Population-Based System of Parenting Support to Reduce the Prevalence of Child Social, Emotional, and Behavioural Problems: Difference-In-Differences Study
The quality of parenting is recognised as an important determinant of children’s mental health. Parenting interventions typically target high-risk families rather than adopting a universal approach. This study examined the population impact of the Triple P Positive Parenting Programme on the prevalence of children’s social, emotional, and behavioural problems. A propensity score matching difference-in-differences method was used to compare intervention and comparison regions matched on socio-demographic characteristics in midlands Ireland. The pre-intervention sample included 1501 and 1495 parents of children aged 4–8 years in the intervention and comparison regions respectively. The post-intervention sample included 1521 and 1544 parents respectively. The primary outcome measure was parental reports on the Strengths and Difficulties Questionnaire. There were some significant reductions in the prevalence rates of social, emotional, and behavioural problems in the intervention regions compared to the comparison regions. Children in the intervention sample experienced lower total difficulties, emotional symptoms, and conduct problems than children in the comparison sample, and they were less at risk of scoring within the borderline/abnormal range for total difficulties, conduct problems, and hyperactivity. The programme reduced the proportion of children scoring within the borderline/abnormal range by 4.7% for total difficulties, 4.4% for conduct problems, and 4.5% for hyperactivity in the total population. This study demonstrated that a universal parenting programme implemented at multiple levels using a partnership approach may be an effective population health approach to targeting child mental health.
KeywordsParent training Mental health Population health approach Propensity score matching Difference-in-differences design
We thank all participating families and partnership members (Athlone Community Services Council, Athlone Education Centre, Carrick-on-Shannon Education Centre, Health Service Executive (Primary Care and Health and Wellbeing Directorates), Longford Community Resources Limited, Longford Vocational Educational Committee, TUSLA Child and Family Agency, Westmeath Community Development, Westmeath County Childcare Committee). We acknowledge the NUIG research team of Saoirse Ni Gabhainn, John Canavan, Allyn Fives, Lisa Pursell, and Catherine Heary for their help in the population study methodology design and inputting of data. Data in the population survey were collected by two market research agencies, Millward Brown and Amarach. We also acknowledge the support and guidance offered by critical friends, The Atlantic Philanthropies and their Expert Advisory Committee, the Centre for Effective Services, Archways, Phil Jennings, Danny Perkins, and especially, the commitment, skill, and passion of the Triple P practitioners.
This work was supported by grants from The Atlantic Philanthropies, the Irish Government’s Department of Children and Youth Affairs, the Irish Health Service Executive, and Tusla. The funders did not have any role in the study design; the collection, analysis, and interpretation of data; the writing of the report; nor the decision to submit the paper for publication.
Compliance with Ethical Standards
Conflict of Interest
The submitted work was supporting by The Atlantic Philanthropies, the Irish Government’s Department of Children and Youth Affairs, the Irish Health Service Executive, and Tusla. Owens and Hegarty are employees of the Health Service Executive and the Longford/Westmeath Parenting Partnership; Owens was responsible for delivering the Triple P programme, and Doyle was a consultant for the Longford/Westmeath Parenting Partnership.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for data collection was granted by the National University of Ireland (NUI) Galway’s Research Ethics Committee.
Informed consent was obtained from all individual participants included in the study.
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