Triple PEvaluation

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 19

Behaviour Change (2019), 1–19

doi:10.1017/bec.2019.7

S TA N D A R D PA P E R

The Impact of the Triple P Seminar Series on Canadian


Parents’ Use of Physical Punishment, Non-Physical
Punishment and Non-Punitive Responses
Miriam Gonzalez1,2*, Christine A. Ateah3, Joan E. Durrant4 and Steven Feldgaier5
1
McGill University, Montréal, QC, Canada, 2Research Institute of the McGill University Health Centre, Montréal, QC,
Canada, 3College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada, 4Community
Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada and 5Clinical Health
Psychology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
*Corresponding author: Miriam Gonzalez, McGill University and at the Research Institute of the McGill University Health
Centre, Montréal, QC, H4A 3S5. Email: miriam.gonzalez@mail.mcgill.ca

(Received 20 June 2018; revised 20 November 2018; accepted 15 February 2019)

Abstract
Physical punishment of children is linked to negative developmental outcomes. The widely used Positive
Parenting Program (Triple P) promotes alternative responses to physical punishment. Data on the effective-
ness of the Triple P Seminar Series is limited. In this study, Canadian parents’ reports of physical punish-
ment, non-physical punishment, and non-punitive responses were compared before and after they attended
the Triple P Seminar Series. Twenty-seven parents of children aged 2 to 6 years attended the Seminar Series
and completed pre- and post-intervention questionnaires measuring the number of times they used various
physical punishments, non-physical punishments, and non-punitive responses in the past month.
Hypotheses were tested using univariate descriptive analyses, paired samples t tests, and Wilcoxon Signed
Rank Tests. Parents’ reports of physical punishment decreased on only one of the four physical punishment
items (shaking/grabbing) from pre- to post-intervention. Over the course of the Seminar Series, parents
became more likely to emphasise rules and to punish their children by taking things away from them.
The findings suggest that the Seminar Series has limited effectiveness in reducing physical punishments
or increasing non-punitive responses. Further research on this question is needed.

Keywords: parenting training; physical punishment; parenting responses; Canadian parent

A considerable body of research demonstrates the link between punitive parenting practices and nega-
tive developmental outcomes for children (Anda et al., 2006; Hoeve et al., 2009; Jeynes, 2007; McLeod,
Weisz, & Wood, 2007). One such practice, physical punishment, continues to be used by parents,
despite research highlighting its harmful effects and its ineffectiveness in guiding children towards
desirable behaviour (Gershoff, 2002, 2010; Gershoff & Grogan-Kaylor, 2016). Physical punishment
has detrimental effects not only on children’s physical, psychological, and social wellbeing but also
on the parent-child relationship (Durrant & Ensom, 2012). Experience of physical punishment in
childhood has also been associated with negative outcomes in adulthood, such as mental health pro-
blems, aggression, criminal and antisocial behaviour, alcohol and other drug use, and a heightened
risk of abusing one’s own child or spouse (Durrant & Ensom, 2012). Moreover, most substantiated
physical abuse takes place within the context of punishment (Trocmé & Durrant, 2003; Trocmé
et al., 2005; Trocmé et al., 2001); that is, in most cases, physical abuse is physical punishment
(Durrant, 2008). In fact, a recent meta analysis found that the effects of physical abuse and physical
punishment (spanking) on children are similar in magnitude and direction across study designs, coun-
tries and age groups (Gershoff & Grogan-Kaylor, 2016). Despite the consistency of research findings
© The Author(s) 2019

Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
2 Miriam Gonzalez et al.

demonstrating that physical punishment predicts only negative developmental outcomes, approxi-
mately 25% of Canadian parents continue to use it, and many Canadian children continue to experi-
ence it (Fréchette & Romano, 2015; LaRoche, Lee, & Ateah, 2013).
Reducing the prevalence of physical punishment is one means of reducing risk of maltreatment
and negative developmental outcomes for children. Parenting programs that discourage physical
punishment and encourage alternative approaches, such as non-physical forms of punishment and
non-punitive parenting responses, hold promise in this area. Examples of alternative approaches
are: providing explanations, teaching and encouraging self-regulation, monitoring children non-
intrusively, and diverting children’s attention. These responses have been linked to reductions in
destructive behaviour and aggression, and to increases in positive social interaction, prosocial behav-
iour, moral regulation, empathy, social competence, self-control, and enhanced communication skills
(Amato & Fowler, 2002; Carlo Knight, McGinley, & Hayes, 2011; Fabiano et al., 2004; Ford, Olmi,
Edwards, & Tingstrom, 2001; Hester, Hendrickson, & Gable, 2009; Jones, Forehand, Brody, &
Armistead, 2002). A parent education program available in Canada that promotes alternatives to phys-
ical punishment is the Positive Parenting Program or Triple P (Sanders & Turner, 2005).
Triple P is a multilevel parenting program based on behaviourist social learning principles that has
been adopted in more than 25 countries (Triple P, n.d.). The program is designed to: (1) improve par-
ental competence and parenting skills by helping parents develop non-violent responses to common
child behaviours (Sanders et al., 2008); (2) reduce behavioural and emotional problems in children
(Prinz, Sanders, Shapiro, Whitaker, & Lutzker, 2009); (3) target five developmental periods: infancy,
toddlerhood, preschool age, primary-school age, and adolescence (Sanders, Markie-Dadds, & Turner,
2003); and (4) provide five levels of intervention of increasing intensity that allows for tailoring the inter-
vention based on parents’ needs and preferences regarding type, intensity and mode of support required
(Sanders et al., 2003). Five meta analyses reveal the program has meaningful but small to moderate
effects on child behaviour, parenting practices, and parent wellbeing (De Graaf, Speetjens, Smit, de
Wolff, & Tavecchio, 2008a, 2008b; Nowak & Heinrichs, 2008; Sanders, Kirby, Tellegen, & Day, 2014;
Thomas & Zimmer-Gembach, 2007). The larger effect sizes have been found for the more intensive
levels of the Triple P program (Sanders, Healy, Grice, & Del Veccio, 2017). Across study designs, parents
consistently report positive changes in their parenting style, confidence and self-efficacy, and reductions
in child behaviour problems (UNODC, 2009). These positive outcomes have been found across family
types (e.g., single-parent, two-parent, and step families; and families where there is parental stress,
depression, marital conflict, or a child with an intellectual disability) and among culturally diverse par-
ents, including Indigenous, Chinese, Indonesian, and African American parents (Leung, Sanders, Leung,
Mak, & Lau, 2003; Matsumoto, Sofronoff, & Sanders, 2007; Prinz et al., 2009; Sanders et al., 2003;
Turner, Richards, & Sanders, 2007). What is not known is whether the program has an impact on
parental use of physical punishment (Voisine & Baker, 2012).
To date, the link between receiving Triple P parent education and parental use of physical punish-
ment has not been examined (Voisine & Baker, 2012). Also, the evidence base for Triple P comes from
studies that have focused on the more intensive levels of the program and have been conducted
in Australia and other countries around the world, such as Germany, Hong-Kong, Netherlands,
Switzerland, Japan, and the United States (Bodenmann, Cina, Ledermann, & Sanders, 2008;
Heinrichs, Bertram, Kuschel, & Hahlweg, 2005; Leung, Sanders, Ip, & Lau, 2006; Matsumoto et al.,
2010). Little research attention has been given to assessing the effectiveness of less intensive levels,
such as Levels 1 and 2 (McConnell, Breitkreuz, Savage, & Hamilton, 2010), and Canadian studies
in this area are largely absent from the literature. Thus, examining the effect of a less intensive
level of Triple P (Level 2) on the parenting responses of a sample of Canadian parents was warranted.

