Jandu Yani U (for all families): evaluating Indigenous Triple P, a community-tailored parenting support program in remote Aboriginal communities

Abstract

ABSTRACTObjectives Although evidence-based parenting programs are widely available, they remain inaccessible to many families of children with social, emotional and behavioural problems, particularly in remote settings. In partnership with Aboriginal communities in the remote Fitzroy Valley, Western Australia, we introduced and evaluated the Indigenous Triple P – Positive Parenting Program, with additional Stepping Stones Triple P strategies (for children with complex needs). Implementation followed community consultation and program adaptation to acknowledge local culture, social complexities and language. The initiative was named Jandu Yani U, meaning “for all families” in the local Bunuba language.Method Local practitioners (parent coaches) were trained to deliver Triple P. Parents and carers (henceforth carers) of children up to 15 years of age were invited to participate. Families attending the program reported on child behaviour, parenting practices, self-efficacy, wellbeing and empowerment pre- and post-intervention and at 8-month follow-up using standardised assessment tools delivered by local community navigators.Results Of 30 participating families, 100% completed Triple P and reported the program was culturally appropriate. Of the index children, 93% were Aboriginal, 63% boys, median age 6.83 years. Following the program, carers reported high levels of empowerment and reaching goals for behaviour change (p < .001) and less use of unhelpful parenting strategies (over-reactivity and hostility; p < .05), and this maintained at 8-month follow-up (p < .001). At follow-up, improvement in carer self-efficacy (p < .001) and reduced anxiety (p < .001) were documented. Significant improvements in prosocial behaviour, reductions in challenging behaviour and decreased intensity and frequency of behavioural problems (all p < .05) were reported in children at follow-up. The average level of goal attainment was 65% at post, which was maintained at follow-up.Conclusion This study demonstrates the feasibility of delivering Indigenous Triple P to Aboriginal families in remote settings, and the importance of partnership with communities. Program tailoring, flexible delivery, use of Aboriginal parent coaches and provision of practical support to families resulted in a culturally acceptable parent support program. With local Aboriginal co-design, this initiative should be generalisable to similar remote communities elsewhere.Key PointsWhat is already known about the topic: Aboriginal and Torres Strait Islander families are more often exposed to stressful life events than non-Indigenous families, with children overrepresented in hospitalisation rates, poor health outcomes, early school dropout, out-of-home care, involvement with the justice system and youth suicide.There is a significant evidence base that parenting programs, such as Triple P, built on the principles of social learning and self-regulation, can be effective in addressing emotional and behavioural problems in children in the short and longer term.Despite the availability of evidence-based parenting programs, a minority of parents of children with behavioural and emotional problems access such programs, and access by Aboriginal and Torres Strait Islander families is lower.What this topic adds: This study determined the feasibility of delivering a community tailored, evidence-based parenting program to families in a very remote Western Australian Aboriginal community.Families reported significant reductions in unhelpful parenting strategies, carer anxiety and challenging child behaviours and significant increases in parenting confidence and empowerment and prosocial child behaviour following the program.Co-design methods, community-led modifications to resources, two-way learning with Aboriginal and non-Indigenous trainers, training local parent coaches, flexible program delivery and long-term practical support were essential for delivering a culturally acceptable parenting program implementation strategy that could be adapted for remote communities elsewhere.KEYWORDS: Aboriginal and Torres Strait Islanderfoetal alcohol spectrum disorderIndigenousparentingTriple P AcknowledgementsThe project would not have been possible without considerable support provided by the extended project team and advisory group, including June Oscar and Emily Carter (MWRC), Marmingee Hand (Fitzroy Valley District High School), Associate Professor Kate Sofronoff and Professor Matthew Sanders (The University of Queensland), Professor Maxwell Bennett (University of Sydney), Dr Jeffrey Nelson (Clinical Psychologist) and Damian Griffiths (Aboriginal Disability Network NSW).Disclosure statementThe Triple P – Positive Parenting Program is owned by The University of Queensland (UQ). The university, through its main technology transfer company UniQuest Pty Ltd, has licenced Triple P International Pty Ltd (TPI) to publish and disseminate the program worldwide. Royalties from this dissemination are distributed to the Parenting and Family Support Centre, School of Psychology, Faculty of Health and Behavioural Sciences, and contributory authors. No author has any share or ownership in TPI. Karen Turner is a contributory author and receives royalties from TPI. Cari McIlduff was a UQ doctoral candidate during this project. No other authors have any conflict to declare.Authors contributionsCari McIlduff, the project implementation coordinator and Ellaina Andersson, the research officer on the Jandu Yani U project made a significant contribution to project coordination, data collection and analysis. Karen Turner is an associate investigator and contributed to the project design and tailoring of program resources. Jadnah Davies and Sue Thomas represent MWRC and the advisory group and provided input into the local tailoring of the research design and intervention delivery. Elizabeth Elliott and Stewart Einfeld are chief investigators and were involved in the conception and management of the project, review and reporting of data. All authors contributed to drafting this paper and have approved the final version.Additional informationFundingThis work is supported by a grant from the Australian National Health and Medical Research Council (NHMRC) targeted call for research into Foetal Alcohol Spectrum Disorders in Aboriginal people [#1068620]. Elizabeth Elliott was supported by an NHMRC Practitioner Fellowship [#1021480] and an NHMRC Centre of Research Excellence grant [#1110341] and a Medical Research Futures Fund Next Generation Fellowship [#1135959].