Caregivers on point: a randomized treatment-control prevention trial for foster and kinship caregivers to reduce behavior challenges among children in foster care.
Humans
Foster Home Care
/ psychology
Caregivers
/ psychology
Child Behavior
Child
Stress, Psychological
/ prevention & control
Parenting
/ psychology
Child, Preschool
Time Factors
Chicago
Female
Male
Randomized Controlled Trials as Topic
Treatment Outcome
Adolescent
Child, Foster
/ psychology
Child Behavior Disorders
/ prevention & control
Child behavior problems
Child welfare
Foster care
Kinship care
Parenting program
Prevention
Journal
Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253
Informations de publication
Date de publication:
10 Oct 2024
10 Oct 2024
Historique:
received:
16
05
2024
accepted:
01
10
2024
medline:
11
10
2024
pubmed:
11
10
2024
entrez:
10
10
2024
Statut:
epublish
Résumé
Children in foster care who are newly placed with licensed or kinship caregivers are often vulnerable to increased behavior problems associated with trauma and social disruptions. When those issues are not addressed, children are susceptible to placement disruptions that exacerbate behavior problems. Few preventive interventions are available for foster and kinship caregivers, and none are designed to be delivered at the time of a child's placement into the home. This study aims to examine the impact of the Chicago Parent Program adapted and customized for foster and kinship caregivers (CPP-FC), locally branded as Caregivers on Point, on caregiver stress, parenting confidence and strategies, children's behaviors, and placement stability. Caregivers (N = 300) are being recruited from a specialized foster care clinic that sees children and caregivers within five business days of a new placement. Upon completing baseline surveys and behavioral observation, caregiver-child dyads are randomized to receive CPP-FC (n = 150) or usual care (n = 150). Those in the treatment condition will complete 11 weekly sessions addressing child behavior management and caregiving approaches. A booster session will occur one month after the weekly sessions conclude. A mid-point assessment and behavioral observation will be collected four months after the baseline assessment for all participants, coinciding with the completion of the CPP-FC programming. At 6 months post-baseline, an end-of-study assessment will be collected. Administrative data will be extracted from the child welfare record to determine placement stability for the 12 months following enrolment. The primary outcome of interest is child behavior, indicated by changes in caregiver reports and objective ratings of behavior from observations, where raters are blinded to the treatment arm and timing of data collection. Secondary outcomes include placement stability and changes in caregiver stress and confidence in managing children's behavior. If found to be effective, CPP-FC would be helpful for families involved with child welfare. It could be delivered by child welfare agencies, licensing and kinship navigator agencies, and foster care clinics and may be eligible for government reimbursement as a preventive intervention for children in foster care. This study was prospectively registered with ClinicalTrials.gov, NCT06170047 .
Sections du résumé
BACKGROUND
BACKGROUND
Children in foster care who are newly placed with licensed or kinship caregivers are often vulnerable to increased behavior problems associated with trauma and social disruptions. When those issues are not addressed, children are susceptible to placement disruptions that exacerbate behavior problems. Few preventive interventions are available for foster and kinship caregivers, and none are designed to be delivered at the time of a child's placement into the home. This study aims to examine the impact of the Chicago Parent Program adapted and customized for foster and kinship caregivers (CPP-FC), locally branded as Caregivers on Point, on caregiver stress, parenting confidence and strategies, children's behaviors, and placement stability.
METHODS
METHODS
Caregivers (N = 300) are being recruited from a specialized foster care clinic that sees children and caregivers within five business days of a new placement. Upon completing baseline surveys and behavioral observation, caregiver-child dyads are randomized to receive CPP-FC (n = 150) or usual care (n = 150). Those in the treatment condition will complete 11 weekly sessions addressing child behavior management and caregiving approaches. A booster session will occur one month after the weekly sessions conclude. A mid-point assessment and behavioral observation will be collected four months after the baseline assessment for all participants, coinciding with the completion of the CPP-FC programming. At 6 months post-baseline, an end-of-study assessment will be collected. Administrative data will be extracted from the child welfare record to determine placement stability for the 12 months following enrolment. The primary outcome of interest is child behavior, indicated by changes in caregiver reports and objective ratings of behavior from observations, where raters are blinded to the treatment arm and timing of data collection. Secondary outcomes include placement stability and changes in caregiver stress and confidence in managing children's behavior.
DISCUSSION
CONCLUSIONS
If found to be effective, CPP-FC would be helpful for families involved with child welfare. It could be delivered by child welfare agencies, licensing and kinship navigator agencies, and foster care clinics and may be eligible for government reimbursement as a preventive intervention for children in foster care.
TRIAL REGISTRATION
BACKGROUND
This study was prospectively registered with ClinicalTrials.gov, NCT06170047 .
