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The Family Check-Up 4 Health (FCU4Health) is an adaptation of the Family Check-Up (FCU) for delivery in primary care settings. While maintaining the original FCU’s focus on parenting and child behavioral health, we added content targeting health behaviors. This study evaluated whether the adapted FCU maintained positive effects on parenting (positive behavior support, limit setting, parental warmth) and child behavioral health (self-regulation, conduct problems, emotional problems). Pediatric (6–12 years) primary care patients with a BMI ≥ 85th%ile (n = 240) were recruited from primary care clinics in Phoenix. Children were 75% Latino, 49% female, and 73% Medicaid recipients. This type 2 effectiveness-implementation hybrid trial compared families randomized to FCU4Health (n = 141) or usual care (n = 99). FCU4Health was delivered over a period of 6 months. This study focuses on a priori secondary outcomes included parenting and child behavioral health targets of the original FCU, assessed at baseline and 3, 6, and 12 months. Significant improvements were found for the FCU4Health condition, compared to usual care, in parenting from baseline to the 3-month assessment [β = .17 (.01; .32)]. Parenting predicted improvements in child self-regulation at 6-months [β = .17 (.03; .30)], which in turn predicted reductions in conduct problems [β = − .38 (− .51; − .23)] and emotional problems [β = − .24 (− .38; − .09)] at 12 months. Ethnicity and language of delivery (English or Spanish) did not moderate these effects. The FCU4Health can improve parenting and child behavioral health outcomes when delivered in primary care. Trial Registration Trial registration number: NCT03013309 ClinicalTrials.gov

Hundreds of studies have documented an association between depression in mothers and behavior problems in children. Theory and empirical findings suggest this association may be confounded by other factors, but little attention has been paid to this issue. We used propensity score methods in a sample of 731 low-income families assessed repeatedly from child age 2 through 14 years to produce a weighted sample of families that were similar at child age 3 years except for mothers' depression. Depressive symptomatology was measured via self-report rating scale. Mothers were categorized as having clinically-elevated versus non-clinically-elevated scores based on an established threshold. Mothers with elevated versus nonelevated scores were equated on 89 other relevant characteristics (e.g., SES, child behavior, marital conflict). We then compared the equated groups on mother, secondary caregiver, and teacher ratings of child externalizing and internalizing behavior from child ages 4 to 14 years. Prior to equating, the mean prima facie effect of exposure to clinically-elevated mothers' depression scores at child age 3 years was d = 0.45 per mothers, d = 0.26 per secondary caregivers, and d = 0.13 per teachers. After equating, the mean adjusted effect was d = 0.07 per mothers, d = 0.01 per secondary caregivers, and d = 0.03 per teachers. Findings suggest that a substantial portion of the prima facie association between mothers' depression and later child behavior problems is accounted for by confounding variables rather than a causal effect of depressive symptoms per se. To fully understand why children of depressed mothers exhibit more behavior problems, a multicausal theory is needed that jointly considers the cluster of co-occurring clinical features that often accompany maternal depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Motivational interviewing (MI) is a therapeutic style in which a provider elicits client motivation and helps strengthen commitment to change (Miller and Rollnick 2002). The original Family Check-Up (FCU; Dishion and Stormshak 2007)—and the adapted version for improving health behaviors in primary care, the Family Check-Up 4 Health (FCU4Health; Smith et al. 2018a)—are brief, assessment-driven, and family-centered preventive interventions that use MI to improve parent engagement in services to improve parenting and prevent negative child outcomes. This study examines the role of MI in the Raising Healthy Children project, a randomized trial to test the effectiveness of the FCU4Health for the prevention of obesity in pediatric primary care, with data from the 141 families assigned to receive the FCU4Health. Families were eligible for the study if the child was between 5.5 and 12 years of age at the time of identification and had a BMI ≥ 85th percentile for age and gender at the most recent visit to their primary care provider. MI skills at the first session predicted caregiver in-session active engagement, attendance at follow-up parenting sessions, and improvements in motivation to address child health and behavior goals. Baseline characteristics of the family (i.e., child health diagnosis, caregiver baseline depression, motivation, and Spanish language preference) had differential associations with responsiveness and MI skills. This study has implications for program development, provider training, and fidelity monitoring.

The present study tested the moderating role of interparental relationship quality and child inhibitory control on the stability of paternal depression over time and associations between paternal depression and child internalizing problems in early childhood. Participants were a subsample (n = 166) of families from the Early Steps Multisite study, a longitudinal study of low-income parents and children. Interparental relationship quality (age 2) attenuated the association between paternal depressive symptoms at age 2 and paternal depressive symptoms at age 3. Both interparental relationship quality (age 3) and child inhibitory control (age 3) attenuated the association between paternal depressive symptoms (age 3) and age 4 child internalizing problems. Results suggest that high interparental relationship quality may be a protective factor in terms of lessening the stability of paternal depressive symptoms over time, as well as the association between paternal depression and later child internalizing problems. Similarly, high levels of inhibitory control may buffer children from the negative effects of paternal depression on the development of internalizing problems.

