Journal of Consulting and Clinical Psychology, Dec 1, 2014
This randomized controlled trial evaluated the efficacy of Primary Care Stepping Stones Triple P,... more This randomized controlled trial evaluated the efficacy of Primary Care Stepping Stones Triple P, a brief individualized parenting program, in a sample of parents of children with autism spectrum disorder (ASD). Sixty-four parents of children aged 2-9 years (M = 5.67, SD = 2.14) with an ASD diagnosis participated in the study. Eighty-six percent of children were male, and 89% of parents identified their child's ethnicity as Australian/White. Families were randomly assigned to 1 of 2 conditions (intervention or care-as-usual) and were assessed at 3 time points (preintervention, postintervention, and 6-month follow-up). Parents completed a range of questionnaires to assess changes in child behavior (Eyberg Child Behavior Inventory) and parent outcomes (Parenting Scale, Depression Anxiety Stress Scale-21, Parent Problem Checklist, Relationship Quality Inventory, Parental Stress Scale) and 30-min home observations of parent-child interactions. Relative to the care-as-usual group, significant short-term improvements were found in the intervention group on parent-reported child behavior problems, dysfunctional parenting styles, parenting confidence, and parental stress, parental conflict, and relationship happiness. No significant intervention effects were found on levels of parental depression or anxiety, or on observed child disruptive and parent aversive behavior. The effect sizes for significant variables ranged from medium to large. Short-term effects were predominantly maintained at 6-month follow-up, and parents reported high levels of goal achievement and satisfaction with the program. The results indicate that a brief low intensity version of Stepping Stones Triple P is an efficacious intervention for parents of children with ASD.
A large-scale population trial using the Triple P-Positive Parenting Program (TPS) was evaluated.... more A large-scale population trial using the Triple P-Positive Parenting Program (TPS) was evaluated. The target population was all parents of 4- to 7-year-old children residing in ten geographical catchment areas in Brisbane (intervention communities) and ten sociodemographically matched catchment areas from Sydney (5) and Melbourne (5), care as usual (CAU) comparison communities. All five levels of the Triple P multilevel system of intervention were employed; including a local mass media strategy, a primary care strategy, and three more intensive levels of parenting intervention delivered by a range of service providers (e.g., health, education, and welfare sectors). Program outcomes were assessed through a computer-assisted telephone interview of a random sample of households (N = 3000) in each community at pre-intervention and again at two years post-intervention. At post-intervention there were significantly greater reductions in the TPS communities in the number of children with clinically elevated and borderline behavioral and emotional problems compared to the CAU communities. Similarly parents reported a greater reduction in the prevalence of depression, stress and coercive parenting. Findings show the feasibility of targeting dysfunctional parenting practices in a cost-effective manner and the public acceptance of an approach that blends universal and targeted program elements. Editors' Strategic Implications: This is the first positive parenting program to demonstrate longitudinal, population-level effects for parents and children. The authors provide an excellent example of multilevel prevention planning, coordination, execution, and evaluation.
ABSTRACT A culturally sensitive approach needs to be adopted in disseminating evidence-based prev... more ABSTRACT A culturally sensitive approach needs to be adopted in disseminating evidence-based preventive programs internationally, and very little is known about effective dissemination into low-resource settings such as low and middle income countries. Following guidelines on optimizing the fit of evidence-based parenting programs worldwide, a cultural relevance study was conducted in Panama, Central America. Parents (N = 120) from low-resource communities were surveyed to explore cultural relevance of material from the Triple P-Positive Parenting Program. Intention to participate and views on delivery formats and program features were also examined. Descriptive statistics and regressions were carried out to analyze the results. Parents found program materials highly relevant and reported that they would be willing to participate in a program if one was offered. A large proportion of the sample expressed a preference for self-directed formats such as books, articles and brochures (77.6 %). Regression analyses suggested that most parents considered material as relevant, interesting and useful, regardless of other factors such as socio-economic status, gender, the level of child behavioral difficulties, parental stress, parental confidence and expectations of future behavioral problems. The study provides a potential approach for dissemination of research and offers an insight into the needs and preferences of a particular segment of the world’s population—parents in low-resource settings. Strategies for meeting the needs and preferences of these parents in terms of service delivery are discussed.