Identifiants
pubmed: 39390601
doi: 10.1186/s13063-024-08524-9
pii: 10.1186/s13063-024-08524-9
doi:
Banques de données
ClinicalTrials.gov
['NCT06170047']
Types de publication
Journal Article
Clinical Trial Protocol
Langues
eng
Sous-ensembles de citation
IM
Pagination
670Informations de copyright
© 2024. The Author(s).
Références
U.S. Department of Health and Human Services. The AFCARS report. 2022. p. 6. Available from: https://www.acf.hhs.gov/sites/default/files/documents/cb/afcars-report-29.pdf . Cited 2023 Nov 30.
Barth RP, Wildfire J, Green RL. Placement into foster care and the interplay of urbanicity, child behavior problems, and poverty. Am J Orthopsychiatry. 2006;76(3):358–66.
doi: 10.1037/0002-9432.76.3.358
pubmed: 16981814
McGuinness TM, Schneider K. Poverty, child maltreatment, and foster care. J Am Psychiatr Nurses Assoc. 2007;13(5):296–303.
doi: 10.1177/1078390307308421
Maloney T, Jiang N, Putnam-Hornstein E, Dalton E, Vaithianathan R. Black-White differences in child maltreatment reports and foster care placements: a statistical decomposition using linked administrative data. Matern Child Health J. 2017;21(3):414–20.
doi: 10.1007/s10995-016-2242-3
pubmed: 28124189
Wulczyn F, Hislop K. Foster care dynamics in urban and non-urban counties. Office of the Assistant Secretary for Planning and Evaluation: United States Department of Health and Human Services; 2002. (Papers on foster care and adoption). Available from: https://aspe.hhs.gov/reports/foster-care-dynamics-urban-non-urban-counties . Cited 2021 Oct 17.
Turney K, Wildeman C. Adverse childhood experiences among children placed in and adopted from foster care: evidence from a nationally representative survey. Child Abuse Negl. 2017;1(64):117–29.
doi: 10.1016/j.chiabu.2016.12.009
Schroeder A, Slopen N, Mittal M. Accumulation, timing, and duration of early childhood adversity and behavior problems at age 9. J Clin Child Adolesc Psychol. 2020;49(1):36–49. https://doi.org/10.1080/15374416.2018.1496440 . Epub 2018 Aug 7. PMID: 30084657; PMCID: PMC6551296.
doi: 10.1080/15374416.2018.1496440
pubmed: 30084657
Beal SJ, Wingrove T, Mara CA, Lutz N, Noll JG, Greiner MV. Childhood adversity and associated psychosocial function in adolescents with complex trauma. Child Youth Care Forum. 2018;48(3):305–22.
doi: 10.1007/s10566-018-9479-5
pubmed: 31467469
pmcid: 6715307
Chambers RM, Crutchfield RM, Goddu Harper SG, Fatemi M, Rodriguez AY. Family reunification in child welfare practice: a pilot study of parent and staff experiences. Child Youth Serv Rev. 2018;1(91):221–31.
doi: 10.1016/j.childyouth.2018.06.020
Park JM, Helton J. Transitioning from informal to formal substitute care following maltreatment investigation. Child Youth Serv Rev. 2010;32(7):998–1003.
doi: 10.1016/j.childyouth.2010.03.027
Barnett ER, Jankowski MK, Butcher RL, Meister C, Parton RR, Drake RE. Foster and adoptive parent perspectives on needs and services: a mixed methods study. J Behav Health Serv Res. 2018;45(1):74–89.
doi: 10.1007/s11414-017-9569-4
pubmed: 28852992
Jee SH, Conn AM, Szilagyi PG, Blumkin A, Baldwin CD, Szilagyi MA. Identification of social-emotional problems among young children in foster care: identification of social-emotional problems in foster care. J Child Psychol Psychiatry. 2010;51(12):1351–8.
doi: 10.1111/j.1469-7610.2010.02315.x
pubmed: 20840498
Hunt TKA, Slack KS, Berger LM. Adverse childhood experiences and behavioral problems in middle childhood. Child Abuse Negl. 2017;1(67):391–402.
doi: 10.1016/j.chiabu.2016.11.005
Yates TM, Dodds MF, Sroufe LA, Egeland B. Exposure to partner violence and child behavior problems: a prospective study controlling for child physical abuse and neglect, child cognitive ability, socioeconomic status, and life stress. Dev Psychopathol. 2003;15(1):199–218.
doi: 10.1017/S0954579403000117
pubmed: 12848442
Zima BT, Bussing R, Freeman S, Yang X, Belin TR, Forness SR. Behavior problems, academic skill delays and school failure among school-aged children in foster care: their relationship to placement characteristics. J Child Fam Stud. 2000;9(1):87–103.
doi: 10.1023/A:1009415800475
Leathers SJ. Placement disruption and negative placement outcomes among adolescents in long-term foster care: the role of behavior problems. Child Abuse Negl. 2006;30(3):307–24.
