adjustment, and father participation in the Triple P Online were not significant predictors of mother- or father-reported treatment outcomes. Limitations include small sample size, the study focused on Triple P Online participants only, there was limited cultural and ethnic diversity of participants and mostly comprised of well-educated parents, parents self-referred from the community rather than being clinic-referred, children displayed clinically elevated but not formally diagnosed disruptive behavior problems, and lack of follow-up

Length of controlled postintervention follow-up: None.

Sanders, M. R., Dittman, C. K., Farruggia, S. P., & Keown, L. J. (2014). A comparison of online versus workbook delivery of a self-help positive parenting program. Journal of Primary Prevention, 35(3), 125–133. https://doi.org/10.1007/s10935-014-0339-2

Type of Study: Randomized controlled trial
Number of Participants: 193 families

Population:

  • Age — Mothers: Mean=37.19 years and Fathers: Mean=39.63 years; Children: 3–8 years (Mean=5.63 years)
  • Race/Ethnicity — Parents: Not specified; Children: 90% New Zealand European
  • Gender — Parents: Not specified; Children: 67% Male
  • Status — Participants were families of children displaying early onset disruptive behavior difficulties.

Location/Institution: New Zealand

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare the efficacy of two self-help variants of the Triple P-Positive Parenting Program: an online version [now called Triple P Online] and a self-help workbook. Participants were randomly assigned to Triple P Online or Every Parent’s Self-Help workbook (Self-Help Triple P; SHTP) interventions. Measures utilized include the Relationship Quality Inventory (RQI), the Child Abuse Potential inventory (Brief CAP), the Client Satisfaction Questionnaire (CSQ), the Eyberg Child Behavior Inventory (ECBI), the Parenting Scale (PS), the Parenting Tasks Checklist (PTC), the Depression Anxiety Stress Scales (DASS-21), the Parental Anger Inventory (PAI), and the Parent Problem Checklist (PPC). Results indicate that the short-term intervention effects of the Triple P Online program were not inferior to the workbook on the primary outcomes of disruptive child behavior and dysfunctional parenting as reported by both mothers and fathers. Both interventions were associated with significant and clinically meaningful declines from preintervention to postintervention in levels of disruptive child behavior, dysfunctional parenting styles, risk of child maltreatment, and interparental conflict on both mother and father report measures. Intervention effects were largely maintained at 6-month follow-up. Limitations include small sample size and length of follow-up.

Length of controlled postintervention follow-up: 6 months.

Ehrensaft, M. K., Knous-Westfall, H. M., & Lopez Alonso, T. (2016). Web-based prevention of parenting difficulties in young, urban mothers enrolled in post-secondary education. The Journal of Primary Prevention, 37(6), 527–542. https://doi.org/10.1007/s10935-016-0448-1

Type of Study: Randomized controlled trial
Number of Participants: 52 families

Population:

  • Age — Parents: 23.76–24.97 years; Children: 2–6 years
  • Race/Ethnicity — Not specified
  • Gender — Parents: 100% Female; Children: Not specified
  • Status — Participants were young mothers with elevated parenting stress that were pursuing postsecondary education in an urban, inner city.

Location/Institution: John Jay College of Criminal Justice, New York City

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to assess the efficacy of Triple P Online in reducing parenting stress and dysfunctional discipline. Participants were randomly assigned to either the web-based intervention condition (Triple P Online) or a waitlist control group. Measures utilized include the Family Background Questionnaire (FBQ), the Parenting Stress Index—Short Form (PSI-SF), and the Parenting Scale (PS). Results indicate that mothers who completed at least the first four core modules of Triple P Online had lower scores on the Parenting Scale’s subscales (Overreactivity, Verbosity, and Laxness), compared to those who did not complete four or more modules. No intervention effects were obtained for parenting stress. Limitations include small sample size; 31% of the parenting program group was lost at postintervention assessment and compliance rates for those in the parenting program were relatively modest; and findings may or may not generalize to mothers attending other postsecondary educational programs in nonurban areas.

Length of controlled postintervention follow-up: None.

Day, J. J., & Sanders, M. R. (2017). Mediators of parenting change within a web-based parenting program: Evidence from a randomized controlled trial of Triple P Online. Couple and Family Psychology: Research and Practice, 6(3), 157–170. https://doi.org/10.1037/cfp0000083

Type of Study: Randomized controlled trial
Number of Participants: 183 families

Population:

  • Age — Parents: 22–51 years (Mean=34.9 years); Children: 1–8 years (Mean=3.5 years)
  • Race/Ethnicity — Parents: 93% White and 7% Other; Children: Not specified
  • Gender — Parents: 96% Female; Children: 53% Female
  • Status — Participants were parents with concerns around managing their child’s behavior.

