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A 12-Month Trial-Based Economic Evaluation Comparing Positive Parenting Program (Triple P) and Circle of Security

Jean Eric Tarride1,2, Gord Blackhouse1, Natalie Harvey-Younis3,4

  • 1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.

Journal of Evaluation in Clinical Practice
|August 23, 2026
PubMed

Insights

The Triple P-Positive Parenting Program (Triple P) and Circle of Security Parenting Program (COSP) are cost-effective interventions compared to treatment as usual (TAU). These programs efficiently use public resources for child health and social care.

Area of Science:

  • Health Economics
  • Child Psychology
  • Public Health

Background:

  • Economic evaluation of parenting programs is crucial for resource allocation.
  • Comparing Triple P-Positive Parenting Program (Triple P) and Circle of Security Parenting Program (COSP) against treatment as usual (TAU) provides insights into their societal value.

Purpose of the Study:

  • To conduct a 12-month economic evaluation comparing Triple P and COSP to TAU from a societal perspective.
  • To determine the cost-effectiveness and cost-utility of Triple P and COSP.

Main Methods:

  • Societal costs and quality-adjusted life-years (QALYs) were calculated using data from a 12-month trial.
  • Caregiver questionnaires (Child and Adolescent Service Use Schedule, Health Status Classification System Preschool Version, Health Utility Index 3) were used for cost and QALY data collection.
  • Cost-effectiveness acceptability curves and sensitivity analyses addressed uncertainty.

Main Results:

  • Triple P and COSP showed minimal differences in societal costs and QALYs compared to TAU.
  • Probabilities of Triple P and COSP being cost-effective were 71% and 68%, respectively, assuming a willingness to pay of $100,000 per QALY.
  • Sensitivity analyses confirmed the robustness of the findings.

Conclusions:

  • Both Triple P and COSP are suggested to be efficient uses of public resources.
  • Parenting interventions like Triple P and COSP offer value for money in child health and social care settings.
Abstract

Keywords:
Circle of Security Parenting ProgramTriple P–Positive Parenting Programcostcost‐effectivenessquality‐adjusted life yearstreatment as usual

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