Triple P Online
Triple P Online is a web-based parenting intervention. The programme can be used as an early intervention strategy or as a more intensive programme for parents with children up to 12 years with significant social, emotional or behavioural problems.
Parents are given access to a website which enables them to work through modules sequentially. It is the equivalent of Level 4 Standard Triple P, which is the face-to-face version of the programme. The online programme is designed to reach parents who prefer to complete a parenting programme online because, for example, they are they are too busy, hesitant or unable to access a programme in-person. A practitioner can provide support alongside the self-directed online programme. It includes 8 modules which focus on positive parenting principles and supporting parents to integrate and generalise parenting strategies through parenting plans.
EIF Programme Assessment
Child outcomes
This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Supporting children's mental health and wellbeing
Improved child behaviour and difficulties (emotional symptoms)
based on study 1
- Statement: 0.92-point reduction on the Strengths and Difficulties Questionnaire (emotional symptoms subscale – parent report)
- Score: 17
- Timeframe: Immediately after the intervention
Preventing crime, violence and antisocial behaviour
Improved child behaviour (intensity)
based on study 1
- Statement: 21.04-point reduction on the Eyberg Child Behaviour Inventory (intensity subscale – parent report)
- Score: 31
- Timeframe: Immediately after the intervention
Improved child behaviour (problem)
based on study 1
- Statement: 4.9-point reduction on the Eyberg Child Behaviour Inventory (problem subscale – parent report)
- Score: 26
- Timeframe: Immediately after the intervention
Improved child behaviour and difficulties (conduct)
based on study 1
- Statement: 0.98-point reduction on the Strengths and Difficulties Questionnaire (conduct subscale – parent report)
- Score: 22
- Timeframe: Immediately after the intervention
Improved behaviour (hyperactivity/inattention)
based on study 2
Improved behaviour (restlessness/impulsivity)
based on study 2
Improved behaviour (social functioning)
based on study 2
Improved behaviour (defiance/aggression)
based on study 2
This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.
Who is it for?
The best available evidence for this programme relates to the following age-groups:
Toddlers Preschool Primary school
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Online or app
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Home
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Targeted indicated
Where has it been implemented?
- Australia
- Canada
- China
- Germany
- Netherlands
- New Zealand
- Singapore
- Turkey
- United Kingdom
- United States
- Ireland
Ireland provision
Ireland evaluation
About the programme
What happens during the delivery?
How is it delivered?
Triple P Online is a self-directed web-based programme for individuals or couples, comprising of eight sessions of 30–60 minutes’ duration each. In addition, one practitioner can provide three hours of support spread over approximately four sessions of 45 minutes each.
What happens during the intervention?
- The first four modules cover core programme content, which relates to positive parenting principles and 17 parenting strategies.
- The remaining four modules focus on helping parents to integrate and generalise strategies through parenting plans. Modules cover topics such as ‘dealing with disobedience’ and ‘preventing problems by planning ahead’.
- The programme includes personalised content, interactive exercises, diverse parent ‘voxpops’ describing their experiences, and video-based modelling of parenting skills. Such elements are designed to engage parents and support learning.
- The programme also provides parents with a customisable and printable workbook.
What are the implementation requirements?
Who can deliver it?
One practitioner with NFQ level 6 previously trained in a Triple P programme provides support to parents completing the self-directed online programme.
What are the training requirements?
Practitioners are previously trained in a Triple P programme. Therefore, no specific training or booster training is required for Triple P Online.
How are the practitioners supervised?
It is recommended that practitioners are supervised by one host agency supervisor (qualified to NFQ-9/10 level). No training specific to Triple P Online is received by the supervisor.
What are the systems for maintaining fidelity?
- Printed material
- Online material
- Face-to-face training
- Fidelity monitoring
A quality assurance checklist is available for organisations to use when planning for quality assurance of Triple P. There are three standard fidelity protocols built into the Triple P Implementation Framework: (1) Practitioner Accreditation, (2) Intervention Fidelity using Session Checklists, (3) Supervision and Practitioner Support Standards using the Peer Support Network. Triple P UK offers trainer-facilitated PASS sessions or a Flexibility & Fidelity workshop for professional development.
Is there a licensing requirement?
There is no licence required to run this programme.
How does it work? (Theory of Change)
How does it work?
- Triple P is based on the idea that parents often unintentionally perpetuate unwanted child behaviour through ineffective parenting strategies.
- Triple P helps parents replace ineffective parenting strategies with effective methods for encouraging positive child behaviour.
- In the short term, parents learn more effective strategies for managing their child’s behaviour and the child’s behaviour improves.
- In the longer term, children should have greater self-regulatory skills and self-confidence and do better in school.
- It is also expected that children will be less likely to have behavioural problems and/or engage in antisocial behaviour.
Intended outcomes
- Active and healthy, physical and mental wellbeing
- Safe and protected from harm
- Safe and protected from harm
Contact details
Matt Buttery
Triple P UK
matt.buttery@triplep.net
About the evidence
Triple P Online’s most rigorous evidence comes from a randomised controlled trial which was conducted in Australia and a randomised controlled trial which was conducted in New Zealand. These studies identified statistically significant positive impact on a number of child and parent outcomes. This programme has evidence from at least one rigorously conducted (level 3) RCT, along with evidence from an additional comparison group study. Subsequently, the programme receives a 3+ rating overall.
