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29 April 2021

Parenting during COVID: Study reveals Triple P as effective online as in-person

At a time when mental health and family support services are stretched to the limit, a newly-published study that compared online and in-person delivery of the Triple P – Positive Parenting Program has found similar results at 12-month follow-up.

The large-scale randomized controlled trial, published this month in The Journal of Child Psychology and Psychiatry, was conducted in the United States with hundreds of families whose children met clinical criteria for significant disruptive behavior problems, which, if untreated, can spiral into more serious problems in adolescence.


Triple P International Country Director (Australia), Carol Markie-Dadds, said that the landmark study of Triple P Online confirms, that once more, online options are a win-win solution for families and policy makers.


“Digital delivery can reach parents who just can’t attend face-to-face sessions for various reasons, such as scheduling, transport and childcare,” Ms Markie-Dadds said.


“At the same time, child mental health and family support services, which often have long waiting lists, can help more people for a fraction of the cost – and now, they can have even greater confidence when offering an online intervention as an alternative or adjunct to face-to-face services.”


Founder of the Triple P – Positive Parenting Program, co-author of the study and Director of The University of Queensland’s Parenting and Family Support Centre at the School of Psychology, Professor Matt Sanders, said that these findings came at a time when mental health issues are exacerbated by COVID-19.


“There’s extra pressure on the mental health system and we don’t have the mental health workforce to help everyone who needs it,” Professor Sanders said.


“So it’s important for policy makers to offer parenting support as an early intervention to the whole population. That’s why we continue to develop and research online delivery methods – to make parenting support more accessible and affordable.


“Just as we do with diabetes or asthma, offering parents the specific skills and knowledge they need to help manage and treat children’s mental health conditions is a public health imperative; however, behavior problems are not as visible and there are still some outdated and incorrect attitudes to helping parents manage these issues.


“There’s no magic formula to work out which children will develop disruptive and challenging behavior, and this is reflected in the make-up of study participants – a majority were well-educated, two-parent families.


“We already know that early-onset behavior problems occur right across the socio-economic spectrum – in fact, 84 per cent of children with these problems are from middle- or upper-income families, according to previous research – and that without treatment, they can continue and become more entrenched,” Professor Sanders said.


The trial randomly allocated some participants to in-person delivery of face-to-face Triple P and others to online delivery, and found that 12 months after completion, both groups showed comparable improvements in areas such as child behavior, parent-child relationships, and teacher-reported oppositional behavior to adults and peers.


The study added to the existing evidence base for Triple P Online, using a non-inferiority trial design. This type of trial, commonly used in the pharmaceutical field, compares a new treatment to an existing proven treatment.


While there were some minor differences in post-intervention and 12-month-follow-up results, the overall findings indicate that Triple P Online is not inferior (equally effective) to in-person delivery of Triple P.


A total of 334 families of children aged 3-7 years volunteered to take part because they were having difficulty dealing with their children’s behavior, and were assessed using a number of standard psychological tests completed by parents and teachers.


Families were recruited for the study in South Carolina and Oregon, with study co-authors representing The University of South Carolina and the Oregon Research Institute in addition to The University of Queensland.