Résumés
Abstract
An inadequate caregiving environment in an orphanage can negatively impact children’s well-being, while a lack of specialized training can induce work-related stress and lower self-efficacy among caregivers. This study examined the effectiveness of the Group Triple P (positive parenting program) with caregivers of children in Pakistani orphanages. Fourteen caregivers across three orphanages completed self-report questionnaires and took part in Group Triple P. A repeated measures ANOVA indicated that the personal well-being of the caregivers improved following intervention. There was also a significant increase in caregivers’ parenting efficacy and a decrease in the use of dysfunctional parenting practices. The frequency and number of children’s challenging behaviors was reported to decrease significantly, along with a significant increase in warmth and reduction in negativity in caregiver–child relationships. This study was the first to implement Group Triple P in an orphanage context. The outcomes support the use of an evidence-based parenting intervention with orphanage caregivers who are in a proxy parenting role.
Keywords:
- behavioral problems,
- parenting practices,
- orphanages,
- Triple P,
- orphanage context,
- orphanage caregivers
Parties annexes
Bibliography
- Akram, M., Anjum, F., & Akram, N. (2015). Role of orphanages to uplift the socio-economic status of orphans focusing on SOS children’s villages in Punjab, Pakistan. Mediterranean Journal of Social Sciences, 6(3 S2), 177–182. https://doi.org/10.5901/mjss.2015.v6n3s2p177
- Alvi, E., Nausheen, M., Kanwal, I., & Anwar, R. (2017). Examining the learning experiences of orphans from a critical perspective. Journal of Research and Reflection in Education, 11(2), 224–239. https://ue.edu.pk/jrre/articles/1100121.pdf
- Al-Amer, R., Ramjan, L., Glew, P., Darwish, M., & Salamonson, Y. (2015). Translation of interviews from a source language to a target language: Examining issues in cross-cultural health care research. Journal of Clinical Nursing, 24(9-10), 1151–1162. https://doi.org/10.1111/jocn.12681
- Al-Amer, R., Ramjan, L., Glew, P., Darwish, M., & Salamonson, Y. (2016). Language translation challenges with Arabic speakers participating in qualitative research studies. International Journal of Nursing Studies, 54, 150–157. https://doi.org/10.1016/j.ijnurstu.2015.04.010
- Arnold, D. S., O’Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The parenting scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5(2), 137–144. https://doi.org/10.1037/1040-3590.5.2.137
- Au, A., Lau, K., Wong, A. H.-C., Lam, C., Leung, C., Lau, J., & Lee, Y. K. (2014). The efficacy of a Group Triple P (positive parenting program) for Chinese parents with a child diagnosed with ADHD in Hong Kong: A pilot randomised controlled study. Australian Psychologist, 49(3), 151–162. https://doi.org/10.1111/ap.12053
- Austin, A. E., Lesak, A. M., & Shanahan, M. E. (2020). Risk and protective factors for child maltreatment: A review. Current Epidemiology Reports, 7(4), 334–342. https://doi.org/10.1007/s40471-020-00252-3
- Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91–97. https://doi.org/10.1901/jaba.1968.1-91
- Baker, S., Sanders, M. R., Turner, K. M. T., & Morawska, A. (2017). A randomized controlled trial evaluating a low-intensity interactive online parenting intervention, Triple P Online Brief, with parents of children with early onset conduct problems. Behaviour Research and Therapy, 91, 78–90. https://doi.org/10.1016/j.brat.2017.01.016
- Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory (pp. 23–28). Prentice Hall.
