A randomised controlled trial of Te Whanau Pou Toru: Maori Adaptation of Primary Care Triple P Discussion Groups for Maori parents of young children with behavioural difficulties.

The Triple P Discussion Groups are preventively focused interventions designed to provide specific advice about common child behaviour or developmental issues. During the two-hour group sessions, parents are taught about the principles of positive parenting, strategies for developing a good parent-child relationship, and strategies for managing specific problem behaviours. These strategies are alternatives to coercive and ineffective discipline strategies. All discussion groups involve video-modelling of behaviour management strategies, a tailored implementation plan, and training in planned activities routines to cope with high-risk situations. The format of the group session includes some didactic presentations, active skills training, and group discussions. Each discussion group is accompanied by a workbook. The Triple P Discussion Groups used in this study will focus on two different topic areas: Being a Positive Parent and Dealing with Disobedience. During the Being a Positive Parent group parents are introduced to the principles of positive parenting and taught a range of skills aimed at assist them to support their child’s competence and development and to build a positive relationship with their child. The Dealing with Disobedience Triple P Discussion Group focuses on reasons for disobedience, parenting traps, ways to encourage positive child behaviour and strategies for dealing with disobedience. The two face to face 2-hour discussion groups (one for each topic area) occurring one week apart, are delivered by accredited Maori Triple P practitioners. The discussion groups take place in health or community organisation meeting rooms. Discussion groups are video-taped to monitor practitioner fidelity of programme implementation. Checklists created by the intervention developers are used to monitor intervention fidelity and provide a measure of the proportion of content covered in each group. Checklist ratings provide by the facilitator and an independent rater are compared to assess adherence to the intervention protocol. Two adjunct resources were developed for this study. These were a graphic connecting eight tikanga (Maori values and ways of doing things) with the five Triple P positive parenting principles in the form of a Maori meeting house (Whare nui) image, and a worksheet which explained the eight tikanga and the Triple P principles and strategies. The resources were used within the parenting discussions groups to illustrate how the Triple P principles and the tikanga (values) of the local iwi (tribe) can both work together to build parenting skills. In addition, practitioners use culturally appropriate examples to illustrate within session exercises. Condition 1 Participants allocated to the intervention group condition will participate in the discussion groups after completion of pre-intervention questionnaires and randomisation to group. Condition 2 Participants allocated to the waitlist list condition will participate in the programme after both groups have completed follow-up questionnaires (6 months after the intervention group has participated in the discussion groups).