Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P)

Scientific Rating:
Well-Supported by Research Evidence
See scale of 1-5

Additional Implementation Resources

Since this program Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P) was highly rated on the Scientific Rating Scale, program representatives were asked to provide additional implementation information.

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P) as listed below:

Support using the Triple P Implementation Framework includes several tools designed to support agencies in the successful adoption of Triple P. Examples of these documents include:

  • Implementation Workbook
  • Implementation Preparation Form
  • Organizational Readiness Checklist
  • Quality Assurance Considerations
  • Evaluation Checklist
  • Sustainability Considerations
  • Shared Learning Networks

Triple P Implementation Tools are provided with support from an Implementation Consultant for agencies adopting Triple P. Please email for more information related to the Triple P Implementation Framework.

Formal Support for Implementation

There is formal support available for implementation of Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P) as listed below:

Triple P America employs Implementation Consultants who provide support through a mix of on-site, teleconferencing, webinar, and email support. Triple P Implementation Consultants support organizations in the implementation planning process and sharing of Triple P implementation tools for agencies/jurisdictions adopting Triple P. This support is available throughout an initiative; often more intensive at first and tapering off as sites/jurisdictions develop effective plans for maintenance. Triple P America provides consultation, resources and tools related to evaluation and fidelity monitoring but does not provide direct oversight or collect data from implementing sites. Implementation Consultants use the tools from the Triple P Implementation Framework to foster local ownership of the intended outcomes and processes for evaluation. Sites are supported in fostering effective leadership and following best practices for workforce development, service delivery, and quality improvement cycles. While Implementation Consultants focus on support for administrators and managers of initiatives, Triple P Trainers are an available resource to sites seeking additional consultation and support for practitioners through developed workshops, tailored support days, and/or consultation calls at an additional cost.

Fidelity Measures

There are fidelity measures for Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P) as listed below:

Triple P has three quality assurance/fidelity checks built into its implementation framework:

  • Accreditation of Practitioners – Completed within the context of a Triple P Provider Training Course, this establishes baseline competence of all practitioners and certifies them as being able to implement the program as intended. The accreditation process has two steps: obtaining a passing score on a written exam and displaying competence in parent consultation skills as scored by an accredited Triple P trainer through direct observation or DVD submission. Procedures are in place to help and "recycle" practitioners to master the intervention when they do not pass accreditation.
  • Session Checklists – Each intervention has a session checklist which assists practitioners in implementing the service as intended. These checklists are integrated into the training protocol and are found in all Triple P manuals. Organizations have the flexibility to utilize these instruments as self-assessments or in more formal quality assurance procedures.
  • Peer Support Networks - A crucial element in implementation sites involves the adoption of a self-regulatory framework and the use of the Peer Assisted Support and Supervision (PASS) model of quality assurance. During PASS sessions, practitioners present cases, obtain feedback from other qualified practitioners, and continue to supplement their skills with continuing education. Practitioners learn the PASS model at training, and the PASS manual and checklist are available to trained practitioners through the Triple P Provider Network.

Other quality assurance and fidelity checks available and Triple P America implementation consultants will work with local agencies to craft a plan that is consistent with local oversight agency procedures. Please email for further information on measures of fidelity.

Implementation Guides or Manuals

There are implementation guides or manuals for Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P) as listed below:

Triple P has two levels of implementation tools available. There are a range of documents available to agency leadership and managers that provide guidance on organizational and systems level factors. Implementation Consultants provide support to organizations to develop their own handbook of implementing Triple P, using the tools and processes in the Implementation Framework to provide a context specific guide for those responsible for coordinating the implementation of Triple P at that organization or region. For the direct service provider, each level of Triple P includes a Practitioner Manual with step-by-step guidelines for successful delivery of Triple P.

Tools associated with the Triple P Implementation Framework are provided in conjunction with support from a Triple P Implementation Consultant for agencies or jurisdictions interested in adopting Triple P. The Triple P Practitioner Manuals are provided as part of the Triple P Provider Training Courses. Please email from more information related to the Triple P Implementation Framework. The relevant Triple P Practitioner Manual is provided to practitioners when they attend a Triple P Provider Training Course.