This study examined the long-term effects of a randomized controlled trial of the Family Check-Up (FCU) intervention initiated at age 2 on inhibitory control in middle childhood and adolescent internalizing and externalizing problems. We hypothesized that the FCU would promote higher inhibitory control in middle childhood relative to the control group, which in turn would be associated with lower internalizing and externalizing symptomology at age 14. Participants were 731 families, with half (n = 367) of the families assigned to the FCU intervention. Using an intent-to-treat design, results indicate that the FCU intervention was indirectly associated with both lower internalizing and externalizing symptoms at age 14 via its effect on increased inhibitory control in middle childhood (i.e., ages 8.5–10.5). Findings highlight the potential for interventions initiated in toddlerhood to have long-term impacts on self-regulation processes, which can further reduce the risk for behavioral and emotional difficulties in adolescence.

This study originated in collaboration with Thomas Dishion because of concerns that a group format for aggressive children might dampen the effects of cognitive-behavioral intervention. Three hundred sixty aggressive preadolescent children were screened through teacher and parent ratings. Schools were randomized to receive either an individual or a group format of the child component of the same evidence-based program. The results indicate that there is variability in how group-based cognitive-behavioral intervention can affect aggressive children through a long 4-year follow-up after the end of the intervention. Aggressive children who have higher skin conductance reactivity (potentially an indicator of poorer emotion regulation) and who have a variant of the oxytocin receptor gene that may be associated with being hyperinvolved in social bonding have better outcomes in their teacher-rated externalizing behavior outcomes over time if they were seen individually rather than in groups. Analyses also indicated that higher levels of the group leaders’ clinical skills predicted reduced externalizing behavior problems. Implications for group versus individual format of cognitive-behavioral interventions for aggressive children, and for intensive training for group therapists, informed by these results, are discussed.

Building on prior work using Tom Dishion's Family Check-Up, the current article examined intervention effects on dysregulated irritability in early childhood. Dysregulated irritability, defined as reactive and intense response to frustration, and prolonged angry mood, is an ideal marker of neurodevelopmental vulnerability to later psychopathology because it is a transdiagnostic indicator of decrements in self-regulation that are measurable in the first years of life that have lifelong implications for health and disease. This study is perhaps the first randomized trial to examine the direct effects of an evidence- and family-based intervention, the Family Check-Up (FCU), on irritability in early childhood and the effects of reductions in irritability on later risk of child internalizing and externalizing symptomatology. Data from the geographically and sociodemographically diverse multisite Early Steps randomized prevention trial were used. Path modeling revealed intervention effects on irritability at age 4, which predicted lower externalizing and internalizing symptoms at age 10.5. Results indicate that family-based programs initiated in early childhood can reduce early childhood irritability and later risk for psychopathology. This holds promise for earlier identification and prevention approaches that target transdiagnostic pathways. Implications for future basic and prevention research are discussed.

Several research teams have previously traced patterns of emerging conduct problems (CP) from early or middle childhood. The current study expands on this previous literature by using a genetically-informed, experimental, and long-term longitudinal design to examine trajectories of early-emerging conduct problems and early childhood discriminators of such patterns from the toddler period to adolescence. The sample represents a cohort of 731 toddlers and diverse families recruited based on socioeconomic, child, and family risk, varying in urbanicity and assessed on nine occasions between ages 2 and 14. In addition to examining child, family, and community level discriminators of patterns of emerging conduct problems, we were able to account for genetic susceptibility using polygenic scores and the study's experimental design to determine whether random assignment to the Family Check-Up (FCU) discriminated trajectory groups. In addition, in accord with differential susceptibility theory, we tested whether the effects of the FCU were stronger for those children with higher genetic susceptibility. Results augmented previous findings documenting the influence of child (inhibitory control [IC], gender) and family (harsh parenting, parental depression, and educational attainment) risk. In addition, children in the FCU were overrepresented in the persistent low versus persistent high CP group, but such direct effects were qualified by an interaction between the intervention and genetic susceptibility that was consistent with differential susceptibility. Implications are discussed for early identification and specifically, prevention efforts addressing early child and family risk.

The confluence model theorizes that dynamic transactions between peer rejection and deviant peer clustering amplify antisocial behavior (AB) within the school context during adolescence. Little is known about the links between peer rejection and AB as embedded in changing networks. Using longitudinal social network analysis, we investigated the interplay between rejection, deviant peer clustering, and AB in an ethnically diverse sample of students attending public middle schools (N = 997; 52.7% boys). Adolescents completed peer nomination reports of rejection and antisocial behavior in Grades 6–8. Results revealed that rejection status was associated with friendship selection, and adolescents became rejected if they were friends with others who were rejected. Youth befriended others with similar levels of AB. Significant patterns of peer influence were documented for AB and rejection. As hypothesized, rejected youth with low AB were more likely to affiliate with others with high AB instead of similarly low AB. In contrast, nonrejected youth preferred to befriend others with similarly high or low AB. Results support an updated confluence model of a joint interplay between rejection and AB as ecological conditions that lead to self-organization into deviant clusters in which peer contagion on problem behaviors operates.

