This study investigated moderators of change in an empirically supported family-centered intervention (the Family Check-Up) for problem behavior in early childhood. Participants were 731 2-to 3-year-olds (49% girls; 28% African American, 50% European American, 13% biracial) from low-income families and had been screened for risk of family stress and early-onset problem behavior. They were randomized to the Family Check-Up intervention or to a no-intervention control group. Latent growth models examined sociodemographic and parent psychological risk factors as potential moderators of change in problem behavior between ages 2, 3, and 4. Results revealed 2 moderators of intervention effectiveness. Caregivers with the lowest educational levels were more responsive to the family-centered intervention, and 2-parent families were more responsive to the intervention. Other risk factors showed no predictive effects. Overall, findings suggest that this brief family-centered intervention can be equally effective in reaching the most distressed and most disadvantaged families, compared to those who are more advantaged. However, results suggest that more attention may be needed to address the intervention needs of single parent families in reducing problem behavior in early childhood.
Keywordschild problem behavior; early prevention; moderators; parenting; conduct problems Numerous randomized trials show that parenting interventions are effective in preventing child problem behavior (Kazdin, 2002). These include "efficacy" trials, conducted in relatively specialist settings, as well as more recent adaptations of these interventions into "effectiveness" trials, which have the potential for widespread dissemination into real-world, communityCorrespondence concerning this article should be addressed to Frances Gardner, Department of Social Policy and Social Work, Barnett House, 32 Wellington Square, Oxford OX1 2ER, United Kingdom. frances.gardner@socres.ox.ac.uk. (Dishion & Stormshak, 2007;Gardner, Burton & Klimes, 2006;Webster-Stratton, 1998a, 1998b. To take such interventions to scale, investigators have developed modified interventions that are brief and low cost (Turner & Sanders, 2006) and that are adapted to engage the most marginalized families (Dishion, Nelson, & Kavanagh, 2003;Shaw, Dishion, Supplee, Gardner, & Arnds, 2006). It is generally accepted that such low-cost interventions, even those with quite modest effect sizes, could potentially be useful and could translate into large public health benefits (Biglan & Taylor, 2000).
NIH Public AccessA key issue underlying the potential for public health impact is whether such brief interventions are effective for the most high-risk families in society, or whether they confer greater benefit on more advantaged families, as reported in recent meta-analyses of predictors of outcome in parent training (Lundahl, Risser, & Lovejoy, 2006;Reyno & McGrath, 2006). This is an important concern, given that high-risk families are also those most likely to have children showin...