Building positive relationships with your teen: evaluating the Teen Triple P programme
| ISRCTN | ISRCTN72900402 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN72900402 |
| IRAS number | 324435 |
| Secondary identifying numbers | SOC.08/22-23, IRAS 324435 |
- Submission date
- 07/09/2023
- Registration date
- 25/09/2023
- Last edited
- 30/09/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
Many UK families with young people at the edge of care experience multiple and long-standing difficulties, including mental ill-health, violence, substance misuse, and relationship and behavioural difficulties. Young people are more at risk of entering the out-of-home care system when experiencing social disadvantage, maltreatment, parental substance misuse, or maternal depression. Drivers of adolescent out of home placements are associated with family stress and breakdown, and adolescent behavioural problems.
Who can participate?
Parents/carers of young people determined as being at risk of being placed in out-of-home care can participate in this study.
What does the study involve?
Standard Teen Triple P (Teen Triple P) is a parent skills training programme. Teen Triple P works with parents to help them find different ways to look after a young person in the family and improve family life. This can include dealing with challenges differently or taking on different positive approaches to supporting the young person. We want to find whether this programme (Teen Triple P) works by running a clinical trial.
Some families will receive Teen Triple P plus the routine support that they would normally get. Other families will only get the routine support that is currently offered. We will decide who gets the programme at random, which is like flipping a coin.
In order to work out whether Teen Triple P is helpful, our trial has two parts. In the first part, we will run what is called a ‘pilot’, this tests whether the trial can be run. If we find that this is the case, we will then move to do the second part, which is continuing with the main trial by inviting more parents/carers and young people to take part. All of the parents/carers and young people who take part will be asked to complete some measures of things that may change because of taking part in Teen Triple P. We are particularly interested in whether problem behaviours change over the course of the trial. We will also ask about their background, their general well-being, relationships within the household and with peers, and any antisocial behaviours. We will also interview some of the parents/carers and young people receiving Teen Triple P, and the professionals that deliver the Teen Triple P programme. We will also ask them about their experiences of taking part in the trial.
What are the possible benefits and risks of participating?
There are no marked disadvantages or risks to participating in this study over and above those associated with taking part in Teen Triple P if a parent/carer is selected to receive this. Their medical care will not be affected if they choose to participate in or withdraw from the study.
Parents and young people will be asked to complete questionnaires and there may be a small risk that some of the questions may cause some distress because of the nature of the questions. They will be about the young people and some of the problems that they face.
Where is the study run from?
University of Warwick (UK)
When is the study starting and how long is it expected to run for?
January 2023 to September 2024
Who is funding the study?
The study is funded by the Youth Endowment Fund (YEF) (UK)
Who is the main contact?
Atiyya Nisar, atiyya.nisar.1@warwick.ac.uk
Contact information
Public
CIDD
Westwood Campus
Kirby Corner Road
Coventry
CV4 7AL
United Kingdom
| Phone | +44 7403023224 |
|---|---|
| warwickteenP@warwick.ac.uk |
Scientific
Westwood Campus
Kirby Corner Road
Coventry
CV4 7AL
United Kingdom
| Phone | +44 7403023224 |
|---|---|
| warwickteenP@warwick.ac.uk |
Principal Investigator
CIDD
Westwood Campus
Kirby Corner Road
Coventry
CV4 7AL
United Kingdom
 ORCID ID |
0000-0001-6518-4240 |
|---|---|
| Phone | +44 2476523638 |
| K.Gray.1@warwick.ac.uk |
Study information
| Study design | Two-armed cluster randomized controlled trial with random allocation at the family level (families as clusters) |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | Built environment/local authority, University/medical school/dental school |
| Study type | Efficacy |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. |
| Scientific title | A cluster-randomised controlled trial evaluating Teen Triple P with support-as-usual vs support-as-usual alone |
| Study hypothesis | Study objective: To determine whether there is a benefit of support as usual (SAU) plus Standard Teen Triple P (TEEN TRIPLE P) over support as usual (SAU) in improving parent/carer rated adolescent externalising behaviour problems at 6-months post-randomisation in adolescents at the edge of care. |