Location/Institution: Australia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine whether measurable and modifiable factors such as a parent’s initial level of distress could predict response to Triple P Online treatment both with and without professional support, and explore its impact on the putative mediating pathway of self-efficacy as a key mechanism of reductions in negative parenting as well as to examine whether professional consultations were primarily responsible for improving outcomes through increasing program engagement, likely due to added accountability and its impact on motivation. Participants were randomly assigned to Triple P Online, Triple P Online enhanced with clinical telephone consultations (TPOLe), or waitlist control (WL). Measures utilized include the Parenting Tasks Checklist, the 21-item Depression, Anxiety and Stress Scale (DASS-21), and the Parenting Scale (PS). Results indicate that self-efficacy was associated with the treatment-negative parenting pathway when parents were provided with professional support, whereas in the absence of support, this pathway was disrupted for parents experiencing high levels of distress before treatment. Additionally, a plausible model was developed showing that telephone consultations influenced program engagement but had additional effects on negative parenting not explained by Triple P Online alone. Limitations include small sample size, numerous other contextual factors not included in the models are likely to contribute to both engagement and outcomes in an online parenting intervention, lack of overall diversity in the sample, and length of follow-up.

Length of controlled postintervention follow-up: 5 months.

Day, J. J., & Sanders, M. R. (2018). Do parents benefit from help when completing a self-guided parenting program online? A randomized controlled trial comparing Triple P Online with and without telephone support. Behavior Therapy, 49(6), 1020–1038. https://doi.org/10.1016/j.beth.2018.03.002

Type of Study: Randomized controlled trial
Number of Participants: 183 families

Population:

  • Age — Parents: 22–51 years (Mean=34.9 years); Children: 1–8 years (Mean=3.5 years)
  • Race/Ethnicity — Parents: 93% White and 7% Asian, Pacific Islander, or Arab; Children: Not specified
  • Gender — Parents: 96% Female; Children: 53% Female
  • Status — Participants were parents of children with concerns about their child’s behavior and at least one area of disadvantage or family difficulty.

Location/Institution: Australia

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Day et al. (2017). The purpose of the study was to examine whether the core benefits of self-directed participation in online parenting interventions are counterbalanced by issues such as high dropout and noncompletion rates commonly reported within the Internet intervention literature. Participants were randomly assigned to Triple P Online only, Triple P Online enhanced with clinical telephone consultations (TPOLe), or waitlist control (WL). Measures utilized include the Parenting Tasks Checklist, the 21-item Depression, Anxiety and Stress Scale (DASS-21), and the Parenting Scale (PS). Results indicate that Triple P Online self-directed participants showed short-term treatment effects, including reductions in overall negative parenting and frequency of child behavior problems, while practitioner support led to greater improvements in negative parenting and intensity of difficult child behaviors. Participants in the supported condition were also more likely to complete modules and reported greater program satisfaction. At follow-up, 50% of outcomes for the Triple P Online self-directed condition were significantly better than the control, while 94% of outcomes were significantly better than the control in the practitioner-supported condition. Limitations include small sample size, the lack of assessment of comorbidity of child and family difficulties, lack of overall diversity in the sample, found no treatment effects other than a general decrease in reported negative child and parent behaviors over time for all conditions, and length of follow-up.

Length of controlled postintervention follow-up: 5 months.

Franke, N., Keown, L. J., & Sanders, M. (2020). An RCT of an online parenting program for parents of preschool-aged children with ADHD symptoms. Journal of Attention Disorders, 24(12), 1716–1726. https://doi.org/10.1177/1087054716667598

Type of Study: Randomized controlled trial
Number of Participants: 53 families

Population:

  • Age — Parents: Mothers: Mean=35.4 years and Fathers: Mean=38.8 years; Children: 3–4 years (Mean=4.0 years)
  • Race/Ethnicity — Parents: Not specified; Children: 79% New Zealand European
  • Gender — Parents: 43 Male and 10 Female; Children: 72% Male
  • Status — Participants were parents of preschoolers with elevated and impairing levels of ADHD symptoms.

