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The Role of Practitioner Self-Efficacy, Training, Program and Workplace Factors on the Implementation of an Evidence-Based Parenting Intervention in Primary Care

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An Erratum to this article was published on 02 September 2014

Abstract

This study examines factors affecting the implementation by primary care practitioners (nursing, education, allied health, and medical) of a brief parenting and family support intervention (the Primary Care Triple P—Positive Parenting Program) following professional training. It assesses the impact of prior experience, self-efficacy, program supports, program barriers, satisfaction with training, and workplace characteristics on reported extent of program use. The majority of practitioners (97%) reported using Triple P following training. Implementation was assessed as the proportion of cases seen who received the full program. Program supports (quality of format and materials) and barriers (management difficulties and lack of fit) impacted on practitioner self-efficacy, and higher self-efficacy was positively associated with implementation. Prior professional experience, satisfaction with training, and workplace factors were not significant predictors. These results highlight the importance of promoting practitioners’ sense of competence or mastery of a program for facilitating the implementation of evidence-based programs in primary care settings.

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Notes

  1. It is estimated that at least 70% of the original sample was contactable at 6-month follow up. This estimate is derived from the non-responder telephone survey in which 30% were unavailable: Of these, 28 (68.29%) had left their position, 9 (21.95%) were on leave at the time, 1 (2.44%) was deceased, and 3 (7.32%) declined participation.

  2. Fewer sessions may be indicative of attrition or a briefer consultation model with advice and written information administered in relation to a specific parenting concern (Selected Triple P), which is also a valid intervention option based on clinical judgment of a family’s needs.

  3. Descriptive printouts, histograms, and plots were examined to determine the normality of distributions for each measured variable. Normality could not be assumed for several variables: one was leptokurtic (statistic/SE = 3.93), three were positively skewed (statistic/SE ranged from 5.31 to 6.92), and six were negatively skewed (statistic/SE ranged from −3.05 to −5.77). As skewness and kurtosis were not extreme and transformation of the skewed variables did not result in improvements in normality, original data were used in the analyses. One multivariate outlier was identified as indicated by Mahalanobis distance. The model was run with and without this subject with no substantive change to fit indices. Data are therefore presented for the full sample. Given that multivariate normality could not be assumed, there was some risk that the model would not resolve. However, the function reached a minimum without error, and all residual means equaled zero.

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Acknowledgments

Special thanks go to the professionals who agreed to participate in this trial and to Stefano Occhipinti and Natalie Loxton for their advice on statistical analysis. Jan Nicholson was funded by an NHMRC Career Development Award (no. 954213).

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Authors and Affiliations

  1. Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia

    Karen M. T. Turner

  2. Murdoch Childrens Research Institute, Melbourne, Australia

    Jan M. Nicholson

  3. School of Psychology, The University of Queensland, Brisbane, Australia

    Matthew R. Sanders

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  1. Karen M. T. Turner
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  2. Jan M. Nicholson
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  3. Matthew R. Sanders
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Correspondence to Karen M. T. Turner.

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This paper is drawn from a doctoral dissertation by the first author, entitled “Parenting and Family Support in Primary Care Settings,” which was supervised by the second and third authors.

An erratum to this article is available at http://dx.doi.org/10.1007/s10935-014-0365-0.

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Turner, K.M.T., Nicholson, J.M. & Sanders, M.R. The Role of Practitioner Self-Efficacy, Training, Program and Workplace Factors on the Implementation of an Evidence-Based Parenting Intervention in Primary Care. J Primary Prevent 32, 95–112 (2011). https://doi.org/10.1007/s10935-011-0240-1

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