Development and Validation of Fidelity Monitoring and Enhancement in an Evidence-Based Parenting Program.

This article adds to current research by examining treatment fidelity of an evidence-based parenting program (namely Triple P) as part of a large clinical trial which included a range of procedures for promoting fidelity including both expert and peer supervision. Procedures for monitoring and promoting fidelity are described, and two major aspects of fidelity, namely content adherence and process fidelity, were evaluated. All treatment sessions for 166 families participating in the Standard Triple P-Positive Parenting Program were video-recorded and then sampled for evaluation without advanced knowledge by delivery practitioners. Independent coders at an external site assessed content adherence and rated delivery process. Fidelity promotion included high-quality training of practitioners on a standardized protocol, ongoing clinical supervision by peers and supervisors, and fidelity feedback sessions. Average content fidelity was consistently high (i.e., over 80%). Process fidelity scores were similarly high across sessions. A brief survey indicated practitioners found that the fidelity and implementation model was useful and contributed to increasing self-efficacy over the course of the initiative.

A Randomized Trial of Baby Triple P for Preterm Infants: Child Outcomes at 2 Years of Corrected Age.

OBJECTIVE: To determine the efficacy of a hospital-based intervention that transitions into existing community support, in enhancing developmental outcomes at 2 years of corrected age in infants born at less than 32 weeks. STUDY DESIGN: In total, 323 families of 384 infants born <32 weeks were randomized to receive intervention or care-as-usual. The intervention teaches parents coping skills, partner support, and effective parenting strategies over 4 hospital-based and 4 home-phone sessions. At 2 years of corrected age maternally reported child behavior was assessed by the Infant and Toddler Social Emotional Adjustment Scale. Observed child behavior was coded with the Revised Family Observation Schedule. Cognitive, language, and motor skills were assessed with the Bayley Scales of Infant and Toddler Development III. RESULTS: Mean gestational age of infants was 28.5 weeks (SD = 2.1), and mothers' mean age was 30.6 years (SD = 5.8). A total of 162 families (n = 196 infants) were allocated to intervention and 161 families (n = 188 infants) received care-as-usual. There was no significant adjusted difference between treatment groups on dysregulation (0.2; 95% CI -2.5 to 3.0, P = .9) externalizing (0.3; 95% CI -1.6 to 2.2, P = .8), internalizing (-1.5; 95% CI -4.3 to 1.3, P = .3), observed aversive (0.00; -0.04 to 0.04, P = .9), or nonaversive behavior (-0.01; 95% CI -0.05 to 0.03, P = .7). Intervention children scored significantly higher on cognition (3.5; 95% CI 0.2-6.8, P = .04) and motor skill (5.5; 95% CI 2.5-8.4, P < .001), and approached significance on language (3.8; 95% CI -0.3 to 7.9, P = .07). CONCLUSIONS: Baby Triple P for Preterm Infants increases cognitive and motor skills but does not impact behavior. The results are evidence that hospital-based interventions can improve some developmental outcomes for infants <32 weeks. TRIAL REGISTRATION: ACTRN 12612000194864.