Cited by 1,077Child and Adolescent Psychosocial and Emotional DevelopmentBehavioral and Psychological StudiesChild Therapy and Development

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The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support

Sanders, Matthew R., Kirby, James N., Tellegen, Cassandra L., Day, Jamin J.·2014·Clinical Psychology Review

DOI 10.1016/j.cpr.2014.04.003

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Abstract

This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family outcomes. Multiple search strategies identified 116 eligible studies conducted over a 33-year period, with 101 studies comprising 16,099 families analyzed quantitatively. Moderator analyses were conducted using structural equation modeling. Risk of bias within and across studies was assessed. Significant short-term effects were found for: children's social, emotional and behavioral outcomes (d=0.473); parenting practices (d=0.578); parenting satisfaction and efficacy (d=0.519); parental adjustment (d=0.340); parental relationship (d=0.225) and child observational data (d=0.501). Significant effects were found for all outcomes at long-term including parent observational data (d=0.249). Moderator analyses found that study approach, study power, Triple P level, and severity of initial child problems produced significant effects in multiple moderator models when controlling for other significant moderators. Several putative moderators did not have significant effects after controlling for other significant moderators. The positive results for each level of the Triple P system provide empirical support for a blending of universal and targeted parenting interventions to promote child, parent and family wellbeing.

