title: Cost and effects of a universal parenting programme delivered to parents of preschoolers.
abstract: BACKGROUND
  Parenting programmes are effective in improving child behaviour and parental well-being, but long follow-up studies of universally offered programmes are scarce.
  
  
  METHODS
  A cluster randomized controlled trial was conducted to assess the costs and effects of Triple P levels 2-3 on child externalizing behaviours and parental mental health. The programme was offered universally to parents of preschoolers (self-selection allowed). Preschools were randomized to Triple P or a waitlist control. Health outcomes were reduction in externalizing behaviours measured on the Eyberg Child Behaviour Inventory-22 and improvement in parental mental health measured on the Depression Anxiety Stress Scales collected at baseline, 6-, 12- and 18-month follow-up. Child outcomes were based on 355 children aged 3-5 years (child sample) and parental outcomes on 759 parents (parental sample) with baseline data. Costs were collected from a municipality perspective, including 312 children and 488 parents with baseline data in the intervention preschools.
  
  
  RESULTS
  Sixty-seven (29%) parents attended the intervention. Triple P showed no significant improvement in child externalizing behaviours or parental mental health at either of the follow-up points. Triple P had an average yearly total cost of 3007 Swedish Krona (SEK) (€323) per child or 1922 SEK (€207) per parent. Running Triple P cost 227 SEK (€24) per child or 145 SEK (€16) per parent yearly.
  
  
  CONCLUSIONS
  Offering low intensity levels of Triple P with 29% attendance may not be a reasonable use of public resources, as no evidence of improvement in child externalizing behaviours or parental mental health was found.
authors.affiliation: 1 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden filipa.sampaio@kbh.uu.se.
authors.forename: Filipa
authors.initials: F
authors.lastname: Sampaio
authors.affiliation: 1 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Sarkadi
authors.affiliation: 1 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden 2 Department of Clinical Neuroscience and Stockholm Brain Institute, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Raziye
authors.initials: R
authors.lastname: Salari
authors.affiliation: 3 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Zethraeus
authors.affiliation: 1 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Inna
authors.initials: I
authors.lastname: Feldman
mesh_terms: D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000193:education*; D012959:Socioeconomic Factors; D013548:Sweden