The Triple P - Positive Parenting Program is a multi-level system of parenting and family support with varying intensities and formats for parents of children birth to 12 years. Originally developed at the University of Queensland Australia, Triple P is implemented in over 25 countries and 25 states within the U.S. The program aims to: (1) promote the independence and health of families; (2) promote the development of non-violent, protective environments for children; (3) promote the development of children; (4) reduce the incidence of child abuse, mental illness, behavioral problems, delinquency and homelessness; and (5) enhance the competence, resourcefulness and self-sufficiency of parents in raising their children. The multi-level framework tailors information and professional support to the needs of families. Triple P builds on parents' strengths, increasing capacity to solve problems and improve their confidence and competence in parenting.

Triple P has five levels of intervention which vary in intensity. Parents can enter at any level of Triple P determined to be most appropriate, and can be referred to a more intensive level if needed. Program components include parenting seminars, parent skills-training sessions, and individual consultations. The quantity of service is adjusted according to a family need and dysfunction severity. Triple P messages are reinforced through media strategies--such as news stories, newsletters, and radio announcements--that promoting positive parenting.

Triple P aims to enhance the knowledge, skills, and confidence of parents to prevent behavioral, emotional, and developmental problems in children and prevent child maltreatment.

Triple P increased confidence in parenting ability and reduced the incidence of verified maltreatment among participants in the program.

Children's Services Council (CSC) began to implement Triple P in late 2009 and is now implementing throughout Palm Beach County. CSC evaluated 22 human service providers and 93 practitioners who are Triple P accredited and implementing Triple P services with clients over a nearly two-year period. Over 5,000 infants and children benefited from individual or group Triple P services, with 68% of participants completing services and 86% expressing a high degree of overall satisfaction. Participants' rate of maltreatment compared favorably to those in high risk zip code areas and Palm Beach County.

Using standardized self-report measures (pre/post assessments) and administrative data on child maltreatment, Primary Care participants experienced increased confidence in parenting ability, and Standard and Enhanced participants experienced increased parental competence; decreased depression, anxiety, and stress; improved marital relationship quality; and reduced frequency of child behavioral problems. In addition, there was a reduced rate of child abuse and neglect in the cohort as compared to both Palm Beach County as a whole and the ten zip code areas in Palm Beach County with the highest documented rates of verified maltreatment. The relative incidence of verified maltreatment in Triple P participants in comparison to the ten zip code areas is noteworthy since a third (32%) of Triple P participants included in the analysis reside in these zip code areas.

Overall satisfaction, along with satisfaction with service quality, and the type and amount of help received were uniformly high (i.e., above 90%) across all levels of Triple P. Participants reported comparatively more improvement in areas emphasized by the program (e.g., child behavior and parenting skills) than in aspects of their marital relationship. In addition, the higher the level of Triple P, the more likely participants were to report that the program met family needs, the child's behavior had improved, and new and effective parenting skills were acquired and used successfully in the family. Results suggest that participants who had the most positive perceptions experienced a more intensive program.