Triple P With Urban African American Fathers: To Adapt Or Not Adapt?

Background: Fathers are mostly absent from the research demonstrating the effectiveness of behavioral parent training (BPT) programs aimed at reducing child behavior problems.  Efforts are needed to determine if evidence-based BPT programs are effective with fathers and if modifications are necessary to engage them in these programs and to improve effectiveness. This multi-phase research project developed and tested an approach to engage urban African American fathers in one BPT, Triple P. Specifically this study focused on the question: is it necessary to adapt Triple P to change the parenting behaviors of this population? 

Methods: In Phase I, qualitative data were collected from urban African American fathers (n=41) and from fatherhood program providers (n=19) to inform the development of our “engagement strategy” (Phase II). In Phase III we field tested Triple P plus Engaging Fathers compared to Triple P with urban African American fathers (n=68). Data were collected on parenting behaviors using the parent involvement, positive parenting, poor monitoring, inconsistent discipline, and corporal punishment subscales of the Alabama Parenting Questionnaire. Fathers were randomly assigned to the treatment (n=33) or comparison conditions (n=35). On average, African American fathers were 35.6 years old (sd=9.3), did not live in the same home as their child (59.7%), were unemployed (71.6%), were single or unmarried/not living with a partner (82.4%), and had a history of incarceration (52.9%). No significant differences between the treatment and comparison conditions were found on these socio-demographic characteristics. T-tests and paired t-tests were conducted to compare pre and post-test parenting behaviors; Cohen d effect sizes were also calculated. 

Results: Data collected in Phase I informed the development of four strategies to engage fathers in Triple P.  In the treatment condition we (1) included strength based motivation orientation exercises, (2) tailored examples to the target population, (3) increased the number of weekly, group sessions from five to eight to allow more opportunities for unstructured discussion to build social support networks, and (4) had an African American male facilitate the groups. No modifications were made to Triple P in the comparison condition. At pretest of the Phase III field test, the mean parenting behavior scores were 36.9 for parental involvement, 26.2 for positive parenting, 13.1 for poor monitoring, 14.0 for inconsistent parenting and 5.0 for corporal punishment with no differences found between conditions. Seventy percent of fathers completed Triple P plus and Triple P (n=48). No significant differences in change from pre- to post-test were found between the treatment and comparison conditions on parenting behaviors. However, across all fathers we found improvements in inconsistent discipline (t=-2.68, p<.05, d=-0.39), corporal punishment (t=-2.23, p<.05, d=-0.35), and parent involvement (t= 1.83, p<.10, d=0.26). The effect sizes indicate moderate practical significance.

Conclusions/Implications: Triple P is a robust intervention that is able to change parenting behaviors among urban African American fathers, with or without modifications.  While much attention is given to the need for cultural adaptations when using interventions with populations that it was not initially developed and tested, our findings suggest that adaptations may not always be necessary.