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IES Grant

Title: Testing the Efficacy of an Ecological Approach to Family Intervention and Treatment During Early Elementary School to Prevent Problem Behavior and Improve Academic Outcomes
Center: NCER Year: 2014
Principal Investigator: Stormshak, Elizabeth Awardee: University of Oregon
Program: Social, Emotional, and Behavioral Context for Teaching and Learning      [Program Details]
Award Period: 4 years (07/1/2014 - 06/30/2018) Award Amount: $3,480,268
Type: Efficacy and Replication Award Number: R305A140189

Co-Principal Investigators: McIntyre, Laura; Garbacz, Stanley

Purpose: The transition to elementary school is a critical time for the development of key skills that are necessary for school success, including sustained attention, self-regulation, initiating and sustaining successful peer relationships, and academic competence. Unfortunately for many children at risk for learning and behavior problems, this transition can be difficult and may lead to early academic problems, which in turn can lead to more severe forms of problem behavior and learning difficulties later in school. On the other hand, parent support at home is associated with school readiness indicators that predict successful adaptation to the school context. The Family Check-Up (FCU) intervention, a three-tiered system of intervention, is designed to leverage the role of parent support in adaptation to school by increasing parenting skills and academic success and decreasing behavior problems. FCU has been successful in early childhood and adolescence, but no studies have examined the critical transition period of entry to kindergarten. The purpose of this study was to conduct the first randomized trial of FCU during the transition into elementary school and examine the impact on behavioral and academic outcomes for students at risk for learning and behavior problems.

Project Activities: Across two school years, two cohorts of kindergarten students were randomly assigned to the intervention or comparison conditions. The first tier or universal component of FCU (i.e., activities designed to facilitate systems-level organization and support for family-school partnerships) was offered to all families in the intervention group regardless of risk. Recruitment efforts for the second and third tiers of intervention targeted schools with children at higher risk of behaviors or learning problems indicated by risk assessment at kindergarten entry. These interventions targeted child skills through family management (e.g., positive daily routines) and tailored interventions for individual child/family needs (e.g., literacy support for parents with home-to-school behavior support, community referrals and resources). FCU was implemented across the kindergarten, first, and second grade year, and assessment of outcomes took place over the course of three years — kindergarten, first grade, and second grade, to determine whether impacts found during the kindergarten year as sustained through early elementary school. The researchers explored moderators (e.g., family stress) and mediators (e.g., parenting skills, children's self-regulation) of intervention response.

Key Outcomes: The main findings of this project are as follows:

  • Children in the Family Check-Up condition outperformed children in the school-as-usual control condition on emotional and behavior problems in first grade, and children experiencing higher levels of emotional and behavior problems at baseline benefitted from the Family Check-Up more than children with lower levels of problems at baseline (Garbacz et al., 2020).
  • The Family Check-Up was associated with improved change in parenting skills, and changes in parenting skills, in turn, predicted reductions in child emotional and behavior problems at second grade (Stormshak et al., 2021).
  • Family Check-Up effects on parenting skills were moderated by parenting contextual stress. As stress increased, so did positive effects of the Family Check-Up on parent monitoring/family routines and negative parenting (Stormshak et al., 2019).
  • Caregivers in the Family Check-Up condition outperformed caregivers in the school-as-usual control condition on family-school engagement at home (Garbacz et al., 2019).
  • A family-centered parent screener is invariant during early elementary school and has adequate predictive and diagnostic capability with adequate reliability (Garbacz et al., 2021). These findings have implications for integrating the Family Check-Up within a broader multi-tiered assessment and intervention framework during elementary school.

Products: The products of this project include evidence of the efficacy of the FCU intervention for young students entering kindergarten, and peer-reviewed publications and presentations.

Structured Abstract

Setting: This project took place in 5 elementary schools in an urban setting in Oregon.

Sample: The sample included 365 kindergarten students and their families.

Intervention: The Family Check-Up (FCU) involves three tiers of intervention and is implemented over the course of a school year. The first level consists of universal components, such as brochures and information about family-to-school planning and skills, which will be offered to all families in the intervention group. The second level focuses on caregivers promoting self-regulation and academic skills in their children by using skilled family management to encourage positive daily routines and provide behavior support. The FCU does this through motivational interviewing and parent meetings with a parent consultant (PC) who builds a collaborative relationship with families and will guide them through the intervention. These meetings build parent relationships with the school, assess various aspects of the home environment (e.g. parenting skills, child behavior, life stressors), and provide specific, strengths-based feedback to the family. The third, or indicated, level is designed to guide decisions about subsequent services and to tailor additional interventions: e.g., continued positive behavior support for daily routines, early literacy support for parents, and community referrals and resources.

