Research Watch

Positive Parenting Program’s (Triple P) effectiveness on addressing child maltreatment

Year of Publication
Reviewed By
Tareq Hardan

Schilling, S., Lanier, P., Rose, R. A., Shanahan, M., & Zolotor, A. J. (2019). A Quasi-Experimental Effectiveness Study of Triple P on Child Maltreatment. Journal of Family Violence, 1-11.


The Positive Parenting Program (Triple P) is an evidence-based multi-tiered parenting intervention designed to enhance parental competence and prevent or alter dysfunctional parenting practices. It incorporates five positive parenting steps: ensuring a safe, engaging, and positive learning environment, using assertive discipline, maintaining reasonable expectations, and taking care of oneself as a parent. In this article, the authors claim that while there appears to be a strong evidence base for the Triple P program, they question the quality/validity of this evidence. 

To address this issue, Schilling and colleagues developed a quasi-experimental study design and performed a difference-in-differences (DiD) analysis to examine the associations between the implementation of Triple P in 34 of North Carolina’s (NC) 100 counties on the following outcomes (1) investigated child maltreatment reports; (2) foster care placement; and (3) emergency department visits concerning child maltreatment. In order to do so, the authors aggregated the Triple P implementation data, child welfare data, emergency department discharge data, and US Census Bureau data to create a single dataset with year-by-county observations from 2008 to 2015. This aggregated sample yielded a total of 23,732 children who received the Triple P program from a total population of 848,531 NC children. They calculated the Triple P treatment effect on the three aforementioned outcomes. Following this, the authors compared Triple P and non-Triple P counties on the change between the average pre-treatment and post-treatment outcomes, conditional on change over time as captured by the linear trend.

Study findings indicate that program implementation is associated with small reductions in the rates of child maltreatment reports and foster care placements. Specifically, a 4% decrease in the county rate of investigated reports of child maltreatment and a 7% decrease in the county rate of children in foster care. There was no reduction in county-level rates of ED visits with ICD-9-CM codes concerning child maltreatment. 

Methodological Notes

The limitations reported for this study include: (a) lack of collected process data; (b) this study may not yet have reached population-level implementation, due to the short initial implementation period of Triple P in NC; and (c) Fidelity remains a potential critical moderator of the relationship between the Triple P intervention and the intended outcomes as no ongoing fidelity measure for the program's implementation.