| Ethics approval(s) |
Approved 16/06/2023, London - City and East Research Ethics Committee (Bristol Research Ethics Committee Centre, Whitefriars Level 3, Block B, Lewins Mead, Bristol, BS1 2NT, United Kingdom; +44 207 104 8124; cityandeast.rec@hra.nhs.uk), ref: 23/LO/0435 |
| Condition | Prevention of young people being placed in out-of-home care. |
| Intervention | Teen Triple P: Teen Triple P is a coordinated multi-level prevention/early intervention strategy that draws on social learning theory, applied behaviour analysis, research on child and adolescent development and developmental psychopathology, social information processing models and public health principles. It has many distinguishing features including its flexibility, varied delivery modalities, multi-disciplinary approach, and focus on self-regulation and generalisation of parenting skills. Teen Triple P is an adaptation of the existing Level 4 Triple P programme (0-12 years), tailored specifically for this developmental period. This extension of the foundation Triple P programme into adolescence retains the relevant core components of the childhood programme (e.g., social and language skills, emotional self-regulation skills, independence skills, and problem-solving skills). However, Teen Triple P acknowledges the developmental shift and impending transition into adulthood, with an increased emphasis on negotiation, compromise, and shared decision-making. In addition, there is a focus on preparing adolescents to safely negotiate negative events and/or potentially risky activities that may negatively impact their health or well-being. Parenting strategies to address issues that arise in adolescence are part of Teen Triple P, and include coaching problem-solving, holding a family meeting, dealing with emotional behaviour, and using skills to manage risky behaviour (Sanders & Mazzuchelli, 2018). An overarching emphasis in Teen Triple P is on changing how parents interact in ways that acknowledge this transitional developmental period (Ralph, 2018). Standard Teen Triple P consists of ten individual sessions delivered one-to-one between practitioner and family. The sessions address: • Initial interview with the parent to gather information about teenager and family background. • Family observation and assessment to identify primary problems, describe parent-teenage, family and community/sociocultural context within which problem behaviours occur. • Sharing of assessment findings. • Encouraging appropriate behaviour by learning strategies to interact with their teenager. • Observation of parent using positive parenting strategies with their teenager (Part 1). • Strategies for managing problem behaviour. • Observation of parent using positive parenting strategies with their teenager (Part 2). • Introducing a routine for dealing with risky behaviour. • Using planning ahead routines for potential risky situations. • Strategies for promoting generalisation and maintenance of behaviour change. A key focus of all Triple P interventions is to train parents to generalise the parenting skills developed throughout the program to new problems, situations and to all relevant siblings. A guided participation model of information transfer (Sanders & Lawton, 1993) is used to discuss assessment information with parents and to develop a shared understanding of the problem and possible contributing factors. This model involves providing descriptive, factual information and providing opportunities for parents to process and react to the practitioner’s inferences and reasoning. The sharing of this reasoning provides a model for parents to examine causal inferences they make about their teenager’s behaviour. A self-regulation approach is used to teach parenting skills that promote parents’ independence, confidence and future problem solving. Training is conducted in a way supportive of generalisation, in that parents are assisted to apply new skills to varied and novel situations rather than learning to apply specific management skills to a single discrete behaviour. Support-as-usual: Support-as-usual will be the standard support offered by local authorities to families accessing the edge-of-care services. The total duration of the intervention is 10 weeks, with follow-up at 6 and 12 months post-randomisation (for both study arms). Following baseline assessment, families will be randomised on a 1:1 basis to either the intervention (Teen Triple P and SAU) or control arm (SAU only) using stratified permuted block randomisation, stratifying by local authority. The randomisation will allocate families as a cluster, so that parents from the same family are in the same trial arm. The randomisation list will be produced in advance and will use a block size of 4. Randomisation will be conducted using statistical software R (version 4.2.2 -2022-10-31 ucrt), using R package ‘blockRand’. Departmental admin will be responsible for allocation and informing participants and intervention practitioners of a participants’ allocation by secure file transfer. |
