This is a population-based evaluation of the effectiveness of the Triple-P-Positive Parenting Program. Triple-P is a system of parenting programs with multiple levels that aims to provide parents with parenting skills and support.

Eighteen counties in the state of South Carolina will be randomized to the dissemination of the Triple-P system or to a waitlist control condition. University of South Carolina staff will train health care professionals in the nine dissemination counties to use the Triple-P parenting programs. Triple-P is a parenting program that uses a tiered system of interventions of increasing strength depending on parents' and children's differing needs, ranging from media and information-based strategies, to two levels of moderate-intensity intervention using a brief consultation format, to two more intensive levels of parent training and behavioral family intervention targeting parenting skills and other family adversity factors such as marital conflict, depression and high levels of parenting stress. The evaluation of the dissemination of Triple-P will rely on two methods: the analysis of aggregate data on child maltreatment, injuries and hospitalizations, and annual surveys of families to examining parenting education, practices, and child behavior.

Inclusion Criteria:

• Counties in South Carolina