Triple P Programming in Manitoba


Triple P has been accessible to parents in Manitoba since 2006 (Healthy Child Manitoba, 2015). In
Manitoba, Triple P’s primary focus is on families with children under the age of 12. Available services
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 3

include the Manitoba Parent Line, Teen Triple P and variants of the five levels of intervention (Healthy
Child Manitoba, 2015). Level 1 Triple P (Universal Triple P) provides information to parents through
media campaigns and is designed to raise awareness and encourage participation in parenting programs.
Level 3 Triple P is for parents with mild-to-moderate challenges (e.g., tantrums, fighting with siblings).
Intervention methods include group, face-to-face, or telephone sessions with a Triple P practitioner,
where parents are taught to respond to challenging situations through advice, rehearsal, and self-
evaluation. Level 4 Triple P is for parents of children considered to have severe behaviour problems
(e.g., oppositional defiant disorder, conduct disorder). Training may be self-directed or involve tele-
phone, face-to-face, or group sessions (8–10 sessions) that focus on parent-child interaction, parenting
skills and activities addressing the causes of children’s behaviour and strategies for managing it, promot-
ing positive family relationships, and encouraging children’s development. Finally, Level 5 Triple P is for
families in which both child behaviour and family dysfunction are of concern. Training is offered
through group sessions, telephone or face-to-face contact, and includes teaching parenting skills, partner
support skills, mood management strategies, and stress coping skills (Sanders, 2008; UNODC, 2009).

Level 2 or Seminar Triple P


Level 2 Triple P is designed for parents interested in participating in parent education and for those
who have minor concerns about their child’s behaviour or development (e.g., bedtime challenges).
Delivery formats include brief consultations and group sessions. The group sessions (Triple P
Seminar Series) consist of a series of three 90-minute public education seminars on positive parenting.
The seminars are offered in the community and are designed for groups of 20 or more parents. They
are aimed at increasing parental competence by: (1) enhancing parents’ communication about parent-
ing issues, (2) promoting and increasing parents’ use of specific parenting principles and strategies, (3)
promoting use of consequences, and (4) reducing stress related to parenting (Sanders & Turner, 2005).
Facilitators provide informal presentations or generate group discussions and provide parents with
support to address the parenting issues of concern (Sanders & Turner, 2005).
In Seminar 1, ‘The Power of Positive Parenting’, parents are introduced to the five principles that
form the basis of the program and strategies that can be implemented to put each principle into prac-
tice (Sanders, Markie-Dadds, & Turner, 2005; Sanders & Turner, 2005). In this seminar, parents are
encouraged to avoid yelling, threatening or spanking and to: give their child attention, use praise, pro-
vide engaging activities, set a good example, use incidental teaching, use prompts to teach new skills,
reward appropriate behaviour, establish ground rules, use directed discussion, watch and supervise, use
planned ignoring for minor misbehaviour, give clear and calm instructions, and use consequences,
quiet time and/or time out (Sanders & Turner, 2005).
In Seminar 2, ‘Building Confident, Competent Children’, parents are given information about fos-
tering children’s social and emotional skills. Strategies are discussed to help parents teach their children
to be respectful and considerate, communicate well with others, develop healthy self-esteem, be good
problem solvers, and become independent. Parents are encouraged to: teach their children to be polite
and cooperative and to follow rules, model being considerate, and provide consequences for inconsid-
erate or hurtful behaviour. To help children develop healthy self-esteem, parents are encouraged to be
affectionate towards their children and to encourage their children to be good friends to others, be
active in outdoor play, set goals, recognise their accomplishments, express their ideas, laugh, and make
decisions. To help children become good problem solvers and become independent, parents are
encouraged to set a good example, teach their child problem-solving steps, and encourage children
to take responsibility and do things for themselves (Sanders et al., 2005; Sanders & Turner, 2005).
During Seminar 3, ‘Raising Resilient Children’, six building blocks of emotional resilience and strat-
egies to promote development are discussed. Parents are encouraged to: (1) discuss feelings with their
children, reward appropriate expression of emotion, and use consequences for inappropriate expression;
(2) encourage their children’s optimism, curiosity, and contentment; (3) teach their children to problem
solve, think positively, relax, and look for support when needed; and (4) set a good example of managing
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
4 Miriam Gonzalez et al.

their own stress and negative emotions, demonstrating problem solving when appropriate, and seeking
professional advice when needed (Sanders et al., 2005; Sanders & Turner, 2005). At the end of each sem-
inar, parenting tip sheets summarising the information and strategies discussed are handed out, 30 min-
utes are allotted to allow parents to ask questions, and Triple P practitioners are available for individual
consultations. If the need for a referral becomes evident through the consultation, the option of partici-
pating in a more intensive level of Triple P is suggested (Sanders & Turner, 2005).

Research on Level 2 or Seminar Triple P


Little research has been conducted on the effectiveness of the Seminar Series (McConnell et al., 2010;
Sanders et al., 2009). To date, four studies have examined its impact on child and parent outcomes
(McConell et al., 2010; Sanders, Prior, & Ralph, 2009; Sumargi, Sofronoff, & Morawska, 2014,
2015). For example, Sumargi et al. (2014) examined whether Level 2 Triple P enhanced parent and
child outcomes (parenting style, child behaviour) with a sample of 30 Indonesian parents residing
in Australia. However, the focus was on examining the effect of delivering one 90-minute Triple P
seminar (as opposed to all three seminars). A pre–post design with a 3-month follow-up component
was used. The Parenting Scale (Arnold, O’Leary, Wolff, & Acker, 1993) was used to measure global
parenting styles: laxness or permissive parenting (characterised by allowing rules to go unenforced,
parents giving in, or providing positive consequences for misbehaviour), over-reactivity or authoritar-
ian parenting (characterised by displays of anger, meanness, and irritability), and verbosity (charac-
terised by long reprimands and reliance on talking even when talking is ineffective). The scale
yields an overall dysfunctional parenting score. Child emotional and behavioural problems were mea-
sured with the Child Adjustment and Parent Efficacy Scale (CAPES; Morawska, Sanders, Haslam,
Filus, & Fletcher, 2014). Post intervention, the average authoritarian parenting score had not decreased
significantly, but parents did report less frequent use of dysfunctional parenting practices (permissive
parenting style in particular), and a reduction was found in child emotional and behavioural problems.
The effects were maintained at a 3-month follow-up.
Two studies have explicitly examined the effect of Level 2 Triple P (all three seminars) on various
child and parent outcomes. Sanders et al. (2009) assessed the impact of the Seminar Series on parenting
style, interparental conflict, relationship quality, parental adjustment, parental confidence, and behav-
ioural and emotional problems in children. A sample of 244 Australian parents who had a child between
the ages of 4 and 7 were assigned to a: (1) partial exposure condition that involved attending the intro-
ductory seminar, (2) full exposure condition that involved attending all three seminars, or (3) waitlist
control group. The Parenting Scale (Arnold et al., 1993) was used to measure parenting style. Post inter-
vention, parents in both the full and partial exposure groups reported lower levels of authoritarian par-
enting and lower total levels of dysfunctional parenting compared to parents in the waitlist control
group. There were no significant reductions in lax or verbose parenting practices among parents in
the full and partial conditions compared to parents in the waitlist control group post-intervention.
Sumargi et al. (2015) examined the effects of Level 2 Triple P on various child and parent outcomes
(parenting style, child behaviour) using a randomised pre–post waitlist comparison group design with
a 6-month follow-up component. The sample comprised 143 parents residing in Indonesia. Child
emotional and behavioural problems were measured with the CAPES (Morawska et al., 2014) while
parenting practices were measured with the Parenting Subscale of the Parenting and Family
Adjustment Scale (PAFAS; Sanders et al., 2014) and the Parenting Scale (Arnold et al., 1993).
Parents in the intervention group reported fewer behavioural problems, had significantly lower scores
on laxness (permissive parenting) and overreactivity (authoritarian parenting), and had significantly
lower scores on dysfunctional parenting as measured by the PAFAS compared to parents in the waitlist
control condition at post-intervention. The effects were maintained at 6-month follow-up. Although
these studies found Level 2 Triple P to be effective in improving parenting practices, the studies
focused on global measures of ‘dysfunctional’ parenting or global measures of parenting practices
that include both effective and ineffective strategies (positive encouragement, consistency, coercive
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 5