International Journal of Behavioral Development, Jul 2, 2015
In the present study, we explored the factor structure as well as validity and reliability of the... more In the present study, we explored the factor structure as well as validity and reliability of the Spanish version of the Child Adjustment and Parent Efficacy Scale (CAPES) suitable for assessing child behavioural and emotional difficulties (Intensity Scale) and parental self-efficacy (Self-Efficacy Scale) among Spanish-speaking parents from the US, Latin America and Spain. This instrument was designed to be brief and easy to read in order to reach parents with low-literacy levels and from under-resourced backgrounds. Psychometrics for the English version of the CAPES indicates good internal consistency, as well as satisfactory construct and predictive validity of the measure (Morawska et al., 2014). A sample of 174 parents of children (91 boys and 78 girls) from Panama participated in this study. They completed the instrument alongside the Strengths and Difficulties Questionnaire (SDQ) for measuring child psychological problems and the Parenting Task Checklist (PTC) for measuring parental self-efficacy. In addition, a group of 49 parents completed the CAPES at time 1 (T1) and 2 weeks after (T2). Psychometric evaluation of the Spanish version of the CAPES revealed that it has adequate internal consistency and test–retest reliability, as well as satisfactory convergent and discriminant validity. In conclusion, this instrument shows promise as a brief outcome measure to be used in clinical settings and to assess the effects of parenting interventions among Spanish-speaking parents. More research into psychometric properties of the Spanish version of the CAPES is needed, before it can be widely applied in practice.
A set of instruments with different response formats is usually used to assess parenting practice... more A set of instruments with different response formats is usually used to assess parenting practices in clinical settings and in research studies. These complex protocols can be problematic for parents with low-literacy levels. The Parenting and Family Adjustment Scales (PAFAS) is a brief, easy to read instrument that has been developed to address these concerns. The English version of this instrument suggested that it has good internal consistency (range from .70 to .96), as well as satisfactory construct and predictive validity. The aim of the present study was to explore the validity and reliability of the Spanish version of the PAFAS. A sample of 174 Spanish-speaking parents (85 % mothers; M = 37 years old; SD = 9.1) from Panama in Central America completed the instrument alongside the Parenting Scale and the Depression Anxiety Stress Scale (DASS-21). Psychometric evaluations revealed that the measure had satisfactory construct and concurrent validity as well as good internal consistency (values >.60 for all subscales) and test-retest reliability (ICC >.60 for all subscales). The PAFAS shows promise as a brief outcome measure to assess parenting practices and family functioning with Spanish-speaking parents. Potential uses of the measure and implications for further validation with diverse samples are discussed.
The importance of champions in the implementation of evidence‐based public health programs has be... more The importance of champions in the implementation of evidence‐based public health programs has been well established. Champions perform a range of behaviors which can have significant influence on the adoption and sustainability of interventions. This study investigates champion behaviors in parenting practitioners with the aim to provide insight into the range and extent that practitioners engage in champion behaviors and to examine predictors of practitioners' champion behaviors using structural equation modeling. Data were collected during a large international implementation survey of 1606 practitioners trained to deliver an evidence‐based parenting program, the triple P—Positive Parenting Program. We developed a 13‐item Champion Behaviors Scale which was administered alongside other measures of predictors of implementation outcomes. Perceived usefulness of the program was the most important facilitator of both public and personal champion behaviors. Certain desirable featur...
Australian and New Zealand Journal of Public Health
OBJECTIVES Parenting is central to children's optimal development and accounts for a substant... more OBJECTIVES Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.
