Family Check-Up® For Children

MODEL
EFFECTIVENESS

Evidence-based model

MIECHV eligible

136
Manuscripts

Released in 1979 through 2025

14
Manuscripts

Impact studies rated high or moderate quality

Services intended at ages
24-35 months
36-47 months
48+ months
Favorable results from well-designed research
Child development and school readiness
Maternal health
Positive parenting practices

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Family Check-Up is a strengths-based, family-centered intervention designed to help parents support their children’s behavioral and mental health and prevent behavior problems. It can be integrated into a variety of services, including home visiting. Families with children ages 2 through 17 are eligible for Family Check-Up. The model serves families with children who are at risk for behavioral and academic difficulties and face family challenges such as socioeconomic disadvantages and maternal depression. The model seeks to reduce children’s behavioral problems, academic difficulties, and emotional issues; decrease maternal depression; increase parental involvement; and encourage positive parenting practices.

Family Check-Up has two phases. In Phase 1, families participate in three sessions with a Family Check-Up home visitor who has been trained in the model. In Phase 2, the home visitor recommends additional services tailored to the family’s needs, as appropriate. Services may include the Everyday Parenting family management training curriculum and referrals to community resources.

Although the model includes services for all age groups regardless of setting, the HomVEE review was limited to studies about implementation that offered the Everyday Parenting curriculum, used home visiting as the primary service delivery method, and focused on families with children ages 2 through 5. Thus, for the purpose of the HomVEE review, HomVEE uses the name Family Check-Up for Children.

Where to find out more

Effectiveness

This model meets criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.

Does not meet criteria for an evidence-based home visiting model for Native communities.

Extent of Evidence

For more information about manuscripts, search the research database.

For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.

136
Manuscripts

Released in 1979 through 2025

29
Manuscripts

Eligible for review

14
Manuscripts

Impact studies rated high or moderate quality

When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

Summary of Findings

To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.

Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.

No effect:
Findings are not statistically significant.

Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.

Ambiguous findings are excluded from this table. An ambiguous finding is a statistically significant impact on an outcome measure in a direction that is not clearly beneficial for or potentially harmful to children and/or parents.

Outcomes Manuscripts Favorable Findings No Effects Findings Unfavorable Findings
Child Development and School Readiness View 8 Manuscripts 10 27 0
Child Health Not measured - - -
Family Economic Self-Sufficiency Not measured - - -
Linkages and Referrals Not measured - - -
Maternal Health View 2 Manuscripts 7 2 0
Positive Parenting Practices View 10 Manuscripts 18 8 1
Reductions In Child Maltreatment Not measured - - -
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured - - -

Research Characteristics

Well-designed impact studies about this model included participants with the following characteristics. The evidence for effectiveness for the model may include additional studies that did not report this participant information.

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American
28%
Hispanic or Latino
12%
White
49%
Two or more races
12%
Unknown
8%

Maternal Education

Less than a high school diploma
24%
High school diploma or GED
41%
Unknown
35%

Other Characteristics

This data is only reported if known for at least 50 percent of participants in well-designed impact studies of the model.

Enrollment in means-tested programs
100%

Well-designed impact studies about this model were conducted in the following locations:

  • Oregon
  • Pennsylvania
  • Virginia

Implementation

In this section:

Overview

Theoretical approach, intended population, and targeted outcomes.

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Support Availability

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Service Delivery

Model services, adaptions and enhancements, model intensity and length.

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Requirements

Staffing and organizational requirements.

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Overview

Theoretical approach

Family Check-Up is a strengths-based, family-centered intervention designed to help parents support their children’s behavioral and mental health and prevent behavior problems. The model is tailored to address the specific needs of each family. It can be integrated into a variety of services, including home visiting. The model can also be delivered by telehealth using virtual sessions for parents or through a web-based application that enables families to engage asynchronously.

Intended population

Family Check-Up is intended for use with any family. It is often used with families that face challenges such as socioeconomic disadvantages and maternal depression and whose children are at risk for behavioral and academic difficulties.

