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A Quasi-Experimental Effectiveness Study of Triple P on Child Maltreatment

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Abstract

We examined the impact of the implementation of The Triple P-Positive Parenting Program in North Carolina (NC) on reducing child maltreatment, a serious public health problem in the US with lasting harmful effects on children. In 2012 and 2013, 34 of 100 counties in NC implemented Triple P. A panel data set with county-level child welfare data and emergency department (ED) discharge data from 2008 to 2015 for 100 counties in NC was constructed. A quasi-experimental design using difference-in-differences analysis estimated the association between the implementation of Triple P and the rate of (1) investigated child maltreatment reports; (2) entry into foster care; and (3) ED visits concerning for child maltreatment. Implementation of Triple P was associated with in a 4% decrease in the county rate of investigated reports of child maltreatment (RR = 0.96, 95% CI [0.93, 0.99]) and a 7% decrease in the county rate of children in foster care (RR = 0.93, 95% CI [0.88, 0.98]). Each of these findings was robust to one but not both sensitivity tests performed. There was no reduction in county-level rates of ED visits with ICD-9-CM codes concerning for child maltreatment. Implementation of Triple P in NC outside of the parameters of scientific study is associated with small reductions in the rates of child maltreatment reports and foster care placements. Additional research is needed to understand whether such small reductions justify the substantial investment communities are making in Triple P.

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Abbreviations

DiD:

difference-in-differences

EDs:

emergency departments

ICD-9-CM:

International Classification of Diseaes-9-Clinical Modification

NC:

North Carolina

TANF:

Temporary Assistance for Needy Families

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Authors and Affiliations

  1. Department of Pediatrics, UNC School of Medicine, University of North Carolina at Chapel Hill, 231 MacNider Hall, Chapel Hill, NC, 27599, USA

    Samantha Schilling

  2. School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Paul Lanier & Roderick A. Rose

  3. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Paul Lanier, Meghan Shanahan & Adam J. Zolotor

  4. Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Meghan Shanahan

  5. Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Adam J. Zolotor

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  1. Samantha Schilling
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Correspondence to Samantha Schilling.

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The project was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001111 and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR001109. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The NC DETECT Data Oversight Committees do not take responsibility for the scientific validity or accuracy of methodology, statistical analyses, results, or conclusions presented.

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Schilling, S., Lanier, P., Rose, R.A. et al. A Quasi-Experimental Effectiveness Study of Triple P on Child Maltreatment. J Fam Viol 35, 373–383 (2020). https://doi.org/10.1007/s10896-019-00043-5

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