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Study Detail

Lunkenheimer, E. S., Dishion, T. J., Shaw, D. S., Connell, A. M., Gardner, F., Wilson, M. N., & Skuban, E. M. (2008). Collateral benefits of the family check-up on early childhood school readiness: Indirect effects of parents’ positive behavior support. Developmental Psychology, 44(6), 1737–1752.

Program(s) Reviewed: Family Check-Up® For Children

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
HighRandomized controlled trialLowEstablished on race/ethnicity, SES, and baseline measures of the outcomes.NoneNone

One outcome in this study rated high: Positive Behavior Support, Age 3, structural equation model (SEM). Two outcomes rated moderate because baseline equivalence was not demonstrated, and baseline measures were not controlled for: language skills, age 3, SEM, and inhibitory control, age 3, SEM. Several outcomes rated low: inhibitory control, repeated-measures ANOVA from ages 2 to 4 and change between ages 3 and 4; inhibitory control, ages 3 and 4, correlations and means; language development, repeated-measures ANOVA from ages 2 to 4 and change between ages 3 and 4; language skills, ages 3 and 4, correlations and means; parent involvement, age 3; positive reinforcement, age 3; engaged interaction, age 3; proactive parenting, age 3; positive behavior support, change between ages 2 and 3; and positive behavior support, age 3, regression and mean. These outcomes were 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. Based on the review of these additional outcomes, the overall rating of this study was revised from a low to a high rating.

Study Characteristics

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 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 Condition Families in the comparison group received the Family Check-Up's comprehensive assessment but did not receive any other interventions or services.
Staff Characteristics and Training Parent consultants for this study had either a master’s or doctorate degree; had previous experience conducting family-based interventions; and were of diverse ethnicities, including Latino, African American, European American, and mixed ethnicity. Consultants were trained for two-and-a-half to three months in strategies that included didactic instruction and role-playing as well as ongoing videotaped supervision of intervention activity. Consultants were certified by lead parent consultants at each site; the lead consultants were certified by a member of the research team. Certification was repeated annually and was established by reviewing videotapes of feedback and follow-up sessions. Weekly conference calls were held to discuss cases, and annual consultant meetings were held to update training, discuss possible changes in the intervention, and address issues related to families’ needs.
Funding Source Grant R305B060014 from the Institute of Education Sciences, awarded to Thomas J. Dishion and Robert H.Horner; grant 5 R01 DA16110 from the National Institute of Health, awarded to Thomas J. Dishion and Daniel S. Shaw.
Author Affiliation The authors are associated with Colorado State University, the University of Pittsburgh, Oxford University, the University of Oregon, Case Western Reserve University, and the University of Virginia. In addition, Thomas Dishion, a study author, is a developer of this program model.

Study Registration Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.


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