Families with children ages 2 through 17 are eligible for Family Check-Up. HomVEE’s review included only studies about implementation that offered the Everyday Parenting curriculum, used home visiting as the primary service delivery method, and focused on families with children ages 2 through 5. Thus, for the purpose of the HomVEE review, HomVEE uses the name Family Check-Up for Children.

Family Check-Up for Children does not appear as a version of Family Check-Up on the developer’s website because the requirements for implementing Family Check-Up for Children do not differ from those for Family Check-Up. The information in this profile applies to Family Check-Up broadly, unless specified otherwise.

Intended outcomes

Family Check-Up is designed to reduce children’s behavioral, emotional, and academic challenges; decrease maternal depression; increase parental involvement with and attention to their children; and encourage positive parenting, including parental warmth and praise.

Highlights

Populations intended
Families with a history of child abuse or neglect, or interactions with child welfare services
Families with a history of substance use disorders or in need of substance use disorder treatment
Families with children who have low student achievement
Services intended at ages
24-35 months
36-47 months
48+ months

Support Availability

Implementation support availability

The University of Oregon and Northwest Prevention Science Inc. (NPS) offer training and resources to Family Check-Up home visitors. All home visitors who plan to implement the model complete self-paced virtual courses followed by applied skills training, which can be delivered on site or virtually. The final phase of core training includes monthly virtual consultations that enable home visitors to ask questions and prepare to implement the model with families.

The University of Oregon offers additional implementation support as needed. This support helps home visitors and site administrators address uptake barriers, establish or tailor implementation benchmarks, or identify an optimal implementation plan.

Highlights

Locations where model has been implemented
Within the U.S.
Internationally, outside the U.S.

Service Delivery

Model services

Family Check-Up has two phases. Phase 1 consists of three sessions: an interview, an assessment, and a feedback session. A Family Check-Up home visitor meets with families to conduct these sessions. During the feedback session, the home visitor and the family work together to decide which follow-up services, if any, would be beneficial. In Phase 2, If families need additional services, the same home visitor refers them to community resources or furnishes the additional services directly if they fall within the home visitor’s role. The home visitor may deliver the Everyday Parenting family management training curriculum. This curriculum provides a basis for more intensive parenting support and is designed to enhance parents’ ability to reinforce positive behavior, set healthy limits, and build relationships. The home visitor tailors Phase 2 services to the family’s needs identified in Phase 1, which might include supporting the child’s school success or addressing the parent’s behavioral or mental health needs.

When used as a health maintenance model, Family Check-Up involves yearly behavioral and mental health check-ups that may be repeated for as many years as desired by the implementing program and the family. Families complete Phase 1 during yearly behavioral and mental health check-ups and participate in Phase 2 as needed following each check-up. These annual contacts enable home visitors to monitor family and child behavior over time and continue to motivate families to change ongoing areas of difficulty.

The Family Check-Up curriculum specifies objectives and activities for the initial interview, assessment, and feedback sessions and the skills needed to accomplish these objectives. It also provides tips and strategies to deliver the model.

The Everyday Parenting curriculum manual presents session outlines and materials organized into three skill areas: (1) supporting positive behavior, (2) setting healthy limits for children, and (3) building family relationships.

Model intensity and length

Home visiting requirements: Phase 1 of Family Check-Up includes three one-hour sessions (interview, assessment, and feedback), all scheduled within a time frame of no more than one month. In Phase 2, parents may choose whether to engage in follow-up services based on the goals established during the feedback session. Follow-up services can include Everyday Parenting sessions and connections to other community resources and supports. Home visitors tailor the duration, number, and content of Everyday Parenting sessions to the parents’ goals and readiness to change.

In some settings, families complete Phase 1 and Phase 2 once. When used as a health maintenance model, the Family Check-Up may be repeated through annual behavioral and mental health check-ups (Phase 1, and Phase 2 if needed) for as many years as desired by the implementing program or the family.

Service duration: On average, families participate in three to four Everyday Parenting sessions and participate in the full model for three to four months.

