Trial Outcomes & Findings for Improving Satisfaction, Engagement and Outcomes Among Traditionally Underserved Children Through Cultural Formulation (NCT NCT03499600)

Last Updated: 2023-04-07

Results Overview

The CFI Clinician Questionnaire is a 4-item measure developed designed to assess clinical utility of the CFI. Items are rated on a 5-point Likert style scale ranging from 1='not at all' to 5='very much'. Each item has a minimum score of 1 and a max of 5. Items include the extent to which conducting the CFI influences content and quality of information obtained in the intake, realtionship with the caregiver, treatment planning, and differential diagnosis. Higher scores indicate higher levels of clinical utility of the CFI. The measure was given only to the CA + CFI condition. This analysis was utilized to assess for initial utility of the CFI and was mistakenly entered into the system as a primary outcome variable. This measure is not used to determine the effect of an experimental variable on participants in the study. Statistical analyses for this measure were descriptive and only examined for the experimental group.

Recruitment status

COMPLETED

Study phase

Target enrollment

89 participants

Primary outcome timeframe

Post Intake Assessment (Week 0)

Results posted on

2023-04-07

Participant Flow

Families were recruited and randomized from August 2017 to October 2018; data collection continued through May 2019. Recruitment and data collection during the provision of clinical services within three community clinics that were embedded within neighborhood centers regularly accessed by the community (i.e., afterschool care centers, family and neighborhood resource programs).

Caregivers and children were considered enrolled in the current study. Caregivers were recruited based on their participation in a parenting intervention for their child. The Enrollment number and number of participants Started/Completed represents the number of dyads (caregiver+child). For example, 39 caregivers started treatment with their child in the CA+CFI group and 50 caregivers started treatment with their child in the CA only group.

Participant milestones

Participant milestones
Measure	Clinical Assessment and CFI CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Overall Study STARTED	39	50
Overall Study COMPLETED	18	20
Overall Study NOT COMPLETED	21	30

Reasons for withdrawal

Reasons for withdrawal
Measure	Clinical Assessment and CFI CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Overall Study Caregiver/child dyad dropped out before completing a full course of treatment	21	30

Baseline Characteristics

CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)

Baseline characteristics by cohort

PRIMARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: Descriptive analyses were conducted to assess clinical utility.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
CFI Clinician Questionnaire Quality of Information Received	4.2 units on a scale Standard Deviation .59	—
CFI Clinician Questionnaire Relationship with Caregiver	4.1 units on a scale Standard Deviation .92	—
CFI Clinician Questionnaire Treatment Planning	3.8 units on a scale Standard Deviation .89	—
CFI Clinician Questionnaire Differential Diagnosis	3.6 units on a scale Standard Deviation 1	—

PRIMARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: Linear regressions tested condition effects on caregiver and provider satisfaction, and the extent to which the provider understood the caregivers' values or what is important to them.

The Satisfaction with Intake Questionnaire is a 7-item measure developed for use in the current study to assess parent and clinician satisfaction with their intake assessment. This measure assesses how well the patient/clinician felt the clinician understood the family's problems, cultural background, how their culture may influence their problem, and how much the parent trusts the clinician. Items are rated on a 5-point Likert style scale ranging from 1='not at all' to 5='very much', with higher scores representing higher satisfaction. Each item has a minimum of 1 and maximum of 5. Items were not summed. Two items were analyzed separately for the main outcomes: linear regressions tested condition effects on caregiver and provider satisfaction, and the extent to which the provider understood the caregivers' values or what is important to them.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Satisfaction With Intake Questionnaire Caregiver Post-Assessment Perceptions and Satisfaction: Provider understands family values	4.48 units on a scale Standard Deviation .93	4.32 units on a scale Standard Deviation .88
Satisfaction With Intake Questionnaire Caregiver Post-Assessment Perceptions and Satisfaction: Overall Satisfaction	4.61 units on a scale Standard Deviation .93	4.7 units on a scale Standard Deviation .75
Satisfaction With Intake Questionnaire Provider Post-Assessment Perceptions and Satisfaction: Understands family values	4.57 units on a scale Standard Deviation .99	4.12 units on a scale Standard Deviation .73
Satisfaction With Intake Questionnaire Provider Post-Assessment Perceptions and Satisfaction: Overall Satisfaction	4.66 units on a scale Standard Deviation .7	4.52 units on a scale Standard Deviation .71

PRIMARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: Descriptive analyses were conducted to assess clinician fidelity to the CFI and potential cross contamination given therapists delivered both conditions. The percentage was calculated by dividing the number of adherent items by number of CFI items (16 items). This was averaged to come up with the overall adherence value by group.

The CFI Fidelity Instrument assesses fidelity to the CFI (i.e. adherence and competence) in the CA+CFI group and potential cross-condition contamination in CA condition. Independent evaluators masked to condition, study design, and study hypotheses coded recordings of all assessments. This analysis was utilized to assess for feasibility of the pilot study and was mistakenly entered into the system as a primary outcome variable. This measure is not used to determine the effect of an experimental variable on participants in the study. Statistical analyses for this measure were only descriptive.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
CFI Fidelity Instrument	84.4 percentage of adherence to CFI Standard Deviation 21.5	4.8 percentage of adherence to CFI Standard Deviation 10.5

SECONDARY outcome

Timeframe: Post Treatment (Anticipated average: Week 14)

The WAI-Short Form Revised (WAI-SR; Hatcher \& Gillaspy, 2006) is a 12-item clinician- and patient-report measure of therapeutic alliance that assesses (a) agreement on the tasks of therapy, (b) agreement on the goals of therapy and (c) development of an affective bond. Items are rated on a 5-point Likert style scale ranging from 1='never' to 5='always'. Scores on each sub scale are summed to create a total score. Total scores range from 12-60 with higher scores representing higher therapeutic alliance.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Working Alliance Inventory-Short Form Revised	54.03 score on a scale Standard Deviation 8.9	57.06 score on a scale Standard Deviation 7.21

SECONDARY outcome

Timeframe: Change from Baseline (Week 0) through post treatment (anticipated average: Week 14)

Population: Treatment response is a dichotomous variable the data presented below is probability for those variables.

Treatment response reflected traditional PCIT graduation criteria: caregiver skill acquisition as coded against specific criteria in both phases of treatment; and (b) child behavior problems dropped into the subclinical range. Families were classified as Treatment Responders in accordance with formal PCIT graduation criteria, that is: (a) caregivers demonstrated skill acquisition, as coded against specific criteria in both phases of treatment; and (b) child behavior problems dropped into the subclinical range - i.e., Eyberg Child Behavior Inventory (ECBI) falls below 114). Participants were coded as either treatment responders=1, or treatment non-responders=0.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Treatment Response	.53 probability treatment response	.35 probability treatment response

SECONDARY outcome

Timeframe: Change from Baseline (Week 0) through post treatment

Population: Initial session completion, and completion of first treatment modules are dichotomous variables the data presented below is probability for those variables.

Engagement will be measured for each family via: (a) dichotomous coding of initial session attendance (yes=1, no=0), (b) dichotomous coding of whether they completed the first treatment module (yes=1, no=0), (c) attendance rate (number of sessions attended over number of weeks in treatment), and (d) mean weekly homework completion across treatment (Homework Compliance)

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Engagement Session Attendance	.65 probability of engagement	.57 probability of engagement
Engagement Homework Completion	.49 probability of engagement	.46 probability of engagement
Engagement Initial Session Attendance	.95 probability of engagement	.91 probability of engagement
Engagement Completion of first treatment modules	.75 probability of engagement	.35 probability of engagement

SECONDARY outcome

Timeframe: Post Treatment (anticipated average: Week 14)

