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Open Access Research article

Brief parenting intervention for parents of NICU graduates: a randomized, clinical trial of Primary Care Triple P

Renske Schappin1*, Lex Wijnroks2, Monica Uniken Venema1, Barbara Wijnberg-Williams3, Ravian Veenstra3, Corine Koopman-Esseboom4, Susanne Mulder-De Tollenaer5, Ingeborg van der Tweel6 and Marian Jongmans24

Author Affiliations

1 Department of Medical Psychology and Social Work, Wilhelmina Children’s Hospital, UMC Utrecht, Utrecht, The Netherlands

2 Department of Special Education, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands

3 Department of Medical Psychology, Isala Clinics, Zwolle, The Netherlands

4 Department of Neonatology, Wilhelmina Children’s Hospital, UMC Utrecht, Utrecht, The Netherlands

5 Department of Neonatology, Isala Clinics, Zwolle, The Netherlands

6 Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands

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BMC Pediatrics 2013, 13:69  doi:10.1186/1471-2431-13-69

Published: 7 May 2013



Preterm-born or asphyxiated term-born children who received neonatal intensive care show more emotional and behavioral problems than term-born children without a medical condition. It is uncertain whether regular parenting intervention programs to which the parents of these children are usually referred, are effective in reducing child problem behavior in this specific population. Our objective was to investigate whether a regular, brief parenting intervention, Primary Care Triple P, is effective in decreasing emotional and behavioral problems in preterm-born or asphyxiated term-born preschoolers.


For this pragmatic, open randomized clinical trial, participants were recruited from a cohort of infants admitted to the neonatal intensive care units (NICU) of two Dutch hospitals. Children born with a gestational age <32 weeks or birth weight <1500 g and children born at a gestational age 37–42 weeks with perinatal asphyxia were included. After screening for a t-score ≥60 on the Child Behavior Checklist (CBCL), children were randomly assigned to Primary Care Triple P (n = 34) or a wait-list control group (n = 33). The primary outcome was child emotional and behavioral problems reported by parents on the CBCL, 6 months after the start of the trial.


There was no effect of the intervention on the CBCL at the trial endpoint (t64 = 0.54, P = .30). On secondary measurements of child problem behavior, parenting style, parenting stress, and parent perceived child vulnerability, groups either did not differ significantly or the intervention group showed more problems. In both the intervention and control group there was a significant decrease in emotional and behavioral problems during the trial.


Primary Care Triple P, a brief parenting intervention, is not effective in reducing child emotional and behavioral problems in preterm-born children or term-born children with perinatal asphyxia.

Trial registration

Netherlands National Trial Register (NTR): NTR2179

Primary Care Triple P; Parenting intervention; Preterm birth; Perinatal asphyxia; RCT