doi: 10.1016/j.chiabu.2005.09.003
pubmed: 16519937
Lindhiem O, Dozier M. Caregiver commitment to foster children: the role of child behavior. Child Abuse Negl. 2007;31(4):361–74.
doi: 10.1016/j.chiabu.2006.12.003
pubmed: 17433438
Leathers SJ, Spielfogel JE, Geiger J, Barnett J, Vande Voort BL. Placement disruption in foster care: children’s behavior, foster parent support, and parenting experiences. Child Abuse Negl. 2019;1(91):147–59.
doi: 10.1016/j.chiabu.2019.03.012
Chamberlain P, Price JM, Reid JB, Landsverk J, Fisher PA, Stoolmiller M. Who disrupts from placement in foster and kinship care? Child Abuse Negl. 2006;30(4):409–24.
doi: 10.1016/j.chiabu.2005.11.004
pubmed: 16600372
Aarons GA, James S, Monn AR, Raghavan R, Wells RS, Leslie LK. Behavior problems and placement change in a national child welfare sample: a prospective study. J Am Acad Child Adolesc Psychiatry. 2010;49(1):70–80. https://doi.org/10.1097/00004583-201001000-00011 . PMID:20215928;PMCID:PMC4131764.
doi: 10.1097/00004583-201001000-00011
pubmed: 20215928
pmcid: 4131764
Mersky JP, Topitzes J, Janczewski CE, Lee CTP, McGaughey G, McNeil CB. Translating and implementing evidence-based mental health services in child welfare. Adm Policy Ment Health Ment Health Serv Res. 2020;47(5):693–704.
doi: 10.1007/s10488-020-01011-8
Festinger T, Baker AJL. The quality of evaluations of foster parent training: an empirical review. Child Youth Serv Rev. 2013;35(12):2147–53.
doi: 10.1016/j.childyouth.2013.10.009
Schoemaker NK, Wentholt WGM, Goemans A, Vermeer HJ, Juffer F, Alink LRA. A meta-analytic review of parenting interventions in foster care and adoption. Dev Psychopathol. 2020;32(3):1149–72.
doi: 10.1017/S0954579419000798
pubmed: 31366418
Bettencourt AF, White A, Breitenstein S, Gross D. The Chicago parent program: guidance for running virtual groups. The Chicago Parent Program; 2023. Available from: https://static1.squarespace.com/static/6499ca5246fe7830e01f27d0/t/64e8f729d5089928176806fb/1692989226331/CPP-Virtual-Implementation-Guide.pdf . Cited 2023 Apr 4.
Gross D, Belcher HME, Budhathoki C, Ofonedu ME, Dutrow D, Uveges MK, et al. Reducing preschool behavior problems in an urban mental health clinic: a pragmatic, non-inferiority trial. J Am Acad Child Adolesc Psychiatry. 2019;58(6):572–581.e1.
doi: 10.1016/j.jaac.2018.08.013
pubmed: 30768419
Breitenstein SM, et al. Parent use and efficacy of a self-administered, tablet-based parent training intervention: a randomized controlled trial. JMIR mHealth uHealth. 2016;4(2):e5202.
Harden BJ, Panlilio C, Morrison C, Duncan AD, Duchene M, Clyman RB. Emotion regulation of preschool children in foster care: the influence of maternal depression and parenting. J Child Fam Stud. 2017;26(4):1124–34.
doi: 10.1007/s10826-016-0636-x
Bater LR, Jordan SS. Child routines and self-regulation serially mediate parenting practices and externalizing problems in preschool children. Child Youth Care Forum. 2017;46(2):243–59.
doi: 10.1007/s10566-016-9377-7
Healey CV, Fisher PA. Young children in foster care and the development of favorable outcomes. Child Youth Serv Rev. 2011;33(10):1822–30.
doi: 10.1016/j.childyouth.2011.05.007
pubmed: 21987598
pmcid: 3188952
Hamik E, Bereset A, Nause K, Greiner MV, Beal SJ. Kinship and foster caregivers’ perspectives on the need to tailor parenting programs: a qualitative study. J Foster Care. 5(1):19–27. Available at https://jfc-ojs-ttu.tdl.org/jfc/article/view/33/18 . Accessed 7 Oct 2024.
