Ireland and the population-level effect: How schools were the key to reaching those most in need

Brief interventions played a major role in the success of a population-level delivery of the Triple P system in the Irish Midlands, the director of the partnership involved in the rollout, Conor Owens, told this year’s Helping Families Change Conference (HFCC) in Amsterdam.

The Longford Westmeath Parenting Partnership made Triple P available free to all parents of children under the age of eight to reduce prevalence rates of clinically elevated social, emotional and behavioural problems in children, estimated to be one in five children in Ireland.

Their goal was also to help parents become more confident and feel more supported, as well as to reduce parents’ levels of anxiety and depression relating to their children’s behaviour.

In his presentation to HFCC 2015, Mr Owens said that when it came to supporting populations, it was important to find “a way in’’ to areas of higher deprivation.

“If you are having trouble reaching those harder to reach it usually means it’s going to take longer,” he said. “You have to find a way of showing the programme’s usefulness and relevance.

“We found a way in via the schools.

“We started looking at the self-referral data. What we found was that the highest professional group coming to the program was teachers. That’s started to open the door for us. After the seminars we asked the teachers for their feedback.

“We also asked the parents for their feedback and if they would like the school to put it on and then we put it in a report and sent it to the school boards.’’

An evaluation of the first phase of the rollout in Longford Westmeath conducted by a team at the University of Ireland, Galway, found that Triple P was associated with population-level effects across a number of indicators for parents and children.

Achieving success

Speaking at this year’s conference at Beurs Van Berlage in Amsterdam, Triple P founder Matt Sanders said the Irish implementation team had done an outstanding job in delivering a major population rollout of Triple P.

“What Conor has shown is that a relatively small number of well-trained and well-supported practitioners with the right leadership and adequate supervision and support can achieve success,” Professor Sanders said.

He said the alternative vision was to train a large number of practitioners who may only have the opportunity to deliver a little – due to capacity issues – when the same reach could be achieved with a small number who delivered a lot.

Mr Owens described how the partnership employed an extensive communications campaign, including Triple P International’s Stay Positive campaign, as well as levels two, three and four of Triple P to reach parents.

Over the course of the evaluation, 803 parents participated in Group Triple P (level 4), 1047 parents participated in Triple P Discussion Groups (level 3) and 2699 participated in level two seminars.

“What we found is that a significant amount of parents who did the lighter interventions later went on to book into another program so that the children who needed the most got the most help,’’ Mr Owens said.

“At the same time parents who appeared to need the least got what they needed. We got a population effect and within that population effect there was a significant effect for children with the highest level of need.”

Over the past two years, the partnership, now the Midlands Area Parenting Partnership, has gone on to deliver more than 5000 seminars. A large number of these have been school induction seminars.

The numbers

“There are 242 national schools in the area, and 72 per cent, or 169 schools, delivered Triple P to parents,’’ Mr Owens said.

“Thirty-one per cent of all parents of junior infants in the area received the Power of Positive Parenting seminars in 2014 with an average attendance of 22 parents at each seminar. Because it is a semi-rural area, the schools tend to be small in size.”

Professor Sanders said this method of delivery played an important role in the “mobilisation and activation of a social contagion effect’’.

“The evaluation of the rollout found that parents who participated in Triple P were highly likely to provide tips and guidance to their friends and neighbours about positive parenting,’’ he said.

“Families in the community became geared towards speaking more positively on issues to do with their children.’’

The Longford Westmeath project was delivered by a core team of between five to six practitioners who did the vast majority of delivery of Triple P.

Mr Owens said sustainability of the program was easier because there were no new staff costs, core team practitioners had been reorientated from within the existing workforce, and there were no ongoing costs related to materials and infrequent training.

“It means that when you are looking for continuation you’re not looking for new money for salaries, you only need materials, you only need money for occasional retraining so it actually becomes really cheap,’’ Mr Owens said.