Although cognitive-behavioral interventions have reduced the risk of substance use, little is known about moderating factors in children with disruptive behaviors. This study examined whether aggressive preadolescents’ inhibitory control and intervention engagement moderates the effect of group versus individual delivery on their substance use. Following screening for aggression in 4th grade, 360 children were randomly assigned to receive the Coping Power intervention in either group or individual formats. The sample was primarily African American (78%) and male (65%). Assessments were made of children’s self-reported substance use from preintervention through a six-year follow-up after intervention, parent-reported inhibitory control at preintervention, and observed behavioral engagement in the group intervention. Multilevel growth modeling found lower increases in substance use slopes for children with low inhibitory control receiving individual intervention, and for children with higher inhibitory control receiving group intervention. Children with low inhibitory control but who displayed more positive behavioral engagement in the group sessions had slower increases in their substance use than did similar children without positive engagement. Aggressive children’s level of inhibitory control can lead to tailoring of group versus individual delivery of intervention. Children’s positive behavioral engagement in group sessions is a protective factor for children with low inhibitory control.

The Family Check-Up 4 Health (FCU4Health) is an adaptation of the Family Check-Up (FCU) for delivery in primary care settings. While maintaining the original FCU's focus on parenting and child behavioral health, we added content targeting health behaviors. This study evaluated whether the adapted FCU maintained positive effects on parenting (positive behavior support, limit setting, parental warmth) and child behavioral health (self-regulation, conduct problems, emotional problems). Pediatric (6-12 years) primary care patients with a BMI ≥ 85

OBJECTIVE. Assessment of fidelity that is effective, efficient, and differentiates from usual practices is critical for effectively implementing evidence-based programs for families. This quasi-experiemntal study sought to determine whether observational ratings of fidelity to the Family Check-Up (FCU) could differentiate between levels of clinician training in the model, and from services as usual, and whether rating segments of sessions could be equivalent to rating complete sessions. METHOD. Coders rated 75 videotaped sessions—complete and 20-minute segments—for fidelity, using a valid and reliable rating system across three groups: (1) highly trained in FCU with universal, routine monitoring; (2) minimally trained in FCU with optional, variable monitoring; and (3) services as usual with no training in the FCU. We hypothesized that certain dimensions of fidelity would differ by training, while others would not. RESULTS. The results indicated that, as expected, one dimension of fidelity to the FCU, Conceptually accurate to the FCU, was reliably different between the groups (χ(2) = 44.63, p

Background Parenting interventions like the Family Check-Up have demonstrated effects on child physical and behavioral health outcomes. However, access to these programs is limited, particularly for populations experiencing health disparities. Primary care settings have become recognized as a potential delivery system in which these programs may be implemented at scale. The purpose of this trial is to test the effectiveness of the Family Check-Up 4 Health (FCU4Health) program, an adaptation of the FCU for primary care, and assess program implementation in an integrated primary care setting. Methods We will conduct a hybrid type 2 effectiveness-implementation trial in partnership with a primary care clinic in a low-income, majority Latino community. Families with 2- to 5-year-old children will be eligible to participate. Families will be randomized to receive the intervention (n = 130) or services as usual (n = 70) and will be assessed annually over three years. Outcomes are informed by the RE-AIM framework (i.e., reach, effectiveness, adoption, implementation, and maintenance). Effectiveness outcomes include child health behaviors (e.g., Dietary Screener Questionnaire), behavioral health (e.g., Strengths and Difficulties Questionnaire), and parenting (e.g., Proactive Parenting). Early stage implementation outcomes are also included (e.g., cost, acceptability, appropriateness, and feasibility). Effectiveness outcomes will be assessed via intent-to-treat (ITT) analyses. Implementation outcomes will be primarily descriptive with comparisons to prior trials of FCU4Health and the original FCU. Projected outcomes This trial will provide evidence related to the potential of integrated primary care settings to deliver evidence-based preventive interventions with a dual focus on behavioral and physical health.

Child birth order (CBO) in the family has received little attention in the field of prevention science. CBO is relevant to early interventionists from a public health perspective, as the most widely disseminated home-visiting program has traditionally targeted mothers and their first-born children. The current paper revisits a previous publication by Shaw et al. (2009) on the effectiveness of the Family Check-Up (FCU) to evaluate CBO (firstborn vs. middle vs. youngest) as a moderator of treatment effects of the FCU in relation to improvements in parenting, maternal depressive symptoms, and child outcomes from ages 2 to 4 in a sample of low-income, ethnically diverse families (N = 709) with multiple children. Results suggest that the FCU elicited improvements in observed parenting from ages 2 to 3 primarily for target children who were the youngest or middle children, but not for firstborns. Findings are discussed in the context of implications for prevention science research, dissemination, and public policy.

Discrimination has been shown to be related to diminished psychological adjustment and greater risk for substance use when personally experienced by adolescents and when their caregivers experience discrimination. Our research considers the impact of primary caregiver experiences of racial- and socioeconomic-based discrimination in early (age 3-5 years) and late childhood (age 9½) on adolescent disruptive behaviors (age 14) with a large sample of diverse caregiver-child dyads (N = 634). In addition, we examine the potential protective effects of parent-child relationship quality in early and late childhood in buffering the effects of caregiver discrimination on adolescent disruptive behaviors. We also explore possible gender differences in children's vulnerability to engage in disruptive behaviors in the context of caregiver experiences of discrimination. The findings from this study indicate that at trend level, early childhood experiences of primary caregiver discrimination (ages 3-5) predicted adolescent disruptive behaviors, accounting for the effects of more recent (age 9½) caregiver discrimination. In addition, parent-child relationship quality at age 9½ years was found to buffer the effects of late childhood (age 9½) primary caregiver discrimination on adolescent disruptive behaviors for both male and female youth. The findings highlight the need for prevention and intervention techniques that foster healthy and positive primary caregiver-child relationships.