The Therapy Attitudes Inventory (TAI; Brestan et al., 2000) is a 10-item parent-report of satisfaction with treatment including change in child behavior problems and parenting skills on a likert style scale from 1="nothing"-5="very many useful techniques". Items are summed to create a total score. Minimum value is 10 and maximum value is 50. Higher scores represent higher satisfaction with treatment.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Therapy Attitudes Inventory	48.490 score on a scale Standard Deviation 3.63	48.581 score on a scale Standard Deviation 2.58

SECONDARY outcome

Timeframe: Change from Baseline (Week 0) through post treatment (anticipated average: Week 14)

The Eyberg Child Behavior Inventory (ECBI; Eyberg \& Pincus, 1999) is a 36-item parent-report measure of disruptive behavior problems in children as young as 2 years that has shown strong psychometrics. The intensity score is summed to form a total score and ranges from 36 to 252 with higher numbers representing more severe behavior problems. The difference in ECBI score between baseline and treatment completion was measured.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Eyberg Child Behavior Inventory	46.35 units on a scale Standard Deviation 42.67	51.737 units on a scale Standard Deviation 39.47

SECONDARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials. Only baseline descriptive data is provided.

The Everyday Stressors Index (ESI Hall, 1983) is a 20-item measure that assesses daily stressors experienced by economically disadvantaged parents with young children. Items are rated on a Likert-style scale ranging from 1='not at bothered' to 4='bothered a great deal' with higher scores indicating higher levels of stress. The minimum value=20, and maximum value=80 This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Everyday Stressors Index	32.6 score on a scale Standard Deviation 6.9	34.7 score on a scale Standard Deviation 9.3

SECONDARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials.

The Multigroup Ethnic Identity Measure- Revised (MEIM-R; Phinney \& Ong, 2007) is a 6-item measure that assesses exploration of and commitment to one's ethnic group. Items are rated on a 5-point Likert-style scale from 1='strongly disagree' to 6='strongly agree', with higher scores indicating stronger ethnic identity. This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Multigroup Ethnic Identity Measure- Revised	2.729 score on a scale Standard Deviation 1.667	2.778 score on a scale Standard Deviation .838

SECONDARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials.

Two subscales of the Parental Attitudes Toward Psychological Services Inventory (PATPSI; Turner, 2012) will be administered: help seeking attitudes scale (8 items) and the stigmatization scale (8 items) comprising 16 items total. The PATPSI assesses caregivers' attitudes toward outpatient mental health services. Items are rated on a 5-point Likert-style scale from 0='strongly disagree' to 5='strongly agree'. Item responses are summed to form a stigma total scale (minimum value=0 and maximum value=40) and a help seeking total scale (minimum value=0 and maximum value=40) with higher scores representing more mental health related stigma and more positive attitudes toward mental health services. This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Parental Attitudes Toward Psychological Services Inventory Stigma Subscale	5.847 score on a scale Standard Deviation 5.19	6.172 score on a scale Standard Deviation 5.57
Parental Attitudes Toward Psychological Services Inventory Help Seeking Subscale	6.384 score on a scale Standard Deviation 5.718	6.970 score on a scale Standard Deviation 6.097

SECONDARY outcome

Timeframe: Post Intake Assessment (Week 0)

Population: This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials. Online baseline data is provided.

The Everyday Discrimination Scale (EDS; Williams et al., 1997) is a 9-item measure that assesses aspects of interpersonal discrimination or unfair treatment in their day-to-day life. Items are rated on a Likert-style scale ranging from 0='never' to 5='almost every day', with higher scores indicating more experiences of discrimination. The minimum score is 0 and maximum score is 45. Scores were averaged to create a mean discrimination score which could range from 0 to 5. This is a single time point assessment and is therefore not an outcome variable. There was an error when registering in clinical trials.

