Journal of Paediatrics and Child Health 43 (2007) 429 – 437 429 © 2007 The Authors Journal compilation © 2007 Paediatrics and Child Health Division (Royal Australasian College of Physicians) doi:10.1111/j.1440-1754.2007.01053.x Key Points 1 There is a need for empirically supported, culturally sensitive parenting support for Indigenous families to address known risk factors and improve child outcomes. 2 A culturally tailored version of the evidence-based Group Triple P – Positive Parenting Program led to improved child behav- iour, reduced dysfunctional parenting and good consumer satisfaction. 3 Further evaluation of programme outcomes and acceptability in more diverse communities is warranted. Correspondence: Dr Karen MT Turner, Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Qld. 4072, Australia. Fax: +61 73365 6724; email: kturner@psy.uq.edu.au Accepted for publication 4 October 2006. ORIGINAL ARTICLE Randomised clinical trial of a group parent education programme for Australian Indigenous families Karen MT Turner, Mary Richards and Matthew R Sanders Parenting and Family Support Centre, The University of Queensland, Brisbane, Queensland, Australia Aim: Parenting programmes have been shown to improve children’s adjustment and reduce problem behaviour; however, little research has addressed outcomes for Indigenous families. The aim of this project was to assess the impact and cultural appropriateness of a parenting programme tailored for Indigenous families, an adaptation of the evidence-based Group Triple P – Positive Parenting Program. Methods: A repeated measures randomised group design methodology was used, comparing the intervention with a waitlist control condition pre- and post-intervention, with a 6-month follow-up of the intervention group. Results: Parents attending Group Triple P reported a significant decrease in rates of problem child behaviour and less reliance on some dysfunctional parenting practices following the intervention in comparison to waitlist families. The programme also led to greater movement from the clinical range to the non-clinic range for mean child behaviour scores on all measures. Effects were primarily maintained at 6-month follow-up. Qualitative data showed generally positive responses to the programme resources, content and process. However, only a small number of waitlist families subsequently attended groups, signalling the importance of engaging families when they first make contact, helping families deal with competing demands, and offering flexible service delivery so families can resume contact when circumstances permit. Conclusions: This study provides empirical support for the effectiveness and acceptability of a culturally tailored approach to Group Triple P conducted by Child Health and Indigenous Health workers in a community setting. The outcomes of this trial may be seen as a significant step in increasing appropriate service provision for Indigenous families and reducing barriers to accessing available services in the community. Key words: behavioural family intervention; cultural tailoring; Indigenous child health; Indigenous health worker; parent group. their carers to be at high risk of clinically significant emotional or behavioural difficulties, in comparison to 15% of non- Indigenous children. 5 Any comprehensive understanding of the health and adjust- ment of Indigenous children and youth has to take into account the broader socio-political factors that contribute to physical, emotional and spiritual well-being. Urbanisation and the stolen generation have had a significant impact on traditional parent- ing skills and personal coping skills. 3 In addition to the historical context, there are many social circumstances that increase risk for the development of behavioural and emotional problems. Family social background appears to have a strong influence on generalised vulnerability to a wide range of childhood health, social, educational and behavioural problems. 6 Other risk fac- tors for childhood disruptive behaviour disorders include early problem behaviour and parents’ ratings of child difficulty, 7 and poor supervision, coercive discipline and inconsistent parenting practices. 8 The factor most commonly associated with high risk in Indigenous children is the number of major life stresses in the preceding year (e.g. illness, family breakdown, financial difficulties, arrests). Of these, family interaction and parenting practices are potentially modifiable through parent education. For children living in families with poor quality parenting (25%), risk for clinically significant emotional or behavioural problems was four times greater than in families with good quality parenting. 5 Family, community and kinship connections are a funda- mental part of life and strengthening these relationships can The poor health status of Indigenous Australians in comparison to the wider Australian population has been well documented. 1 Indigenous children and youth are extremely disadvantaged on most indices of health and well-being: they have higher rates of health risk behaviours, early school dropout, suicide, involve- ment with the juvenile justice system, family fragmentation and forced removal of children, and are over-represented in abuse and neglect cases. 2–4 In the recent Western Australian Aboriginal Child Health Survey of almost 4000 children aged 4–17 years, approximately 24% of Indigenous children were reported by