Journal of Consulting and Clinical Psychology, Dec 1, 2014
This randomized controlled trial evaluated the efficacy of Primary Care Stepping Stones Triple P,... more This randomized controlled trial evaluated the efficacy of Primary Care Stepping Stones Triple P, a brief individualized parenting program, in a sample of parents of children with autism spectrum disorder (ASD). Sixty-four parents of children aged 2-9 years (M = 5.67, SD = 2.14) with an ASD diagnosis participated in the study. Eighty-six percent of children were male, and 89% of parents identified their child's ethnicity as Australian/White. Families were randomly assigned to 1 of 2 conditions (intervention or care-as-usual) and were assessed at 3 time points (preintervention, postintervention, and 6-month follow-up). Parents completed a range of questionnaires to assess changes in child behavior (Eyberg Child Behavior Inventory) and parent outcomes (Parenting Scale, Depression Anxiety Stress Scale-21, Parent Problem Checklist, Relationship Quality Inventory, Parental Stress Scale) and 30-min home observations of parent-child interactions. Relative to the care-as-usual group, significant short-term improvements were found in the intervention group on parent-reported child behavior problems, dysfunctional parenting styles, parenting confidence, and parental stress, parental conflict, and relationship happiness. No significant intervention effects were found on levels of parental depression or anxiety, or on observed child disruptive and parent aversive behavior. The effect sizes for significant variables ranged from medium to large. Short-term effects were predominantly maintained at 6-month follow-up, and parents reported high levels of goal achievement and satisfaction with the program. The results indicate that a brief low intensity version of Stepping Stones Triple P is an efficacious intervention for parents of children with ASD.
A large-scale population trial using the Triple P-Positive Parenting Program (TPS) was evaluated.... more A large-scale population trial using the Triple P-Positive Parenting Program (TPS) was evaluated. The target population was all parents of 4- to 7-year-old children residing in ten geographical catchment areas in Brisbane (intervention communities) and ten sociodemographically matched catchment areas from Sydney (5) and Melbourne (5), care as usual (CAU) comparison communities. All five levels of the Triple P multilevel system of intervention were employed; including a local mass media strategy, a primary care strategy, and three more intensive levels of parenting intervention delivered by a range of service providers (e.g., health, education, and welfare sectors). Program outcomes were assessed through a computer-assisted telephone interview of a random sample of households (N = 3000) in each community at pre-intervention and again at two years post-intervention. At post-intervention there were significantly greater reductions in the TPS communities in the number of children with clinically elevated and borderline behavioral and emotional problems compared to the CAU communities. Similarly parents reported a greater reduction in the prevalence of depression, stress and coercive parenting. Findings show the feasibility of targeting dysfunctional parenting practices in a cost-effective manner and the public acceptance of an approach that blends universal and targeted program elements. Editors' Strategic Implications: This is the first positive parenting program to demonstrate longitudinal, population-level effects for parents and children. The authors provide an excellent example of multilevel prevention planning, coordination, execution, and evaluation.
ABSTRACT A culturally sensitive approach needs to be adopted in disseminating evidence-based prev... more ABSTRACT A culturally sensitive approach needs to be adopted in disseminating evidence-based preventive programs internationally, and very little is known about effective dissemination into low-resource settings such as low and middle income countries. Following guidelines on optimizing the fit of evidence-based parenting programs worldwide, a cultural relevance study was conducted in Panama, Central America. Parents (N = 120) from low-resource communities were surveyed to explore cultural relevance of material from the Triple P-Positive Parenting Program. Intention to participate and views on delivery formats and program features were also examined. Descriptive statistics and regressions were carried out to analyze the results. Parents found program materials highly relevant and reported that they would be willing to participate in a program if one was offered. A large proportion of the sample expressed a preference for self-directed formats such as books, articles and brochures (77.6 %). Regression analyses suggested that most parents considered material as relevant, interesting and useful, regardless of other factors such as socio-economic status, gender, the level of child behavioral difficulties, parental stress, parental confidence and expectations of future behavioral problems. The study provides a potential approach for dissemination of research and offers an insight into the needs and preferences of a particular segment of the world’s population—parents in low-resource settings. Strategies for meeting the needs and preferences of these parents in terms of service delivery are discussed.