Tailored services and enhanced models

Phase 1 of Family Check-Up has been delivered in two, rather than three, sessions, with an extended interview and assessment during the first session and feedback during the second session. Home visitors may make this adjustment when families have limited time for sessions or live in remote locations and need to make the most of each session. Phase 1 may also include additional sessions, such as two initial interviews when more time is needed to address barriers to parent engagement. Phase 2 may include more than the average three to four Everyday Parenting sessions when families have multiple challenges, including child welfare issues. In these circumstances, the overall duration of services may be about six months.

During implementation planning, a Family Check-Up consultant from NPS discusses allowable enhancements with home visitors, to meet the needs and service delivery of local implementing programs. In the skills training, the NPS consultant trainer conducts in-depth discussions with trainees about the factors to consider when planning these enhancements. During follow-up consultations, the NPS consultant trainer helps to identify any emerging needs for enhancements based on specific issues arising with each family. These enhancements are designed to meet the needs of local implementing programs without compromising model fidelity.

Implementation with Native communities

The Family Check-Up has been implemented with Native communities in Arizona, Hawaii, and New York. Implementation has been tailored when appropriate, including by developing alternatives to video recording of the family interaction tasks during the assessment process, and by incorporating community elders into work with families.

Highlights

Program is available in other language(s)
Spanish
Maximum program duration
Program duration varies
Visit frequency
Visit frequency varies
Delivery method supported
Supports hybrid in-person and virtual service delivery
Implementation with Native communities
Has been implemented with Native communities

Requirements

Staffing requirements

Education and supervisory requirements:

Staff. Agencies implementing the model must have at least two types of staff: home visitors and supervisors. At least one supervisor must be certified by NPS as a supervisor-trainer. Supervisor-trainers complete their certification through virtual meetings; during these meetings they receive guidance and review fidelity assessments based on supervisor-trainer practice videos.

Education and experience. Family Check-Up home visitors must have experience delivering family-based interventions. It is also recommended that home visitors have experience with behavior-based parent training programs and motivational interviewing. Although not required, it is recommended that home visitors have a master’s degree in counseling, social work, education, or a related field, plus relevant experience. Home visitors may also have a bachelor’s degree plus relevant experience.

Supervisor-trainers are expected, but not required, to have a master’s degree (or equivalent) in education, social work, psychology, or a related field, plus training or experience in motivational interviewing.

Supervision. NPS strongly recommends, but does not require, that the Family Check-Up supervisor-trainer provide weekly individual and monthly group supervision. Supervision is intended to promote implementation quality and fidelity, as well as provide an opportunity to address implementation barriers and discuss adaptations to sustain the model.

To implement with fidelity, supervisors are expected to conduct a monthly fidelity assessment of one recorded or observed family session for each home visitor. Supervisors use an observational tool and rating system to assess fidelity to Family Check-Up.

Training and professional development:

Pre-Service Training. The University of Oregon requires home visitors to complete 10 to 11 hours of training on Phase 1 (four to five hours for the virtual course and six hours for the skills training) and 10 to 11 hours of training on Phase 2 (four to five hours for the virtual course and six hours for the skills training) before they begin delivering services.

Ongoing professional development. After completing initial training, monthly one-hour group consultations are required during the first six months of implementation.

Along with these monthly consultations, individuals seeking to become a Family Check-Up supervisor-trainer must demonstrate competence in using the Family Check-Up fidelity assessment tool, delivering training, and supervising staff. On average, this certification process requires 55 to 65 hours, including independent work conducted by the trainee and consultation time with the Family Check-Up consultant trainer.

NPS recertifies supervisor-trainers every two years.

Please contact the model developer for more information about the ongoing professional development requirement.

Organizational requirements

Family Check-Up for Children is typically implemented by community mental or behavioral health agencies. During implementation planning, the NPS consultant works with the implementing organization’s leaders to identify the practices, equipment, and materials needed to support implementation. These can include appropriate consent forms, recording devices, and training in motivational interviewing for all home visitors and supervisor-trainers.

For implementation with full fidelity, the model expects home visitors to meet the criteria in the fidelity tool, as assessed by their supervisor. Please contact the model developer for more information about these guidelines.

Highlights

Minimum education requirement
High school diploma or GED
Professional certification required for home visitors
No

HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer. HomVEE reserves the right to edit the profile for clarity and consistency. The description of the implementation of the model here may differ from how the model was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.