Abstract
Evidence-based parenting support programs (EBPS) based on social learning and cognitive behavioral principles are effective in reducing conduct-related problems in a diverse range of cultural contexts. However, much less is known about their effects with indigenous families. A Collaborative Participation Adaptation Model (CPAM) was used to culturally adapt a low-intensity, two-session group variant of the Triple P-Positive Parenting Program for Māori parents of young children in New Zealand. CPAM involved collaborating closely with Māori tribal elders, practitioners as end-users, and parents as consumers through a participatory process to identify content and delivery process used in Triple P that would ensure that traditional Māori cultural values were incorporated. The culturally adapted program (Te Whānau Pou Toru) was then evaluated with 70 parents of 3–7-year-old children in a two-arm randomized clinical trial (intervention vs waitlist control). Results showed that parents in the intervention group reported significantly greater improvements in child behavior problems and reduced interparental conflict about child-rearing compared to parents in the control group at immediate post-intervention. These intervention effects were either maintained or improved further at follow-up assessment. At 6-month follow-up intervention-group parents reported significantly greater reductions in overreactive parenting practices and greater confidence in managing a range of difficult child behaviors than control parents. The culturally adapted program was associated with high levels of parental satisfaction. Findings are discussed in terms of making brief, effective, culturally adapted parenting support available to Māori families.
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References
Advisory Group on Conduct Problems (2009). Conduct problems: Best practice report. Retrieved from http://www.msd.govt.nz/about-msd-and-our-work/publications-resources/research/conduct-problems-best-practice/
Arnold, D., O’Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137–144. https://doi.org/10.1037/1040-3590.5.2.137.
BigFoot, D. S., & Funderburk, B. W. (2011). Honoring children, making relatives: The cultural translation of parent-child interaction therapy for American Indian and Alaska native families. Journal of Psychoactive Drugs, 43, 309–318. https://doi.org/10.1080/02791072.2011.628924.
Dadds, M. R., & Powell, M. B. (1991). The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinical children. Journal of Abnormal Child Psychology, 19, 553–567. https://doi.org/10.1007/BF00925820.
Dittman, C. K., Farruggia, S. P., Keown, L. J., & Sanders, M. R. (2016). Dealing with disobedience: An evaluation of a brief parenting intervention for young children showing noncompliant behavior problems. Child Psychiatry and Human Development, 47, 102–112. https://doi.org/10.1007/s10578-015-0548-9.
Dretzke, J., Davenport, C., Frew, E., Barlow, J., Stewart-Brown, S., Bayliss, S., et al. (2009). The clinical effectiveness of different parenting programmes for children with conduct problems: A systematic review of randomised controlled trials. Child and Adolescent Psychiatry and Mental Health, 3, 7. https://doi.org/10.1186/1753-2000-3-7.
Eyberg, S. M., & Pincus, D. (1999). Eyberg child behavior inventory and sutter-eyberg student behavior inventory-revised: professional manual. Odessa: Psychological Assessment Resources.
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.
Goodman, R. (1999). The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry, 40, 791–799. https://doi.org/10.1111/1469-7610.00494.
Gupta, S. K. (2011). Intention-to-treat concept: A review. Perspectives in Clinical Research, 2, 109–112. https://doi.org/10.4103/2229-3485.83221.
Jaccard, J., & Guilamo-Ramos, V. (2002). Analysis of variance frameworks in clinical child and adolescent psychology: Issues and recommendations. Journal of Clinical Child and Adolescent Psychology, 31, 130–146. https://doi.org/10.1207/S15374424JCCP3101_15.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. https://doi.org/10.1037/0022-006X.59.1.12.
Kumpfer, K., Magalhães, C., & Xie, J. (2017). Cultural adaptation and implementation of family evidence-based interventions with diverse populations. Prevention Science, 18, 649–659. https://doi.org/10.1007/s11121-016-0719-3.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychological Foundation of Australia.
Mazzucchelli, T. G., & Sanders, M. R. (2010). Facilitating practitioner flexibility within an empirically supported intervention: Lessons from a system of parenting support. Clinical Psychology: Science and Practice, 17, 238–252. https://doi.org/10.1111/j.1468-2850.2010.01215.x.
Mejia, A., Calam, R., & Sanders, M. R. (2015). A pilot randomized controlled trial of a brief parenting intervention in low-resource settings in Panama. Prevention Science, 16, 707–7017. https://doi.org/10.1007/s11121-015-0551-1.
Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E., & Zubrick, S. R. (2014). Gaps in indigenous disadvantage not closing: A census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14, 201. https://doi.org/10.1186/1471-2458-14-201.
