Turner, K. M. T., & Sanders, M. R. (2006). Help when it's needed first: A controlled evaluation of brief, preventive behavioral family intervention in a primary care setting. Behavior Therapy, 37(2), 131–142. https://doi.org/10.1016/j.beth.2005.05.004

Type of Study: Randomized controlled trial
Number of Participants: 30 families

Population:

• Age — Children: Intervention: Mean=37.38 months; Waitlist Control: Mean=43.07 months; Parents: Mean=33–35 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were parents of a child with behavioral problems or developmental issues.

Location/Institution: Brisbane, Australia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of Primary Care Triple P [now called Triple P - Positive Parenting Program® - Level 3 Primary Care (Level 3 Triple P Primary)] one-on-one format with parents requesting help for child behavior problems. Participants were randomly assigned to the brief Primary Care Triple P intervention or a wait-list control condition. Measures utilized include the Family Background Questionnaire (FBQ), the Parent Daily Report (PDR), the Eyberg Child Behavior Inventory (ECBI), Home and Community Problem Checklist (HCPC), Parenting Scale (PS), Family Observation Schedule (FOS), the Parenting Sense of Competence Scale (PSOC), the Depression, Anxiety, and Stress Scales (DASS), the Goal Achievement Scales (GAS), the Parenting Experience Survey (PES), and the Client Satisfaction Questionnaire (CSQ). Results indicate that parents who received Primary Care Triple P reported significantly lower rates of the targeted problem child behaviors than those in the wait-list condition on the PDR target behavior score and fewer problem settings at home (HCPC). There were also significantly fewer children in the intervention condition in the clinical range on the PDR following the intervention in comparison to children in the wait-list condition. Mothers receiving the intervention reported significantly less use of dysfunctional parenting practices (PS laxness, over-reactivity, and verbosity scales) than mothers in the wait-list condition. Intervention condition mothers reported a significantly greater level of satisfaction with their parenting role following the intervention in comparison to mothers who had not received the program. The result for the PSOC efficacy scale indicated a trend in the same direction for intervention condition mothers with them reporting significantly lower anxiety and stress than mothers in the wait-list condition. Intervention gains found at the postintervention assessment were primarily maintained at a 6-month follow-up of the intervention group. However, as there was no follow-up assessment of control families (since they had received Primary Care Triple P also at that point), it is not possible to conclude whether these measures of child behavior and parenting would vary from those of a control group at this assessment time. Limitations include potential reporting biases due to interpreting changes found on parent-report measures of child behavior and parenting, and follow-up limited to intervention group only.

Length of controlled postintervention follow-up: 6 months (intervention group only).

de Graaf, I., Onrust, S., Haverman, M., & Janssens, J. (2009). Helping families improve: An evaluation of two primary care approaches to parenting support in the Netherlands. Infant and Child Development: An International Journal of Research and Practice, 18(6), 481–501. https://doi.org/10.1002/icd.634

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 129 parents

Population:

• Age — Children: Mean=6.2 years; Parents: Not specified
• Race/Ethnicity — Not specified
• Gender — 65% Male, Parents: 96% Female
• Status — Participants were parents of children with mild to moderate behavioral and/or emotional problems.

Location/Institution: The Netherlands

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the most widely used Dutch practices for primary care parenting support and Primary Care Triple P [now called Triple P - Positive Parenting Program® - Level 3 Primary Care (Level 3 Triple P Primary)]. Participants were receiving either Dutch parenting consulting practices or Primary Care Triple P. Measures utilized include the Family Background Questionnaire (FBQ), Strengths and Difficulties Questionnaire (SDQ), Parenting Scale (PS), and the Being a Parent Scale (BPS). Results indicate that both interventions produced significant reductions in reported child emotional and behavior problems, that also remained after 3 months. For both groups, parenting styles were also found to have improved at both posttest and follow-up measurement. When compared with the regular Dutch parenting consultation practices, however, the Primary Care Triple P approach produced greater reductions in parental laxness and total parenting dysfunction, and greater improvement in total parenting competence at both posttest and follow-up. Limitations include lack of randomization of participants, self-reported measures, and length of follow-up.

Length of controlled postintervention follow-up: 3 months.

Schappin, R., Wijnroks, L., Uniken Venema, M., Wijnberg-Williams, B., Veenstra, R., Koopman-Esseboom, C., Mulder-De Tollenaer, S., van der Tweel, I., & Jongmans, M. (2013). Brief parenting intervention for parents of NICU graduates: A randomized, clinical trial of Primary Care Triple P. BMC Pediatrics, 13(1), 1–9. https://doi.org/10.1186/1471-2431-13-69

Type of Study: Randomized controlled trial
Number of Participants: 67

Population:

• Age — Children: Control: Mean=43.6 months; Intervention: Mean=45.6 months; Mothers: Control: Mean=32.2 years; Intervention: Mean=34.1 years
• Race/Ethnicity — Children: Not specified; Parents: Intervention: 97% European and 3% North-African (mothers only); Control: 100% European
• Gender — Children: 60% Male; Parents: Not specified
• Status — Participants were parents and their children born preterm or asphyxiated.