- Bani Ismail, L., Hindawi, H., Awamleh, W., & Alawamleh, M. (2018). The key to successful management of child care centres in Jordan. International Journal of Child Care and Education Policy, 12(1), Article 3. https://doi.org/10.1186/s40723-018-0042-5
- Bettmann, J. E., Mortensen, J. M., & Akuoko, K. O. (2015). Orphanage caregivers’ perceptions of children’s emotional needs. Children and Youth Services Review, 49, 71–79. https://doi.org/10.1016/j.childyouth.2015.01.003
- Bodenmann, G., Cina, A., Ledermann, T., & Sanders, M. R. (2008). The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: A comparison with two other treatment conditions. Behaviour Research and Therapy, 46(4), 411–427. https://doi.org/10.1016/j.brat.2008.01.001
- Bromfield, L., Lamont, A., Parker, R., & Horsfall, B. (2010). Issues for the safety and wellbeing of children in families with multiple and complex problems: The co-occurrence of domestic violence, parental substance misuse, and mental health problems. National Child Protection Clearing House Issues, 33, 1–23. https://aifs.gov.au/cfca/sites/default/files/publication-documents/issues33.pdf
- Clément, M.-È, Bérubé, A., & Chamberland, C. (2016). Prevalence and risk factors of child neglect in the general population. Public Health, 138, 86–92. https://doi.org/10.1016/j.puhe.2016.03.018
- Dahlan, T. H.. (2016). Mindful parenting program in improving parenting skills of orphanage caregivers at Rumbela Muthmainnah-Bandung. International Journal of Early Childhood Education and Care, 5, 57–64. https://eric.ed.gov/?id=EJ1208147
- Darkwah, E., Asumeng, M., & Daniel, M. (2017). Caring for “parentless” children: An exploration of work stressors and resources as experienced by caregivers in children’s homes in Ghana. International Journal of Child, Youth and Family Studies, 8(2), 59–89. https://doi.org/10.18357/ijcyfs82201717850
- de Graaf, I., Speetjens, P., Smit, F., de Wolff, M., & Tavecchio, L. (2008). Effectiveness of the Triple P Positive Parenting Program on behavioral problems in children: A meta-analysis. Behavior Modification, 32(5), 714–735. https://doi.org/10.1177/0145445508317134
- Deb, S. (Ed.). (2015). Child safety, welfare and well-being: Issues and challenges. Springer. https://doi.org/10.1007/978-81-322-2425-9
- Devlin, A. M., Wight, D., & Fenton, C. (2018). Are parenting practices associated with the same child outcomes in sub-Saharan African countries as in high-income countries? A review and synthesis. BMJ Global Health, 3(6), e000912. https://doi.org/10.1136/bmjgh-2018-000912
- Driscoll, K., & Pianta, R. C. (2011). Mothers’ and fathers’ perceptions of conflict and closeness in parent-child relationships during early childhood. Journal of Early Childhood and Infant Psychology, 7, 1–24. https://psycnet.apa.org/record/2013-00755-001
- Eyberg, S., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student Behavior Inventory - Revised: Professional manual. Psychological Assessment Resources.
- Farris, J. L. (2017). Examining differences between foster parents who continue to foster children and those who do not [Doctoral disseration, Walden University]. Walden Dissertations and Doctoral Studies. https://scholarworks.waldenu.edu/dissertations/3986
- Fujiwara, T., Kato, N., & Sanders, M. R. (2011). Effectiveness of Group Positive Parenting Program (Triple P) in changing child behavior, parenting style, and parental adjustment: An intervention study in Japan. Journal of Child and Family Studies, 20(6), 804–813. https://doi.org/10.1007/s10826-011-9448-1
- Gallart, S. C., & Matthey, S. (2005). The effectiveness of Group Triple P and the impact of the four telephone contacts. Behaviour Change, 22(2), 71–80. https://doi.org/10.1375/bech.2005.22.2.71
- Gardner, F., Montgomery, P., & Knerr, W. (2016). Transporting evidence-based parenting programs for child problem behavior (age 3-10) between countries: Systematic review and meta-analysis. Journal of Clinical Child and Adolescent Psychology, 45(6), 749–762. https://doi.org/10.1080/15374416.2015.1015134
- Johnston, C., & Mash, E. J. (1989). Parenting Sense of Competence Scale (PSOC) [Database record]. APA PsycTests. https://doi.org/10.1037/t01311-000
- Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9(1), 139–145. https://doi.org/10.1017/S0033291700021644
- Gray, G. R., Totsika, V., & Lindsay, G. (2018). Sustained effectiveness of evidence-based parenting programs after the research trial ends. Frontiers in Psychology, 9, 2035–2035. https://doi.org/10.3389/fpsyg.2018.02035
- Guo, M., Morawska, A., & Sanders, M. R. (2016). A randomized controlled trial of Group Triple P with Chinese Parents in mainland China. Behavior Modification, 40(6), 825–851. https://doi.org/10.1177/0145445516644221
- Hankins, M. (2008). The reliability of the twelve-item General Health Questionnaire (GHQ-12) under realistic assumptions. BMC Public Health, 8, Article 355. https://doi.org/10.1186/1471-2458-8-355
- Hart, B., & Risley, T. R. (1995). Meaningful differences in the everyday experience of young American children. Brookes.
