• Renske Schappin, Lex Wijnroks, Monica Uniken Venema, Barbara Wijnberg-Williams, Ravian Veenstra, Corine Koopman-Esseboom, Susanne Mulder-De Tollenaer, Ingeborg van der Tweel, and Marian Jongmans.
• Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands. r.schappin@umcutrecht.nl.
• Bmc Pediatr. 2014 Jan 1;14:305.

BackgroundPreterm-born or asphyxiated term-born children show more emotional and behavioral problems at preschool age than term-born children without a medical condition. It is uncertain whether parenting intervention programs aimed at the general population, are effective in this specific group. In earlier findings from the present trial, Primary Care Triple P was not effective in reducing parent-reported child behavioral problems. However, parenting programs claim to positively change child behavior through enhancement of the parent-child interaction. Therefore, we investigated whether Primary Care Triple P is effective in improving the quality of parent-child interaction and increasing the application of trained parenting skills in parents of preterm-born or asphyxiated term-born preschoolers with behavioral problems.MethodsFor this pragmatic, open randomized clinical trial, participants were recruited from a cohort of infants admitted to the neonatal intensive care units of two Dutch hospitals. Children aged 2-5 years, with a gestational age <32 weeks and/or birth weight <1500 g and children with a gestational age 37-42 weeks and perinatal asphyxia were included. After screening for a t-score ≥60 on the Child Behavior Checklist, children were randomly assigned to Primary Care Triple P (n = 34) or a wait-list control group (n = 33). Trial outcomes were the quality of parent-child interaction and the application of trained parenting skills, both scored from structured observation tasks.ResultsThere was no effect of the intervention on either of the observational outcome measures at the 6-month trial endpoint.ConclusionsPrimary Care Triple P, is not effective in improving the quality of parent-child interaction nor does it increase the application of trained parenting skills in parents of preterm-born or asphyxiated term-born children with behavioral problems. Further research should focus on personalized care for these parents, with an emphasis on psychological support to reduce stress and promote self-regulation.Trial RegistrationNetherlands National Trial Register NTR2179 . Registered 26 January 2010.

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