Te Whānau Pou Toru: a Randomized Controlled Trial (RCT) of a Culturally Adapted Low-Intensity Variant of the Triple P-Positive Parenting Program for Indigenous Māori Families in New Zealand
Evidence-based parenting support programs (EBPS) based on social learning and cognitive behavioral principles are effective in reducing conduct-related problems in a diverse range of cultural contexts. However, much less is known about their effects with indigenous families. A Collaborative Participation Adaptation Model (CPAM) was used to culturally adapt a low-intensity, two-session group variant of the Triple P-Positive Parenting Program for Māori parents of young children in New Zealand. CPAM involved collaborating closely with Māori tribal elders, practitioners as end-users, and parents as consumers through a participatory process to identify content and delivery process used in Triple P that would ensure that traditional Māori cultural values were incorporated. The culturally adapted program (Te Whānau Pou Toru) was then evaluated with 70 parents of 3–7-year-old children in a two-arm randomized clinical trial (intervention vs waitlist control). Results showed that parents in the intervention group reported significantly greater improvements in child behavior problems and reduced interparental conflict about child-rearing compared to parents in the control group at immediate post-intervention. These intervention effects were either maintained or improved further at follow-up assessment. At 6-month follow-up intervention-group parents reported significantly greater reductions in overreactive parenting practices and greater confidence in managing a range of difficult child behaviors than control parents. The culturally adapted program was associated with high levels of parental satisfaction. Findings are discussed in terms of making brief, effective, culturally adapted parenting support available to Māori families.
KeywordsEvidence-based parenting support Parenting Cultural adaptation Prevention Conduct problems
This research was funded by the New Zealand Ministry of Health, grant number 414953/349190/00.
Compliance with Ethical Standards
Conflicts of Interest
The Parenting and Family Support Centre is partly funded by royalties stemming from published resources of the Triple P–Positive Parenting Program, which is developed and owned by The University of Queensland (UQ). Royalties are also distributed to the Faculty of Health and Behavioral Sciences at UQ and contributory authors of published Triple P resources. Triple P International (TPI) Pty Ltd. is a private company licensed by Uniquest Pty Ltd. on behalf of UQ to publish and disseminate Triple P worldwide. Matthew Sanders is the founder and an author on various Triple P programs and a consultant to Triple P International. No other authors have any conflicts of interest to disclose.
All procedures performed were in accordance with the ethical standards of the University of Auckland and with the 1964 Helsinki declaration and its later amendments. Ethics approval was obtained from the University of Auckland Human Research Ethics Committee on 31 March 2015, reference number 013889.
Informed consent was obtained from all individual participants included in the study.
A Consort checklist for the study is available online resource 1.
- Advisory Group on Conduct Problems (2009). Conduct problems: Best practice report. Retrieved from http://www.msd.govt.nz/about-msd-and-our-work/publications-resources/research/conduct-problems-best-practice/
- BigFoot, D. S., & Funderburk, B. W. (2011). Honoring children, making relatives: The cultural translation of parent-child interaction therapy for American Indian and Alaska native families. Journal of Psychoactive Drugs, 43, 309–318. https://doi.org/10.1080/02791072.2011.628924.CrossRefPubMedGoogle Scholar
- Dadds, M. R., & Powell, M. B. (1991). The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinical children. Journal of Abnormal Child Psychology, 19, 553–567. https://doi.org/10.1007/BF00925820.CrossRefPubMedGoogle Scholar
- Dittman, C. K., Farruggia, S. P., Keown, L. J., & Sanders, M. R. (2016). Dealing with disobedience: An evaluation of a brief parenting intervention for young children showing noncompliant behavior problems. Child Psychiatry and Human Development, 47, 102–112. https://doi.org/10.1007/s10578-015-0548-9.CrossRefPubMedGoogle Scholar
- Dretzke, J., Davenport, C., Frew, E., Barlow, J., Stewart-Brown, S., Bayliss, S., et al. (2009). The clinical effectiveness of different parenting programmes for children with conduct problems: A systematic review of randomised controlled trials. Child and Adolescent Psychiatry and Mental Health, 3, 7. https://doi.org/10.1186/1753-2000-3-7.CrossRefPubMedPubMedCentralGoogle Scholar
- Eyberg, S. M., & Pincus, D. (1999). Eyberg child behavior inventory and sutter-eyberg student behavior inventory-revised: professional manual. Odessa: Psychological Assessment Resources.Google Scholar
- Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychological Foundation of Australia.Google Scholar
- Mazzucchelli, T. G., & Sanders, M. R. (2010). Facilitating practitioner flexibility within an empirically supported intervention: Lessons from a system of parenting support. Clinical Psychology: Science and Practice, 17, 238–252. https://doi.org/10.1111/j.1468-2850.2010.01215.x.CrossRefGoogle Scholar
- Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E., & Zubrick, S. R. (2014). Gaps in indigenous disadvantage not closing: A census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14, 201. https://doi.org/10.1186/1471-2458-14-201.CrossRefPubMedPubMedCentralGoogle Scholar
- Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624–640. https://doi.org/10.1037/0022-006x.68.4.624.CrossRefGoogle Scholar
- Social Policy Evaluation and Research Unit (Superu) (2015). Parenting programmes effective with whānau. New Zealand. Retrieved from http://www.superu.govt.nz/publication/what-works-parenting-programmes-effective-whānau.
- Spoon, J. (2014). Quantitative, qualitative, and collaborative methods: Approaching indigenous ecological knowledge heterogeneity. Ecology and Society, 19. https://doi.org/10.5751/ES-06549-190333.
- Turner, K. M. T., Sanders, M. R., Keown, L. J., & Shepherd, M. (2017). A collaborative partnership adaptation model. In M. R. Sanders & T. G. Mazzucchelli (Eds.), The power of positive parenting: Transforming the lives of children, parents and communities using the Triple P system (pp. 310–320). New York: Oxford University Press.Google Scholar