triple p presentation for first 5 santa cruz county commission
DESCRIPTION
Presentation on the status of implementing the Positive Parenting Program (Triple P) in Santa Cruz County. Triple P is an evidence-based, public health approach to parent education and support. Implementation in Santa Cruz County is a multi-year project involving public agencies, nonprofits and independent practitioners.TRANSCRIPT
The Positive Parenting Program (Triple P)
First 5 Santa Cruz County
Commission Meeting
September 22, 2010
www.first5scc.orgPrepared by Optimal Solutions Consulting
www.opti-solutions.com
Desired Outcomes
Understand the Triple P system and how it is being implemented in Santa Cruz County.
Learn about agencies’ early experiences with implementing Triple P.
Review initial outcome data.
Understand the steps being taken to build service capacity and leverage funding.
What is Triple P?
An evidence-based, public health approach to parenting and family support Increase parents’ confidence and
competence in raising their children Improve parent-child relationships De-stigmatize parent education and
support Increase access to parenting information
and services
5 Principles of Positive Parenting
1. Ensuring a safe, engaging environment
2. Creating a positive learning environment
3. Using assertive discipline
4. Having realistic expectations
5. Taking care of yourself as a parent
An Ecological Approach
System
Community
Family
Individual
Triple P Levels of Intervention
Level 1 – Universal - Media-based parenting information campaign
Level 2 – Selected Individual & Seminar - Information or advice for a specific parenting concern
Level 3 – Primary Care - Narrow-focus parenting skills training
Level 4 – Standard & Group - Broad-focus parenting skills training
Level 5 – Enhanced & Pathways - Additional interventions for families with risk factors
Minimal Sufficiency
Universal
Selected & Seminars
Primary Care
Standard & Group
Enhanced &
Pathways
Self-Regulatory Framework
Practitioner provides information, skills training and support based on what the parent needs or wants….
…which may be different than what the practitioner needs or wants.
Parent uses self-evaluation to set goals and assess progress
Parallel process: Practitioner helps Parent build confidence & competence
Parent helps Child build confidence & competence
17 Core Parenting Skills
Promoting positive relationships Brief quality time, Talking to children, Affection
Encouraging desirable behavior Praise, Positive attention, Engaging activities
Teaching new skills and behaviors Modeling, Incidental teaching, Ask-say-do,
Behavior charts Managing misbehavior
Ground rules, Directed discussion, Planned ignoring, Clear & calm instructions, Logical consequences, Quiet time, Time-out
17 Core Parenting Skills
Promoting Positive Relationships
Encouraging Desirable Behavior
Teaching New Skills &
Behaviors
Managing Misbehavior
Santa Cruz County Triple P Pilot
Sponsors: First 5 Santa Cruz County, HSA - Children’s Mental Health, HSD – Family & Children’s Services
Long-term vision = implement all levels Start small with interested agencies and staff Implement levels incrementally, starting with
Levels 4 & 5 Conduct pilot for a minimum of 2 years
Pilot Plan – Year 1 (FY 2009-10)
Level 4 - Group & StandardLevel 5 - Enhanced & Pathways
Level 3 - Primary Care
•Children’s Mental Health•Familia Center•Families Together•Head Start•La Manzana Community Resources•Parents Center
• Children’s Mental Health• Dominican Pediatrics• Familia Center• Head Start/Early Head Start• LMCR• Mountain Community Resources• Parents Center• SC Women’s Health Center• Women’s Crisis~Defensa
Total: 18 Total: 40
Pilot Plan – Year 2 (FY 2010-11)
Trainings Level 4 Standard/Group (1 training, 20 practitioners)
October 2010 Level 3 Primary Care (1 training, 20 practitioners)
October 2010 Level 2 Seminars (1 training, 20 practitioners that have
been accredited in Level 3 or 4) January 2011
Level 1 Universal
Agencies – TBD
Practitioners’ Experiences
Name & Organization/Affiliation Level(s) accredited in How Triple P is being implemented by you
and/or your organization How parents are responding to Triple P
services Successes, challenges and next steps
Evaluation
Measuring outcomes at individual/family and community levels
Extensive set of assessments for Levels 4/5 Briefer set of assessments for Levels 2/3 Preliminary data January – June 2010:
~100 parents served (Levels 3-5) Informed consent from ~50 parents Level 4 outcome data for ~30 parents On average, high levels of client satisfaction
Parent’s Perception of Child Behavior (Intensity)
Series136
72
108
144
180
216
252
125.5
85.8
Pre Post
Clinical Cut-Off:>= 131
Behavior always occurs
Behavior never oc-curs
n = 29
Parent’s Perception of Child Behavior – (# of Problems)
Series10
6
12
18
24
30
36
15.3
7.4
Pre Post
Clinical Cut-Off:>= 15
All behaviors were a problem
No behaviors were a problem
n = 30
Parent’s Perception of Child Behavior - % in Clinical Range
Intensity Problem0%
10%
20%
30%
40%
50%
40%
45%
10%
21%
Pre Post
Parenting Style
Overall Laxness Over-Reactivity Hostility1
2
3
4
5
6
7
3.12.9
3.1
1.6
2.62.4
2.7
1.4
Pre PostDysfunctional Parent-ing Style
FunctionalParenting Style
Clinical Cut-Off:>= 3.2
Clinical Cut-Off:Females >= 3.6Males >= 3.4
Clinical Cut-Off:Females >= 4.0Males >= 3.9
Clinical Cut-Off:Males >= 3.5Females >= 2.4
n = 33 n = 33n = 32 n = 32
Parenting Style – % in Clinical Range
Overall Laxness Over-Reactivity Hostility0%
10%
20%
30%
40%
50%
39%
31%
21%
13%
27%
13%
9% 9%
Pre PostDysfunctional Parenting
FunctionalParenting
Parenting Confidence
Setting Self-Efficacy Behavioral Self-Efficacy 0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
86.1
75
92
88
Pre Post
Clinical Cut-Off:<= 79.3
Clinical Cut-Off:<= 68.4
Certain I can do it
Certain I can't do it
n = 34
Parenting Confidence – % in Clinical Range
Setting Self-Efficacy Behavioral Self-Efficacy 0%
10%
20%
30%
40%
50%
0.24
0.32
0.06 0.06
Pre Post
Client Satisfaction – Overall
Parent's opinion of child's behavior at completion of program
Program helped parent develop skills that can be applied to other family members
Program helped parent deal more effectively with problems in family
Program helped parent deal more effectively with child's behavior
Parent received type of help wanted from program
1 2 3 4 5 6 7
5.97
6.18
6.09
6.34
6.06
Building a Sustainable Model for Funding & Service Expansion
• Level 2 Individual• Level 3 Primary CareFunders pay for training & materials only
Agency provides services with existing funding
• Level 2 Seminar• Level 3 Primary Care• Level 4 Standard/Group• Level 5 Enhanced/Pathways
Funders pay for training, materials & services
(contract or fee-for-service)
• Level 4 Standard/Group• Level 5 Enhanced/PathwaysFunders pay for training & materials
Parent pays for services
(Practitioner sets fee or bills insurance)
Leveraging Funding
First 5 Santa Cruz County
Health Services Agency
(MHSA - PEI)
Human Services
Department
(Title IV-E Training)
Triple P America
Coordination
Fee-for-Service
Contracts with Agencies