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Sitnick, S. L., Shaw, D. S., Gill, A., Dishion, T., Winter, C., Waller, R., Gardner, F., & Wilson, M. (2015). Parenting and the family check-up: Changes in observed parent-child interaction following early childhood intervention. Journal of Clinical Child & Adolescent Psychology, 44(6), 970–984.

Model(s) Reviewed: Family Check-Up® For Children
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
High Randomized controlled trial Low Established on race/ethnicity, SES, and baseline measures of the outcomes. None None
Notes:

footnote295

Submitted by user on Fri, 03/15/2019 - 14:29

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).

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 (for example, conduct problems or high-conflict relationships with adults); (2) primary caregiver problems (for example, maternal depression, daily parenting challenges, self-report of substance or mental health diagnosis, or status as a teen parent at first birth); and (3) socioeconomic status (low caregiver 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, 4, and 5 years old.
Comparison conditions Families in the comparison group received the Family Check-Up intervention'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 sources Not reported.
Author affiliation Thomas Dishion, a study author, is a developer of this model.
Study Registration:
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

Child development and school readiness
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) Oppositional/Aggressive, Age 5, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 5 614 families Not reported Not reported Not Reported Not available Not statistically significant, p ≥ 0.05
High Child Behavior Checklist (CBCL) Oppositional/Aggressive, Age 5, T-test
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 5 614 families Unadjusted mean = 0.43 Unadjusted mean = 0.47 Mean difference = -0.04 HomeVEE calculated = 0.11 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Dyadic Coercion - Age 3 (T-test)
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 3 635 families Unadjusted mean = 0.09 Unadjusted mean = 0.09 Mean difference = -0.01 HomeVEE calculated = 0.07 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Dyadic Coercion - Age 4 (T-test)
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 4 561 families Unadjusted mean = 0.09 Unadjusted mean = 0.09 Mean difference = 0.01 HomeVEE calculated = -0.01 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Dyadic Coercion - Age 5 (T-test)
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 5 572 families Unadjusted mean = 0.06 Unadjusted mean = 0.07 Mean difference = -0.01 HomeVEE calculated = 0.12 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Dyadic Coercion, Age 3, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 3 635 families Not reported Not reported Not Reported Not available Not statistically significant, p ≥ 0.05
High Dyadic Coercion, Age 4, SEM
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 4 731 families Not reported Not reported Not Reported Not available Statistically significant, p<0.052

footnote261

Submitted by user on Fri, 03/15/2019 - 14:29

Authors used structural equation models to estimate the impact, and reported a beta coefficient, standard error, and p-value. The following covariates were reported: child race, ethnicity, and gender; family income; mother's education; site location; positive engagement (age 2), coercion (age 2), OPP/AGG (age 2).

High Dyadic Coercion, Age 4, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 4 561 families Not reported Not reported Not Reported Not available Not statistically significant, p ≥ 0.05
High Dyadic Coercion, Age 5, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 5 572 families Not reported Not reported Not Reported Not available Not statistically significant, p ≥ 0.05
High Positive Engagement, Age 3, SEM
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 3 731 families Not reported Not reported Not Reported Not available Statistically significant, p<0.012

footnote261

Submitted by user on Fri, 03/15/2019 - 14:29

Authors used structural equation models to estimate the impact, and reported a beta coefficient, standard error, and p-value. The following covariates were reported: child race, ethnicity, and gender; family income; mother's education; site location; positive engagement (age 2), coercion (age 2), OPP/AGG (age 2).

High Positive Engagement, Age 3, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 3 635 families Not reported Not reported Not Reported Not available Statistically significant, p<0.01
High Positive Engagement, Age 3, T-test
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 3 635 families Unadjusted mean = 0.37 Unadjusted mean = 0.34 Mean difference = 0.03 HomeVEE calculated = -0.24 Statistically significant, p<0.01
High Positive Engagement, Age 4, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 4 561 families Not reported Not reported Not Reported Not available Not statistically significant, p ≥ 0.05
High Positive Engagement, Age 4, T-test
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 4 561 families Unadjusted mean = 0.28 Unadjusted mean = 0.27 Mean difference = 0.01 HomeVEE calculated = -0.03 Not statistically significant, p ≥ 0.05
High Positive Engagement, Age 5, Correlation
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 5 572 families Not reported Not reported Not Reported Not available Statistically significant, p<0.05
High Positive Engagement, Age 5, T-test
FavorableUnfavorable or ambiguousNo Effect
WIC sites in Pittsburgh, PA, Eugene, OR, and Charlottesville, VA Age 5 572 families Unadjusted mean = 0.38 Unadjusted mean = 0.36 Mean difference = 0.02 HomeVEE calculated = -0.17 Statistically significant, p<0.05

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

Child Behavior Checklist (CBCL) Oppositional/Aggressive, Age 5, Correlation

This measure was created from 8 oppositional and aggressive items from the CBCL. The CBCL for ages 1.5–5 is a 99-item assessment of behavioral problems in young children. Parent/caregiver report

alpha=0.80

Child Behavior Checklist (CBCL) Oppositional/Aggressive, Age 5, T-test

This measure was created from 8 oppositional and aggressive items from the CBCL. The CBCL for ages 1.5–5 is a 99-item assessment of behavioral problems in young children. Parent/caregiver report

alpha=0.80

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

Dyadic Coercion - Age 3 (t-test)

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 3=0.94

Dyadic Coercion - Age 4 (t-test)

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 4=0.93

Dyadic Coercion - Age 5 (t-test)

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 5=0.94

Dyadic Coercion, Age 3, Correlation

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 3=0.94

Dyadic Coercion, Age 4, SEM

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 4=0.93

Dyadic Coercion, Age 4, Correlation

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 4=0.93

Dyadic Coercion, Age 5, Correlation

A summary score describing mutually coercive behaviors between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 5=0.94

Positive Engagement, Age 3, SEM

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 3=0.94

Positive Engagement, Age 3, Correlation

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 3=0.94

Positive Engagement, Age 3, T-test

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 3=0.94

Positive Engagement, Age 4, Correlation

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 4=0.93

Positive Engagement, Age 4, T-test

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 4=0.93

Positive Engagement, Age 5, Correlation

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 5=0.94

Positive Engagement, Age 5, T-test

A summary score describing duration of positive and neutral engagement between parent and child. Coding of videotaped interactions (Relationship Affect Coding System)

Overall Kappa score=0.93, Kappa at age 5=0.94