parenting). Further, the results from the Sanders et al. (2009) study were based on data from randomly
and non-randomly assigned samples.
One Canadian study examined the impact of integrating Triple P services into Parent Link Centres
(PLCs) in Alberta (McConnell et al., 2010). One of the goals was to assess whether Levels 2 and 3
Triple P enhanced client outcomes (positive parenting practices, child difficulties, family functioning,
and parenting stress) compared to PLC services as usual. Level 2 Triple P was defined as providing
health promotion information or advice for specific concerns regarding child development or behav-
iour issues. Parent education was provided via one-on-one sessions or group seminars (Seminar
Series) with the use of videotapes and parenting tip sheets. Level 3 Triple P provided a four-session
intervention that incorporated one-on-one active skills training for parents reporting mild-to-
moderate challenges (McConnell et al., 2010). Intervention sites consisted of PLCs that provided
Levels 2 and 3 Triple P as well as services as usual, while comparison sites consisted of PLCs that pro-
vided only services as usual. Comparisons on child, parent, and family outcomes of interest revealed
no differences between Triple P and services as usual groups (McConnell et al., 2010).
Although McConnell et al. (2010) examined whether Triple P (Levels 2 and 3) enhanced client out-
comes compared to PLC services as usual, the authors did not focus solely on the effect of the Seminar
Series on the outcomes of interest. Further, parenting practices were measured with a scale that mea-
sures global parenting styles (parenting scales of the National Longitudinal Survey of Children and
Youth; NLSCY).

Purpose and Hypotheses


Given the lack of research on Level 2 Triple P, the methodological problems noted in the available
research, and the lack of data on the relationship between Level 2 Triple P and physical punishment,
non-physical punishment and non-punitive responding, the proposed study sought to examine these
relationships among a sample of parents residing in one Canadian city. For the purposes of this study,
physical punishment is defined as ‘An action intended to cause physical discomfort or pain to correct
a child’s behaviour, to “teach a lesson”, or deter the child from repeating the behaviour’ (Durrant,
Ensom, & Coalition on Physical Punishment of Children and Youth, 2004, p. 1). Non-physical
punishment refers to imposed non-physical consequences for a misbehaviour: withholding privileges,
penalties, and time-out (Martin & Pear, 2010). Non-punitive parenting responses refer to positive,
non-violent strategies for dealing with problem behaviour and developmental issues: explaining or
teaching desirable behaviour, using rewards, monitoring children’s behaviour, withdrawing attention,
and diverting children’s attention (Sanders, 2008). Parental reports of physical punishment, non-
physical punishment, and non-punitive responses were compared before and after parents attended
the Level 2 Triple P parent education seminars.
Although the relationship between Level 2 Triple P and parents’ use of physical punishment has not
been examined (Voisine & Baker, 2012), the primary objectives of Triple P, the program’s content, and
research on the more intensive levels of the program (Sanders et al., 2005) suggest that receiving Triple P
parent education should decrease use of physical punishment by educating parents about child develop-
ment and a range of potential responses to challenging situations. Triple P also promotes the use of both
non-physical punishment and non-punitive parenting. Therefore, it is reasonable to expect that partici-
pation in Level 2 Triple P should increase both non physical punishment and non punitive strategies.
We hypothesised that:

(1) Post-intervention, compared to pre-intervention, parents would use physical punishment less
frequently.
(2) Post-intervention, compared to pre-intervention, parents would use non-physical forms of
punishment (withholding of privileges, penalties, and time out) more frequently.
(3) Post-intervention, compared to pre-intervention, parents would use non-punitive parenting
strategies (explain/teach, diversion, reward, monitoring, planned ignoring) more frequently.
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
6 Miriam Gonzalez et al.

Method
Design
A pre–post design was used. Baseline data were collected from participants via an online survey prior
to their participation in the intervention. Post-intervention data were collected via an online survey 2
weeks following intervention completion.

Sample
Sample size calculation
Sample size calculations were conducted taking into account the pre–post intervention design. The
minimum number of participants required to detect a medium effect size (0.6) when comparing
mean differences for a given sample for a one-tailed test (examining statistical significance in the
direction of interest as hypothesised), where power = .80 and alpha= .05, was determined to be 27
(Faul, Erdfelder, Buchner, & Lang, 2009).

Inclusion criteria
Parents were required to have children between the ages of 2 and 6 years. This age group was selected
because research suggests that children in this age group are those most likely to experience physical pun-
ishment (Durrant et al., 2004). Therefore, the potential to detect change would be maximised. All parti-
cipants were required to be 18 years of age or older, speak English, not have participated in another parent
education program, and have common parenting concerns (e.g., non-compliance, bedtime routines).

Sampling procedure
Participant recruitment began in March 2014. Various recruitment strategies were used: (1) managers
of community agencies were asked to share study information with clients, including a flyer and infor-
mation letter providing details about the study; (2) diverse sites advertised the study: paediatricians’
offices, daycare centres in all community areas of the city, public indoor and outdoor pools, public
libraries, community centres, family centres, resource centres, YMCAs, supermarkets, and centres
that provide primary care and family services; and (3) several university and college departments
advertised the study. All school divisions, community agencies that offer programming for parents,
and parent-child coalitions in the city where the study was conducted were approached to ask if
they were interested in hosting the seminars. Once an agency or coalition agreed to host the seminars,
daycares, community centres and parent-child drop-in centres in the area were visited and study
information was shared with parents. The study was also advertised through a study Facebook
page, community newspapers, and parent-child coalitions’ networks.
To entice parents to participate, participants who attended the seminars had the opportunity to
enter their name into a $50 draw at the end of each seminar. They also had the chance to enter
their names into a draw to win $50 upon completing the pre-test and another $50 upon completing
the post-test. Free childcare was also provided. After 13 months of recruitment, 29 parents had agreed
to participate. Recruitment was discontinued 2 months after the third offering of the seminars and
once all agencies that could host the parenting seminars had been approached.
Through a standardised telephone script, the 29 interested parents were screened to determine
whether they met the inclusion criteria. All parents met the criteria but two mothers decided not
to participate due to the distance between their homes and the locations where the seminars were
held. The remaining 27 parents were sent a copy of the consent form, received session information
reminders, and attended all three seminars.

Participants
Table 1 summarises the sample’s characteristics. All but one of the participants were female. The
majority of participants were married (74.1%) and were between the ages of 28 and 42 years
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 7

Table 1. Sample Characteristics

Parent characteristics

n %

Marital status (n = 27)


Single 1 3.7
Married 20 74.1
Living with partner 4 14.8
Divorced 2 7.4
Missing data 0 0.0
Total 27 100.0
Sex (n = 27)
Female 26 96.3
Male 1 3.7
Missing data 0 0.0
Total 27 100.0
Age (n = 27)
18–22 1 3.7
23–27 4 14.8
28–32 10 37.0
33–37 6 22.2
38–42 5 18.5
43+ 1 3.7
Missing data 0 0.0
Total 27 100.0
Education (n = 27)
Grade school — —
Some high school 5 18.5
Completed high school 2 7.4
Some college or technical school 4 14.8
Completed 4 year college or university 6 22.2
Some post-graduate education — —
Completed a postgraduate degree (e.g., MA, MD, PhD) 10 37.0
Missing data 0 0.0
Total 27 100.0
Number of children (under 18 yrs) living with parent (n = 27)
1 14 51.9
2 12 44.4
4 1 3.7
Missing data 0 0.0
(Continued )

Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
8 Miriam Gonzalez et al.

Table 1. (Continued.)