- Hermenau, K., Goessmann, K., Rygaard, N. P., Landolt, M. A., & Hecker, T. (2017). Fostering child development by improving care quality: A systematic review of the effectiveness of structural interventions and caregiver trainings in institutional care. Trauma, Violence & Abuse, 18(5), 544–561. https://doi.org/10.1177/1524838016641918
- Hermenau, K., Kaltenbach, E., Mkinga, G., & Hecker, T. (2015). Improving care quality and preventing maltreatment in institutional care: A feasibility study with caregivers. Frontiers in Psychology, 6, 937–937. https://doi.org/10.3389/fpsyg.2015.00937
- Holzer, P. J., Higgins, J. R., Bromfield, L. M., Richardson, N., & Higgins, D. J. (2006). The effectiveness of parent education and home visiting child maltreatment prevention programs. Child Abuse Prevention Issues, 24, 1–23. https://aifs.gov.au/cfca/sites/default/files/publication-documents/issues24.pdf
- Isnaeni, Y, Hartini, S, Marchira, C. R. (2021). Intervention model for orphan’s emotional and behavioral problems: A scoping review. Open Access Macedonian Journal of Medical Sciences, 9, 211–218. https://doi.org/10.3889/oamjms.2021.6249
- Karoly P. (1993). Mechanisms of self-regulation: A systems view. Annual Review of Psychology, 44(1), 23–52. https://doi.org/10.1146/annurev.ps.44.020193.000323
- Kaufman, K. L., Erooga, M., Mathews, B., & McConnell, E. (2019). Recommendations for preventing child sexual abuse in youth-serving organizations: Implications from an Australian Royal Commission Review of the literature. Journal of Interpersonal Violence, 34(20), 4199–4224. https://doi.org/10.1177/0886260519869239
- Khalid, A., Morawska, A., & Turner, K. M. T. (2022). Pakistani orphanage caregivers’ perspectives regarding their caregiving abilities, personal and orphan children’s psychological wellbeing. Child: Care, Health & Development, 49(1), 145–155. https://doi.org/10.1111/cch.13027
- Khalid, A., Morawska, A., & Turner, K. M. T. (2023). Caregivers’ perspectives on the impact of the Group Triple P-Positive Parenting Program in Pakistani orphanages. Child & Family Social Work, 29(1), 78–89. https://doi.org/10.1111/cfs.13052
- Khowaja, Y., Karmaliani, R., Hirani, S., Khowaja, A. R., Rafique, G., & McFarlane, J. (2016). A pilot study of a 6-week parenting program for mothers of pre-school children attending family health centers in Karachi, Pakistan. International Journal of Health Policy and Management, 5(2), 91–97. https://doi.org/10.15171/ijhpm.2015.181
- Kim, Y., & Steiner, P. (2016). Quasi-experimental designs for causal inference. Educational Psychologist, 51(3-4), 395–405. https://doi.org/10.1080/00461520.2016.1207177
- Knerr, W., Gardner, F., & Cluver, L. (2013). Improving positive parenting skills and reducing harsh and abusive parenting in low- and middle-income countries: A systematic review. Prevention Science, 14(4), 352–363. https://doi.org/10.1007/s11121-012-0314-1
- Lakhdir, M. P. A., Farooq, S., Khan, U. R., Parpio, Y., Azam, S. I., Razzak, J., Laljee, A. A., & Kadir, M. M. (2021). Factors associated with child maltreatment among children aged 11 to 17 years in community settings of Karachi, Pakistan, using Belsky ecological framework. Journal of Interpersonal Violence, 36(1-2), 297–313. https://doi.org/10.1177/0886260517726973
