PARENTING+:Using media-based dissemination of intervention to improve parenting and prevent dysfunction
Submitting InstitutionUniversity of Manchester
Unit of AssessmentPsychology, Psychiatry and Neuroscience
Summary Impact TypeSocietal
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Psychology and Cognitive Sciences: Psychology
Summary of the impact
Approximately 15% of children show significant behavioural difficulties.
Research at the University of Manchester (UoM) established that delivery
of evidence-based parenting information via broadcast TV changed viewers'
parenting behaviour and, in turn, reduced child behavioural problems. This
novel delivery method was implemented and internationally disseminated via
the Triple P-Positive Parenting Program. These new Triple P materials have
reached an estimated 7 million families in 25 countries. This effective
delivery method has also informed UK government policy and initiatives by
the United Nations Office on Drugs and Crime (UNODC).
See section 3 for references 1 and 2. UoM researchers are given in
Rachel Calam (Senior Lecturer, 1994-2006; Reader, 2006-2011;
Matthew R Sanders (Professor 20%, 2006-date; founder, Triple
P-Positive Parenting Program)
Context and background
The Parenting and Family Research Group at UoM investigates the most
effective ways of enhancing the skills and confidence of parents in order
to improve parenting and prevent behavioural and emotional problems in
children. In 2006, Sanders was appointed to UoM (20%) to formalise
a collaboration with Calam (established in 2001) and,
specifically, to develop `Triple P' approaches in the UK and increase
their international impact. Calam and Sanders have
developed new ways of delivering Triple P more widely, with a focus on
reaching parents who may not benefit from standard parenting interventions
offered in clinic settings. The Group's research has directly influenced
policy development by local and national government and the United Nations
through its Office on Drugs and Crime (UNODC) — see Section 4.
Media-based research programme: The Great Parenting Experiments
The underpinning research for this impact tested whether it was possible
to improve parenting in large numbers of families through a novel,
media-based delivery approach.
ITV commissioned Sanders to develop a primetime series based on
evidence-based parenting research. Driving Mum and Dad Mad (DMDM)
presented the intensive group-based Triple P programme in a popular
format. The Home Office funded the UoM Research Group to complete a trial,
`The Great Parenting Experiment' (GPE), in order to test the
efficacy of this mass media delivery form in changing viewers' parenting
practices. The Home Office subsequently funded a second study on a second
series of DMDM (GPE2). The two resulting research papers
were published in 2008 (1, 2).
The research established that it is possible to improve parenting
practices and reduce child behavioural difficulties through viewing a
demonstration of an evidence-based parenting programme in a mass media
In addition, enhancement using supplementary self-directed and web-based
materials produced significantly stronger improvement effects (1). The
research demonstrated significant reductions in parenting practices
associated with child maltreatment. Parents at the highest risk of
maltreatment were most likely to remain engaged with the research study
(2), an effect not usually observed in clinic-based delivery of parenting
programmes. The majority of families participating in the GPE
studies reported significant behaviour difficulties with their children at
baseline reflected by behaviour inventory scores above clinic cut-off; 83%
had not sought prior professional help. The research demonstrated
significant improvements in parenting and child behaviour following the
mass media delivery of the programme, with a large effect size (d=.80)
from pre-intervention to follow-up.
In summary, the research challenged orthodox opinions on effective
delivery mechanisms and established that well-crafted exemplars presented
via the media are sufficiently powerful to facilitate significant change
in parenting and child behaviour problems. This contributed to a new
approach to effective delivery of parenting interventions via public
health models to reduce child maltreatment and social and emotional
problems in children (see Section 4).
References to the research
The research for the Great Parenting Experiments (GPE & GPE2)
was funded by grants from the UK Government Home Office and Respect Task
Force. The two resultant publications were:
1. Calam RM, Sanders MR, Carmont SA, Miller C, Sadhnani
V. Can technology and the media help reduce dysfunctional parenting and
increase engagement with preventative parenting interventions? Child
Maltreatment. 2008;13(4):347-361. DOI: 10.1177/1077559508321272
2. Sanders MR, Calam R, Durand M, Liversidge T, Carmont
SA. Does self-directed and web-based support for parents enhance the
effects of viewing a reality television series based on the Triple P
Positive Parenting programme? Journal of Child Psychology and
Details of the impact
See section 5 for corroborating sources S1-S10.
Approximately 15% of children show significant behavioural difficulties.
Triple P, an evidence-based positive parenting approach, has been shown
to be effective in reducing these behavioural difficulties. However,
parenting interventions typically rely upon face-to-face individual or
group-based delivery in clinic, educational and community settings, which
do not reach all those who could benefit. In particular, delivery often
fails to reach: a) families with the most demanding problems who do not
engage with conventional service settings; and b) large populations in
countries where health and social care systems are not widely equipped to
deliver face-to-face interventions. Achieving large-scale population reach
of these interventions would have a major public health impact on
immediate behavioural and emotional outcomes for children as well as
reducing risk of maltreatment. The UNODC has recognised that longer-term
beneficial effects, in relation to mental health, drug and alcohol misuse
and crime, would also result from these interventions.
Reach and significance of the impact
Impact on Triple P International (TPI) delivery strategy
The proof of quantifiable benefit from this form of universal delivery (see
Section 2) made a definitive case for media-based approaches in
population rollout without the direct intervention of a therapist. It
provided TPI with evidence for media-based strategies for population-level
delivery and Triple P Online.