Development involves synergistic interplay among genotypes and the physical and cultural environments, and integrating genetics into experimental designs that manipulate the environment can improve understanding of developmental psychopathology and intervention efficacy. Consistent with differential susceptibility theory, individuals can vary in their sensitivity to environmental conditions including intervention for reasons including their genotype. As a consequence, understanding genetic influences on intervention response is critical. Empirically, we tested an interaction between a genetic index representing sensitivity to the environment and the Family Check-Up intervention. Participants were drawn from the Early Steps Multisite randomized prevention trial that included a low-income and racially/ethnically diverse sample of children and their families followed longitudinally (n = 515). As hypothesized, polygenic sensitivity to the environment moderated the effects of the intervention on 10-year-old children's symptoms of internalizing psychopathology, such that children who were genetically sensitive and were randomly assigned to the intervention had fewer symptoms of child psychopathology than genetically sensitive children assigned to the control condition. A significant difference in internalizing symptoms assessed with a clinical interview emerged between the intervention and control groups for those 0.493 SD above the mean on polygenic sensitivity, or 25% of the sample. Similar to personalized medicine, it is time to understand individual and sociocultural differences in treatment response and individualize psychosocial interventions to reduce the burden of child psychopathology and maximize well-being for children growing up in a wide range of physical environments and cultures.

The college transition is uniquely challenging for many first-year students. Few studies have investigated developmental change in students' adjustment across this brief, but significant transition, nor the daily interpersonal dynamics that are associated with adjustment across this same time. Guided by ecological and stage-environment fit frameworks, this study examined trajectories of first-year students' positive and negative affect across the transition to college. Further, we examined daily interactions with parents and friends as predictors of these trajectories. Participants were 146 first-year college students from a large southwestern university entering their first semester of college (Mage = 17.82, SD = 0.50). Electronic ecological momentary assessments (EMAs) were administered to students twice weekly (maximum 49 observations) from July to December to assess daily experiences during the transition to college and across the first semester. Multilevel growth analyses showed that students reported a meaningful decrease in positive affect across the first semester, but stable levels of negative affect. Involvement and conflict with parents and friends predicted variability in these average changes, as well as daily affective states. As expected, greater involvement with parents and friends was associated with greater positive and less negative affect, and reports of conflict with parents and friends predicted negative affect experiences. Together, these findings suggest the importance of support from parents and friends during the initial adaptation to college, as well as the potential undermining role of conflict with significant others. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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.

Coping Power is an evidence-based preventive intervention for youth with aggressive behavior problems that has traditionally been delivered in small group formats, but because of concerns about potentially diminished effects secondary to aggregation of high risk youth, an individual format of Coping Power has been developed. The current study examined whether physiological characteristics of the child may provide information about which intervention delivery format works best for that individual. Indicators of sympathetic and parasympathetic nervous system functioning were examined in 360 fourth-grade children (65% male; 76.4% self-reported African-American) who were randomly assigned to Group Coping Power (GCP) or Individual Coping Power (ICP) (Lochman et al., 2015). Longitudinal assessments of teacher- and parent-reported proactive and reactive aggression were collected through a one-year follow-up. For children with higher initial levels of aggression, those with lower parasympathetic functioning at pre-intervention showed greater reductions in teacher-rated proactive aggression in the ICP condition than the GCP condition. For children with high parasympathetic functioning, there was no differential effect of intervention format. Regardless of intervention format, youth with lower levels of sympathetic functioning at pre-intervention demonstrated greater reductions in teacher-rated proactive aggression. These findings suggest that physiological indicators may be worth considering in future studies examining which youth respond best to specific types of interventions.

This study examined longitudinal changes in peer network selection and influence associated with self-reported antisocial behavior (AB) and violent behavior (VB) over the course of middle school in a sample of ethnically diverse adolescents. Youth and families were randomly assigned to a school-based intervention focused on the prevention of substance use. Using a longitudinal social network modeling approach, we found that students with similar levels of AB were more likely to affiliate during the transition from sixth to seventh grade (peer selection). Higher levels of AB in the seventh grade led to growth in network size by eighth grade. No peer selection effects documented for VB, but youth became more similar to total levels of VB reported by their peers between seventh and eighth grades (peer influence). As expected, AB was positively associated with VB levels. Random assignment to intervention condition affected peer selection at Grade 7 but did not reduce levels of self-reported AB or VB. These findings suggest that managing peer networks using a variety of strategies is likely to reduce peer contagion for AB and VB in a public middle school setting. We discuss emerging intervention strategies for the management and the prevention of emotional and behavioral disorders.

