Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb 4:13:25.
doi: 10.1186/s12916-014-0260-9.

Stepping Stones Triple P: the importance of putting the findings into context

Affiliations

Stepping Stones Triple P: the importance of putting the findings into context

Cassandra L Tellegen et al. BMC Med. .

Abstract

The Stepping Stones Triple P (SSTP) parenting program is an evidence-based program for parents of children with a disability. A trial of SSTP was recently published in BMC Medicine, which reported results of a randomized controlled trial comparing SSTP to care-as-usual. Although the paper described what should be an important replication trial of SSTP, there are significant shortcomings to the scientific approach of the reporting that need to be addressed. The paper initially cites only a few published SSTP studies and describes evidence for the efficacy of the program as "very scarce". A meta-analysis of studies evaluating SSTP published prior to submission of this paper was not cited. The results are inconsistent with previous evidence for SSTP, yet the authors provide scant interpretation for this inconsistency. Similarly, the unusually high dropout rate of 49% was not adequately explained. The claims that previous research has only been conducted by the developers, has not included children with intellectual disability, and has not used care-as-usual comparison groups, are inaccurate. This commentary explores these issues further in order to place the findings from the recent trial into context.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Effect sizes for different levels of SSTP interventions based on data from the SSTP meta-analysis [ 2 ] . d, standardized difference effect size; n, number of trials; SSTP, Stepping Stones Triple P-Positive Parenting Program.

Comment in

References

    1. Kleefman M, Jansen DEMC, Stewart RE, Reijneveld SA. The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems: a randomised controlled trial. BMC Med. 2014;12:191. doi: 10.1186/s12916-014-0191-5. - DOI - PMC - PubMed
    1. Tellegen CL, Sanders MR. Stepping Stones Triple P-Positive Parenting Program for children with disability: a systematic review and meta-analysis. Res Dev Disabil. 2013;34:1556–71. doi: 10.1016/j.ridd.2013.01.022. - DOI - PubMed
    1. Flay BR, Biglan A, Boruch RF, Castro FG, Gottfredson D, Kellam S, et al. Standards of evidence: criteria for efficacy, effectiveness and dissemination. Prev Sci. 2005;6:151–75. doi: 10.1007/s11121-005-5553-y. - DOI - PubMed
    1. Brown FL, Whittingham K, Boyd RN, McKinlay L, Sofronoff K. Improving child and parent outcomes following paediatric acquired brain injury: a randomised controlled trial of Stepping Stones Triple P plus Acceptance and Commitment Therapy. J Child Psychol Psychiatr. 2014;55:1172–83. doi: 10.1111/jcpp.12227. - DOI - PubMed
    1. Yanagawa T, Hirao K, Kato N, Ueno M, Kitano N, Iemoto M, et al. Implementation of Stepping Stones Triple P (Positive Parenting Program) with parents of a child with an autism spectrum disorder. Japanese J Child Abuse Negl. 2012;14:135–52.