Manuscript Details

Gardner, F., Connell, A., Trentacosta, C. J., Shaw, D. S., Dishion, T. J., & Wilson, M. N. (2009). Moderators of outcome in a brief family-centered intervention for preventing early problem behavior. Journal of Consulting and Clinical Psychology, 77(3), 543–553.

Moderate rating
Study reviewed under: Handbook of Procedures and Standards, Version 1
Model(s) Reviewed
Author Affiliation

The authors are associated with Oxford University, Case Western Reserve University, Wayne State University, the University of Pittsburgh, the University of Oregon, and the University of Virginia. In addition, Thomas Dishion, a study author, is a developer of this model.

Funding Sources

National Institutes of Health grant R01 DA16110 to Gardner, Shaw, Dishion, and Wilson.

Study Design
Design Attrition Baseline equivalence Confounding factors Valid, reliable measures?
Randomized controlled trial Low

Not established on race/ethnicity, SES, or baseline measures of the outcomes.

None

Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1

This study is part of a large RCT described by Dishion et al. (2008).

Earlier, this study was listed as an additional source for Dishion et al. 2008. In the course of the 2017 annual review, HomVEE identified outcomes within this study that were eligible for review beyond those that were reported within Dishion et al. 2008, so it is eligible for review on its own and is not solely an additional source of information published in another study. Based upon a review of these additional outcomes, the study receives a moderate rating.

Findings that rate moderate or high in this manuscript

Maternal health
Outcome measure Timing of follow-up Rating Direction of Effect Effect size (absolute value) Stastical significance Sample size Sample description
Maternal Depression (Center for Epidemiological Studies Depression Scale), Age 3, Mean and SD Age 3 Moderate
0.15 Not statistically significant, p=0.06 651 mothers WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Child development and school readiness
Outcome measure Timing of follow-up Rating Direction of Effect Effect size (absolute value) Stastical significance Sample size Sample description
Eyeberg Child Behavior Inventory Problem Score, Age 3, Mean and SD Age 3 Moderate
0.08 Not statistically significant, p=0.28 642 children WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Eyeberg Child Behavior Inventory Problem Score, Age 4, Mean and SD Age 4 Moderate
0.18 Statistically significant, p=0.03 616 children WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Child Behavior Checklist (CBCL) Externalizing, Age 3, Mean and SD Age 3 Moderate
0.03 Not statistically significant, p=0.70 651 children WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Child Behavior Checklist (CBCL) Externalizing, Age 4, Mean and SD Age 4 Moderate
0.19 Statistically significant, p=0.02 619 children WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Eyeberg Child Behavior Inventory Problem Score, Ages 3 and 4, Latent growth model Ages 3 and 4 Moderate
Statistically significant, p 723 children WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Child Behavior Checklist (CBCL) Externalizing, Ages 3 and 4, Latent growth model Ages 3 and 4 Moderate
Statistically significant, p 723 children WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
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).

Home Visiting 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.

Model(s) Reviewed
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

• Maternal education (less than high school education or at least high school education) • Relationship status (single or partnered) • Maternal substance use/disorder (yes or no) • Maternal age (less than 18 years) • Maternal depression (present based on screening) • Reports high daily hassles of parenting (yes or no)

This study included participants with the following characteristics at enrollment:

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
13%
White
50%
Two or more races
13%
Unknown
9%

Maternal Education

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

Other Characteristics

Enrollment in means-tested programs
100%