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Background
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Influential
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Canário, C., Abreu‐Lima, I., Santos, S., Silva‐Martins, M., Campos, J., Rodrigues, C. M. E., Tavares, M., Mansilha, H. F., Torres, S., de Lemos, M. S., et al. (2021) · Journal of Family Therapy · doi:10.1111/1467-6427.12334 · Cited by 11
Group Psychoeducational Intervention for Grandparents of Young Children with ASD: An Open Feasibility Study
Engstrand, R. Z., Roll‐Pettersson, L., Andersson, K., Larsson, H., Allodi, M. W., & Hirvikoski, T. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05189-0 · Cited by 15
“…reported a considerable decrease in children’s behavioural problems, a decrease in dysfunctional parenting style, improvements in parental adjustment, parenting confidence, and parental relationships with their partners (Tellegen & Sanders, 2014; Van Voorhis et al., 2015; Whittingham et al., 2009).”
Background
Psychological and the physical health impacts of forensic workplace trauma
Mistry, D., Gozna, L. F., & Cassidy, T. (2021) · Journal of Forensic Practice · doi:10.1108/jfp-05-2021-0027 · Cited by 12
Family Violence, Suicidality, and Substance Abuse in Active Duty Military Families: An Ecological Perspective
Wojda, A. K., Heyman, R. E., Slep, A. M. S., Foran, H. M., Snarr, J. D., & Oliver, M. A. (2017) · Military Behavioral Health · doi:10.1080/21635781.2017.1343698 · Cited by 11
Treatment Effects of Parent–Child Focused Evidence-Based Programs on Problem Severity and Functioning among Children and Adolescents with Disruptive Behavior
Vidal, S., & Connell, C. M. (2018) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2018.1469092 · Cited by 11
“Research has shown, for example, that factors such as parenting practices and efficacy (Sanders et al., 2014), treatment fidelity, (Brunk, Chapman, & Schoenwald, 2014; Henggeler et al.”
Background
Mental health among children of mothers with multiple sclerosis: A Danish cohort and register‐based study
Andersen, J. B., Moberg, J. Y., Niclasen, J., Laursen, B., & Magyari, M. (2018) · Brain and Behavior · doi:10.1002/brb3.1098 · Cited by 11
Communication and coping intervention for mothers of adolescents with type 1 diabetes: Rationale and trial design
Jaser, S. S., Hamburger, E., Pagoto, S., Williams, R., Meyn, A., Jones, A. C., & Simmons, J. H. (2019) · Contemporary Clinical Trials · doi:10.1016/j.cct.2019.105844 · Cited by 11
“Building on effective cognitive behavioral therapy (CBT) interventions for depression in adults [12] and positive parenting programs [13], our team has developed and pilot tested an intervention, Communication & Coping, for mothers of adolescents with T1D.”
Method
Changes in practitioners’ attitudes, perceived training needs and self-efficacy over the implementation process of an evidence-based parenting program
Côté, M., & Gagné, M. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05939-3 · Cited by 12
Group parental guidance programs: A systematic review
Benedetti, T. B., Rebess, I. P., & Neufeld, C. B. (2020) · Psicologia - Teoria e Prática · doi:10.5935/1980-6906/psicologia.v22n1p399-430 · Cited by 11
“Divided into five levels, it ranges from positive parenting communication strategies (level 1, less complex), to advanced interventions of 8 to 10 group or individual sessions for the discussion of positive parenting and additional problems (level 5, more complex) (Sanders et al., 2014).”
Background
Treating attention problems in children exposed to intimate partner violence: Evaluating the Preschool Kids’ Club
Clark, H. M., Galano, M. M., Grogan‐Kaylor, A. C., Stein, S. F., & Graham‐Bermann, S. A. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.106138 · Cited by 12
Successful implementation of parenting support at preschool: An evaluation of Triple P in Sweden
Dahlberg, A., Salari, R., Fängström, K., Fabian, H. M., & Sarkadi, A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0265589 · Cited by 16
“However, the statistically significant change in child and parent outcomes is in line with several RCT’s examining the effectiveness of Triple P [25, 26, 28].”
BackgroundResult
The Prevention of Child Maltreatment
Sanders, M. R., & Pickering, J. (2017) · Wiley eBooks · doi:10.1002/9781118976111.ch11 · Cited by 11
‘I just want my parenting to be able to be better than what it is’: A qualitative exploration of parenting strengths and needs of mothers experiencing homelessness
Owens, C. R., Stokes, M. N., & Haskett, M. E. (2022) · Child & Family Social Work · doi:10.1111/cfs.12924 · Cited by 13
Housing insecurity and adolescent behavioral outcomes: The mediating role of aggression in parenting
Marçal, K. E., Bosetti, R. L., & Barr, N. (2023) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106039 · Cited by 11
Parenting and mental health in protracted refugee situations: A systematic review
Khraisha, Q., Abujaber, N., Carpenter, S., Crossen, R. J., Kappenberg, J., Kelly, R., Murphy, C., Norton, O., Put, S. M., Schnoebelen, K., et al. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152536 · Cited by 14
Addendum to “Four-Year Follow-Up of a Randomized Controlled Trial of Triple P Group for Parent and Child Outcomes”
Heinrichs, N., Kliem, S., & Hahlweg, K. (2017) · Prevention Science · doi:10.1007/s11121-017-0782-4 · Cited by 11
PROTOCOL: A systematic review and meta‐analysis of randomised controlled trials evaluating the impact of parenting programmes for parents of adolescents (10–18 years) on adolescent mental health outcomes, positive development and the parent–adolescent relationship
Burke, K., Dittman, C. K., Forbes, E. J., & Eggins, E. (2021) · Campbell Systematic Reviews · doi:10.1002/cl2.1146 · Cited by 14
“…with the child in ways that support positive behaviour and offer strategies to deal with negative or challenging behaviours result in positive outcomes for children (Sanders et al., 2014), with the more limited evidence also demonstrating positive outcomes for adolescents (Medlow et al., 2016).”
Background
The Impact of Attachment-Based Parenting Interventions on Externalizing Behaviors in Toddlers and Preschoolers: A Systematic Narrative Review
Kohlhoff, J. R., & Cibralic, S. (2021) · Child & Youth Care Forum · doi:10.1007/s10566-021-09667-5 · Cited by 16
“The evidence-base for PT programs in the treatment of childhood externalizing behaviors is strong and has been documented in a number of systematic and meta-analytic reviews (Menting et al., 2013; Sanders et al., 2014; Thomas et al., 2017; Ward et al., 2016).”