Study 1
| Citation: | Sanders, Baker, & Turner (2012) |
| Design: | RCT |
| Country: | Australia |
| Sample: | 116 parents with a 2- to 9-year-old child (mean age = 4.7 years) |
| Timing: | Post-test |
| Child outcomes: |
|
| Other outcomes: |
|
| Study rating: | 3 |
Sanders, M. R., Baker, S., & Turner, K. M. (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(11), 675-684
Available at
http://www.sciencedirect.com/science/article/pii/S0005796712001192
Study design and sample
The first study is a rigorously conducted RCT. This study involved random assignment of parents to a Triple P Online intervention group or a control condition (allowing internet use as usual). This study was conducted in Australia, with a sample of children aged between 2 and 9 with elevated levels of disruptive behaviour. Most families (76%) had an income at or above the Australian median. The ethnic group most commonly identified with was described as Australian (91%).
Measures
- Child behaviour and adjustment was measured using the Eyberg Child Behaviour Inventory (parent report).
- Prosocial and difficult behaviour was measured using the Strengths and Difficulties Questionnaire (parent report).
- Child disruptive behaviour was measured using an observation of child disruptive behaviour: coded using an adapted version of the Family Observation Schedule (independent observer report).
- Parenting style was measured using the Parenting Scale (self-report).
- Parenting confidence was measured using the Parenting Tasks Checklist (self-report).
- Parental adjustment was measured using the Depression Anxiety Stress Scales (self-report).
- Parental anger was measured using the Parental Anger Inventory (self-report).
- Conflict over parenting was measured using the Parent Problem Checklist (self-report).
Findings
This study identified statistically significant positive impact on a number of child and parent outcomes. Outcomes which have the same strength of evidence as the overall study are reported in the tables above. All these outcomes were found at post-test, when attrition was relatively low:
- Eyberg Child Behavior Inventory: problem and intensity scales
- Strengths and Difficulties Questionnaire: conduct and emotion scales
- Parenting Scale: laxness, over-reactivity and verbosity scales
- Parenting Tasks Checklist: behaviour self-efficacy and setting self-efficacy scales
- Parental Anger Inventory: problem and intensity scale.
Further outcomes were found at six-month follow-up, which were judged to be less rigorous as attrition had increased. At six-month follow up, all the same results found at post-test remained significant, apart from both scales on the Strengths and Difficulties Questionnaire, which were no longer significant. In addition, the following outcomes became significant:
- Depression Anxiety Stress Scales: stress scale
- Parent Problem Checklist: problem and extent
- Adapted version of the Family Observation Schedule (although this was undertaken on a subset of 26 children).
Study 2
| Citation: | Franke et al. (2016) |
| Design: | RCT |
| Country: | New Zealand |
| Sample: | 53 parents with a 3- to 4-year-old child (M = 4.0 years) |
| Timing: | Post-test and / or 6-month follow up |
| Child outcomes: |
|
| Other outcomes: |
|
| Study rating: | 2+ |
Franke, N., Keown, L. J., & Sanders, M. R. (2016). An RCT of an Online Parenting Program for Parents of Preschool-Aged Children With ADHD Symptoms. Journal of Attention Disorders, 1-11
Available at
https://www.ncbi.nlm.nih.gov/pubmed/27609783
Study design and sample
The second study is an RCT. Participants were randomised to a Triple P online intervention group or a waiting list control group. This study was conducted in New Zealand, with a sample of 53 parents with a 3- to 4-year-old child (M = 4.0 years). All children had elevated and impairing levels of ADHD symptoms. The majority of the children were described as of New Zealand European ethnicity (79.2%). Just over half of the mothers had a university degree (55.7%) and most of the participants were of higher than average socio-economic status.
Measures
- Behaviour was measured using the Conners Early Childhood Behaviour scale (parent report).
- Child behaviour and peer relations were measured using the Child Behaviour Scale (teacher report).
- Prosocial and difficult behaviour was measured using the Strengths and Difficulties Questionnaire (teacher report).
- Parenting style was measured using the Parenting Scale (self-report).
- Positive parenting was measured using the Authoritative Parenting scale of the Parenting Styles and Dimensions Questionnaire (self-report).
- Parental adjustment was measured using the Depression Anxiety Stress Scales (self-report).
- Parenting sense of competence was measured using the Parenting Sense of Competence scale (self-report).
Findings
This study identified statistically significant positive impact on a number of child and parent outcomes. Outcomes which have the same strength of evidence as the overall study are reported:
- The Conners Early Childhood Behaviour scale: hyperactivity / inattention, restlessness /impulsivity, social functioning and defiance /aggression scales
- The Parenting Scale: overreacitity*, verbosity* and laxness scales.
- The Parenting Styles and Dimensions Questionnaire: authoritative parenting scale
- The Depression Anxiety Stress Scales: depression*, stress* and anxiety** scales
- The Parenting Sense of Competence scale: satisfaction* and self-efficacy* scales
* = remained significant at six-month follow-up
** = only significant at six-month follow-up