Comparison Condition: Students and families in the control condition received standard services.

Research Method: Across two school years, entering kindergarten students whose parents consented to the project were randomly assigned to the intervention or comparison conditions, resulting in 2 cohorts of students. The universal component of FCU was offered to all families in the intervention group, and recruitment efforts included a home visit to explain to establish rapport with the family. Recruitment efforts for the second and third tiers of intervention targeted families with children at higher risk of or behaviors or learning problems indicated by risk assessment at kindergarten entry.

The research aims included (1) testing the efficacy FCU in comparison with a randomly assigned control condition for reducing the growth of behavior problems and academic problems in early elementary school; (2) testing the efficacy of the FCU on the proposed mediators in this model, including parenting skills, children's self-regulation, and early literacy skills in early elementary school; and (3) understanding moderating factors related to engagement of families in the intervention and successful school adaptation, including behavioral adjustment and academic competence. The research team tracked services received in and out of schools by families in the intervention and comparison groups. A portion of FCU sessions were videotaped to assess fidelity of implementation. Assessments of outcomes took place over the course of three years — kindergarten, first grade, and second grade — to determine longitudinal effects of treatment.

Key Measures and Outcomes:  A variety of measures were used to assess outcomes in the following domains: family sociocultural contexts and resources, student behavioral regulation and academic competence, and family management and parent-school involvement. The research team used multiple informants (parents, teachers, observers) and multiple methods (e.g., questionnaires, interviews, observations). Measures of family sociocultural contexts and resources include family demographic information, the Financial Stress Questionnaire, Holmes and Rahe Stressful Life Events Inventory, Parent Substance Use Questionnaire, Patient Health Questionnaire Depression Screener, General Anxiety Disorders Screener, Dyadic Adjustment Scale (parental relationship satisfaction) and the Family Conflict Scale. Measures of student behavioral regulation and academic competence included academic competence scales, Strengths and Difficulties Questionnaire, and Teacher Report of problem behavior. Family management and parent-school involvement were assessed via the Parental Monitoring Interview and Parent Involvement Scale as measures of positive behavioral support. In addition, videotaped home observations were used to assess quality of parent-child relationship, parenting skills, and academic support at home. The Family Satisfaction Questionnaire was used to assess caregiver and parent treatment satisfaction.

Data Analytic Strategy: Researchers analyzed treatment effects comparing both conditions across time using latent growth curve modeling. To determine effects of students being nested within schools, researchers used a fixed-effects model to estimate the impact of random assignment to FCU. Researchers analyzed effects of moderators such as family conflict levels, peer effects, parent engagement in the intervention, and family structure (e.g. single parent). Parent engagement and its impact on results was analyzed using complier average causal effect (CACE) modeling.

Related IES Projects: Family-Centered Intervention in Schools to Reduce Social and Behavioral Problems From Early Elementary School to Adolescence (R324A180037); Preventing Emotional and Behavior Problems in Middle School Youth at risk of Disability after the COVID-19 Pandemic with the Family Check-Up Online (R324X220003)

Products and Publications

Stormshak, E. A., DeGarmo, D., Garbacz, S. A., McIntyre, L. L., & Caruthers, A. (2021). Using motivational interviewing to improve parenting skills and prevent problem behavior during the transition to kindergarten. Prevention Science, 22, 747–757.

Stormshak, E. A., McIntyre, L. L., Garbacz, S. A., & Kosty, D. B. (2019). Family-centered prevention to enhance parenting skills during the transition to elementary school: A randomized trial. Journal of Family Psychology. doi: 10.1037/fam0000570.

Garbacz, S. A., Lee, Y., Hall, G., Stormshak, E. A., & McIntyre, L. L. (2021). Initiating family-school collaboration through a proactive and positive strengths and needs assessment. School Mental Health, 13(3), 667–679.

Garbacz, S. A., Stormshak, E. A., McIntyre, L. L., & Kosty, D. B. (2019). Examining family school engagement in a randomized controlled trial of the Family Check-Up. School Psychology Quarterly, 34, 433–443. doi: 10.1037/spq0000284.

Garbacz, S. A., McIntyre, L. L., Stormshak, E. A., & Kosty, D. B. (2020). The efficacy of the Family Check-Up on children's emotional and behavior problems. Journal of Emotional and Behavior Disorders, 28, 67–79. Advance online. doi: 10.1177/1063426618806258