Location/Institution: University Medical Center Utrecht/Wilhelmina Children's Hospital (Utrecht) and the Isala Clinics (Zwolle) – The Netherlands

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of the Primary Care Triple P [now called Triple P - Positive Parenting Program® - Level 3 Primary Care (Level 3 Triple P Primary)] one-on-one format in improving the quality of parent-child interaction and increasing the application of trained parenting skills in parents of preterm-born or asphyxiated term-born preschoolers with behavioral problems. Children were randomly assigned to Primary Care Triple P or a wait-list control group. Measures utilized include the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), Eyberg Child Behavior Inventory (ECBI) and the Client Satisfaction Questionnaire (CSQ). Results indicate that Primary Care Triple P is not effective in improving the quality of parent-child interaction nor does it increase the application of trained parenting skills in parents of preterm-born or asphyxiated term-born children with behavioral problems. There was no significant difference in favor of Primary Care Triple P between the intervention group and the control group at the 6-month trial endpoint. At the 12-month follow-up, most measures showed no changes in parenting behavior. However, when changes were present, TRF presented more problems for the Primary Care Triple P group, whilst they increased or remained stable in the control group. Limitations include intervention showed no effect on outcomes, reliance on self-reported measures, small sample size, and lack of generalizability due to ethnicity.

Length of controlled postintervention follow-up: 12 months.

Spijkers, W., Jansen, D. E., & Reijneveld, S. A. (2013). Effectiveness of Primary Care Triple P on child psychosocial problems in preventive child healthcare: A randomized controlled trial. BMC Medicine, 11(1), 1–8. https://doi.org/10.1186/1741-7015-11-240

Type of Study: Randomized controlled trial
Number of Participants: 81 families

Population:

• Age — Children: 9–11 years; Parents: Usual Care: Mean=40.94 years; Primary Care: Mean=44.06 years
• Race/Ethnicity — Children: Not specified; Parents: 96% Dutch
• Gender — Children: 56% Male; Parents: Not specified
• Status — Participants were parents of children with mild psychosocial problems.

Location/Institution: The Netherlands

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to assess the effectiveness of the Primary Care Triple P (PCTP) program [now called Triple P - Positive Parenting Program® - Level 3 Primary Care (Level 3 Triple P Primary)] one-on-one format compared with care as usual (UC) for parents of children with mild psychosocial problems. Participants were randomly assigned to PCTP or usual care UC. Measures utilized include the Strengths and Difficulties Questionnaire (SDQ), Parenting Scale (PS), Problem Setting and Behaviour Checklist (PSBC), the Parenting Stress Index (PSI), the Depression Anxiety Stress Scale (DASS) and the Eyberg Child Behaviour Inventory (ECBI). Results indicate that at 6- and 12-month follow-up there were no statistically significant differences between parents in the PCTP and UC groups on either the primary or secondary outcome measures, but those in the PCTP group yielded slightly better results than UC on most of these outcomes. Only in one SDQ field, namely, conduct problems, was a statistically significant difference detected, which was in favor of the PCTP condition. In general, a decrease in child psychosocial problems and parenting stress was found for both PCTP and UC. Limitations include small sample size, and reliance on self-reported measures.

Length of controlled postintervention follow-up: 6 and 12 months.

McCormick, E., Kerns, S. E. U., McPhillips, H., Wright, J., Christakis, D. A., & Rivara, F. P. (2014). Training pediatric residents to provide parent education: A randomized controlled trial. Academic Pediatrics, 14(4), 353–360. https://doi.org/10.1016/j.acap.2014.03.009

Type of Study: Randomized controlled trial
Number of Participants: 154 (53 Residents; 101 Parents)

Population:

• Age — Children: Mean=4.8 years; Parents: Not specified; Residents: Not specified
• Race/Ethnicity — Children: Not specified; Parents: 38% Other, 34% White, and 27% African American/Black; Residents: Not specified
• Gender — Children: 48% Female; Parents: 80% Female; Residents: 79% Female
• Status — Participants were pediatric residents and the parents of the children to whom the pediatric resident provided care.

Location/Institution: Three community clinics operated by the University of Washington

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of the Primary Care Triple P (PC Triple P) intervention [now called Triple P - Positive Parenting Program® - Level 3 Primary Care (Level 3 Triple P Primary)] one-on-one format on pediatric residents’ skill and confidence in delivering parenting information; and to understand the potential impact of residents’ PC Triple P training status on parents’ sense of self-efficacy in parenting and discipline strategies as well as child behavior. Residents who consented to participation were randomized into one of two conditions: 1) intervention, which involved immediate training in PC Triple P, or 2) wait-list control, which involved the usual provision of well-child services until subsequent training in PC Triple P. Residents trained in PC Triple P then provided PC Triple P to parents of their patients as appropriate. Measures utilized include Child Behavior Checklist (CBCL), Parent Consultation Skills Checklist (PCSC), Parenting Sense of Competence Scale (PSOC), and the International Society for the Prevention of Child Abuse and Neglect’s Child Abuse Screening Tool–Parent Version (ICAST-P). Results indicate that at postintervention compared to the waitlist control group, the impact of intervention-trained residents on parent’s sense of self-efficacy, discipline strategies, and child behavior was mixed, with the greatest group effect occurring on parent-reported discipline strategies, especially among parents who reported the most problems at baseline. Parents exposed to PC Triple P trained residents demonstrated a higher rate of positive discipline strategies at follow-up. However, there appeared to be little impact of the intervention on the other parent measures. No differences were found for child behavior or parenting sense of confidence. Compared to the control group, intervention gains were maintained for residents at 9 month follow-up. Limitations include small sample size, self-reported measures, and recruitment and implementation level barriers.

Length of controlled postintervention follow-up: 9 months.