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Triple P-Positive Parenting Program®-Home Visiting (Triple P-Home Visiting)

In Brief

Last Updated

July 2014

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Evidence of Model Effectiveness

This model does not meet the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population or for tribal populations.

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Model Description

Triple P–Positive Parenting Program® (Triple P) is a parenting and family support system designed to prevent and treat behavioral and emotional problems in children from birth through their teenage years. Specialized interventions target certain subgroups, including children with a disability and indigenous families. To meet the needs of different families and implementing agencies, the Triple P system uses five levels of increasing intensity, a range of delivery methods (such as one-on-one consultations in the home or group seminars), and staff from multiple disciplines (including paraprofessionals, counselors, and nurses). The intensity and length of services also varies across levels. For example, Primary Care Triple P (Level 3) includes approximately four individual consultations of 15 to 30 minutes over one to two months, and Enhanced Triple P (Level 5) includes approximately eight individualized sessions, each lasting 60 to 90 minutes.

The HomVEE review is based on Triple P interventions where home visiting was the primary service delivery mechanism with prenatal parents or families with children birth to age 5 (Triple P–Home Visiting).

This report also includes reviews of one Triple P-Home Visiting component (Child Management Training) and a specialized Triple P-Home Visiting intervention (Stepping Stones Triple P) for children with a disability; both are considered Level 4 Triple P interventions. During Child Management Training, therapists meet with parents in the home and explain how parents can help teach their children new behaviors using a six-step procedure of descriptive praise and contingent consequences. In this component, a therapist provides verbal and written instruction, lecture presentations, and modeling behavior in an effort to teach parents about a sequence of steps intended to modify their child’s behavior. Then, they observe parent-child and parent-parent interactions and provide verbal feedback and written enrichment materials. (As the model was being developed, this component was originally called Instructions + Feedback.) Stepping Stones is a variant of Triple P-Home Visiting intended specifically for parents of children with disabilities. It provides assessment of parenting strategies and then instruction and support that aim to promote child competencies in social and language skills, emotional skills, independence, and problem solving.

For more information, please read the Model Overview.

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Extent of Evidence

Results of Search and ReviewNumber of Studies for Triple P-Home VisitingNumber of Studies for Triple P-Home Visiting: Child Management Training ComponentNumber of Studies for Triple P-Home Visiting: Stepping Stones
Released from 1979 to 2013 98510
Eligible for review 151
     Rated high 010
     Rated moderate 031
     Rated low 110
     Additional sourcesa 000

aAdditional sources overlap with another study and are not rated.

Note: For this model, several Triple P studies compared various components of the model, sometimes in a single-case design format with multiple phases. For screening and reviewing studies, we focused on those with a contrast between Triple P—Home Visiting and a non-Triple P condition.

For more information, read the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

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Summary of Findings



Triple P-Home Visiting
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness Not measured Not measured
Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices Not measured Not measured
Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Triple P-Home Visiting: Child Management Training Component*
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 1
No effect: 5
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices Not measured Not measured
Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Triple P-Home Visiting: Stepping Stones
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 3
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 5
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured
*The table includes results from single-case design studies. However, these results are not factored into whether a model meets the DHHS criteria unless additional criteria are also met. Please read the DHHScriteria for evidence-based program models for more information.
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This table summarizes the effects found in research across outcome domains. Outcomes with a favorable impact are listed in green and outcomes with an unfavorable or ambiguous impact are listed in red. Outcomes that have high attrition or lack of baseline equivalence are excluded from this report.

Favorable Impact: A statistically significant impact on an outcome measure in a direction that is beneficial for children and parents. This impact could statistically be positive or negative, and is determined “favorable” based on the end result. For example, a favorable impact could be an increase in children’s vocabulary or daily reading to children by parents, or a reduction in harsh parenting practices or maternal depression.

Unfavorable or Ambiguous Impact: A statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents. This impact could statistically be positive or negative, and is determined “unfavorable or ambiguous” based on the end result. NOTE: While some outcomes are clearly unfavorable, for other outcomes it is not as clear which direction is desirable. For example, an increase in children’s behavior problems is clearly unfavorable, while an increase in number of days mothers are hospitalized is more ambiguous. This may be viewed as an unfavorable impact because it indicates that mothers have more health problems, but it could also indicate that mothers have increased access to needed health care due to their participation in a home visiting program.

Primary Outcome Measure: For the HomVEE review, an outcome measured through direct observation, direct assessment, or administrative data; or self-reported data collected using a standardized (normed) instrument.

Secondary Outcome Measure: For the HomVEE review, most self-reported data, excluding self-reports based on a standardized (normed) instrument.

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

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Criteria Established by the Department of Health and Human Services

 Triple P-Home VisitingTriple P-Home Visiting: Child Management Training ComponentTriple P-Home Visiting: Stepping Stones
Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? NoYesYes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
NoNoNo
Favorable impacts on full sample? NAYesNo
Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a NoNoNo
One or more favorable, statistically significant impact reported in a peer-reviewed journal?a NoYesNo

NA = not applicable.

aThis information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Programs for more information.

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