Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. (2009). Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Development and Psychopathology, 21, 417–439.
Model(s) Reviewed:
Family Check-Up® For Children
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Established on race/ethnicity and SES; not established on baseline measures of the outcomes. | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
Even though baseline equivalence was not established on baseline measures of the outcomes, this study rated high because it had low attrition, established baseline equivalence on race/ethnicity and SES, and controlled for baseline measures of some outcomes in the analyses. Those outcomes rated high. In addition to the outcomes that rated high, several outcomes in this study rated low: Eyeberg problem behavior at ages 3 and 4, externalizing behavior at ages 3 and 4, parent involvement at age 3, positive parenting at age 3, parent neutral at age 3, and Proactive parenting at age 3. These outcomes rated low because we could not assess attrition or baseline equivalence based on information reported in the study, nor was this information available from the author. Also, some outcomes in the structural equation models reported in this study were not eligible for review because the model did not estimate the direct, total effect of the intervention on the outcome.This study is part of a large RCT described by Dishion et al. (2008).
This study review was updated in 2017. Specifically, HomVEE identified additional outcomes within this study that were eligible for review in the course of the 2017 annual review. Those additional outcomes that received a moderate or high rating are reported for the study. The review of additional outcomes did not affect the overall study rating.
| Study participants | The study included 731 families that met two criteria. First, they participated in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) when their son or daughter was between 2 years 0 months old and 2 years 11 months old. Second, they met the study’s criteria for being at risk for behavior problems—defined as one standard deviation or more above normative averages in at least two of three domains: (1) child behavior problems (such as conduct problems or high-conflict relationships with adults); (2) primary caregiver problems (such as maternal depression, daily parenting challenges, self-reported substance or mental health diagnosis, or status as a teen parent at first birth); and (3) socioeconomic status (a caregiver with low educational achievement or low family income based on WIC criteria). Screening was conducted in 2002 and 2003. Of the 731 primary caregivers who agreed to participate, 41 percent had a high school diploma or GED, 32 percent had one or two years of post-high school training, and 24 percent had less than a high school diploma or GED. More than two-thirds of the randomized sample had an annual income below $20,000. Of the 731 children in the study, 50 percent were European American, 28 percent were African American, 13 percent were biracial, and 9 percent were from another racial group. Thirteen percent were Hispanic. The children were 29.9 months old on average at the time of the age 2 assessments. Forty-nine percent of the children were female, and 58 percent lived in two-parent households. |
|---|---|
| Setting | Families were recruited from WIC program sites in and around Pittsburgh, Pennsylvania (37 percent of sample); Eugene, Oregon (37 percent of sample); and Charlottesville, Virginia (26 percent of sample). |
| Intervention services | The Family Check-Up program typically involves three meetings: an initial contact meeting (a “get to know you” meeting); an assessment meeting, during which families participate in a comprehensive assessment of child and family functioning; and a feedback meeting to discuss the results of the assessment. After the feedback meeting, families can choose to participate in additional follow-up meetings. For this study, the order of the meetings was changed. All families participating in the study were given the comprehensive assessment. The researchers then randomized families into intervention and comparison groups. Following randomization, families in the intervention group participated in the initial contact and feedback meetings, which were led by parent consultants. These consultants discussed family issues and family functioning during the initial contact meeting and, during the feedback meeting, used motivational interviewing techniques to discuss the results of the assessment, areas of strength, areas for improvement, and recommended services that might help the family. After the feedback meetings, families could choose to participate in additional follow-up meetings. Families assigned to the intervention group received the intervention once yearly when their children were 2, 3, and 4 years old. |
| Comparison conditions | Families in the comparison group received the Family Check-Up's comprehensive assessment but did not receive any other interventions or services. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). Subgroups are not listed for manuscripts reviewed before 2021. |
| Funding sources | Not reported. |
| Author affiliation | The authors are associated with the University of Pittsburgh, Case Western Reserve University, the University of Oregon, the University of Virginia, and Oxford University. In addition, Thomas Dishion, a study author, is a developer of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Study Registration:
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Child Behavior Checklist (CBCL) Externalizing, Age 3, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 651 children | Not reported | Not reported | Not reported | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Child Behavior Checklist (CBCL) Externalizing, Age 4, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 4 | 619 children | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.05 | |
| High | Child Behavior Checklist (CBCL) Internalizing, Age 3, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 651 children | Not reported | Not reported | Not reported | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Child Behavior Checklist (CBCL) Internalizing, Age 4, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 4 | 619 children | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.05 | |
| High | Eyeberg Child Behavior Inventory Problem Score, Age 3, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 642 children | Not reported | Not reported | Not reported | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Eyeberg Child Behavior Inventory Problem Score, Age 4, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 4 | 616 children | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.05 | |
| High | Growth in Child Behavior Checklist (CBCL) Externalizing from ages 2 to 4, Latent growth model | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Ages 3 and 4 | 731 children | Not reported | Not reported | Not reported | Study reported = 0.23 | Statistically significant, p<0.051 | Authors used a latent growth model to estimate the impact, and reported a coefficient, standard error, and effect size.
|
| High | Growth in Child Behavior Checklist (CBCL) Internalizing from ages 2 to 4, Latent growth model | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Ages 3 and 4 | 731 children | Not reported | Not reported | Not reported | Study reported = 0.21 | Statistically significant, p<0.051 | Authors used a latent growth model to estimate the impact, and reported a coefficient, standard error, and effect size.
|
| High | Growth in Eyeberg Child Behavior Inventory Problem Score from ages 2 to 4, Latent growth model | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Ages 3 and 4 | 731 mothers | Not reported | Not reported | Not reported | Study reported = 0.23 | Statistically significant, p<0.051 | Authors used a latent growth model to estimate the impact, and reported a coefficient, standard error, and effect size.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, SEM, Figure 2 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.052 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, SEM, Figure 3 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.052 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, SEM, Figure 4 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.052 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, SEM, Figure 5 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.052 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, SEM, Figure 6 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.052 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, SEM, Figure 7 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.052 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, Autoregressive model | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Study reported = 0.18 | Statistically significant, p<0.051 | Authors used an autoregressive model to estimate the impact, and reported a coefficient, standard error, and effect size.
|
| High | Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, Correlation | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 651 mothers | Not reported | Not reported | Not reported | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Positive Parenting, Age 3, SEM, Figure 5 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.051 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Positive Parenting, Age 3, SEM, Figure 6 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.051 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|
| High | Positive Parenting, Age 3, SEM, Figure 7 | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 mothers | Not reported | Not reported | Not reported | Not available | Statistically significant, p<0.051 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value.
|