This study applied latent class analysis to a family-centered prevention trial in early childhood to identify subgroups of families with differential responsiveness to the Family Check-Up (FCU) intervention. The sample included 731 families with 2-year-olds randomized to the FCU or control condition and followed through age 5 with yearly follow-up assessments. A two-step mixture model was used to examine whether specific constellations of family characteristics at age 2 (baseline) were related to intervention response across ages 3, 4, and 5. The first step empirically identified latent classes of families based on several family risk and adjustment variables selected on the basis of previous research. The second step modeled the effect of the FCU on longitudinal change in children's problem behavior in each of the empirically derived latent classes. Results suggested a five-class solution, where a significant intervention effect of moderate to large size was observed in one of the five classes-the class characterized by child neglect, legal problems, and parental mental health issues. Pairwise comparisons revealed that the intervention effect was significantly greater in this class of families than in two other classes that were generally less at risk for the development of child disruptive behavior problems, albeit still low-income. Thus, findings suggest that (a) the FCU is most successful in reducing child problem behavior in more highly distressed, low-income families, and (b) the FCU may have little impact for relatively low-risk, low-income families. Future directions include the development of a brief screening process that can triage low-income families into groups that should be targeted for intervention, redirected to other services, monitored prospectively, or left alone.

Coping Power is an evidence-based preventive intervention program for youth with aggressive behavior problems that has traditionally been delivered in small group formats. Because of concerns about iatrogenic effects secondary to aggregation of high risk youth, the current study examined whether genetic risk may moderate intervention outcome when youth were randomly assigned to group versus individual formats of an intervention. The oxytocin receptor gene (OXTR) has been associated with social behavior and may influence susceptibility to social reinforcement in general and deviant peer influence in particular. One variant of OXTR (rs2268493) was examined in 197 fourth-grade African-American children (64% male) who were randomly assigned to Group Coping Power (GCP) or Individual Coping Power (ICP) (Lochman et al., 2015). Longitudinal assessments of teacher- and parent-reported behavior were collected through a one-year follow-up. Growth curve analyses revealed a genotype by delivery format interaction. Youth with the A/A genotype demonstrated reductions in externalizing problems over the course of the intervention regardless of intervention format. In contrast, carriers of the G allele receiving the group-based intervention showed little improvement during the intervention and a worsening of symptoms during the follow-up year, while those receiving the individual format demonstrated reductions in externalizing problems. Given the associations between this OXTR variant and social bonding, carriers of the G allele may be more sensitive to social rewards from deviant peers in the group setting. This study suggests that genetic factors may be useful in predicting which type of intervention will be most effective for a particular individual.

Marital quality and social support satisfaction were tested as moderators of the association between maternal depressive symptoms and parenting during early childhood (18-36 months) among 2 large, divergent, longitudinal samples (n = 526; n = 570). Unexpectedly, in both samples the association between maternal depressive symptoms and reduced parenting quality was strongest in the context of high marital quality and high social support, and largely nonsignificant in the context of low marital quality and low social support. Possible explanations for these surprising findings are discussed. Results point to the importance of accounting for factors in the broader family context in predicting the association between depressive symptoms and maternal parenting. (PsycINFO Database Record

Maternal depression is among the most consistent and well-replicated risk factors for negative child outcomes, particularly in early childhood. Although children of depressed mothers are at an increased risk of adjustment problems, conversely, children with emotional or behavioral problems also have been found to adversely compromise maternal functioning, including increasing maternal depression. The purpose of this investigation was to examine transactional associations among maternal depression, parent-child coercive interaction, and children's conduct and emotional problems in early childhood using a cross-lagged panel model. Participants were 731 toddlers and families that were part of the Early Steps Multisite Study, a sample of diverse ethnic backgrounds and communities (i.e., rural, urban, suburban) recruited from Women, Infants, and Children Nutritional Supplement Centers. Analyses provided support for the existence of some modest transactional relations between parent-child coercion and maternal depression and between maternal depression and child conduct problems. Cross-lagged effects were somewhat stronger between children age 2-3 than age 3-4. Similar patterns were observed in the model with child emotional problems replacing conduct problems, but relations between coercion and maternal depression were attenuated in this model. In addition, the transactional hypothesis was more strongly supported when maternal versus secondary caregiver reports were used for child problem behavior. The findings have implications for the need to support caregivers and reinforce positive parenting practices within family-centered interventions in early childhood.

Objective To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood. Study design A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7.5, 8.5, and 9.5 years. Results Results showed that higher scores on the Fluharty-2 predicted a reduced likelihood of having an individualized education program (OR 0.48), being referred for special education (OR 0.55), and being held back a grade (OR 0.37). These findings did not vary by sex, race, or ethnicity, and remained significant after controlling for male sex, behavior problems, parental education, and family income. The Fluharty-2 remained predictive of special education outcomes even after controlling for children's academic skills at age 5 years. Conclusions Results suggest that structured, brief assessments of language in early childhood are robust predictors of children's future engagement in special education services and low academic achievement. Primary care physicians may use a multipronged developmental surveillance and monitoring protocol designed to identify children who may need comprehensive evaluation and intervention. Early intervention may reduce the need for costly special education services in the future and reduce comorbid conditions.