- Leijten, P., Raaijmakers, M. A. J., de Castro, B. O., & Matthys, W. (2013). Does socioeconomic status matter? A meta-analysis on parent training effectiveness for disruptive child behavior. Journal of Clinical Child & Adolescent Psychology, 42(3), 384–392. https://doi.org/10.1080/15374416.2013.769169
- Li, N., Peng, J., & Li, Y. (2021). Effects and moderators of Triple P on the social, emotional, and behavioral problems of children: Systematic review and meta-analysis. Frontiers in Psychology, 12, Article 709851. https://doi.org/10.3389/fpsyg.2021.709851
- Locke, L. M., & Prinz, R. J. (2002). Measurement of parental discipline and nurturance. Clinical Psychology Review, 22(6), 895–929. https://doi.org/10.1016/S0272-7358(02)00133-2
- Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86–104. https://doi.org/10.1016/j.cpr.2005.07.004
- Mahmood, A., Ullah, F., & Shah, S. F. H. (2020). Problems of orphan children in state-sponsored orphanages of Khyber Pakhtunkhwa, Pakistan. Liberal Arts and Social Sciences International Journal, 4(1), 102–113. https://doi.org/10.47264/idea.lassij/4.1.10
- Mamauag, B. L., Alampay, L. P., Lachman, J. M., Madrid, B. J., Hutchings, J., Ward, C. L., & Gardner, F. (2021). A south‐to‐south cultural adaptation of an evidence‐based parenting program for families in the Philippines. Family Process, 60(4), 1202–1216. https://doi.org/10.1111/famp.12625
- Markie-Dadds, C., Turner, K. M. T., & Sanders, M. R. (2009). Every parent’s group workbook: Triple P positive parenting solutions (3rd ed.). Triple P International.
- Maciejewski, M. L. (2020). Quasi-experimental design. Biostatistics & Epidemiology, 4(1), 38–47. https://doi.org/10.1080/24709360.2018.1477468
- Matsumoto, Y., Sofronoff, K., & Sanders, M. R. (2007). The efficacy and acceptability of the Triple P – Positive Parenting Program with Japanese parents. Behaviour Change, 24(4), 205–218. https://doi.org/10.1375/bech.24.4.205
- Morawska, A., & Sanders, M. R. (2007). Are parent-reported outcomes for self-directed or telephone-assisted behavioral family intervention enhanced if parents are observed? Behavior Modification, 31(3), 279–297. https://doi.org/10.1177/0145445506293784
- Morawska, A., Haslam, D., Milne, D., & Sanders, M. R. (2011). Evaluation of a brief parenting discussion group for parents of young children. Journal of Developmental and Behavioral Pediatrics, 32(2), 136–145. https://doi.org/10.1097/DBP.0b013e3181f17a28
- Morawska, A., Sanders, M., Goadby, E., Headley, C., Hodge, L., McAuliffe, C., Pope, S., & Anderson, E. (2011). Is the Triple P-Positive Parenting Program acceptable to parents from culturally diverse backgrounds? Journal of Child and Family Studies, 20, 614–622. https://doi.org/10.1007/s10826-010-9436-x
- Nogueira, S., Canário, A. C., Abreu-Lima, I., Teixeira, P., & Cruz, O. (2022). Group Triple P intervention effects on children and parents: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 19(4), Article 2113. https://doi.org/10.3390/ijerph19042113
- Nowak, C., & Heinrichs, N. (2008). A comprehensive meta-analysis of Triple P-Positive Parenting Program using hierarchical linear modeling: Effectiveness and moderating variables. Clinical Child and Family Psychology Review, 11(3), 114–144. https://doi.org/10.1007/s10567-008-0033-0
- Palusci, V. J. (2011). Risk factors and services for child maltreatment among infants and young children. Children and Youth Services Review, 33(8), 1374–1382. https://doi.org/10.1016/j.childyouth.2011.04.025
- Pianta, R. C. (1992). Child-parent relationship scale. University of Virginia.