Research on How to Implement the Program

Research has been conducted on how to implement Triple P - Positive Parenting Program - Level 4® (Level 4 Triple P) as listed below:

  • Aldridge, W. A., II, Murray, D. W., Prinz, R. J., & Veazey, C. A. (2016). Final report and recommendations: The Triple P implementation evaluation, Cabarrus and Mecklenburg counties, NC. Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill.
  • Asgary-Eden, V., & Lee, C. M. (2012). Implementing an evidence-based parenting program in community agencies: What helps and what gets in the way? Administration and Policy in Mental Health and Mental Health Services Research, 39(6), 478–488.
  • Breitkreuz, R., McConnell, D., Savage, A., & Hamilton, A. (2011). Integrating triple P into existing family support services: A case study on program implementation. Prevention Science, 12(4), 411–422.
  • Fawley-King, K., Trask, E., Calderon, N. E., Aarons, G. A., & Garland, A. F. (2014). Implementation of an evidence-based parenting programme with a Latina population: feasibility and preliminary outcomes. Journal of Children's Services, 9, 295–306.
  • Fives, A., Pursell, L., Heary, C., Nic Gabhainn, S., & Canavan, J. (2014). Parenting support for every parent: A population-level evaluation of Triple P in Longford Westmeath. Final report. Athlone, Ireland: Longford Westmeath Parenting Partnership.
  • Mazzucchelli, T. G. & Sanders, M. R. (2010). Facilitating practitioner flexibility within evidence-based practice: Lessons from a system of parenting support. Clinical Psychology: Science and Practice, 17(3), 238–252.
  • McPherson, K. E., Sanders, M. R., Schroeter, B., Troy, V., & Wiseman, K. (2016). Acceptability and feasibility of Peer Assisted Supervision and Support for intervention practitioners: A Q-methodology evaluation. Journal of Child and Family Studies, 25(3), 720–732.
  • McWilliam, J., Brown, J., Sanders, M. R., & Jones, L. (2016). The Triple P implementation framework: The role of purveyors in the implementation and sustainability of evidence-based programs. Prevention Science, 17, 636–645.
  • Morawska, A., Sanders, M., Goadby, E., Headly, C., Hodge, L., McAuliffe, C., Page, S., & Anderson, E. (2011). Is the Triple P-Positive Parenting Program acceptable to parents from culturally diverse backgrounds? Journal of Child and Family Studies, 20, 614–622.
  • Romney, S., Israel, N., & Zlatevski, D. (2014). Exploration-stage implementation variation: Its effect on the cost-effectiveness of an evidence-based parenting program. Zeitschrift für Psychologie, 22, 37–48.
  • Sanders, M. R., Prinz, R. J., & Shapiro, C. J. (2009). Predicting utilization of evidence-based parenting interventions with organizational, service-provider and client variables. Administration and Policy in Mental Health and Mental Health Services Research, 36(2), 133–143.
  • Seng, A. C., Prinz, R. J., & Sanders, M. R. (2006). The role of training variables in effective dissemination of evidence-based parenting interventions. The International Journal of Mental Health Promotion, 8, 20–28.
  • Shapiro, C. J., Prinz, R. J., & Sanders, M. R. (2012). Facilitators and barriers to implementation of an evidence-based parenting intervention to prevent child maltreatment the Triple P-Positive Parenting Program. Child Maltreatment, 17(1), 86–95.
  • Shapiro, C. J., Prinz, R. J., & Sanders, M. R. (2015). Sustaining use of an evidence-based parenting intervention: Practitioner perspectives. Journal of Child and Family Studies, 24, 1615–1624.
  • Van Mourik, K., Crone, M. R., & Reis, R. (2018). Relevance of the intervention module "Coping with stress and unhelpful emotions" for parents living in multi-ethnic deprived neighborhoods. Children and Youth Services Review, 88, 426–433.