The TPI website cites the work as a key research finding (S1). Footage
has been incorporated into Triple P materials to strengthen delivery of
parenting interventions for the public. It demonstrates added value, as
the materials can convey key messages without the need for
person-to-person facilitation and reach many more families than could be
accessed face-to-face. Since our research, every large scale population
rollout of the Triple P system has included a sophisticated media and
communication strategy as part of the intervention, including service
implementations in the UK (Glasgow), Ireland (Longforth and Westmeath),
Belgium (Antwerp), The Netherlands (Amsterdam), Canada (Alberta and
Manitoba), Australia (New South Wales and Queensland), and some US states.
Following our proof of effectiveness, DMDM footage has been
incorporated into DVD material for Triple P groups for families and
training programmes for professionals, with 47580 practitioners
trained between 2008 and 2012 (S2), as well as the recently
developed Triple P Online. Both of these are now internationally
disseminated parenting programmes. TPI estimate 7 million families
have had exposure worldwide across 25 countries.
The Managing Director of TPI Pty Ltd, which has an exclusive licence to
disseminate the Triple P-Positive Parenting Program, underlines the
importance of the research into media-based delivery for TPI's operations:
`The research conducted by you [the UoM group] has provided evidence for
the effectiveness of a media-based modality to both reach and promote
change in groups of parents who have not already engaged with parenting
programmes but who could benefit. Its principles have provided important
evidence for the development of Triple P Online, which has potential
benefits for people with specific needs, limited access to services or
multiple commitments limiting conventional access to help' (S3). For
example, the online and media components of the city-wide rollout of
Triple P by NHS Greater Glasgow and Clyde is based on the foundational
work of the Great Parenting Experiments (S4).
Impact on policymaking in the UK and internationally
The research was presented to the Prime Minister, Chancellor of the
Exchequer and Home Secretary pre-publication in 2006. The Respect Task
Force on antisocial behaviour (2006-2010) incorporated this research into
Government policy, stating that parenting support should be provided
alongside approaches such as antisocial behaviour orders (S5). The
Director of the Troubled Families Team and the Department for Communities
and Local Government confirms that: `The results [of GPE and GPE2]
helped inform the rollout of parenting interventions across the UK from
2006' (S6). Triple P is one of two programmes awarded the top 4* rating by
the Department for Education (S7).
b) International Reach
The task of reaching parents in low and middle income countries is
developing globally. The UNODC identified family skills programmes as a
first step in drug and alcohol misuse prevention programmes (S8).
Media-based materials have the scope to reach communities that would not
otherwise be able to access information and support. Calam has
been invited to UNODC in Vienna five times in the last three years: 1) as
a technical consultant to the group drafting international guidelines on
family skills training; 2) as keynote speaker to its group of
international drug prevention leads; and 3) as keynote and facilitator for
the Paris Pact initiative to reduce opiate use and trade in Afghanistan.
The Director of the Drug Prevention and Health Branch underlines the
importance of the work on DMDM: `[Calam's] role has been to
explain the capacity of parenting interventions to deliver change. For
each keynote, footage from the ITV series "Driving Mum and Dad Mad" (DMDM)
has been specifically requested, as a highly accessible example of
transformation that can be achieved through media delivery of an
evidence-based parenting intervention' (S8). The Panamanian government has
collaborated with UNODC to test the feasibility and acceptability of
Triple P discussion groups, incorporating video footage (S9). Findings
indicate strong effect sizes; similar implementation is now under way in
Costa Rica, and planned in other Latin American countries. The appeal of
this media-based approach is the provision of video materials which can
deliver a successful intervention where access to specifically trained
practitioners is limited. Triple P is now listed as having the strongest
evidence base in UNODC's compilation of evidence for parenting programmes
for policymakers and non-governmental organisations worldwide. The
compilation makes specific reference to mass media strategies (S10, p. 6).
Sources to corroborate the impact
S1.The Triple P International (TPI) website includes the DMDM
studies among its key research findings:http://www.triplep.net/glo-en/the-triple-p-system-at-work/evidence-based/key-research-findings/
S2. Email from Triple P International Pty Ltd, Australia, providing a
record of the number of training places January 2008-June 2012.
S3.Corroborating letter from Managing Director, Triple P International
Pty Ltd, Australia.
S4.Greater Glasgow and Clyde: http://glasgow.triplep-staypositive.net/
S5. The Guardian, 26 July 2006. `No more misbehaving'.
Casey discusses parenting and TV parenting programmes and the
commissioning of GPE.
S6. Corroborating letter from Director, Troubled Families programme,
Department for Communities and Local Government.
S7.Department for Education Commissioning Toolkit for parenting
S8.Corroborating letter from Director, Drug Prevention and Health Branch,
United Nations Office on Drugs and Crime.
S9.Implementation of a Triple P discussion Group is demonstrated in a
short video documentary made in 2012-3 in a very low income neighbourhood
of Panama characterised by very high levels of drugs, violence and crime.
S10.UNODC. Guide to implementing family skills training programmes
for drug abuse prevention. New York: United Nations, 2009:
UNODC. Compilation of Evidence-Based Family Skills Training Programmes,
pp. 5-12. Includes a description of universal delivery incorporating media