A Targeted Prevention Approach to Reducing Child Emotional and Behaviour Problems

NCT ID: NCT02800603

Last Updated: 2020-09-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

207 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-08-18

Study Completion Date

2020-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of the study is to evaluate the first Canadian implementation project of the Family Check up (FCU), an evidence-based prevention and early intervention model that engages families and communities in reducing the burden of childhood emotional and behaviour problems (EBP).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The aim of this study is to establish and evaluate the first Canadian implementation project of the FCU as an evidence-based prevention and early intervention model that engages families and communities in reducing the burden of childhood EBP. These objectives will be achieved in two foundational phases. During Phase 1, the clinical and systems infrastructure required to deliver, sustain and ultimately scale up the FCU will be built. During Phase 2, a 1:1 randomized controlled trial (RCT) will be conducted. The RCT will involve 280 participating caregiver-child dyads to examine the effects of the FCU as a targeted prevention intervention within the Canadian context, as delivered to caregivers and children aged 2-4 years at high risk of persistent childhood EBP.

Phase 1: Training, and Implementation: The REACH Institute at Arizona State University has developed an efficient model for international implementation of the FCU. They will help implement the intervention within McMaster Children's Hospital (MCH), train MCH therapists as FCU consultants, and two trainers. All therapists will be credentialed as FCU consultants by REACH through a process of supervision, consultation and monitoring of therapeutic fidelity.

Phase 2: Investigators will conduct a 1:1 randomized controlled trial of 280 children aged 2-4 years into either the FCU (n=140) or community control (CC, n=140). All 280 participants will undergo screening and a baseline FCU assessment before randomization. Once randomized, the FCU group will be provided with a feedback visit and up to 6 optional sessions of the Everyday Parenting (EDP) curriculum over 16 weeks. The CC group will receive general information about currently available community services in Hamilton. At 6 months, both groups will undergo light assessments. At 12 months both groups will repeat the baseline assessment, and the FCU group will have 1-2 FCU visits.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Emotional Problems Behavior Problems

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Family Check Up

FCU Intervention: All 280 participants will undergo screening and a baseline FCU assessment before randomization. Once randomized, the FCU group (n=140) will be provided with a feedback visit and up to 6 optional sessions of the EDP curriculum over 16 weeks.

Group Type EXPERIMENTAL

Family Check Up

Intervention Type BEHAVIORAL

The FCU is an ecologically sensitive, evidence-based, targeted intervention that aims to reduce child EBP. Features of the FCU: 1) Assessment-driven: a multi-method, multi-informant assessment in which the consultant reviews strengths and difficulties across domains of contextual risk, family functioning and child health. A tailored intervention plan is then created based on results 2) Motivational interviewing: Caregivers engage in self-assessment about motivation and barriers to addressing factors that may perpetuate risk. The consultant and caregiver work to establish a menu of services 3) The family may be offered up to 6 sessions of the "Everyday Parenting" curriculum. The FCU has demonstrated effectiveness and cultural sensitivity across multiple US settings.

Community Control

The Community Control group (n=140) will receive general information that includes a list of all the relevant services available in Hamilton. As such, the community control group would be provided with all the information needed to obtain standard care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Family Check Up

The FCU is an ecologically sensitive, evidence-based, targeted intervention that aims to reduce child EBP. Features of the FCU: 1) Assessment-driven: a multi-method, multi-informant assessment in which the consultant reviews strengths and difficulties across domains of contextual risk, family functioning and child health. A tailored intervention plan is then created based on results 2) Motivational interviewing: Caregivers engage in self-assessment about motivation and barriers to addressing factors that may perpetuate risk. The consultant and caregiver work to establish a menu of services 3) The family may be offered up to 6 sessions of the "Everyday Parenting" curriculum. The FCU has demonstrated effectiveness and cultural sensitivity across multiple US settings.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Custodial caregivers of a child aged 2 years, 0 months to 4 years, 11 months.
2. Definition of "at-risk" for child EBP as measured by (a) OR (b):

* Elevated child EBP as indexed by above-population mean total scores on Strengths and Difficulties Questionnaire (SDQ), plus one of the following family or contextual risk factors

* Caregiver challenges: teen parent status, caregiver mental health problems (as indexed by K6 psychological distress scale), lone caregiver
* Sociodemographic risk factors (as indexed by the 2014 Ontario Child Health Study (OCHS) demographics questionnaire): family income below low-income cut-off (LICO), caregiver with less than grade 12 education, caregiver on social assistance.
* Families who score within norms on caregiver or sociodemographic risk AND child SDQ scores fall within the "high" range, indicating significant burden of EBP (and thus increased risk of persistent, severe problems over time).
3. Caregivers with sufficient knowledge of English needed for assessment measures
4. Caregivers capable of giving informed, written consent

