Coercion theory posits a cyclical relationship between harsh and coercive parent–child interactions and problem behavior beginning in early childhood. As coercive interactions have been theorized and found to facilitate the development and growth of early conduct problems, early interventions often target parenting to prevent or reduce early disruptive problem behavior. This study utilizes direct observations of parent–child interactions from the Early Steps Multisite study (N = 731; 369 boys) to examine the effect of the Family Check-Up, a family-centered intervention program, on measures of parent–child positive engagement and coercion from age 2 through 5, as well as on childhood problem behavior at age 5. Results indicate that high levels of parent–child positive engagement were associated with less parent–child coercion the following year, but dyadic coercion was unrelated to future levels of positive engagement. In addition, families assigned to the Family Check-Up showed increased levels of positive engagement at ages 3 and 5, and the association between positive engagement at age 3 and child problem behavior at age 5 was mediated by reductions in parent–child coercion at age 4. These findings provide longitudinal confirmation that increasing positive engagement in parent–child interaction can reduce the likelihood of coercive family dynamics in early childhood and growth in problem behavior.

This article describes a case study in the use of the Family Check-Up (FCU), a family-based and ecological preventive intervention for children at risk for problem behavior. The FCU is an assessment-driven intervention that utilizes a health maintenance model; emphasizes motivation for change; and offers an adaptive, tailored approach to intervention. This case study follows one Caucasian family through their initial assessment and subsequent treatment for their toddler daughter's conduct problems over a 2-year period. Clinically meaningful improvements in child and family functioning were found despite the presence of child, parent, and neighborhood risk factors. The case is discussed with respect to the findings from a current multisite randomized control trial of the FCU and its application to other populations.There is growing interest in identifying young children at risk for early and persistent trajectories of antisocial behavior (Shaw & Gross, 2008), motivated by several studies of earlystarting antisocial youth (Moffitt, 1993). Several researchers have documented that compared to late starters (who begin delinquent activity in mid-to late adolescence), early starters (who typically initiate antisocial activities before age 10) show a more persistent and chronic trajectory of antisocial behavior extending from middle childhood to adulthood (Moffitt & Caspi, 2001;Patterson & Yoeger, 1993). Early starters represent approximately 6% to 7% of the general population of youth yet are responsible for almost half of all adolescent crime and three fourths of violent crimes (Offord, Boyle, & Racine, 1991). During the past 2 decades, Copyright © Taylor & Francis Group, LLC Correspondence should be addressed to Anne Gill, 210 South Bouquet Street, 4419 SENSQ, Pittsburgh, PA 15260. E-mail: E-mail: amgst35@pitt.edu. Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. (Shaw & Bell, 1993). NIH Public AccessThe Family Check-Up (FCU) is a preventive intervention that has been adapted specifically to address the normative challenges parents face during the terrible 2s, particularly in high-risk environments where these normative challenges are more likely to lead to negative outcomes (Dishion et al., in press;Shaw, Dishion, Supplee, Gardner...

BACKGROUND AND OBJECTIVES: Heterogeneity in risk among low-income families suggests the need for tiered interventions to prevent disparities in school readiness. Smart Beginnings (SB) integrates two interventions: Video Interaction Project (VIP) (birth to 3 years), delivered universally to low-income families in pediatric primary care, and Family Check-Up (6 months to 3 years), targeted home visiting for families with additional family risks. Our objective was to assess initial SB impacts on parent-child activities and interactions at 6 months, reflecting early VIP exposure. METHODS: Two-site randomized controlled trial in New York City (84% Latinx) and Pittsburgh (81% Black), with postpartum enrollment and random assignment to treatment (SB) or control. At 6 months, we assessed parent-child interactions through surveys (StimQ, Parenting Your Baby) and observation (video-recorded play, coded by using Parent-Child Interaction Rating Scales – Infant Adaptation). RESULTS: A total of 403 families were enrolled at child’s birth (201 treatment) with 362 (89.8%) assessed at 6 months. Treatment families had increased StimQ, including total score (Cohen’s d = 0.28; P < .001) and domains reflecting reading (d = 0.23; P = .02) and teaching (d = 0.25; P = .01), and Parent-Child Interaction Rating Scales – Infant Adaptation, including a cognitive stimulation factor (d = 0.40; P < .001) and domains reflecting support for cognitive development (d = 0.36; P < .001), and language quantity (0.40; P < .001) and quality (d = 0.37; P < .001). Thus, significant effects emerged across a broad sample by using varied methodologies. CONCLUSIONS: Findings replicate and extend previous VIP findings across samples and assessment methodologies. Examining subsequent assessments will determine impacts and feasibility of the full SB model, including potential additive impacts of Family Check-Up for families at elevated risk.

This study is a qualitative analysis of facilitators and barriers in the dissemination of Family Check-Up (FCU), a U.S.-developed preventive intervention in Sweden. The FCU is inherently culturally flexible because it was designed to be tailored to each family's needs and context, including cultural norms and values. We present the FCU implementation framework (IF) as a conceptual framework for cross-country transport of the FCU and evidence-based programs (EBP) more generally. The FCU IF draws from implementation science literature and involves specifying barriers and facilitators related to implementation drivers (e.g., competency) at each implementation phase and applying these data to inform phase-specific, readiness-building activities for each driver. In addition to driver-related influences, barriers and facilitators specific to the FCU and the collaborative partnership between the U.S. and Swedish purveyors emerged in the data. The partnership's reliance on a hybrid bottom-up, top-down approach that balanced the Swedish purveyor's autonomy and cultural expertise with guidance from the U.S. purveyor facilitated adaptation of the FCU for Sweden. Relying on previously collected data, we also explored similarities and differences in barriers and facilitators to FCU scale-up in the United States versus Sweden. In general, across drivers, the same barriers and facilitators were salient. This study suggests that dissemination of culturally flexible EBPs guided by a dynamic implementation framework can facilitate cross-country transport of EBPs. This study promotes a culture of prevention by highlighting barriers, facilitators, and readiness-building strategies that influence the cross-cultural transportability of EBPs that prevent the onset and escalation of child problem behavior.

The link between problem behavior in early childhood and serious problem behavior in later childhood and adolescence has been well documented, as has the link between parent–child interactions associated with the amplification of these problem behaviors. These linkages underscore the need to support parenting practices from early childhood through adolescence with parenting interventions that fit within the service delivery milieu that can engage children and families from a range of risk ecologies. The Family Check‐Up ( FCU ) is one such empirically supported intervention that was specifically designed to address child problem behavior at periods of developmental transition, such as toddlerhood and adolescence, among families experiencing multiple types of family and socioeconomic adversity. The FCU is an assessment‐driven, tailored, brief intervention that addresses motivational issues and utilizes a health maintenance model and a strengths‐based approach. The FCU allows the clinician to very directly meet the parent's needs and stated goals while considering the broader contextual issues as they relate to the presenting concerns and treatment goals. The FCU is an empirically validated model that supports the efficient provision of parent skills training within an ecological and culturally sensitive framework.