| Intervention type | Behavioural |
| Primary outcome measure | 6 months post-randomisation Strengths and Difficulties Questionnaire (SDQ; Goodman, 1999) parent report externalising problems scale |
| Secondary outcome measures | Measured at baseline (pre-randomisation), 6 months post-randomisation and 12 months post-randomisation: 1. Strengths and Difficulties Questionnaire (SDQ; Goodman, 1999) parent report internalising problems scale, adolescent report externalising and internalising problems scales. 2. Parenting practices: Parenting Scale Adolescent version (PSA) parent report 3. Adolescent prosocial behaviours – The Prosocial behaviour subscale of the SDQ (Goodman, 1999). Adolescent and parent report. 4. Adolescent peer relationships – The Peer Relationship Problem subscale of the SDQ (Goodman, 1999). Adolescent and parent report. 5. Interparental outcome - Dyadic Adjustment Scale (DAS-7) is a 7-item measure (Sharpley & Cross 182; Hunsley et al., 2001). Parent report. 6. Parent mental health – the Kessler 6 (Kessler et al., 2003). Parent report. 7. Parent Wellbeing - The Warwick-Edinburgh Mental Well-being Scale (SWEMWBS; Tennant et al., 2007). Parent report. 8. Conflict Behavior Questionnaire (CBQ-20) (Robin & Foster, 1989). Parent and adolescent report. 9. Child-parent relationship – the Closeness subscale of the Child-Parent Relationship Scale (CPRS, short form) measures (Pianta, 1995). Parent report. 10. Family functioning – the Family APGAR scale. (Adapatability, Partnership, Growth, Affection and Resolve; APGAR; Smilkstein, 1978). Parent report. 11. Parent self-regulation – the Parenting Self-Regulation Scale is a 12-item parent-completed measure of parental-regulation (Tellegen et al., 2022). 12. Out of home placement 13. Antisocial behaviours - Self Report Delinquency Measure (SRDM; Smith & McVie, 2003) |
| Overall study start date | 03/01/2023 |
| Overall study end date | 30/09/2024 |
Eligibility
| Participant type(s) | Service user, Other |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | Approximately 275 families, with up to 2 parents/carers in each family (cluster). 412 parents/carers in total. |
| Total final enrolment | 32 |
| Participant inclusion criteria | 1. Parents/carers of young people determined as being at risk of being placed in out-of-home care 2. Parent/carer is able to participate in the Teen Triple P programme 3. Young people are aged 11-15 years at screening |
| Participant exclusion criteria | 1. Families where one or more parent has received a multi-session parenting programme covering similar content to Triple P over the previous 12 months 2. Families where one or more parent is currently receiving a multi-session parenting programme covering similar content to Triple P or any multi-component manualised family intervention, such as Multi-Systemic Therapy. |
| Recruitment start date | 01/08/2023 |
| Recruitment end date | 29/02/2024 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centres
Cambridge
CB4 2PS
United Kingdom
Westgate Street
Gloucester
GL1 2TG
United Kingdom
Ground Floor
Lancaster Circus
Queensway
Birmingham
B4 7DJ
United Kingdom
Bittern Way
Fletton Quays
Peterborough
PE2 8TY
United Kingdom
Morden
SM4 5DX
United Kingdom
Birkenhead
CH41 1ND
United Kingdom
Sponsor information
University/education
Research & Impact services
University House
Kirby Corner Road
Coventry
CV4 8UW
England
United Kingdom
| Phone | +44 2476575733 |
|---|---|
| sponsorship@warwick.ac.uk | |
| Website | http://www2.warwick.ac.uk/ |
"ROR" |
https://ror.org/01a77tt86 |
Funders
Funder type
Charity
Private sector organisation / Trusts, charities, foundations (both public and private)
- Alternative name(s)
- YouthEndowFund, YEF
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 30/06/2026 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Trial outputs will be published and disseminated in open access peer reviewed journal articles in international academic journals, at national and international academic conferences and at University public engagement events. A publications plan and policy will be written for the trial. The first report published about the impact of the intervention will be the evaluation report to the funder. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be available upon reasonable request from warwickTeenP@warwick.ac.uk |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol (other) | 12/09/2023 | No | No |
Editorial Notes
30/09/2024: The following changes were made to the study record:
1. The recruitment end date was changed from 30/09/2024 to 29/02/2024.
2. The overall study end date was changed from 31/10/2026 to 30/09/2024.
3. Total final enrolment added.
12/09/2023: Trial's existence confirmed by London - City and East Research Ethics Committee