Exclusion Criteria

1. Children with suspected severe to profound developmental delay
2. Current enrolment in another clinical intervention trial
3. Caregiver or child with a serious medical condition that, based on Investigator judgment, might interfere with the conduct of the study, confound interpretation of the study results, or endanger their own well-being
Minimum Eligible Age

2 Years

Maximum Eligible Age

4 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hamilton Health Sciences Corporation

OTHER

Sponsor Role collaborator

Arizona State University

OTHER

Sponsor Role collaborator

University of Calgary

OTHER

Sponsor Role collaborator

Simon Fraser University

OTHER

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Teresa Bennett, MD/PhD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

McMaster University

Hamilton, Ontario, Canada

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Canada

References

Explore related publications, articles, or registry entries linked to this study.

Egger HL, Angold A. Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. J Child Psychol Psychiatry. 2006 Mar-Apr;47(3-4):313-37. doi: 10.1111/j.1469-7610.2006.01618.x.

Reference Type BACKGROUND
PMID: 16492262 (View on PubMed)

Cadman D, Boyle M, Szatmari P, Offord DR. Chronic illness, disability, and mental and social well-being: findings of the Ontario Child Health Study. Pediatrics. 1987 May;79(5):805-13.

Reference Type BACKGROUND
PMID: 2952939 (View on PubMed)

Furniss T, Beyer T, Guggenmos J. Prevalence of behavioural and emotional problems among six-years-old preschool children: baseline results of a prospective longitudinal study. Soc Psychiatry Psychiatr Epidemiol. 2006 May;41(5):394-9. doi: 10.1007/s00127-006-0045-3. Epub 2006 Mar 25.

Reference Type BACKGROUND
PMID: 16565920 (View on PubMed)

Skovgaard AM. Mental health problems and psychopathology in infancy and early childhood. An epidemiological study. Dan Med Bull. 2010 Oct;57(10):B4193.

Reference Type BACKGROUND
PMID: 21040689 (View on PubMed)

Shonkoff JP, Richter L, van der Gaag J, Bhutta ZA. An integrated scientific framework for child survival and early childhood development. Pediatrics. 2012 Feb;129(2):e460-72. doi: 10.1542/peds.2011-0366. Epub 2012 Jan 4.

Reference Type BACKGROUND
PMID: 22218840 (View on PubMed)

Bernier A, Carlson SM, Whipple N. From external regulation to self-regulation: early parenting precursors of young children's executive functioning. Child Dev. 2010 Jan-Feb;81(1):326-39. doi: 10.1111/j.1467-8624.2009.01397.x.

Reference Type BACKGROUND
PMID: 20331670 (View on PubMed)

Gill AM, Hyde LW, Shaw DS, Dishion TJ, Wilson MN. The Family Check-Up in early childhood: a case study of intervention process and change. J Clin Child Adolesc Psychol. 2008 Oct;37(4):893-904. doi: 10.1080/15374410802359858.

Reference Type BACKGROUND
PMID: 18991138 (View on PubMed)

Smith JD, Knoble NB, Zerr AA, Dishion TJ, Stormshak EA. Family check-up effects across diverse ethnic groups: reducing early-adolescence antisocial behavior by reducing family conflict. J Clin Child Adolesc Psychol. 2014;43(3):400-14. doi: 10.1080/15374416.2014.888670. Epub 2014 Apr 14.

Reference Type BACKGROUND
PMID: 24731120 (View on PubMed)

Shaw DS, Dishion TJ, Supplee L, Gardner F, Arnds K. Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood. J Consult Clin Psychol. 2006 Feb;74(1):1-9. doi: 10.1037/0022-006X.74.1.1.

Reference Type BACKGROUND
PMID: 16551138 (View on PubMed)

Dishion TJ, Shaw D, Connell A, Gardner F, Weaver C, Wilson M. The family check-up with high-risk indigent families: preventing problem behavior by increasing parents' positive behavior support in early childhood. Child Dev. 2008 Sep-Oct;79(5):1395-414. doi: 10.1111/j.1467-8624.2008.01195.x.

Reference Type BACKGROUND
PMID: 18826532 (View on PubMed)

Dishion TJ, Brennan LM, Shaw DS, McEachern AD, Wilson MN, Jo B. Prevention of problem behavior through annual family check-ups in early childhood: intervention effects from home to early elementary school. J Abnorm Child Psychol. 2014;42(3):343-54. doi: 10.1007/s10802-013-9768-2.

Reference Type BACKGROUND
PMID: 24022677 (View on PubMed)

Connell A, Bullock BM, Dishion TJ, Shaw D, Wilson M, Gardner F. Family intervention effects on co-occurring early childhood behavioral and emotional problems: a latent transition analysis approach. J Abnorm Child Psychol. 2008 Nov;36(8):1211-25. doi: 10.1007/s10802-008-9244-6.