Parent characteristics

n %

Total 27 100.0
Household income (n = 27)
<$30,000 5 18.5
$30,000–59,999 5 18.5
>$60,000 17 62.9
Missing data 0 0.0
Total 27 100.0
Number of people living on this income (n = 27)
2 2 7.4
3 11 40.7
4 13 48.1
6 1 3.7
Missing data 0 0.0
Total 27 100.0
Type of home participant lives in (n = 27)
Rented apartment or condo 4 14.8
Rented house 6 22.2
House owned by participant or partner 17 63.0
Missing data 0 0.0
Total 27 100.0
Identified ethnic background (n = 27)
Aboriginal (First Nations, Inuit, Metis) 5 18.5
Chinese 2 7.4
European 12 44.4
Black (e.g., African, Haitian, Jamaican) 2 7.4
South Asian (e.g., East Indian, Pakistani, Punjabi, Sri Lankan) 1 3.7
Other 5 18.5
Missing data 0 0.0
Total 27 100.0
Child characteristics
n %
Child sex (n = 27)
Female 11 40.7
Male 16 59.3
Missing data 0 0.0
Total 27 100.0
(Continued )

Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 9

Table 1. (Continued.)

Parent characteristics

n %

Child age at last birthday (n = 27)


1–2 6 22.2
3–4 17 62.9
5–6 4 14.8
Missing data 0 0.0
Total 27 100.0
Relationship of child to parent (n = 27)
Child by birth 26 96.3
Child by adoption 1 3.7
Missing data 0 0.0
Total 27 100.0

(77.7%). Participants who attended the seminars were highly educated. Slightly more than a third
(37.0%) had completed a postgraduate degree. Approximately two-thirds of participants reported
household incomes of $60,000 or more (62.9%) and reported living in houses they and/or their part-
ners owned (63.0%).
Participants were asked to answer questions in reference to their 2- to 6-year-old child. If they had
more than one child in that age group, they were asked to choose one on whom to focus their
responses (the target child). More than half of the target children were boys (see Table 1). Almost
two-thirds of the target children were between 3 and 4 years of age. All but one of the participants
reported that the target child was their biological child.

Materials
Survey questionnaire (pre-intervention and post-intervention)
The pre- and post-questionnaires included sections of the Parent and Adult Recall forms of the
Dimensions of Discipline Inventory (DDI; for information about the DDI, see Straus & Fauchier,
2007). The internal consistency of the DDI has been examined: Cronbach alphas have ranged from
.50 to .61 across samples of parents and from .51 to .89 among samples of university students
(Straus & Fauchier, 2007). The DDI has been found to have good validity. For example, scores on
the DDI’s Sociodemographic Risk Index have been found to correlate significantly with mothers’
and fathers’ reports of physical punishment. The scales have been found to discriminate between psy-
chological aggression and parents’ use of discipline methods as measured by each of the scales (Straus
& Fauchier, 2007). For detailed information about the psychometrics of each of the DDI’s subscales
(e.g., reliability analysis and results), please see Straus and Fauchier (2007).
Given the low internal consistency of the DDI among parent samples, the questionnaire used for
this study also included four physical punishment items taken from the nine-item Parental Responses
to Child Misbehavior Revised (PRCM-R) scale (see Holden, 2001, for more on the PRCM). Test–retest
reliability for the original PRCM has been reported for a sample of middle- to upper-middle-class
mothers with correlations for various items averaging .64 (Holden, 2001). The PRCM has been
found to have good validity. For example, reports of spanking on this measure have been found to
correlate significantly with a measure of attitudes toward spanking as well as reported daily reports
of spanking: r = .54 and .77 respectively (Holden, 2001; Holden, Coleman, & Schmidt, 1995).
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
10 Miriam Gonzalez et al.

Procedure
Outcome variables

Physical punishment
Parental use of physical punishment was measured with the four items that make up the DDI’s
Corporal Punishment (CP) scale. These items assess how often in the past month the parent: (1)
shook or grabbed the child to get their attention; (2) spanked, slapped, smacked, or swatted the
child; (3) used a paddle, hairbrush, belt or other object; and (4) washed the child’s mouth out with
soap, put hot sauce on their tongue, or something similar. Response categories for each item have
assigned weights and included: 0 = never, 36 = a few times a month (2–3 times a month), 50 = weekly
(1–2 times a week), 200 = several times a week (3–4 times a week), 350 = daily (5 or more times a
week), and 700 = two or more times a day. A total CP score is obtained by summing the weights across
items. CP scores can range from 0 to 2,100. The higher the score, the more frequently physical pun-
ishment is used (Straus & Fauchier, 2007). As the weights were assigned somewhat arbitrarily by the
measure’s creator (e.g., a response of ‘daily’ is given a value of 350 by rounding down the number of
days in a year), this scoring system may distort the results. Therefore, we also used the simple rating
scale given to parents: 0 = never; 1 = a few times a month (2 to 3 times a month); 2 = weekly (1 to
2 times a week); 3 = several times a week (3 to 4 times a week); 4 = daily (5 or more times a week);
5 = two or more times a day. To examine whether the weighted scoring system and the simple scoring
system would yield different results, we conducted the pre–post analyses using both the weighted
scores and the simple rating scores.

Non-physical punishment
Non-physical punishment was measured with two scales of the DDI. The Deprivation of Privileges
scale measures how often in the past month parents: (1) took away the child’s allowance, toys or pri-
vileges; (2) sent the child to bed without a meal; (3) withheld allowance, toys or other privileges; and
(4) grounded the child or restricted the child’s activities. The Penalty Tasks and Restorative Behavior
Scale assesses how often in the past month parents: (1) gave the child extra chores; (2) made the child
do something to make up for the misbehaviour; and (3) made the child apologise. The Non-Physical
Punishment measure also included one item from the DDI’s Diversion scale: how often in the past
month the parent put the child in time out or sent the child to their room.
To obtain a total non-physical punishment score, the assigned scores for the scale items noted
above were summed: 0 = never, 36 = a few times a month, 50 = weekly, 200 = several times a week,
350 = daily, and 700 = two or more times a day. Total non-physical punishment scores could range
from 0 to 5,600. The higher the score, the more frequently non-physical punishment was used
(Straus & Fauchier, 2007).

Non-punitive parenting responses


Non-punitive parenting responses were measured with the DDI’s Non-Punitive Responding scale,
which assesses how often in the past month parents: (1) explained rules to the child, (2) showed or
demonstrated the right thing to do, (3) deliberately did not pay attention when the child misbehaved,
(4) let the child misbehave so they would have to deal with the results, (5) praised the child, (6) gave
the child money or other things for stopping misbehaviour or for behaving well, (7) checked on the
child so they could tell them they were doing a good job, (8) told the child they were watching or
checking to see if the child did something, and (9) checked on the child to see if he or she was mis-
behaving. Although some of these items are debatably punitive (e.g., planned ignoring), we decided to
use this scale as it was the only one we found that included all parenting responses of interest. We also
included one item from the DDI’s Diversion subscale, which asks parents how often in the past month
they give the child something else to do instead of what they were doing wrong. To obtain a total non-
punitive responding score, each parents’ scores on these 10 items were summed. Response categories
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 11

for scale items have assigned values and include: 0 = never, 36 = a few times a month, 50 = weekly,
200 = several times a week, 350 = daily, and 700 = two or more times a day. Total scores could range
from 0 to 7,000. The higher the score, the more frequently non-punitive responses were used.

Data collection
Pre- and post-intervention questionnaires were created with FluidSurvey, an online survey platform.
Parents were asked to complete the pre-intervention questionnaire electronically 2 weeks prior to
attending the seminars. Those who requested a paper copy of the survey as they did not check
their email frequently were sent a copy of the questionnaire via post along with a postage-paid return
envelope. Parents were telephoned and emailed 3 days prior to the first seminar to remind them of the
seminar times and location. An accredited Level 2 Triple P practitioner was hired and facilitated the
seminars. All seminars were facilitated by the same individual for consistency. The Seminar Series was
delivered to participating parents with 1 week between seminars. Two weeks following the completion
of the third seminar, parents were sent an email message providing a link to the post-intervention
questionnaire. Those with infrequent access to email were sent a copy of the post-intervention ques-
tionnaire via regular mail. Once all parents had completed the post-intervention questionnaire, they
were sent a thank you letter via email (all parents indicated they wished to receive the thank you letter
via email). All parents were sent a summary of the findings via email once the project was completed.

