An evaluation by academics of Glasgow’s flagship parenting programme – the Triple P (Positive Parenting Programme) – has found a low completion rate among families, particularly those from more deprived areas, and minimal impact on the most vulnerable children.

Around 5,000 children were measured for emotional well-being at the age of five each year from 2010, and no improvements were found after the implementation of the city-wide Triple P programme.

The final report of the Parenting Support Framework Evaluation by researchers from the University of Glasgow and Aberdeen recommends that NHS Greater Glasgow and Clyde and Glasgow City Council should not commit any further investment in Triple P training or materials, unless used for independently-conducted randomised trials of specific interventions.

The evaluation was commissioned by the Scottish Government, NHSGGC and the city council, and covered the period 2009-13. Around 730 members of staff were trained to deliver the programme over the period.

The Triple P programme was designed by Professor Matt Sanders and colleagues at the University of Queensland in Australia. It evolved from a small, home-based, individually-administered training programme for parents of disruptive pre-school children into a comprehensive, preventative whole-population intervention programme.

It is now used in some 20 countries, including the USA, England, Ireland, Wales, Canada, Australia, New Zealand, Belgium, Japan, Iran, Hong Kong, Singapore, the Netherlands, Germany, Curacao, Romania, Switzerland, Austria and Sweden.

Triple P is one of the central components of Glasgow’s Parenting Support Framework: elements range from mass-media campaigns to one-off seminars for the parents and carers of every child in Primary 1 through to intensive group-based interventions.

The study, led by Professor Philip Wilson, Professor of Primary Care and Rural Health at the University of Aberdeen, and Visiting Professor at the University of Glasgow, found:

• More than 50% of families starting Triple P interventions dropped out before the end of the course;
• Families with greater problems than those in the general population were more likely to attend Group Triple P sessions, but those with more severe problems were less likely to complete interventions;
• Families living in more deprived areas were more likely to start Triple P interventions than those living in affluent areas but more affluent and more highly-educated families were more likely to complete Triple P interventions;
• Although families who completed interventions reported high levels of satisfaction with Triple P, and reported improvements in parenting behaviours, emotional well-being and child behaviour, it was not possible to be sure whether these improvements were a result of the intervention or whether they represented the passage of time or “regression to the mean”. This uncertainty, coupled with low completion rates, rendered assessment of the effectiveness of interventions impossible;
• Practitioners were generally satisfied with the Triple P approach to parenting support but some expressed negative views about a target-driven approach and some considered the programme inappropriate for some families;
• The social and emotional functioning of the population of children aged five years’ old did not change during the implementation of the Parenting Support Framework.

Professor Wilson said: “The lack of change in social and emotional functioning among the child population of Glasgow, together with the low completion rates for Triple P interventions, selective benefit for more privileged families and recent published evidence of overall lack of efficacy leads us to recommend that Glasgow should not commit to further investment in Triple P training or materials except within the context of independently conducted randomised trials of specific interventions.”

The research group recommended that Glasgow’s “excellent infrastructure” for provision of parenting support should be further strengthened by the introduction of alternative parenting programmes and more robust systems for monitoring activity. 

The report concluded: “While the Triple P programme itself may have been ineffective, there is good reason to believe that the parenting support infrastructure in Glasgow has matured substantially. There is now a large cohort of practitioners versed in the principles of behaviour management and there is strong evidence that professional skills in engaging with families who could benefit from parenting support have developed to a remarkable extent.

“The near-universal acceptance of the benefits of monitoring the social and emotional well-being of young children within Glasgow is another reason for optimism: whole population data of this sort can be used to identify neighbourhoods, institutions and projects which are ‘getting it right’ for children. This in turn could allow Glasgow to identify approaches which will improve the well-being of the whole population in the future.”

Find out more

• Professor Philip Wilson
• Dr Lucy Thompson
• Louise Marryat
• Institute of Health and Wellbeing
• Mental Health and Wellbeing
• Parenting Support Framework Evaluation: Final Report

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Media Enquiries: Liz.Buie@glasgow.ac.uk/ 0141 330 2702

First published: 12 November 2014