Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008). The family check-up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79(5), 1395–1414.
| 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 |
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 the 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 | National Institutes of Health grant 5 R01 DA16110 to the first and second authors. |
| Author affiliation | Thomas Dishion, a study author, is a developer of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
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 | Positive Behavior Support, Age 3, SEM | FavorableUnfavorable or ambiguousNo Effect |
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA | Age 3 | 731 caregivers | Not reported | Not reported | Not reported | Study reported = 0.33 | Statistically significant, p<0.051 | Authors used structural equation models to estimate the impact, and reported a coefficient, standard error, and p-value. Model controls for income, ethnicity, gender, and baseline (age 2) measure of child behaviors and outcome.
|
| 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 caregivers | 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. Model controls for income, ethnicity, gender, and baseline (age 2) measure of child behaviors and outcome.
|
| 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 caregivers | 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. Model controls for income, ethnicity, gender, and baseline (age 2) measure of child behaviors and outcome.
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