Ethical considerations
The project received ethics approval from the Education and Nursing Research Ethics Board of the
University of Manitoba. All criteria for informed consent were reviewed with potential participants
upon initial telephone contact. Participants’ contact information was not connected to their question-
naires. Their email addresses were uploaded directly to FluidSurvey. The program assigned a code to
the survey link sent to each participant and recorded only the assigned code along with each person’s
responses. The codes were used to connect pre- to post-test data but not to connect data to individuals.
When a participant requested paper copies of the questionnaires, these were assigned a randomly
generated code. No record was kept of the codes assigned to participants.

Method of data analysis


Univariate descriptives, paired samples t tests, and Wilcoxon signed rank tests were used to test the
study’s hypotheses.

Results
Hypothesis 1: Parents’ Use of Physical Punishment Will Decrease From Pre- to Post-Intervention
Table 2 provides the results of the paired samples t test on the Corporal Punishment scale before and
after attending the Triple P parenting sessions. There was a significant decrease on this scale from pre-
(M = 31.69, SD = 66.68) to post-intervention (M = 7.46, SD = 15.79) for a one-tailed test at the .05 level
of significance; t(25) = 1.99, p = .03.
The paired samples t test on the Corporal Punishment scale was also conducted with the simple
rating scale given to parents to assess whether the weighted scores were confounding the findings
(see Table 3). Again, the Corporal Punishment score decreased from pre- to post-intervention.
To further examine this finding, a descriptive analysis of the items that make up the Corporal
Punishment scale was conducted. It revealed that there was a decrease pre- to post-intervention
only in the case of shaking/grabbing. Prior to the intervention, 66.7% of parents (18 parents) reported
never shaking/grabbing a child while all parents (27 parents) reported never doing so following the
intervention. On the spanking/slapping/smacking/swatting item, two parents moved categories
(from more often to less often) but no one moved to the never category. There was also a floor effect
for two (hit child with objects, wash child’s mouth out with soap) of the four items of this scale. That
is, pre-intervention, the majority of parents reported never hitting their child with an object or
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
12 Miriam Gonzalez et al.

Table 2. Results of Paired Samples t Test on Outcome Measures Using Dimensions of Discipline Inventory (DDI) Weighted
Scores

Continuous variables

Pre n Post n
Variables Mean (SD) Mean (SD) Paired t p

Corporal Punishment Scale (n = 26) (n = 26)


31.69 (66.68) 7.46 (15.79) 1.99 .03
Non-Physical Punishment Scale (n = 27) (n = 27)
572.22 (415.55) 591.93 (476.71) −0.24 .41
Non-Punitive Responding Scale (n = 27) (n = 27)
2061.33 (957.82) 1977.48 (668.69) 0.55 .29

Table 3. Results of Paired Samples t Test on Outcome Measures Using Dimensions of Discipline Inventory (DDI) Simple
Rating Scale

Continuous variables

Pre n Post n
Variables Mean (SD) Mean (SD) Paired t p

Corporal Punishment Scale (n = 26) (n = 26)


0.73 (1.34) 0.23 (0.51) 2.11 .02
Non-Physical Punishment Scale (n = 27) (n = 27)
8.22 (3.85) 9.59 (4.55) −2.06 .03
Non-Punitive Responding Scale (n = 27) (n = 27)
23.70 (5.81) 23.81 (5.45) −0.10 .46

washing their child’s mouth out with soap. To further examine how parents’ post-test scores on the
Corporal Punishment items differed from their pre-test scores, Wilcoxon signed rank tests were con-
ducted for each pair of items. As can be seen in Table 4, post-test scores were significantly higher than
pre-test scores only on the shaking/grabbing item, z = −2.76, p = .01. That is, parental use of shaking/
grabbing significantly decreased from a mean frequency of a few times a month (M = 5.44) pre-
intervention to never (M = 6.00) post-intervention.

Hypothesis 2: Parents’ Use of Non-Physical Punishment Will Increase From Pre- to Post-Intervention
As shown in Table 2, parents’ Non-Physical Punishment Scale scores did not change significantly from
pre- to post-intervention (M = 572.22, M = 591.93) for a one-tailed test at the .05 level of significance,
t(26)= -.24, p = .41. Results of the paired samples t test using the simple rating scale revealed a signifi-
cant increase on the Non-Physical Punishment Scale (see Table 3).
To further examine this increase, a frequency analysis of items that make up the Non-Physical
Punishment Scale was conducted. There was a floor effect for the item ‘How often do you send the
child to bed without a meal?’. To examine whether this item affected the results of the paired samples
t test, the analysis was conducted again without this item using the weighted scores and the simple
rating scale. The pre- to post-intervention difference on this item remained non-significant whether
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 13

Table 4. Results of Wilcoxon Signed Rank Test Comparing Physical Punishment Items Pre-and Post-Intervention

Pre n mean Post n mean z


Variables (SD) (SD) score p

How often shake or grab this child (n = 27) (n = 27)


5.44 (0.97) 6.00 (0.00) −2.76 .01
How often spank, slap, smack, or swat this child (n = 27) (n = 27)
5.67 (0.78) 5.78 (0.51) −1.13 .26
How often use paddle, hairbrush, belt, or other object (n = 27) (n = 27)
5.96 (0.19) 5.96 (0.19) 0.00 1.00
How often wash child mouth out with soap, put hot (n = 26) (n = 26)
sauce on their tongue or something similar
6.00 (0.00) 6.00 (0.00) 0.00 1.00

the weighted scores or the simple ratings were used. The frequency analysis also revealed that all
remaining items of the Non-Physical Punishment Scale showed increases in some of their categories
pre- to post-intervention. For instance, when it came to how often the parent made the child apologise,
18.5% of parents (five parents) reported doing this several times a week prior to the intervention while
33.3% (nine parents) reported doing so post-intervention.
To examine mean differences between the pre- and post-test scores, Wilcoxon signed rank tests
were conducted on each item (Table 5). Scores increased pre- to post-intervention only for the
‘Make the child apologise’ item, but this increase was not statistically significant (z = −0.84, p = .40).
For the item with the previously noted floor effect (send child to bed without a meal), scores did
not change pre- to post-intervention. For all remaining items, pre- to post-test scores decreased but
the difference was statistically significant only for the ‘Take away allowance, toys, or privileges’
item, z = −2.11, p = .04.

Hypothesis 3: Parents’ Use of Non-Punitive Responses Will Increase From Pre- to Post-Intervention
As shown in Table 2, parents’ scores on the Non-Punitive Responding scale did not differ significantly
from pre- to post-intervention (M = 2,061.33, M = 1,977.48) for a one tailed test at the .05 level of sig-
nificance, t(26) = 0.55, p = .29. Results of the paired samples t test using the simple rating scale were
similar (see Table 3).
A frequency analysis of the Non-Punitive Responding items revealed that for all but one item
(where scores stayed the same for each category), there were small changes pre- to post-intervention
for various item categories. For instance, prior to the intervention, 11.1% of parents (three parents)
indicated they used praise with their children several times a week while 22.2% (six parents) reported
doing so after the intervention. To further examine parental responses to the Non-Punitive
Responding items pre- to post-intervention, Wilcoxon signed rank tests were conducted on each
item. As Table 6 indicates, there was a significant decrease from pre- to post-test scores on the explain
rules item, z = −2.59, p = .01. Given that similar results (except for Non-Physical Punishment) were
found whether the weighted scores or the simple rating scale was used, the weighted scores are
used when discussing the findings.

Discussion
A significant decrease was found in parents’ reporting of physical punishment overall from pre- to
post-intervention. However, this decrease was due to change on only one of four items: shaking/
grabbing the child. The floor effects at pre-test on two items (hitting with objects, washing the child’s
mouth out with soap) made it impossible to find a decrease on these items post-intervention. The
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
14 Miriam Gonzalez et al.