Card JJ, Solomon J, Cunningham SD. How to adapt effective programs for use in new contexts. Health Promot Pract. 2011;12(1):25–35.
doi: 10.1177/1524839909348592
pubmed: 19858321
Freedland KE, King AC, Ambrosius WT, Mayo-Wilson E, Mohr DC, Czajkowski SM, et al. The selection of comparators for randomized controlled trials of health-related behavioral interventions: recommendations of an NIH expert panel. J Clin Epidemiol. 2019;110:74–81.
doi: 10.1016/j.jclinepi.2019.02.011
pubmed: 30826377
pmcid: 6543841
Freedland KE. Demanding attention: reconsidering the role of attention control groups in behavioral intervention research. Psychosom Med. 2013;75(2):100.
doi: 10.1097/PSY.0b013e3182851b75
pubmed: 23362502
Mohr DC, Spring B, Freedland KE, Beckner V, Arean P, Hollon SD, et al. The selection and design of control conditions for randomized controlled trials of psychological interventions. Psychother Psychosom. 2009;78(5):275–84.
doi: 10.1159/000228248
pubmed: 19602916
Breitenstein SM, Gross D, Bettencourt AF. The Chicago parent program. In: Ending the physical punishment of children: a guide for clinicians and practitioners. Washington, DC: American Psychological Association; 2020. p. 109–19.
Breitenstein SM, Fogg L, Garvey C, Hill C, Resnick B, Gross D. Measuring implementation fidelity in a community-based parenting intervention. Nurs Res. 2010;59(3):158.
doi: 10.1097/NNR.0b013e3181dbb2e2
pubmed: 20404777
pmcid: 3421455
Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45.
doi: 10.1097/00004583-200111000-00015
pubmed: 11699809
PCIT. Research and Training DPICS-IV Manual (2013). Available from: http://www.pcit.org/store/p19/Research_and_Training_DPICS-IV_Manual_%282013%29.html Cited 2021 Oct 5.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1984;1(24):385–96.
Berry JO, Jones WH. The parental stress scale: initial psychometric evidence. J Soc Pers Relat. 1995;12(3):463–72. https://doi.org/10.1177/0265407595123009 .
doi: 10.1177/0265407595123009
Gibaud-Wallston J, Wandersman LP. Parenting Sense of Competence Scale. 2012. Available from: http://doi.apa.org/getdoi.cfm? https://doi.org/10.1037/t01311-000 . Cited 2023 May 5.
Reid CAY, Roberts LD, Roberts CM, Piek JP. Towards a model of contemporary parenting: the parenting behaviours and dimensions questionnaire Botbol M, editor. PloS one. 2015;10(6):e0114179.
doi: 10.1371/journal.pone.0114179
pubmed: 26043107
pmcid: 4456141
Wilson PA, Hansen NB, Tarakeshwar N, Neufeld S, Kochman A, Sikkema KJ. Scale development of a measure to assess community-based and clinical intervention group environments. J Community Psychol. 2008;36(3):271–88.
doi: 10.1002/jcop.20193
pubmed: 19018295
pmcid: 2583446
Snow G. blockrand: randomization for block random clinical trials. R Package Version. 2020;1.5. Available from: https://CRAN.R-project.org/package=blockrand .
R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2023. Available from: https://www.R-project.org/ .
Kersten P, Czuba K, McPherson K, Dudley M, Elder H, Tauroa R, et al. A systematic review of evidence for the psychometric properties of the strengths and difficulties questionnaire. Int J Behav Dev. 2016;40(1):64–75.
doi: 10.1177/0165025415570647
Cotter AM, Brestan-Knight E. Convergence of parent report and child behavior using the Dyadic Parent-Child Interaction Coding System (DPICS). J Child Fam Stud. 2020;29(11):3287–301.
doi: 10.1007/s10826-020-01813-2
StataCorp. Stata statistical software: Release 18. College Station, TX: StataCorp, LLC; 2023.
Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006;5(1):80–92.
doi: 10.1177/160940690600500107
Proudfoot K. Inductive/deductive hybrid thematic analysis in mixed methods research. J Mix Methods Res. 2023;17(3):308–26.
doi: 10.1177/15586898221126816
Swain J. A hybrid approach to thematic analysis in qualitative research: using a practical example. 1 Oliver’s Yard, 55 City Road, London EC1Y 1SP United Kingdom: SAGE Publications Ltd; 2018. Available from: https://methods.sagepub.com/case/hybrid-approach-thematic-analysis-qualitative-research-a-practical-example . Cited 2024 Mar 28.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
doi: 10.1191/1478088706qp063oa
Rubin DB. Inference and missing data. Biometrika. 1976;63(3):581–92.
doi: 10.1093/biomet/63.3.581
Graham JW. Adding missing-data-relevant variables to FIML-based structural equation models. Struct Equ Model Multidiscip J. 2003;10(1):80–100.
doi: 10.1207/S15328007SEM1001_4
Taichman DB, Sahni P, Pinborg A, Peiperl L, Laine C, James A, et al. Data sharing statements for clinical trials: a requirement of the International Committee of Medical Journal Editors. PLOS Med. 2017;14(6):e1002315.
doi: 10.1371/journal.pmed.1002315
pubmed: 28582414
pmcid: 5459581