Reference Type BACKGROUND
PMID: 18473160 (View on PubMed)

Lunkenheimer ES, Dishion TJ, Shaw DS, Connell AM, Gardner F, Wilson MN, Skuban EM. Collateral benefits of the Family Check-Up on early childhood school readiness: indirect effects of parents' positive behavior support. Dev Psychol. 2008 Nov;44(6):1737-52. doi: 10.1037/a0013858.

Reference Type BACKGROUND
PMID: 18999335 (View on PubMed)

Weaver CM, Shaw DS, Crossan JL, Dishion TJ, Wilson MN. Parent-child conflict and early childhood adjustment in two-parent low-income families: parallel developmental processes. Child Psychiatry Hum Dev. 2015 Feb;46(1):94-107. doi: 10.1007/s10578-014-0455-5.

Reference Type BACKGROUND
PMID: 24610382 (View on PubMed)

Brennan LM, Shelleby EC, Shaw DS, Gardner F, Dishion TJ, Wilson M. Indirect Effects of the Family Check-Up on School-Age Academic Achievement Through Improvements in Parenting in Early Childhood. J Educ Psychol. 2013 Aug 1;105(3):10.1037/a0032096. doi: 10.1037/a0032096.

Reference Type BACKGROUND
PMID: 24319295 (View on PubMed)

Leijten P, Shaw DS, Gardner F, Wilson MN, Matthys W, Dishion TJ. The family check-up and service use in high-risk families of young children: a prevention strategy with a bridge to community-based treatment. Prev Sci. 2015 Apr;16(3):397-406. doi: 10.1007/s11121-014-0479-x.

Reference Type BACKGROUND
PMID: 24643281 (View on PubMed)

Shaw DS, Connell A, Dishion TJ, Wilson MN, Gardner F. Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Dev Psychopathol. 2009 Spring;21(2):417-39. doi: 10.1017/S0954579409000236.

Reference Type BACKGROUND
PMID: 19338691 (View on PubMed)

Chang H, Shaw DS, Dishion TJ, Gardner F, Wilson MN. Direct and indirect effects of the family check-up on self-regulation from toddlerhood to early school-age. J Abnorm Child Psychol. 2014 Oct;42(7):1117-28. doi: 10.1007/s10802-014-9859-8.

Reference Type BACKGROUND
PMID: 24599383 (View on PubMed)

Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008 Jun;41(3-4):327-50. doi: 10.1007/s10464-008-9165-0.

Reference Type BACKGROUND
PMID: 18322790 (View on PubMed)

Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1337-45. doi: 10.1097/00004583-200111000-00015.

Reference Type BACKGROUND
PMID: 11699809 (View on PubMed)

Achenbach TM, Ruffle TM. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatr Rev. 2000 Aug;21(8):265-71. doi: 10.1542/pir.21-8-265. No abstract available.

Reference Type BACKGROUND
PMID: 10922023 (View on PubMed)

Willoughby MT, Blair CB, Wirth RJ, Greenberg M. The measurement of executive function at age 5: psychometric properties and relationship to academic achievement. Psychol Assess. 2012 Mar;24(1):226-39. doi: 10.1037/a0025361. Epub 2011 Oct 3.

Reference Type BACKGROUND
PMID: 21966934 (View on PubMed)

Mischel W, Shoda Y, Rodriguez MI. Delay of gratification in children. Science. 1989 May 26;244(4907):933-8. doi: 10.1126/science.2658056.

Reference Type BACKGROUND
PMID: 2658056 (View on PubMed)

Landry SH, Miller-Loncar CL, Smith KE, Swank PR. The role of early parenting in children's development of executive processes. Dev Neuropsychol. 2002;21(1):15-41. doi: 10.1207/S15326942DN2101_2.

Reference Type BACKGROUND
PMID: 12058834 (View on PubMed)

Kochanska G, Murray K, Jacques TY, Koenig AL, Vandegeest KA. Inhibitory control in young children and its role in emerging internalization. Child Dev. 1996 Apr;67(2):490-507.

Reference Type BACKGROUND
PMID: 8625724 (View on PubMed)

Zelazo PD, Muller U, Frye D, Marcovitch S, Argitis G, Boseovski J, Chiang JK, Hongwanishkul D, Schuster BV, Sutherland A. The development of executive function in early childhood. Monogr Soc Res Child Dev. 2003;68(3):vii-137. doi: 10.1111/j.0037-976x.2003.00260.x.

Reference Type BACKGROUND
PMID: 14723273 (View on PubMed)

Gerstadt CL, Hong YJ, Diamond A. The relationship between cognition and action: performance of children 3 1/2-7 years old on a Stroop-like day-night test. Cognition. 1994 Nov;53(2):129-53. doi: 10.1016/0010-0277(94)90068-x.