International Journal of Behavioral Development, Jul 2, 2015
In the present study, we explored the factor structure as well as validity and reliability of the... more In the present study, we explored the factor structure as well as validity and reliability of the Spanish version of the Child Adjustment and Parent Efficacy Scale (CAPES) suitable for assessing child behavioural and emotional difficulties (Intensity Scale) and parental self-efficacy (Self-Efficacy Scale) among Spanish-speaking parents from the US, Latin America and Spain. This instrument was designed to be brief and easy to read in order to reach parents with low-literacy levels and from under-resourced backgrounds. Psychometrics for the English version of the CAPES indicates good internal consistency, as well as satisfactory construct and predictive validity of the measure (Morawska et al., 2014). A sample of 174 parents of children (91 boys and 78 girls) from Panama participated in this study. They completed the instrument alongside the Strengths and Difficulties Questionnaire (SDQ) for measuring child psychological problems and the Parenting Task Checklist (PTC) for measuring parental self-efficacy. In addition, a group of 49 parents completed the CAPES at time 1 (T1) and 2 weeks after (T2). Psychometric evaluation of the Spanish version of the CAPES revealed that it has adequate internal consistency and test–retest reliability, as well as satisfactory convergent and discriminant validity. In conclusion, this instrument shows promise as a brief outcome measure to be used in clinical settings and to assess the effects of parenting interventions among Spanish-speaking parents. More research into psychometric properties of the Spanish version of the CAPES is needed, before it can be widely applied in practice.
A set of instruments with different response formats is usually used to assess parenting practice... more A set of instruments with different response formats is usually used to assess parenting practices in clinical settings and in research studies. These complex protocols can be problematic for parents with low-literacy levels. The Parenting and Family Adjustment Scales (PAFAS) is a brief, easy to read instrument that has been developed to address these concerns. The English version of this instrument suggested that it has good internal consistency (range from .70 to .96), as well as satisfactory construct and predictive validity. The aim of the present study was to explore the validity and reliability of the Spanish version of the PAFAS. A sample of 174 Spanish-speaking parents (85 % mothers; M = 37 years old; SD = 9.1) from Panama in Central America completed the instrument alongside the Parenting Scale and the Depression Anxiety Stress Scale (DASS-21). Psychometric evaluations revealed that the measure had satisfactory construct and concurrent validity as well as good internal consistency (values >.60 for all subscales) and test-retest reliability (ICC >.60 for all subscales). The PAFAS shows promise as a brief outcome measure to assess parenting practices and family functioning with Spanish-speaking parents. Potential uses of the measure and implications for further validation with diverse samples are discussed.
The importance of champions in the implementation of evidence‐based public health programs has be... more The importance of champions in the implementation of evidence‐based public health programs has been well established. Champions perform a range of behaviors which can have significant influence on the adoption and sustainability of interventions. This study investigates champion behaviors in parenting practitioners with the aim to provide insight into the range and extent that practitioners engage in champion behaviors and to examine predictors of practitioners' champion behaviors using structural equation modeling. Data were collected during a large international implementation survey of 1606 practitioners trained to deliver an evidence‐based parenting program, the triple P—Positive Parenting Program. We developed a 13‐item Champion Behaviors Scale which was administered alongside other measures of predictors of implementation outcomes. Perceived usefulness of the program was the most important facilitator of both public and personal champion behaviors. Certain desirable featur...
Australian and New Zealand Journal of Public Health
OBJECTIVES Parenting is central to children's optimal development and accounts for a substant... more OBJECTIVES Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.
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Papers by Matthew Sanders