Morawska, A., Haslam, D., Milne, D., & Sanders, M. R. (2011). Evaluation of a brief parenting discussion group for parents of young children. Journal of Developmental and Behavioral Pediatrics, 32, 136–145. https://doi.org/10.1097/DBP.0b013e3181f17a28.
Morris, S. B. (2008). Estimating effect sizes from pretest-posttest-control group designs. Organizational Research Methods, 11, 364–386. https://doi.org/10.1177/1094428106291059.
Norton, R. (1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and the Family, 45, 141–151. https://doi.org/10.2307/351302.
Pfiffner, L. J. (2014). Meta-analysis supports efficacy of behavioral interventions for attention-deficit/hyperactivity disorder—Related problems. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 830–832. https://doi.org/10.1016/j.jaac.2014.03.006.
Sanders, M. R., & Kirby, J. N. (2014). A public-health approach to improving parenting and promoting children’s well-being. Child Development Perspectives, 8, 250–257. https://doi.org/10.1111/cdep.12086.
Sanders, M. R., & Woolley, M. L. (2005). The relationship between maternal self-efficacy and parenting practices: Implications for parent training. Child: Care, Health and Development, 31, 65–73. https://doi.org/10.1111/j.1365-2214.2005.00487.x.
Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624–640. https://doi.org/10.1037/0022-006x.68.4.624.
Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, D. D. (2014). The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34, 337–357. https://doi.org/10.1016/j.cpr.2014.04.003.
Social Policy Evaluation and Research Unit (Superu) (2015). Parenting programmes effective with whānau. New Zealand. Retrieved from http://www.superu.govt.nz/publication/what-works-parenting-programmes-effective-whānau .
Spoon, J. (2014). Quantitative, qualitative, and collaborative methods: Approaching indigenous ecological knowledge heterogeneity. Ecology and Society, 19. https://doi.org/10.5751/ES-06549-190333.
Turner, K. M. T., Richards, M., & Sanders, M. R. (2007). Randomised clinical trial of a group parent education programme for Australian indigenous families. Journal of Paediatrics and Child Health, 43, 429–437. https://doi.org/10.1111/j.1440-1754.2007.01053.x.
Turner, K. M. T., Sanders, M. R., Keown, L. J., & Shepherd, M. (2017). A collaborative partnership adaptation model. In M. R. Sanders & T. G. Mazzucchelli (Eds.), The power of positive parenting: Transforming the lives of children, parents and communities using the Triple P system (pp. 310–320). New York: Oxford University Press.
Funding
This research was funded by the New Zealand Ministry of Health, grant number 414953/349190/00.
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The Parenting and Family Support Centre is partly funded by royalties stemming from published resources of the Triple P–Positive Parenting Program, which is developed and owned by The University of Queensland (UQ). Royalties are also distributed to the Faculty of Health and Behavioral Sciences at UQ and contributory authors of published Triple P resources. Triple P International (TPI) Pty Ltd. is a private company licensed by Uniquest Pty Ltd. on behalf of UQ to publish and disseminate Triple P worldwide. Matthew Sanders is the founder and an author on various Triple P programs and a consultant to Triple P International. No other authors have any conflicts of interest to disclose.
Ethical Approval
All procedures performed were in accordance with the ethical standards of the University of Auckland and with the 1964 Helsinki declaration and its later amendments. Ethics approval was obtained from the University of Auckland Human Research Ethics Committee on 31 March 2015, reference number 013889.
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Informed consent was obtained from all individual participants included in the study.
A Consort checklist for the study is available online resource 1.
Electronic Supplementary Material
ESM 1
CONSORT 2010 checklist of information to include when reporting a randomised trial*. (DOCX 55 kb)
ESM 2
The Collaborative Participation and Adaptation Model (CPAM): Te Whānau Pou Toru example. (DOCX 20 kb)
ESM 3
Te Whānau Pou Toru Diagram. (PDF 3192 kb)
ESM 4
Te Whānau Pou Toru The Three Pillars of Positive Parenting Practices Handout. (PDF 961 kb)
ESM 5
Demographic characteristics of the sample. (DOCX 23 kb)
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Keown, L.J., Sanders, M.R., Franke, N. et al. Te Whānau Pou Toru: a Randomized Controlled Trial (RCT) of a Culturally Adapted Low-Intensity Variant of the Triple P-Positive Parenting Program for Indigenous Māori Families in New Zealand. Prev Sci 19, 954–965 (2018). https://doi.org/10.1007/s11121-018-0886-5
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DOI: https://doi.org/10.1007/s11121-018-0886-5