Will a modified Triple P Parenting
og a
e, which
c ta
takes
es into
to accou
accountt
Programme,
cultural issues, produce better outcomes for
a UK South Asian community in the West
Midlands?
Dr Neelam Kumar
How it all began…
Trained in Triple P
Delivered Triple P to South Asian
community
Recognised need for change in delivery of the
manualised Triple P
Many assumptions
made
(using a top down
model)
Initial thoughts
g ‐ culturallyy adapting
p g to include
religious references
Change of direction
(b
(bottom
up approach)
h)
Focus groups with parents who
had experienced the original
group
Q ti
i given
i
t accredited
dit d
Questionnaire
to
practitioners delivering Triple P in these
communities
Changes =
Consultation with
professionals
Limitations identified by the literature review and how future research could address them
Studies have not used comparison
groups to compare an adapted
programme with the original
programme
• Future studies to compare adapted group
with control group
Studies have only used quantitative • Research suggests using both quantitative
and qualitative measures
measures to evaluate programme
p g
effectiveness/satisfaction
Studies using western measures
which have no empirical evidence
for the community they are
evaluating
Some studies have made adaptations consulting
with professionals and other agencies. Parents
have not been consulted about the adaptations
made neither have they been asked to verify the
adaptations suggested.
suggested
• Use appropriate measures that have been
validated with the community in question
• Have parents as part of the adaptation
process from the very beginning so that they
inform adapted intervention
In some studies many adaptations are • Future research to look at which adaptations are
made which makes it difficult to
packaged
g p
programmes
g
are
necessaryy to ensure p
determine which adaptations are
successful for ethnic minority parents
necessary for successful interventions
Aim – The aim of the present study is to assess the impact of an
adapted parenting programme tailored to the South Asian
community.
• RQ 1: Does Triple P have a significant impact
with a UK South Asian communityy in the West
Midlands?
• RQ 2: Does a modified Triple P programme
have a greater impact in terms of parents’
ability
b l to manage their
h children
hl
and their
h
satisfaction with the programme?
Adapting Triple P
• Questionnaires completed by Triple P
p
accredited practitioners
• Meeting with the city parenting co‐ordinator
and clinical psychologist
• A focus group with parents who had received
the original Triple P
Visual representation of the issues highlighted and ways of
addressing these issues
Extra
sessions
ADDITIONAL SESSIONS
FOR BOTH GROUPS
Widespread
advertising
Both parents
to attend
Culturally
relevant
examples
What is
needed ?
needed…?
Involve
extended
families
Address culturally
sensitive issues
FACE TO FACE
CONSULTATION
Sessions to be
delivered at
different times
Follow up
support sessions
More visual
aids
Address
literacy levels
required
ADDITIONAL SLIDES
Control (Original)
Adapted
10 week programme
Each session 2.5
2 5 hours
Same method of recruitment
O i i l Triple
Original
T i l P slides
lid
Additi
Additional
l slides
lid
Telephone consultations
Face-to-face
consultations
Methodology
• Mixed methods research design – qualitative
quantitative approaches
pp
used
and q
• A mixed methodology was considered
appropriate for this study to support the
quantitative data, but more importantly to
address the
h llimitations off using Western
measures with ethnically diverse populations.
Quantitative – Triple P measures
Demographic information • Family Background Questionnaire
Child b
behaviour
h i
• Strengths and Difficulties Questionnaire
Parenting style
• Parenting Scale
Parenting confidence
• Being a parent scale
P
l adjustment
dj
Parental
• Depression,
D
i
A
Anxiety‐Stress
i
S
SScales
l
Conflict over parenting
Relationship Satisfaction
Consumer satisfaction
• Parenting problem checklist
• Relationship quality index
• Client satisfaction questionnaire
Qualitative – Focus groups
Non‐threatening questions
‐How did you hear about the course?
‐Have you found the programme useful?
‐Have
H
you noticed
i d a change
h
i yours and
in
d your
child’s behaviour?
‐What did you particularly like about the
course?
Difficult Questions
‐Would you change anything
about the course?
‐How would you like to see
parenting programmes
run ideally?
‐What improvements
to the programme
would you like
to see?
Delivery of the parenting programmes
Children’s centre (CC)
Time of delivery
CC 1
CC 2
Summer term
2009
Autumn Term
2009
Spring term 2010
Original Triple P
Adapted Triple P
Original Triple P
Adapted Triple P
Findings
• (RQ 1) Does Triple P have a significant impact
with a UK South Asian communityy in the West
Midlands?
‐ANOVA analysis ‐ combined results for both
parenting programmes (control and adapted)
had a significant effect for parents over time.
Findings
Pre and post intervention scores for parents in their respective groups
Findings
• Data from the qualitative analysis found that
parents in both groups
p
g p were able to reflect on
their own behaviour, and more importantly
how their behaviour affects their children’s
children s
behaviour.
Findings
• RQ 2:
2 Does
D
a modified
difi d TTriple
i l P programme have
h
a
greater impact in terms of parents’ ability to manage
their children and their satisfaction with the
programme?
• ANOVA analysis ‐ no significant interactions between
th adapted
the
d t d and
d control
t l groups across the
th pre and
d postt
measures. This suggests that a modified Triple P
parentingg programme
p
p g
did not have a ggreater impact
p in
terms of parents’ ability to manage their children.
• Independent t test for CSQ measure parents in the
adapted
d
d group were significantly
i ifi
l more satisfied
i fi d with
ih
the programme than parents in the control group.
Findings
• Th
The majority
j it off comments
t related
l t d to
t group dynamics
d
i (83%) came
from parents in the adapted group suggesting that they were
particularly satisfied having the opportunity for group face‐to‐face
consultation (Kane et al
consultation.
al. (2007)
(2007), suggest that parents value the
opportunity for peer support).
• 65% of comments related to the positive aspects came from the
adapted group – (clarity of the information presented and having
face‐to‐face consultations).
• 74% of comments for programme improvement came from parents
in the control group.
group Parents requested more time with the
facilitator and the rest of the group; they felt it was difficult to
discuss issues in‐depth over the phone.
• Parents in the control group felt that they needed more resources
to help support the parenting programme.
Findings
The
importance of
group
dynamics
Parenting
programmes
need to
provide space
f discussion
for
di
i
& ensure
understanding
by providing
additional
slides and
culturallly
relevant
examples.
The importance
of mixed
methodology
when carrying
out research in
this field
Need to develop
community
psychology
approach to
adapting/
developing
parenting
programmes