Reference Type BACKGROUND
PMID: 7805351 (View on PubMed)

Carlson SM. Developmentally sensitive measures of executive function in preschool children. Dev Neuropsychol. 2005;28(2):595-616. doi: 10.1207/s15326942dn2802_3.

Reference Type BACKGROUND
PMID: 16144429 (View on PubMed)

Russell E, Koren G, Rieder M, Van Uum S. Hair cortisol as a biological marker of chronic stress: current status, future directions and unanswered questions. Psychoneuroendocrinology. 2012 May;37(5):589-601. doi: 10.1016/j.psyneuen.2011.09.009. Epub 2011 Oct 4.

Reference Type BACKGROUND
PMID: 21974976 (View on PubMed)

Stalder T, Kirschbaum C. Analysis of cortisol in hair--state of the art and future directions. Brain Behav Immun. 2012 Oct;26(7):1019-29. doi: 10.1016/j.bbi.2012.02.002. Epub 2012 Feb 15.

Reference Type BACKGROUND
PMID: 22366690 (View on PubMed)

Manenschijn L, Koper JW, Lamberts SW, van Rossum EF. Evaluation of a method to measure long term cortisol levels. Steroids. 2011 Sep-Oct;76(10-11):1032-6. doi: 10.1016/j.steroids.2011.04.005. Epub 2011 Apr 14.

Reference Type BACKGROUND
PMID: 21515299 (View on PubMed)

Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998 Sep 14;158(16):1789-95. doi: 10.1001/archinte.158.16.1789.

Reference Type BACKGROUND
PMID: 9738608 (View on PubMed)

Dumas JE, Nissley J, Nordstrom A, Smith EP, Prinz RJ, Levine DW. Home chaos: sociodemographic, parenting, interactional, and child correlates. J Clin Child Adolesc Psychol. 2005 Mar;34(1):93-104. doi: 10.1207/s15374424jccp3401_9.

Reference Type BACKGROUND
PMID: 15677284 (View on PubMed)

Smith JD, Dishion TJ, Shaw DS, Wilson MN. Indirect effects of fidelity to the family check-up on changes in parenting and early childhood problem behaviors. J Consult Clin Psychol. 2013 Dec;81(6):962-74. doi: 10.1037/a0033950. Epub 2013 Jul 29.

Reference Type BACKGROUND
PMID: 23895087 (View on PubMed)

Chiapa A, Smith JD, Kim H, Dishion TJ, Shaw DS, Wilson MN. The trajectory of fidelity in a multiyear trial of the family check-up predicts change in child problem behavior. J Consult Clin Psychol. 2015 Oct;83(5):1006-11. doi: 10.1037/ccp0000034. Epub 2015 Jun 29.

Reference Type BACKGROUND
PMID: 26121303 (View on PubMed)

Boyle MH, Offord DR, Hofmann HG, Catlin GP, Byles JA, Cadman DT, Crawford JW, Links PS, Rae-Grant NI, Szatmari P. Ontario Child Health Study. I. Methodology. Arch Gen Psychiatry. 1987 Sep;44(9):826-31. doi: 10.1001/archpsyc.1987.01800210078012.

Reference Type BACKGROUND
PMID: 3632257 (View on PubMed)

Radloff, L. S. The CES-D scale: A self-report depression scale for research in the general population. Applied psychological measurement 1(3): 385-401, 1977.

Reference Type BACKGROUND

Eaton WW, Muntaner C, Smith C, Tien A, Ybarra M. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, Volume 3: Instruments for Adults, 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004. Chapter 11, Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R); p 363-377.

Reference Type BACKGROUND

Gratz, K.L., & Roemer, L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment 26(1): 41-54, 2004.

Reference Type BACKGROUND

Bennett T, Georgiades K, Gonzalez A, Janus M, Lipman E, Pires P, Prime H, Duku E, Jambon M, McLennan JD, Gross J; Making the Race Fair Study Team. Targeted Child Mental Health Prevention and Parenting Support Within a Canadian Context: A Randomized Controlled Trial Evaluating the U.S.-Developed Family Check-Up(R). Prev Sci. 2025 May;26(4):555-567. doi: 10.1007/s11121-024-01741-3. Epub 2024 Nov 22.

Reference Type DERIVED
PMID: 39572487 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

FCU

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Couple & Family Contexts
NCT01631721 COMPLETED
Parents Advancing Toddler Health
NCT04824989 UNKNOWN NA
Fostering Healthy Futures for Teens: An RCT
NCT03707366 ACTIVE_NOT_RECRUITING NA
Promoting Infant Mental Health in Foster Care
NCT00339365 COMPLETED PHASE2/PHASE3
Early Prevention of Conduct Problems
NCT00051714 COMPLETED PHASE4