Background
The efficacy of a self-help parenting program for parents of children with externalizing behavior: a randomized controlled trial
de Jong, S. R. C., van den Hoofdakker, B. J., van der Veen‐Mulders, L., Veenman, B., Twisk, J. W. R., Oosterlaan, J., & Luman, M. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02028-0 · Cited by 16
Predictors of Change in Stepping Stones Triple Interventions: The Relationship between Parental Adjustment, Parenting Behaviors and Child Outcomes
Sanders, M. R., Hoang, A., Hodges, J., Sofronoff, K., Einfeld, S., Tonge, B. J., Gray, K. M., & The MHYPEDD Team (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013200 · Cited by 10
“Such findings were consistent with and supported previous studies of a behavioral parenting intervention, suggesting that families with more problems at baseline respond better to intervention [22,23].”
Result
Rapid white matter changes in children with conduct problems during a parenting intervention
Brien, S. O., Sethi, A., Blair, J., Viding, E. M., Beyh, A., Mehta, M. A., Dallyn, R. A., Ecker, C., Petrinovic, M. M., Doolan, M., et al. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02635-8 · Cited by 11
“Boys with CP were recruited from two parenting programmes in the UK (the Incredible Years (IY) and Triple P) [33, 34].”
Management of Conflict of Interest in Psychosocial Research on Parenting and Family Interventions
Sanders, M. R. (2015) · Journal of Child and Family Studies · doi:10.1007/s10826-015-0127-5 · Cited by 11
Parasympathetic reactivity and disruptive behavior problems in young children during interactions with their mothers and other adults: A preliminary investigation
Cooper‐Vince, C. E., DeSerisy, M., Cornacchio, D., Sanchez, A. L., McLaughlin, K. A., & Comer, J. S. (2017) · Developmental Psychobiology · doi:10.1002/dev.21511 · Cited by 10
Evaluation of a Parenting Training Program, “Limits”, in a Juvenile Justice Service: Results and Challenges
Muñoz, M. M., Arnau‐Sabatés, L., & Sabaté, M. (2018) · Psychosocial Intervention · doi:10.5093/pi2018a14 · Cited by 14
“Also, some studies show little evidence of sustained deterrent effects through strong research designs and multiple site replications (Mihalic, Fagan, Irwin, Ballard, & Elliott, 2004); consequently, they have a limited impact at the population level (Sanders et al., 2014).”
Background
The efficacy and acceptability of the Triple P: Positive Parenting Program with Turkish parents
Arkan, B., Güvenir, T., Ralph, A., & Day, J. J. (2020) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12283 · Cited by 10
An Evaluation of an Integrated Stuttering and Parent-Administered Self-Regulation Program for Early Developmental Stuttering Disorders
Druker, K., Mazzucchelli, T. G., Hennessey, N. W., & Beilby, J. M. (2020) · Journal of Speech Language and Hearing Research · doi:10.1044/2020_jslhr-19-00310 · Cited by 10
Promoting positive parenting and mental wellbeing in Hong Kong Chinese parents: A pilot cluster randomised controlled trial
Sun, Y., Wang, M., Chan, C., Lo, D. L. O., Wan, A., Lam, T.-H., & Ho, S. (2022) · PLoS ONE · doi:10.1371/journal.pone.0270064 · Cited by 9
Effectiveness of the Incredible Years parenting program for children with behavioral problems: An experience in a developing country during a pandemic
Masiran, R., Ibrahim, N., Awang, H., Ying, L. P., Lin, C. T., & Narayanasamy, S. G. (2022) · Children and Youth Services Review · doi:10.1016/j.childyouth.2022.106629 · Cited by 10
Predictors of champion behaviors in an evidence‐based parenting program: A structural equation modeling approach
Ma, T., Tellegen, C. L., & Sanders, M. R. (2022) · American Journal of Community Psychology · doi:10.1002/ajcp.12623 · Cited by 10
Efficacy of the Triple P – Positive Parenting Program on 0–12 year-old Quebec children's behavior
Gagné, M., Piché, G., Brunson, L., Clément, M., Drapeau, S., & Jean, S.-M. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.106946 · Cited by 11
Assessing child maltreatment prevention via administrative data systems: A case example of reproducibility
Prinz, R. J. (2016) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2016.12.005 · Cited by 10
Enhancing maternal and infant wellbeing: study protocol for a feasibility trial of the Baby Triple P Positive Parenting programme for mothers with severe mental health difficulties (the IMAGINE study)
Wittkowski, A., Cartwright, K. L., Emsley, R., Bee, P., Camacho, E. M., Calam, R. M., Cross, C., Abel, K. M., & Reid, H. E. (2018) · Trials · doi:10.1186/s13063-018-2869-z · Cited by 36
Social Learning Influences: Modelling, Instructions, Consequences
Mazzucchelli, T. G. (2018) · Springer eBooks · doi:10.1007/978-3-319-94598-9_4 · Cited by 9
Family Structure and the Nature of Couple Relationships: Relationship Distress, Separation, Divorce, and Repartnering
Zemp, M., & Bodenmann, G. (2018) · Springer eBooks · doi:10.1007/978-3-319-94598-9_18 · Cited by 10
Accommodating Race and Ethnicity in Parenting Interventions
Haslam, D. M., & Mejía, A. (2017) · Oxford University Press eBooks · doi:10.1093/med-psych/9780190629069.003.0030 · Cited by 10

Authors: Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J.
Affiliations: The University of Queensland (AU)
Corresponding author: Sanders, Matthew R.
ORCID: Sanders, Matthew R.
Kirby, James N.
Tellegen, Cassandra L.
Day, Jamin J.
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2014-06
Volume: 34
Issue: 4
Pages: 337-357
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2014.04.003
OpenAlex: W2147100455
Cited by: 1,077
References: 170
Citations by year: 2026: 86 · 2025: 98 · 2024: 110 · 2023: 104 · 2022: 83 · 2021: 95 · 2020: 119 · 2019: 94 · 2018: 78 · 2017: 72 · 2016: 83 · 2015: 36 · 2014: 17
FWCI: 10.48
Type: journal article
Language: en
Update notices: erratum (2014-12-01)
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
Keywords: Triple P-Positive Parenting Program, parenting support, child behavior problems, parenting practices, parenting satisfaction, parental adjustment, parent-child relationship, child well-being, family well-being
MeSH terms: Adult, Child, Child Behavior Disorders, Female, Humans, Male, Parents, Personal Satisfaction, Social Support, Program Evaluation, Parenting

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The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support

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