- Prinz, R. J., Metzler, C. W., Sanders, M. R., Rusby, J. C., & Cai, C. (2022). Online‐delivered parenting intervention for young children with disruptive behavior problems: A noninferiority trial focused on child and parent outcomes. Journal of Child Psychology and Psychiatry, 63(2), 199–209. https://doi.org/10.1111/jcpp.13426
- Raskin, M., Kotake, C., Easterbrooks, M. A., Ebert, M., & Miller, L. C. (2015). Job-related stress and depression in orphanage and preschool caregivers in Ukraine. Journal of Research in Childhood Education, 29(1), 130–145. https://doi.org/10.1080/02568543.2014.978516
- Rhoades, K. A., & O’Leary, S. G. (2007). Factor structure and validity of the Parenting Scale. Journal of Clinical Child & Adolescent Psychology, 36(2), 137–146. https://doi.org/10.1080/15374410701274157
- Riaz, H., & Reza, H. (1998). The evaluation of an Urdu version of the GHQ‐28. Acta Psychiatrica Scandinavica, 97(6), 427–432. https://doi.org/10.1111/j.1600-0447.1998.tb10027.x
- Robinson, E. A., Eyberg, S. M., & Ross, A. W. (1980). The standardization of an inventory of child conduct problem behaviors. Journal of Clinical Child Psychology, 9(1), 22–29. https://doi.org/10.1080/15374418009532938
- Sanders, M. R. (2012). Development, evaluation, and multinational dissemination of the Triple P – Positive Parenting Program. Annual Review of Clinical Psychology, 8, 345–379. https://doi.org/10.1146/annurev-clinpsy-032511-143104
- Sanders, M. R. (2023). The Triple P System of evidence-based parenting support: Past, present, and future directions. Clinical Child and Family Psychology Review, 26(4), 880–903. https://doi.org/10.1007/s10567-023-00441-8
- Sanders, M. R., Turner, K. M. T., & Markie-Dadds, C. (2018). Every parent’s survival guide (3rd ed.) [DVD]. Triple P International.
- Sanders, M. R., & Mazzucchelli, T. G. (Eds.). (2018). The power of positive parenting: Transforming the lives of children, parents, and communities using the Triple P system. Oxford University Press.
- Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J. (2014). The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34(4), 337–357. https://doi.org/10.1016/j.cpr.2014.04.003
- Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of consulting and clinical psychology, 68(4), 624–640. https://doi.org/10.1037/0022-006X.68.4.624
- Shafiq, F., Haider, S. I., & Ijaz, S. (2020). Anxiety, depression, stress, and decision-making among orphans and non-orphans in Pakistan. Psychology Research and Behavior Management, 13, 313–318. https://doi.org/10.2147/PRBM.S245154
- Shakil, M., Aslam, R., Ashraf, F., & Idris, M. (2021). Demographic characteristics, coping skills, and parental sense of competence of working and nonworking mothers. Pakistan Journal of Psychological Research, 36(1), 103–114. https://doi.org/10.33824/PJPR.2021.36.1.07.
- Schoemaker, N. K., Wentholt, W. G. M., Goemans, A., Vermeer, H. J., Juffer, F., & Alink, L. R. A. (2020). A meta-analytic review of parenting interventions in foster care and adoption. Development and Psychopathology, 32(3), 1149–1172. https://doi.org/10.1017/S0954579419000798
- Slack, K. S., Berger, L. M., DuMont, K., Yang, M.-Y., Kim, B., Ehrhard-Dietzel, S., & Holl, J. L. (2011). Risk and protective factors for child neglect during early childhood: A cross-study comparison. Children and Youth Services Review, 33(8), 1354–1363. https://doi.org/10.1016/j.childyouth.2011.04.024
- Tehranidoost, M., Shahrivar, Z., Moharreri, F., & Gharaei, J. M. (2008). Efficacy of the Positive Parenting Program (Triple-P) for a group of parents of children with attention deficit hyperactivity disorder (ADHD). Iranian Journal of Psychiatry, 3(2), 59–63. https://ijps.tums.ac.ir/index.php/ijps/article/view/471
- Turner, K. M. T., Markie-Dadds, C., & Sanders, M. R. (2010). Group Triple P session presentations [CD]. Triple P International.
- Turner, K. M. T., Markie-Dadds, C., & Sanders, M. R. (2015). Practitioner’s manual for Group Triple P. Triple P International.