Table 5. Results of Wilcoxon Signed Rank Test Comparing Non Physical Punishment Items Pre- and Post-Intervention

Pre n mean Post n mean z


Variables (SD) (SD) score p

How often take away allowance, toys, or privileges (n = 27) (n = 27)


4.59 (1.22) 4.00 (1.24) −2.11 .04
How often send child to bed without a meal (n = 27) (n = 27)
6.00 (0.00) 6.00 (0.00) 0.00 1.00
How often withhold allowance, toys, other (n = 27) (n = 27)
privileges
4.96 (1.13) 4.70 (1.20) −1.37 .17
How often ground child or restrict activities (n = 27) (n = 27)
5.52 (0.94) 5.44 (1.05) −0.71 .48
How often give child extra chores (n = 27) (n = 27)
5.81 (0.48) 5.70 (0.61) −1.00 .32
How often make child do something to make up (n = 27) (n = 27)
for misbehaviour
5.70 (0.47) 5.52 (0.85) −1.22 .22
How often make child apologize (n = 27) (n = 27)
2.93 (1.64) 3.22 (1.28) −0.84 .40
How often put child in time-out or send to their (n = 27) (n = 27)
room
4.26 (1.20) 3.81 (1.36) −1.65 .10

analysis was therefore limited to the remaining two items (shaking/grabbing and spanking/slapping/
smacking/swatting). The mean frequency of spanking/slapping/smacking/swatting did not decrease
post-intervention, and in fact increased slightly, though non-significantly. Therefore, the first hypothesis
was only partially supported.
This study is the first to investigate whether Level 2 Triple P has potential to reduce parental use of
physical punishment. As the most common form of physical punishment (spanking/slapping/smack-
ing/swatting) did not decrease, the potential usefulness of the Seminar Series in reducing physical
punishment as defined in this study cannot be fully ascertained and needs to be further explored.
In addition to the floor effects at pre-test on two of the four physical punishment scale items, there
are three other possible explanations for the lack of a significant decrease in overall use of physical
punishment pre- to post-intervention. One explanation might be the measures used in this study.
The DDI’s Corporal Punishment scale is designed to assess changes in specific, goal-directed beha-
viours (Straus & Fauchier, 2007). Studies that have found the Triple P seminars to be effective in redu-
cing coercive parenting have used instruments that measure parenting styles, or global dimensions or
categorisations, such as permissive discipline or authoritarian discipline (Sumargi et al., 2014; Sanders
et al., 2009). Another explanation may be that parents may need longer than the 2-week assessment
period post-intervention to implement other strategies learned. It may also be that the Seminar Series
increases parents’ awareness of and desire to change their use of physical punishment, but not their
actual behaviour.
While parents’ reports of non-physical punishment did not change overall from pre- to post-
intervention, their reports of taking things away from their children (allowance, toys, and privileges)
increased. Similarly, although parents’ non-punitive responding did not change overall over the course
of the program, the frequency analysis revealed there was an increase in the frequency with which they
explained rules, from several times a week at pre-intervention to daily at post-intervention. Therefore,
hypotheses 2 and 3 were only weakly supported.
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 15

Table 6. Results of Wilcoxon Signed Rank Test Comparing Non-Punitive Responding Items Pre- and Post = Intervention

Pre n mean Post n mean z


Variables (SD) (SD) score p

How often explain rules (n = 27) (n = 27)


2.74 (1.56) 1.96 (0.85) −2.59 .01
How often show/demonstrate right thing to do (n = 27) (n = 27)
2.67 (1.11) 2.59 (0.97) −0.35 .72
How often deliberately did not pay attention when (n = 27) (n = 27)
child misbehaved
4.33 (1.07) 4.63 (1.15) −1.35 .18
How often let this child misbehave so they’d have to (n = 27) (n = 27)
deal with results
5.37 (0.97) 5.33 (1.00) −0.30 .76
How often praise child (n = 27) (n = 27)
2.48 (1.45) 2.33 (1.18) −0.59 .55
How often give child money or other things for (n = 27) (n = 27)
stopping misbehaving or for behaving well
4.85 (1.51) 4.85 (1.23) −0.09 .93
How often check on this child so you could tell them (n = 27) (n = 27)
they were doing a good job
2.26 (1.10) 2.37 (1.12) −0.34 .74
How often tell child you were watching/checking to see (n = 27) (n = 27)
if they did something
4.85 (1.20) 4.85 (1.20) −0.06 .95
How often check on child to see if misbehaving (n = 27) (n = 27)
3.41 (1.74) 3.67 (1.64) −0.70 .48
How often give child something else they might like to (n = 27) (n = 27)
do instead of what they were doing wrong
3.33 (1.60) 3.59 (1.34) −0.79 .43

This study is the first to examine the relationship between Level 2 Triple P and parents’ reports
of non-physical punishment and non-punitive responding. The finding that parents who partici-
pated in Level 2 Triple P took things away from their children and explained rules more often
following the program is consistent with research on targeted Triple P that suggests the program
leads to increased non-physical punishment (e.g., taking away allowance or toys) and non-punitive
responses such as explaining rules (De Graaf et al., 2008a; Hahlweg, Heinrich, Kuschel, &
Feldmann, 2008; Nowak & Heinrichs, 2008; Thomas & Zimmer-Gembach, 2007). However, a
study that implemented all five levels of Triple P found no significant difference from pre- to post-
intervention in parents’ total use of non-physical punishment and non-punitive responses, such as
applying consequences that fit the situation, giving rewards or descriptive praise, or calling a family
meeting to work out a solution (Sanders et al., 2008). Together with these findings, the present
results might indicate that Level 2 Triple P is not sufficient to convince or enable parents to elim-
inate their use of physical and other punishments. They may require a more intensive program
variant or more discussion time, examples of how to implement the strategies, or additional sup-
port (Sanders et al., 2008; Sumargi et al., 2014). Given that in two of the three seminars there is
limited focus on teaching actual strategies, changes in seminar content may be required to achieve
changes in parents’ behaviour. Alternatively, it might be the case that the content of the Seminar
Series places emphasis on taking things away from children as punishment and on setting rules.
Thus, the present findings may indicate that the Seminar Series conveys these messages effectively
to parents.
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
16 Miriam Gonzalez et al.

Limitations
Due to the study design used, any changes seen from pre- to post-intervention cannot be interpreted
to be solely the result of the Triple P seminars. Also, the study design did not include a follow-up com-
ponent, so it was not possible to assess maintenance of effects (or non-effects) over the long term.
With regard to the sample, all participants who expressed interest in participating were accepted pro-
vided they met inclusion criteria. Thus, self-selection bias may have occurred. More than half of the
parents had completed at least one university degree and two-thirds had household incomes of at least
$60,000. Therefore, this sample was likely not representative of the Canadian parent population.
Although the sample size was adequate according to our power calculation, a larger sample size
would have increased the power to detect change.
Regarding the measures, the DDI scales have been found to have low internal consistency, and
some of their constituent items are double-barrelled questions, affecting the reliability of the data.
Also, the scale used to measure non-punitive responding included planned ignoring, which is actually
a form of punishment (Martin & Pear, 2010), reducing the validity of the non-punitive responding
scale. The floor effects found on several of the physical and non-physical punishment items at pre-test
made it impossible to find a decrease on them post-intervention. Finally, biases inherent in self-reports
such as social desirability bias and recall bias might have affected the findings.

