Evaluating the efficacy of the Family Check-Up Online: A school-based, eHealth model for the prevention of problem behavior during the middle school years

Abstract

<jats:title>Abstract</jats:title><jats:p>This study evaluated the efficacy of a family-centered preventive intervention, the Family Check-Up (FCU), delivered as an online, eHealth model to middle school families. To increase accessibility of family-centered prevention in schools, we adapted the evidence-based FCU to an online format, with the goal of providing a model of service delivery that is feasible, given limited staffing and resources in many schools. Building on prior research, we randomly assigned participants to waitlist control (<jats:italic>n</jats:italic> = 105), FCU Online as a web-based intervention (<jats:italic>n</jats:italic> = 109), and FCU Online with coaching support (<jats:italic>n</jats:italic> = 108). We tested the effects of the intervention on multiple outcomes, including parental self-efficacy, child self-regulation, and child behavior, in this registered clinical trial (NCT03060291). Families engaged in the intervention at a high rate (72% completed the FCU assessment) and completed 3-month posttest assessments with good retention (94% retained). Random assignment to the FCU Online with coaching support was associated with reduced emotional problems for children (<jats:italic>p</jats:italic> = .003, <jats:italic>d</jats:italic> = −0.32) and improved parental confidence and self-efficacy (<jats:italic>p</jats:italic> = .018, <jats:italic>d</jats:italic> = 0.25) when compared with waitlist controls. Risk moderated effects: at-risk youth showed stronger effects than did those with minimal risk. The results have implications for online delivery of family-centered interventions in schools.</jats:p>

Therapeutic alliance as a predictor of behavioral outcomes in a relationally focused, family‐centered telehealth intervention

“…The divergent results across outcome measures also complicate the picture. Although previous research using this sample has demonstrated an effect of random assignment to the FCU condition on child emotional problems and outcomes (Stormshak et al, 2019), the present study shows that the dosage-response relationship may vary based on specific outcomes of interest. Alternatively, it is possible that these child report measures are not sensitive enough to change to detect a difference.…”

“…Because previous research suggests that the addition of guided support may enhance online interventions (Mohr et al, 2011), the FCU Online includes a therapist‐coach to support behavioral change and engagement in the intervention (Stormshak et al, 2019). Results of the FCU Online suggest high engagement and retention rates, along with decreased emotional problems in children and enhanced feelings of self‐efficacy in parents (Stormshak et al, 2019). Further, children who exhibited higher behavioral risk showed greater behavioral change than youth with minimal risk (Stormshak et al, 2019).…”

“…Results of the FCU Online suggest high engagement and retention rates, along with decreased emotional problems in children and enhanced feelings of self-efficacy in parents (Stormshak et al, 2019). Further, children who exhibited higher behavioral risk showed greater behavioral change than youth with minimal risk (Stormshak et al, 2019). The FCU Online provides flexibility and accessibility for a diverse range of families (Danaher et al, 2018).…”

The Family Check-Up Online: A Telehealth Model for Delivery of Parenting Skills to High-Risk Families With Opioid Use Histories

“…The FCU Online was delivered to students across eight middle schools in Oregon (both rural and urban) with a high percentage of students and families who were at risk (more than 70% economically disadvantaged and fewer than 50% passing state testing with proficiency). Results suggest that the FCU Online with coaching support improved parents' self-efficacy (d = 0.25) and child emotional problems (d = 0.32) at 3 months post-test, with outcomes moderated by risk in the expected direction (e.g., higher risk was associated with greater improvements; Stormshak et al, 2019b). Furthermore, for children with higher levels of behavior problems, the FCU Online also showed intervention effects on effortful control and parenting confidence, key FCU mechanisms of change.…”

Honoring the Contributions and Legacy of Thomas Dishion

“…The final group of papers extends prior research on the Family Check-Up, using both early adolescent and early childhood versions. Stormshak and colleagues (2019) introduce an eHealth version of the FCU to increase its accessibility for middle school families. Random assignment to the FCU Online program, with coaching support, is linked to short-term improvements in child emotional problems and both parental confidence and self-efficacy.…”