High-quality evidence about the costs of effective interventions for children can provide a foundation for fiscally responsible policy capable of achieving impact. This study estimated the costs to society of the Family Check-up, an evidence-based brief home-visiting intervention for high-risk families implemented in the Early Steps multisite efficacy trial. Intervention arm families in three sites were offered 4 consecutive years of intervention, when target children were ages 2 through 5. Data for estimating total, average, and marginal costs and family burden (means and standard deviations, 2015 USD, discounted at 3% per year) came from a detailed database that prospectively documented resource use at the family level and a supplemental interview with trial leaders. Secondary analyses evaluated differences in costs among higher and lower risk families using repeated measures analysis of variance. Results indicated annual average costs of $1066 per family (SD = $400), with time spent by families valued at an additional $84 (SD = $99) on average. Costs declined significantly from ages 2 through 5. Once training and oversight patterns were established, additional families could be served at half the cost, $501 (SD = $404). On the margin, higher risk families cost more, $583 (SD = $444) compared to $463 (SD = $380) for lower risk families, but prior analyses showed they also benefited more. Sensitivity analyses indicated potential for wage-related cost savings in real-world implementation compared to the university-based trial. This study illustrates the dynamics of Family Check-up resource use over time and across families differing in risk.

This study investigates suicide risk in late childhood and early adolescence in relation to a family-centered intervention, the Family Check-Up, for problem behavior delivered in early childhood. At age 2, 731 low-income families receiving nutritional services from Women, Infants, and Children programs were randomized to the Family Check-Up intervention or to a control group. Trend-level main effects were observed on endorsement of suicide risk by parents or teachers from ages 7.5 to 14, with higher rates of suicide risk endorsement in youth in the control versus intervention condition. A significant indirect effect of intervention was also observed, with treatment-related improvements in inhibitory control across childhood predicting reductions in suicide-related risk both at age 10.5, assessed via diagnostic interviews with parents and youth, and at age 14, assessed via parent and teacher reports. Results add to the emerging body of work demonstrating long-term reductions in suicide risk related to family-focused preventive interventions, and highlight improvements in youth self-regulatory skills as an important mechanism of such reductions in risk.

This chapter reviews a 25-year program of research on the benefits and optimal strategies for embedding evidence-based parenting supports into the public-school system. Specifically, translational research is described that led to the development of a systemic approach referred to as Positive Family Support (PFS). Implementation findings from a randomized hybrid effectiveness trial across 41 public middle schools facilitated the identification of three key needs related to enhancing implementation fidelity: (a) trained professional staff working within schools to provide parenting supports, (b) centralized training to minimize disruptions in family support secondary to staff turnover, and (c) district support to principals for monitoring and engaging parents of high-risk students in an effort to prevent school failure and expulsion.

Alcohol problems are influenced by both genetic and environmental factors. Evidence from twin models and measured gene-environment interaction studies has demonstrated that the importance of genetic influences changes as a function of the environment. Research has also shown that family-centered interventions may protect genetically susceptible youth from developing substance use problems. In this study, we brought large-scale gene identification findings into an intervention study to examine gene-by-intervention effects. Using genome-wide polygenic scores derived from an independent genome-wide association study of adult alcohol dependence, we examined whether an adolescent family-centered intervention would moderate the effect of genetic risk for alcohol dependence on lifetime alcohol dependence in young adulthood, approximately 15 years after the start of intervention, among European American (N = 271; 48.3% in the intervention condition) and African American individuals (N = 192; 51.6% in the intervention condition). We found that among European American individuals, the intervention moderated the association between alcohol dependence polygenic scores and lifetime alcohol dependence diagnosis in young adulthood. Among participants in the control condition, higher alcohol dependence polygenic scores were associated with a greater likelihood of receiving an alcohol dependence diagnosis; in contrast, among participants in the intervention condition, there was no association between alcohol dependence polygenic scores and alcohol dependence diagnosis. No moderation effect was found among African Americans. These results demonstrate that modifying environments of genetically vulnerable youth could reduce the likelihood of developing alcohol dependence and underscore the significance of environmentally focused prevention and intervention efforts.

Aims To translate evidence-based programs (EBP) for a new setting, attention must be given to the characteristics of the intervention and the local setting, as well as evidence that is compelling to decision-makers. This paper describes the history of a partnership and stakeholder recommendations to inform the adaptation of an EBP for primary care. Methods We established a community advisory board (CAB) consisting of stakeholders with expertize in primary care delivery. A thematic analysis was conducted with fieldnotes and transcriptions from CAB meetings and regular meetings with participating clinics. Results We found that (a) parenting programs with a focus on behavioral and physical health are appropriate for this setting, (b) variability in the structure of primary care means implementation must be tailorable, and (c) financial and organizational outcomes are compelling for decision-makers. Conclusion Factors related to the content and structure of evidence-based programs are uniquely related to distinct implementation outcomes of interest to key stakeholders.