Directions for Future Research


Examining the impact of the Seminar Series on changes in parents’ use of physical and other punish-
ments with a larger sample and a randomised control design is warranted. Future research should
follow parents over a few months following program completion, with repeated data collection at spe-
cific time periods to allow for the examination of change over time. Samples should be more diverse,
including more fathers, younger parents, and parents from diverse socioeconomic and ethnic back-
grounds. Future studies also should include two or more sources of data (e.g., children’s reports,
teachers’ reports) or make use of other methodologies (e.g., audio recordings of family interactions,
home observation and coding of family interactions) to enhance validity of outcome measurement.
Given our findings, parents’ awareness and desire to change their use of physical punishment follow-
ing completion of the seminars should also be assessed.
Finally, the time commitment required for the Seminar Series may be seen as too great by parents
of young children, who often have many competing demands on their time (e.g., challenging to recruit
participants, only one father participated). Offering a range of delivery modes (e.g., web-based
program, self-directed with telephone assistance, television program) may facilitate accessibility to
parents. Strategies that were found in this study to facilitate recruitment were: (1) identifying organi-
sations or school divisions interested in offering the seminars well in advance, (2) providing monetary
contributions to organisations that agree to offer the seminars, (3) minimising the work required of
host organisations, (4) identifying the ideal time for recruitment within participating organisations,
(5) offering child-minding services and snacks, and (6) providing a token of appreciation for each par-
ticipant after each seminar.

Conclusions
This study serves as a feasibility study to guide future work examining the relationship between Level 2
Triple P, physical punishment, and non-punitive parental responses. We gathered useful information for
conducting a full-scale study on this topic in a Canadian context by: (1) collecting preliminary data on a
relationship not previously examined, (2) assessing the adequacy of the instruments as well as the sam-
pling frame and technique, and (3) identifying effective recruitment strategies for parents of preschoolers.
The lack of change found in parents’ reports of the most common forms of physical punishment
(spanking/slapping/smacking/swatting) should be further examined from both a qualitative (parental
Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 17

experience of the seminars) and a quantitative perspective. The increase found in parents’ tendency to
take things away from their children may be cause for some concern, as taking things away from
children is a power assertive act that does not actually help the child to acquire skills or understanding.
It is important to gain a better understanding of the actual content of the seminars to determine the
extent to which parents are taught to use punishments (e.g., taking things away from children) over
non-punitive responses. Finally, parents did not report modelling appropriate behaviour, praising
their children, or ‘catching them being good’ more often. Thus, several ‘positive parenting’ strategies
did not increase over the course of the Seminar Series. It is important to highlight that changing
behaviour is a complex task. From a socio-ecological perspective, intrapersonal (e.g., individual
child characteristics such as child age or behaviour, parent characteristics such as knowledge and
skills), interpersonal (e.g., family, friends, social networks), and broader environmental factors (e.g.,
organisational: schools, workplaces; community: connectedness, spaces; and laws and policy) influence
behaviour (McLeroy, Bibeau, Steckler, & Glanz, 1988). The Triple P Seminar Series targets influences
at the intrapersonal level (e.g., parental knowledge, skills), which are factors at one level of the multiple
levels that interact to influence behaviour. Further research is needed on the impact of the Seminar
Series on physical punishment and non-punitive responses by parents.
Acknowledgments. This work was completed in partial fulfillment of the corresponding author’s doctoral work. The
Children’s Hospital Research Institute of Manitoba (Grant # SMG13-15, 2013), Research and Education for Solutions to
Violence and Abuse (RESOLVE), and the University of Manitoba are acknowledged for their financial support. The funding
sources had no role in the design of the study, analysis of data, writing of the paper, or the decision to publish.

Declaration of Interest. None.

Ethical Standards. The authors assert that all procedures contributing to this work comply with the ethical standards of the
relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as
revised in 2008.

References
Amato PR and Fowler F (2002). Parenting practices, child adjustment, and family diversity. Journal of Marriage and Family,
64, 703–716.
Anda RF, Felitti VJ, Bremmer JD, Walker JD, Whitfield C, Perry BD, Dube SR and Giles WH (2006). The enduring
effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemi-
ology. European Archives of Psychiatry and Clinical Neuroscience, 256, 174–186.
Arnold DS, O’Leary SG, Wolff LS and Acker MM (1993). The Parenting Scale: A measure of dysfunctional parenting in
discipline situations. Psychological Assessment, 5, 137–144.
Bodenmann G, Cina A, Ledermann T and Sanders MR (2008). The efficacy of Positive Parenting Program (Triple P) in
improving parenting and child behaviour: A comparison with two other treatment conditions. Behavior Research and
Therapy, 46, 411–427.
Carlo G, Knight GP, McGinley M and Hayes R (2011). The roles of parental inductions, moral emotions, and moral cogni-
tions in prosocial tendencies among Mexican American and European American early adolescents. Journal of Early
Adolescence, 31, 757–781.
De Graaf I, Speetjens P, Smit F, de Wolff M and Tavecchio L (2008a). Effectiveness of the Triple P Positive Parenting pro-
gram on parenting: A meta-analysis. Family Relations, 57, 553–566.
De Graaf I, Speetjens P, Smit F, de Wolff M and Tavecchio L (2008b). Effectiveness of the Triple P positive parenting pro-
gram on behavioral problems in children: A meta-analysis. Behavior Modification, 32, 714–735.
Durrant JE (2008). Physical punishment, culture, and rights: Current issues for professionals. Journal of Developmental and
Behavioral Pediatrics, 29, 55–66.
Durrant JE and Ensom R (2012). Physical punishment of children: Lessons from 20 years of research. Canadian Medical
Association Journal, 184, 1373–1377.
Durrant JE, Ensom R and Coalition on Physical Punishment of Children and Youth (2004). Joint Statement on Physical
Punishment of Children and Youth. Ottawa, Canada: Coalition on Physical Punishment of Children and Youth.
Fabiano GA, Pelham WE, Manos MJ, Gnagy EM, Chronis AM, Onyango AN … Swain S (2004). An evaluation of three
time-out procedures for children with attention deficit/hyperactivity disorder. Behavior Therapy, 35, 449–469.
Faul F, Erdfelder E, Buchner A and Lang A-G (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and
regression analyses. Behavior Research Methods, 41, 1149–1160.

Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
18 Miriam Gonzalez et al.

