What’s the Big Deal about Evidence-based Practice?
Whether we’re buying underwear, skin care products, protein snacks, transit tickets, or an electronic device, we want to know what we’re spending money on fits our needs and works for us. We’re all too familiar with extravagant claims that a product or service will change our lives, only to find that it’s not quite what we were hoping for. Some of us have closets full of clothes that don’t look as good on us as they did in the picture, or tools that don’t seem as easy to use as they were in the promotional video. Recycling bins are filled with purchases that did not measure up to expectations. The same applies to parenting programs.
Parents want tools that are backed by solid research and have consistently and repeatedly been shown to make a difference. This is where Triple P stands out.
Triple P’s Evidence Base
Originally developed at the University of Queensland in Australia, Triple P is a suite of programs that has been evaluated and refined over 40 years of rigorous research by hundreds of researchers across 43 countries. Triple P was recognized by the United Nations as the parenting support system with the strongest research foundation. The World Health Organization found that the strategies promoted by Triple P are effective in preventing child maltreatment and enhancing parent-child relationships1.
The Parenting and Family Support Centre at the University of Queensland maintains a database of research conducted globally on Triple P programs. This database shows the dynamic nature of the research on Triple P. Across the world, organizations have examined the usefulness of the program to address families’ changing and diverse needs.
Research has consistently found that parents find the Triple P strategies acceptable. When they have completed a Triple P program, parents feel more confident and appreciate using positive ways to help their children. Communities offering Triple P programs have achieved impressive reduction in indicators of child abuse. Research conducted over several years in Québec underlined the helpfulness of the program when delivered in a different socio-cultural context to the one in which it was developed2.
Research feeds the evolution of the program to meet the needs of diverse parents. Studies that identify obstacles to program delivery lead to further innovations. So, for example, when practitioners found that some parents had difficulty attending a series of in-person sessions (due to scheduling issues and transportation difficulties) an alternative workshop format was developed and trialed. Most programs can now be delivered in a variety of formats according to community needs, resources and preferences.
Yes, that’s great, but does it fit for my community/family/child?
Knowing that Triple P has research support from dozens of countries, in other communities and with other families is not enough. Triple P encourages continuous goal setting and evaluation. The Triple P system of programs is constantly being expanded to address new needs and concerns.
Flexibility and Fidelity
To get the full benefit of an evidence-based product or service, it needs to be used in the way it was originally developed. However, it also needs to be flexible enough to meet the needs of a specific context.
The Covid-19 global pandemic challenged our normal practices. Triple P pivoted to help communities continue to support families. Practitioner training was offered by videoconference. Research by Triple P showed similar gains in practitioner knowledge and confidence when training was offered by videoconference to when it was offered in person3. In addition, Triple P offered guidance to practitioners on how to deliver programs to parents by videoconference. Echoing the results found for practitioners, parents in lockdown appreciated accessing parenting support via videoconference.
In Triple P training, practitioners learn about aspects of the program that are essential to good outcomes (like encouraging the parent to make choices and offering ways to practice). If fidelity to these aspects is reduced, there is a risk that the program efficacy will be diluted. Practitioners are also encouraged to think of flexible ways to tailor the program (like giving local or relevant examples).
The Triple P Implementation Framework
Triple P invites organizations to clearly identify the outcomes they seek (such as reaching new parents, those who are dealing with conflict, or supporting a child with a disability) and the data they need to be able to see if a program meets their objectives (such as how easily parents can access the program, the number of attendees, reductions in child behaviour problems, increased parental confidence). The Triple P Implementation Framework offers organizations and communities tools that help them navigate the choice of Triple P program and the way it will be put into practice. Triple P encourages ongoing evaluation so that organizations can see whether the program is working for them and achieving desired outcomes such as reduced waiting lists, parent satisfaction, and reduction in child abuse.
Parents are encouraged in evidence-based practice
The evidence-based approach applies to parents too. Parents are the ultimate decision-makers about whether to use Triple P strategies. Across all Triple P programs, each parent is invited to reflect on the changes that they would like to see and the skills they would like to help their children develop. Parents choose what they would like to work on, changes they’d like to see in their children and changes they might like to see in themselves.
Parents are encouraged to notice and celebrate signs of change
Early in Triple P programs parents learn to keep track of the changes they would like to see, such as how well the child plays with peers, how cooperative they are with parental requests, the frequency of temper tantrums, the way they manage the activities of daily living. This way, parents can see the extent to which their strategies are working and when strategies need tweaking. When positive changes occur, individuals are encouraged to consider what contributed to these improvements. The consistent message across parents from diverse backgrounds is that taking time to have positive interactions with their children transforms their lives.
Responding to change
Ongoing evaluation ensures that parents and organizations can see how well things are working, so they can celebrate changes and adjust if needed.
Evidence-based practice means benefiting from prior research to select programs and strategies that have been shown to work elsewhere and gathering data to see how well they work for a specific province, community, agency, practitioner, family, parent and child. Evidence-based practice is a way of thinking about options — picking those with a high likelihood of success, then carefully assessing whether they are making a difference, and tweaking them to fit the needs of a specific context. Parents are the experts who choose what’s important for their children. Just like when parents choose products or advice, it's important to know that the strategies they use are backed by research and proven to work.
Behind every effective program are real people dedicated to understanding what really helps, refining their approach and making sure it makes a difference for families. This ongoing commitment to evidence-based practice ensures that our programs remain a reliable and valuable resource for families, every step of the way.
References
- WHO guidelines on parenting interventions to prevent maltreatment and enhance parent–child relationships with children aged 0–17 years. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO
- Gagné, M.-H., Piché, G., Brunson, L., Clément, M.-È., Drapeau, S., & Jean, S.-M. (2023). Efficacy of the Triple P – Positive Parenting Program on 0–12 year-old Quebec children’s behavior. Children and Youth Services Review, 149, 106946. https://doi.org/10.1016/j.childyouth.2023.106946
- Sanders, M. R., Hoang, N. P. T., Gerrish, R. J., Ralph, A., & McWilliam, J. (2023). The change of practitioner’s self-efficacy in Triple P professional training: Moderating role of practitioner characteristics, country, and delivery mode. Journal of Child and Family Studies, 32(5), 1470-1482. https://doi.org/10.1007/s10826-023-02568-2