Item does not contain fulltext Background: There is limited empirical integration between peer clustering theory and the Gateway framework. The goal of the present study was to test the hypothesis that friendship associations partly predict gateway escalations in the use of drugs from adolescence to adulthood. Method: This longitudinal study analyzed 3 waves of data from a community sample of 711 male and female participants without a history of illicit drug use reporting drug use at age 17, 22, and 27. Substance use assessments including tobacco, alcohol, cannabis, onset and abuse/dependence tendency of illicit drugs other than cannabis (i.e., cocaine, methamphetamine, and opiates), and friends' reported use of illicit drugs. Structural equation modeling was used to test the hypothesized model. Results: Participants' cannabis use level at age 17 was positively associated with perceived friends' drug use at age 22, which in turn predicted participants' onset of illicit drug use between ages 22 and 27. Moreover, progression of tobacco use throughout age 17 to 22 was associated with an increased onset of illicit drug use between ages 22 and 27. Apart for an effect of cannabis use at age 22 on abuse and dependence tendency to various drugs at age 28, results were similar. Conclusions: During this period of development, the availability and selection of drug-using friends contributes to the progression to potentially more rewarding and damaging illicit drugs. These findings suggest the need to attend to the peer ecology in prevention and support the common practice of using abstaining peers in treatment for drug dependence. 7 p.

This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children’s adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training–Oregon model), and family attenuation and dissolution (Treatment Foster Care–Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements.

A vast majority of psychological science focuses on snapshots of individuals. Clinical outcome studies may integrate multiple snapshots, typically with yearly intervals. However, there is much to learn about psychological processes as they unfold over real time, including minutes, days, weeks, and months. This special issue contains several articles that make significant advances in real-time assessment of psychological processes using state-of-the-art measurement. This is a brief summary of the specific innovations of this special issue. The summary includes suggestions for applying these measurement innovations to the study of functional dynamics that lead to clinically and socially significant events. Several examples provide ways in which a dynamical analysis of function may be revealing. Most important, the assessment of dynamic mechanisms underlying the amplification of psychopathology seems especially useful for tailoring clinical interventions to meet clients’ specific needs.

This study tested a transactional hypothesis predicting early adult sexual coercion from family maltreatment, early adolescent gang affiliation, and socialization of adolescent friendships that support coercive relationship norms. The longitudinal study of a community sample of 998 11-year-olds was intensively assessed in early and middle adolescence and followed to 23–24 years of age. At age 16–17 youth were videotaped with a friend, and their interactions were coded for coercive relationship talk. Structural equation modeling revealed that maltreatment predicted gang affiliation during early adolescence. Both maltreatment and gang affiliation strongly predicted adolescent sexual promiscuity and coercive relationship norms with friends at age 16–17 years. Adolescent sexual promiscuity, however, did not predict sexual coercion in early adulthood. In contrast, higher levels of observed coercive relationship talk with a friend predicted sexual coercion in early adulthood for both males and females. These findings suggest that peers have a socialization function in the development of norms prognostic of sexual coercion, and the need to consider peers in the promotion of healthy relationships.

The current study sought to advance our understanding of transactional processes among maternal depression, neighborhood deprivation, and child conduct problems (CP) using two samples of low-income families assessed repeatedly from early childhood to early adolescence. After accounting for initial levels of negative parenting, independent and reciprocal effects between maternal depressive symptoms and child CP were evident across both samples, beginning in early childhood and continuing through middle childhood and adolescence. In addition, neighborhood effects were consistently found in both samples after children reached age 5, with earlier neighborhood effects on child CP and maternal depression found in the one exclusively urban sample of families with male children. The results confirm prior research on the independent contribution of maternal depression and child CP to the maintenance of both problem behaviors. The findings also have implications for designing preventative and clinical interventions to address child CP for families living in high-risk neighborhoods.

A key challenge of community-based prevention programs is engaging families in the context of services settings involving children and families. The Family Check-Up (FCU) program is designed to engage families in parenting support appropriate to their level of need by use of assessment-enhanced motivational interviewing. This study involved families screened for risk who were seeking services at women, infant, and children's offices in three geographical regions (N = 731). Families in the randomized intervention group (N = 367) were offered the FCU yearly, from age 2 through 10. The results of multivariate modeling indicated that caregivers reporting high levels of perceived caregiving stress (i.e., depression, low parenting satisfaction, daily hassles) participated at a higher rate in two critical components (feedback and follow-up support interventions) of the FCU program over the 8-year trial period than caregivers reporting lesser degrees of stress. The implications of these findings are discussed in the context of family-centered programs for the prevention of child behavior problems and directions for future research.

This study evaluates the internal validity of the “Perception of Peer Group Norms Questionnaire” (PPGNQ), a 17-item measure that assesses middle school students’ perceptions of positive and negative norms among their grade mates. The sample consisted of 1073 Grade 6 students. The factorability of the two hypothesized factors was assessed with exploratory factor analysis and a clear two-factor structure emerged. Using confirmatory factor analysis, this two-factor model evidenced good fit once items of similar wording and subject matter were permitted to correlate. Support was found for metric, strict, scalar, construct and latent means invariance between genders, suggesting that boys and girls perceived items similarly. The results indicate that the PPGNQ may be recommended as a research questionnaire that demonstrates high internal validity and measurement invariance, and can be used to study the influence of the perception of both negative and positive norms on adolescent behavior in school settings.