- Turner, K. M. T., Richards, M., & Sanders, M. R. (2007). Randomised clinical trial of a group parent education programme for Australian Indigenous families. Journal of Paediatrics and Child Health, 43(6), 429–437. https://doi.org/10.1111/j.1440-1754.2007.01053.x
- Turner, K. M. T., & Sanders, M. R. (2006). Help when it’s needed first: A controlled evaluation of brief, preventive behavioral family intervention in a primary care setting. Behavior Therapy, 37(2), 131–142. https://doi.org/10.1016/j.beth.2005.05.004
- Turner, K. M. T., Singhal, M., McIlduff, C., Singh, S. and Sanders, M. R. (2020). Evidence-based parenting support across cultures: The Triple P—Positive Parenting Program experience. In W. K. Halford & F. van de Vijver (Eds.), Cross-cultural family research and practice (pp. 603–644). Elsevier. https://doi.org/10.1016/b978-0-12-815493-9.00019-3
- Van Holen, F., Vanderfaeillie, J., Omer, H., & Vanschoonlandt, F. (2018). Training in nonviolent resistance for foster parents: A randomized controlled trial. Research on Social Work Practice, 28(8), 931–942. https://doi.org/10.1177/1049731516662915
- Vashchenko, M., Easterbrooks, M. A., & Miller, L. C. (2010). Becoming their mother: Knowledge, attitudes, and practices of orphanage personnel in Ukraine. Infant Mental Health Journal, 31(5), 570–590. https://doi.org/10.1002/imhj.20272
- Vik, K., Daudi, V. Z., Kajula, L. J., Rohde, R., Ubuguyu, O. S., & Saibulu, J. N. (2018). Infancy and caring: Descriptions from motherless infants’ caregivers in an institution in rural Tanzania. Psychology and Developing Societies, 30(1), 105–125. https://doi.org/10.1177/0971333617749141
- Vlahovicova, K., Melendez-Torres, G. J., Leijten, P., Knerr, W., & Gardner, F. (2017). Erratum to: Parenting programs for the prevention of child physical abuse recurrence: A systematic review and meta-analysis. Clinical Child and Family Psychology Review, 20(3), 366–366. https://doi.org/10.1007/s10567-017-0238-1
- Whetten, K., Ostermann, J., Pence, B. W., Whetten, R. A., Messer, L. C., Ariely, S., O’Donnell, K., Wasonga, A. I., Vann, V., Itemba, D., Eticha, M., Madan, I., Thielman, N. M., & The Positive Outcomes for Orphans (POFO) Research Team. (2014). Three-year change in the wellbeing of orphaned and separated children in institutional and family-based care settings in five low- and middle-income countries. PloS One, 9(8), e104872. https://doi.org/10.1371/journal.pone.0104872
- Whetten, K., Ostermann, J., Whetten, R. A., Pence, B. W., O’Donnell, K., Messer, L. C., Thielman, N. M. & The Positive Outcomes for Orphans (POFO) Research Team. (2009). A comparison of the wellbeing of orphans and abandoned children ages 6-12 in institutional and community-based care settings in 5 less wealthy nations. PloS One, 4(12), e8169. https://doi.org/10.1371/journal.pone.0008169
- Yendork, J. S., & Somhlaba, N. Z. (2014). Stress, coping and quality of life: An exploratory study of the psychological well-being of Ghanaian orphans placed in orphanages. Children and Youth Services Review, 46, 28–37. https://doi.org/10.1016/j.childyouth.2014.07.025
- Yousuf, S., & Khan, B. (2017). Challenges faced by women orphans’ caregivers: A qualitative study. Pakistan Journal of Gender Studies, 15(1), 213–228. https://doi.org/10.46568/pjgs.v15i1.136
- Zhou, Y. Q., Chew, Q. R. C., Lee, M., Zhou, J., Chong, D., Quah, S. H., Ho, M., & Tan, L. J. (2017). Evaluation of Positive Parenting Programme (Triple P) in Singapore: Improving parenting practices and preventing risks for recurrence of maltreatment. Children and Youth Services Review, 83, 274–284. https://doi.org/10.1016/j.childyouth.2017.10.029