Community-wide implementation of a parenting program: The South East Sydney Positive Parenting project
Carlie Dean
South Eastern Sydney Area Health Service, Sydney NSW
Karen Myors
South Eastern Sydney Area Health Service, Sydney NSW
Elizabeth Evans
School of Psychiatry, University of New South Wales, Sydney NSW
PP: 179 - 190
Abstract
This paper provides a description and evaluation of a community-wide implementation of a parenting program - the group version of Triple P - in South Eastern Sydney. The implementation was undertaken in partnership with a range of public health services and community agencies that participated on a voluntary basis.
A number of strategies were shown to development the capacity of services and professionals to deliver the Triple P program to parents. Parent evaluations at the conclusion of the program demonstrated a reduction in disruptive child behaviour, lower levels of dysfunctional parenting, reduction in conflict between parents over child-rearing, and gains in parental mental health. Gains in all of these domains were maintained at 6 and 12 month follow-up.
The results of the study indicate that it is possible to take a population health approach to parenting, successfully involve multiple services and professionals in the delivery of the program, and maintain the effectiveness of the parenting intervention in a community-wide implementation.
Keywords
parenting, prevention, dissemination, family intervention, parent management training, capacity building
Article Text
Prevalence studies in Australia report that around 14% of children and adolescents experience a mental health disorder in any 6 month period (Sawyer, Arney, Baghurst et al., 2000). In addition, it is estimated that 10-15% of pre-school children have mild to moderate behavioural problems, and another 10-15% experience moderate to severe behavioural problems (Marshall & Watt, 1999). As young children with behavioural problems are at increased risk of later developing more severe and long-lasting mental disorders, early intervention for these children should be a priority in a population approach to children's mental health (Sanders & Markie-Dadds, 1996).
Population studies have found that coercive or inconsistent styles of parenting are linked to higher rates of mental health problems, whilst encouraging parental styles are associated with lower rates of mental health problems in children (Silburn, Zubrick, Garton et al., 1996). Research has shown that prevention and early intervention strategies targeting parenting are amongst the most effective strategies for preventing chronic problems (Webster-Stratton, 1997). Parent management training (PMT) based on social learning models (Patterson, 1982) has been found to be an efficacious intervention for children with behaviour disorders (Kazdin, 1997). Typically, PMT teaches parents to increase their positive interactions with their children, whilst reducing coercive and inconsistent interactions.
However, reducing children's mental health problems within the population will require a strategy that takes PMT from the clinical treatment setting and makes it available widely to parents in the community. In order to address the need for population based parenting and family interventions, Sanders and colleagues have developed the Triple-P Positive Parenting Program (Sanders, 1999).
The Triple P Program aims to prevent behavioural, emotional and developmental problems in children by enhancing the knowledge, skills and confidence of parents. It promotes nurturing, safe, engaging, non-violent, and low conflict environments for children. It also aims to promote children's social, emotional, language and behavioural competencies through positive parenting practices (Sanders, 1999). This program has five levels of intervention, on a continuum of increasing strength and narrowing reach, which are designed to be used according to the needs of the families being targeted. The Triple P Program has been found to be an efficacious treatment in a range of controlled randomised trials (Sanders, 1999; Sanders, Markie-Dadds, Tully & Bor, 2000).
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