This study examines the impact of the Family Check-Up, a school-based prevention program, as delivered in public secondary schools on suicide risk across adolescence. Students were randomly assigned to a family-centered intervention (N = 998) in sixth grade, and offered a multilevel intervention that included (a) a universal classroom-based intervention, (b) the Family Check-Up (selected; Dishion, Stormshak, & Kavanagh, 2011), and (c) family management treatment (indicated). Engagement with the FCU predicted significant reductions in suicide risk across adolescence and early adulthood.

Although substance use has traditionally been linked to peer deviance, a parallel literature has explored the influence of peer social status (being "well-liked"). This literature hypothesizes that adolescents with higher status will anticipate shifts in social norms and modify their behavior earlier and/or more substantially than lower-status students. As substance use becomes more socially acceptable during early-to-mid-adolescence, higher status youth are hypothesized to reflect this shift in norms by accelerating their use more rapidly than lower status youth. Although some evidence exists to support this hypothesis, it has never been evaluated in conjunction with the opposing hypothesis (i.e., that substance use contributes to elevated peer status). In this study, we evaluated reciprocal links between peer status and substance use (i.e., alcohol and tobacco) using 3years of data from 8 middle schools in the Pacific Northwest. Social network analysis enabled us to model standard network effects along with unique effects for the influence of the network on behavior (i.e., increased substance use as a result of being well-liked) and the influence of behavior on the network (i.e., increased status as a result of substance use). Our results indicated significant bidirectional effects for alcohol use but no significant effects for tobacco use. In other words, being well-liked significantly predicted alcohol use and vice versa, but these processes were not significant for tobacco use. Prevention efforts should consider the dynamics of peer status and peer norms in adolescence with the goal of preventing escalations in problem behavior that can compromise future adjustment.

We used provider (n = 112) data that staff at the agency disseminating the Family Check-Up (FCU; REACH Institute) collected to profile provider diversity in community settings and to examine whether provider profiles are related to implementation fidelity. Prior to FCU training, REACH Institute staff administered the FCU Provider Readiness Assessment (PRA), a provider self-report measure that assesses provider characteristics previously linked with provider uptake of evidence-based interventions. We conducted a latent class analysis using PRA subscale scores as latent class indicators. Results supported four profiles: experienced high readiness (ExHR), experienced low readiness (ExLR), moderate experience (ME), and novice. The ExHR class was higher than all other classes on: (1) personality variables (i.e., agreeableness, conscientiousness, openness, extraversion); (2) evidence-based practice attitudes; (3) work-related enthusiasm and engagement; and (4) their own well-being. The ExHR class was also higher than ExLR and ME classes on clinical flexibility. The ME class was lowest of all classes on conscientiousness, supervision, clinical flexibility, work-related enthusiasm and engagement, and well-being. During the FCU certification process, FCU Consultants rated providers’ fidelity to the model. Twenty-three of the 112 providers that completed the PRA also participated in certification. We conducted follow-up regression analyses using fidelity data for these 23 providers to explore associations between probability of class membership and fidelity. The likelihood of being in the ExHR class was related to higher FCU fidelity, whereas the likelihood of being in the ExLR class was related to lower fidelity. We discuss how provider readiness assessment data can be used to guide the adaptation of provider selection, training, and consultation in community settings.

The current project explores maternal inter-parental (IP) romantic partner satisfaction in relation to mother-child conflict and later peer and teacher relations from early to middle childhood among a sample of low-income, ethnically diverse mothers (N = 271) who were part of a longitudinal study testing the effectiveness of the Family Check-Up intervention. We hypothesized spillover effects from IP dissatisfaction during early childhood to mother-child conflict two years later. Greater mother-child conflict in turn was expected to lead to poorer peer relations and greater conflict with teachers in middle childhood. Results support a spillover effect from lower IP satisfaction at age 3 to higher mother-child conflict at age 5 to poorer peer relations and greater conflict with teachers at school at ages 8.5, 9.5, and 10.5. Mother-child conflict significantly mediates these pathways. Results support the importance of IP satisfaction and mother-child conflict in early childhood as critical factors in pathways leading to low-income children's social relationships at school during middle childhood.

Contains fulltext : 199033.pdf (Author’s version preprint ) (Closed access) Using coercive strategies to resolve conflicts with romantic partners has toxic effects on relationships. Coercion predicts relationship dissatisfaction, instability, and intimate partner violence. The early adult romantic relationships model hypothesizes that such strategies first emerge within the family and continue to affect romantic relationships into adulthood. We tested whether adolescent antisocial behaviors and deviancy training with peers mediated between early disruptive parenting and adult romantic relationship coercion. Furthermore, we tested the impact of trauma in this longitudinal model. We studied 230 adults in committed relationships, whom we initially recruited and studied when they were age 11. We collected videotaped observations with friends (when participants were ages 16-17) and with intimate partners (when participants were ages 28-30). As hypothesized, disruptive parenting predicted antisocial behaviors and deviancy training with friends in adolescence, which in turn predicted coercion within intimate adult relationships. Moreover, disruptive parenting in early adolescence also directly predicted romantic partner coercion 15 years.later. No significant effects were found for trauma. Findings suggest the promise of promoting healthy adult intimate relationships through early relationships with parents and friends 9 p.