Fréchette S and Romano E (2015). Change in corporal punishment over time in a representative sample of Canadian par-
ents. Journal of Family Psychology, 29, 507–517.
Ford AD, Olmi DJ, Edwards RP and Tingstrom DH (2001). The sequential introduction of compliance training compo-
nents with elementary-aged children in general education. School Psychology Quaterly, 16, 142–157.
Gershoff ET (2002). Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and
theoretical review. Psychological Bulletin, 128, 539–579.
Gershoff ET (2010). More harm than good: A summary of scientific research on the intended and unintended effects of
corporal punishment on children. Law and Contemporary Problems, 73, 31–56.
Gershoff ET and Grogan-Kaylor A (2016). Spanking and child outcomes: Old controversies and new meta-analysis. Journal
of Family Psychology, 30, 453–469. doi:10.1037/fam0000191
Hahlweg K, Heinrichs N, Kuschel A and Feldmann M (2008). Therapist-assisted, self-administered bibliotherapy to
enhance parental competence: Short and long term effects. Behavior Modification, 32, 659–681.
Healthy Child Manitoba (2015). Healthy Child Manitoba annual report 2014–2015. Retrieved February 12, 2016 from http://
www.gov.mb.ca/healthychild/about/annual.html
Heinrichs N, Bertram H, Kuschel A and Hahlweg K (2005). Parent recruitment and retention in a universal prevention
program for child behavior and emotional problems: Barriers to research and program participation. Prevention
Science, 6, 275–286.
Hester PP, Hendrickson JM and Gable RA (2009). Forty years later: The value of praise, ignoring, and rules for preschoolers
at risk for behavior disorders. Education and Treatment of Children, 32, 513–535.
Hoeve M, Dubas JS, Eichelsheim VI, van der Laan PH, Smeenk W and Gerris JRM (2009). The relationship between par-
enting and delinquency: A meta-analysis. Journal of Abnormal Child Psychology, 37, 749–775.
Holden GW (2001). Parental responses to chid misbehavior (PRCM). In J Touliatos, BF Perlmutter and GW Holden (Eds.),
Handbook of family measurement techniques (vol 2, Abstracts). Thousand Oaks, CA: Sage.
Holden GW, Coleman S, and Schmidt K (1995). Why 3-year-old children get spanked- parent and child determinants as
reported by college educated mothers. Merrill-Palmer Quarterly, 41, 431–452.
Jeynes WH (2007). The relationship between parental involvement and urban secondary school student academic achieve-
ment: A meta-analysis. Urban Education, 42, 82–110.
Jones DJ, Forehand R, Brody GH and Armistead L (2002). Positive parenting and child psychosocial adjustment in inner-
city single-parent African American families. Behavior Modification, 26, 464–481.
Laroche KJ, Lee CM and Ateah CA (2013, June 13). Changing tides: Physical punishment use by Canadian parents.
Symposium presentation at Canadian Psychological Association convention. Québec City: QC.
Leung C, Sanders MR, Ip F and Lau J (2006). Implementation of Triple P positive parenting program in Hong Kong:
Predictors of program completion and clinical outcomes. Journal of Children’s Services, 1, 4–17.
Leung C, Sanders MR, Leung S, Mak R and Lau J (2003). An outcome evaluation of the implementation of the Triple
P--Positive Parenting Program in Hong Kong. Family Process, 42, 531–544.
Martin G and Pear J (2010). Behavior modification: What it is and how to do it (10th ed). Pearson Education: Allyn & Bacon.
Matsumoto Y, Sofronoff K and Sanders MR (2007). The efficacy of the Triple P Positive Parenting program with Japanese
parents. Behavior Change, 24, 205–218.
Matsumoto Y, Sofronoff K and Sanders MR (2010). Investigation of the effectiveness and social validity of the Triple P –
Positive Parenting Program in Japanese society. Journal of Family Psychology, 24, 87–91.
McConnell D, Breitkreuz R, Savage A and Hamilton A (2010). Supported parenting: Integrating ‘Triple P’ into parent link
centres — An independent evaluation. Alberta, Canada: University of Alberta, Family and Disabilities Studies.
McLeod BD, Weisz JR and Wood JJ (2007). Examining the association between parenting and childhood depression: A
meta-analysis. Clinical Psychology Review, 27, 986–1003.
McLeroy KR, Bibeau D, Steckler A and Glanz K (1988). An ecological perspective on health promotion programs. Health
Education Quarterly, 15, 351–377.
Morawska A, Sanders MR, Haslam D, Filus A and Fletcher R (2014). Child adjustment and parent efficacy scale:
Development and initial validation of a parent report measure. Australian Psychologist, 49, 241–252.
Nowak C and Heinrichs N (2008). A comprehensive meta-analysis of Triple P positive parenting program using
hierarchical linear modeling: Effectiveness and moderating variables. Clinical Child and Family Psychology Review, 11,
114–144.
Prinz RJ, Sanders MR, Shapiro CJ, Whitaker DJ and Lutzker JR (2009). Population based prevention of child maltreat-
ment: The US Triple P system population trial. Prevention Science, 10, 1–12.
Sanders MR (2008). Triple P Positive Parenting Program as a public health approach to strengthening parenting. Journal of
Family Psychology, 22, 506–517.
Sanders MR, Healy KL, Grice C and Del Vecchio T (2017). Evidence-based parenting programs: Integrating science into
school-based practice. In M Thielking & MD Terjesen (Eds.), Handbook of Australian school psychology: Integrating inter-
national research, practice, and policy (pp. 537–552). Switzerland: Springer International

Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7
Behaviour Change 19

Sanders MR, Kirby JN, Tellegen L and Day JJ (2014). The Triple P Positive Parenting Program: A systematic review and
meta-analysis of a multi-level system of parenting Support. Clinical Psychology Review, 34, 337–357.
Sanders MR, Markie-Dadds C, and Turner KMT (2003). Theoretical, scientific and clinical foundations of the Triple P
Positive Parenting program: A population approach to the promotion of parenting competence. Parenting Research and
Practice Monograph, 1, 1–24.
Sanders MR, Markie-Dadds C, and Turner KMT (2005). Every parent’s survival guide. Brisbane, Australia: Triple P
International Pty Ltd.
Sanders MR, Morawska A, Haslam DM, Filus A and Fletcher R (2014). Parenting and Family Adjustment Scales (PAFAS):
Validation of a brief parent-report measure for use in assessment of parenting skills and family relationships. Child
Psychiatry and Human Development, 45, 255–272.
Sanders MR, Prior J and Ralph A (2009). An evaluation of a brief universal seminar series on positive parenting: A feasi-
bility study. Journal of Children’s Services, 4, 4–20.
Sanders MR, Ralph A, Sofronoff K, Gardiner P, Thompson R, Dwyer S and Bidwell K (2008). Every family: A population
approach to reducing behavioral and emotionalproblems in children making the transition to school. Journal of Primary
Prevention, 29, 197–222.
Sanders MR and Turner KMT (2005). Facilitator’s manual for Selected Triple P. Brisbane, Australia: Triple P International.
Straus MA and Fauchier A (2007). Manual for the Dimensions of Discipline Inventory (DDI). Durham, NH: University of
New Hampshire, Family Research Laboratory. Retrieved from http://pubpages.unh.edu/~mas2/
Sumargi A, Sofronoff K and Morawska A (2014). Evaluation of a brief format of the Triple P Positive Parenting Program: A
pilot study with Indonesian parents residing in Australia. Behavior Change, 31, 144–158.
Sumargi A, Sofronoff K and Morawska A (2015). A randomized-controlled trial of the Triple P Positive Parenting Program
seminar series with Indonesian parents. Child Psychiatry and Human Development, 46, 747–762.
Thomas R and Zimmer-Gembach MJ (2007). Behavioral outcomes of parent-child interaction therapy and Triple P positive
parenting program: A review and meta-analysis. Journal of Abnormal Child Psychology, 35, 475–495.
Triple P Positive Parenting Program (n.d.). The world of Triple P. Retrieved October 7, 2017 from http://www.triplep.net/
glo-en/find-out-about-triple-p/the-world-of-triple-p/
Trocmé N and Durrant JE (2003). Physical punishment and the response of the Canadian child welfare system: Implications
for legislative reform. Journal of Social Welfare and Family Law, 25, 39–56.
Trocmé N, Fallon B, MacLaurin B, Daciuk J, Felstiner C, Black T… Cloutier R (2005). Canadian incidence study of
reported child abuse and neglect – 2003: Major findings. Minister of Public Works and Government Services Canada
Trocmé N, MacLaurin B, Fallon B, Daciuk J, Billingsley D, Tourigny M … McKenzie B (2001). Canadian incidence study
of reported child abuse and neglect: Final report. Ottawa, Canada: Minister of Public Works and Government Services
Canada.
Turner K, Richards M and Sanders MR (2007). Randomised clinical trial of a group parent education programme for
Australian indigenous families. Journal of Paediatrics and Child Health, 43, 429–437.
UNODC (United Nations Office on Drugs and Crime) (2009). Compilation of evidence-based family skills training pro-
grammes. Retrieved Dec 02, 2012 from http://www.unodc.org/docs/youthnet/Compilation/10-50018_Ebook.pdf
Voisine S and Baker AJL (2012). Do universal parenting programs discourage parents from using corporal punishment: A
program review. The Journal of Contemporary Social Services, 93, 212–218.

Cite this article: Gonzalez M, Ateah CA, Durrant JE, Feldgaier S (2019). The Impact of the Triple P Seminar Series on
Canadian Parents’ Use of Physical Punishment, Non-Physical Punishment and Non-Punitive Responses. Behaviour
Change 1–19. https://doi.org/10.1017/bec.2019.7

Downloaded from https://www.cambridge.org/core. IP address: 66.11.34.101, on 15 Apr 2019 at 15:58:56, subject to the Cambridge Core terms of use, available at
https://www.cambridge.org/core/terms. https://doi.org/10.1017/bec.2019.7

You might also like