Location/Institution: New Zealand

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of an online self-help program, Triple P Online, in a sample of parents of preschoolers with ADHD symptoms. Participants were randomly assigned to the intervention group or the delayed intervention group. Measures utilized include the Werry–Weiss–Peters (WWP) Activity Rating Scale, the Parental Account of Child Symptoms (PACS), the Adult ADHD Self-Report Scale (ASRS), the Conners Early Childhood Behavior (Conners EC-BEH) Scale, the Child Behavior Scale (CBS), the Strengths and Difficulties Questionnaire (SDQ), the Parenting Scale (PS), the Authoritative Parenting Scale of the Parenting Styles and Dimensions Questionnaire (PSDQ), Depression Anxiety Stress Scales (DASS-21), the Parenting Sense of Competence (PSOC), and the Client Satisfaction Questionnaire (CSQ). Results indicate that there were significant postintervention improvements in mother-rated child hyperactivity/inattention, restlessness/impulsivity, defiance/aggression, social functioning, and teacher-rated prosocial behavior, as well as significant improvements in maternal over-reactivity, verbosity, laxness, positive parenting, parenting satisfaction, self-efficacy, stress, and depression. At 6-month follow-up, effects were maintained for maternal over-reactivity and verbosity, parenting satisfaction and self-efficacy, and parental stress and depression. Limitations include small sample size, a more diverse sample may have provided greater power to detect long-term condition effects for child ADHD symptoms and to generalize findings to families from different ethnic and SES backgrounds, some teacher data were missing at the final assessment, parenting measures were based on maternal reports, the design of the study raises the possibility that parents in the delayed intervention condition may have anticipated change due to upcoming therapy, high attrition rate, and length of follow-up.

Length of controlled postintervention follow-up: 6 months.

Prinz, R. J., Metzler, C. W., Sanders, M. R., Rusby, J. C., & Cai, C. (2021). Online‐delivered parenting intervention for young children with disruptive behavior problems: A noninferiority trial focused on child and parent outcomes. Journal of Child Psychology and Psychiatry. Advance online publication.

Type of Study: Randomized controlled trial
Number of Participants: 334 families

Population:

  • Age — Parents: Not specified; Children: 3–7 years (Mean=4.79 years)
  • Race/Ethnicity — Parents: 71% White, 21% African American, and 8% Other; Children: 63% White, 22% African American, and 15% Other
  • Gender — Parents: 71% White, 21% African American, and 8% Other; Children: 63% White, 22% African American, and 15% Other
  • Status — Participants were parents of children who reported experiencing difficulty handling their children’s oppositional and disruptive behaviors.

Location/Institution: USA

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare the efficacy of Triple P Online to an equivalent in-person intervention, Standard Triple P. Participants were randomized to Triple P Online or Standard Triple P. Measures utilized include the Eyberg Child Behavior Inventory (ECBI), Parenting Practices Inventory, Parenting Daily Hassles Scale, Impact on Family Questionnaire, and the Child and Adolescent Disruptive Behavior Inventory (CADBI). Results indicate that Triple P Online was found to be noninferior to Standard Triple P on the primary outcome: independently observed child disruptive behavior and parent-reported child behavior problems. The pattern for secondary outcomes was more varied: (a) noninferiority for observed positive and aversive parenting; (b) noninferiority for observed quality of parent–child relationship at post but not follow-up assessment; (c) noninferiority for parent-reported inappropriate/ inconsistent discipline for per-protocol (PP) but not intent-to-treat (ITT) analyses; and (d) noninferiority not confirmed for parenting daily hassles and adverse family quality of life, despite large effect sizes for Triple P Online. Finally, Triple P Online noninferiority was found for teacher-reported child disruptive behavior. Limitations include attrition from treatment; program completion for Triple P Online; lack of parents with low educational attainment in the sample; recruitment depending on multiple strategies making it difficult to compare outcomes to study samples that may only include clinical referrals; no documentation of process variations regarding how parents used Triple P Online from day to day; and no analysis at time of publication of putative moderators, mediators, or predictors of Triple P Online adherence or outcomes.

Length of controlled postintervention follow-up: 8 months.

Additional References

Sanders, M. R. (2012). Development, evaluation, and multinational dissemination of the Triple P-Positive Parenting Program. Annual Review of Clinical Psychology, 8, 345–379. https://doi.org/10.1146/annurev-clinpsy-032511-143104

Sanders, M. R., & Mazzucchelli, T. G. (2018). The power of positive parenting: Transforming the lives of children, parents and communities using the Triple P system. Oxford University Press.

Sanders, M. R., Turner, K. M. T., & McWilliam, J. (2015). The Triple P – Positive Parenting Program: A community-wide approach to parenting and family support. In M. J. Van Ryzin, K. L. Kumpfer, G. M. Fosco, & M. T. Greenberg (Eds.), Family-based prevention programs for children and adolescents: Theory, research, and large-scale dissemination (pp. 134-159). Psychology Press.

Contact Information

Triple P America
Website: www.triplep.net
Email:
Phone: (803) 451-2278
Fax: (803) 451-2277

Date Research Evidence Last Reviewed by CEBC: October 2024

Date Program Content Last Reviewed by Program Staff: January 2022

Date Program Originally Loaded onto CEBC: February 2022