Outcome measures

Outcome measures
Measure	Clinical Assessment and CFI n=39 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=50 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.
Everyday Discrimination Scale	.806 score on a scale Standard Deviation .746	.658 score on a scale Standard Deviation .627

Adverse Events

Clinical Assessment and CFI

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Clinical Assessment Only

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Amanda Sanchez

George Mason University

Phone: 703-993-1354

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place

Measure	Clinical Assessment and CFI n=78 Participants CA and CFI families will receive the Cultural Formulation Interview prior to their standard Clinical Assessment during their intake. Clinical Assessment and CFI: CA and CFI families will participate in the Cultural Formulation Interview prior to their standard intake.	Clinical Assessment Only n=100 Participants CA families will receive a standard Clinical Assessment during intake. Clinical Assessment: CA families will participate their standard intake procedures.	Total n=178 Participants Total of all reporting groups
Age, Continuous Child Age	5.2 years STANDARD_DEVIATION 1.6 • n=39 Participants • CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)	5.03 years STANDARD_DEVIATION 1.5 • n=50 Participants • CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)	5.1 years STANDARD_DEVIATION 1.6 • n=89 Participants • CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)
Age, Continuous Caregiver Age	35.1 years STANDARD_DEVIATION 7.4 • n=39 Participants • CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)	33.8 years STANDARD_DEVIATION 70 • n=50 Participants • CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)	34.4 years STANDARD_DEVIATION 7.2 • n=89 Participants • CA + CFI group = 39 caregivers and 39 children (39 caregiver/child dyads). CA only group = 50 caregivers and 50 children (50 caregiver/child dyads)
Sex: Female, Male Child Sex · Female	11 Participants n=39 Participants • We only have sex data available for the child, not the caregiver. There are n=39 children in the CA+CFI group and n=50 children in the CA only group.	17 Participants n=50 Participants • We only have sex data available for the child, not the caregiver. There are n=39 children in the CA+CFI group and n=50 children in the CA only group.	28 Participants n=89 Participants • We only have sex data available for the child, not the caregiver. There are n=39 children in the CA+CFI group and n=50 children in the CA only group.
Sex: Female, Male Child Sex · Male	28 Participants n=39 Participants • We only have sex data available for the child, not the caregiver. There are n=39 children in the CA+CFI group and n=50 children in the CA only group.	33 Participants n=50 Participants • We only have sex data available for the child, not the caregiver. There are n=39 children in the CA+CFI group and n=50 children in the CA only group.	61 Participants n=89 Participants • We only have sex data available for the child, not the caregiver. There are n=39 children in the CA+CFI group and n=50 children in the CA only group.
Race (NIH/OMB) Child Race · American Indian or Alaska Native	1 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	1 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Child Race · Asian	1 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	1 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Child Race · Native Hawaiian or Other Pacific Islander	0 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Child Race · Black or African American	11 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	8 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	19 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Child Race · White	22 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	34 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	56 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Child Race · More than one race	4 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	4 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	8 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Child Race · Unknown or Not Reported	0 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	4 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	4 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · American Indian or Alaska Native	1 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	1 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · Asian	1 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	1 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · Native Hawaiian or Other Pacific Islander	0 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	0 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · Black or African American	12 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	9 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	21 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · White	22 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	34 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	56 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · More than one race	3 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	2 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	5 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race (NIH/OMB) Primary Caregiver Race · Unknown or Not Reported	0 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	5 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	5 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race/Ethnicity, Customized Child Ethnicity · Hispanic/Latinx	21 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	35 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	56 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race/Ethnicity, Customized Child Ethnicity · Haitian	1 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	3 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	4 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race/Ethnicity, Customized Child Ethnicity · Non-Hispanic or Haitian	17 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	12 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	29 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race/Ethnicity, Customized Primary Caregiver Ethnicity · Hispanic/Latinx	20 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	36 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	56 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race/Ethnicity, Customized Primary Caregiver Ethnicity · Haitian	2 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	2 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	4 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Race/Ethnicity, Customized Primary Caregiver Ethnicity · Non-Hispanic or Haitian	17 Participants n=39 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	12 Participants n=50 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)	29 Participants n=89 Participants • Total number of participants= 78 for the CA+CFI group (39 caregivers + 39 children); =100 for CA only group (50 caregivers + 50 children)
Income to needs ratio	2.2 ratio STANDARD_DEVIATION 2.8 • n=39 Participants • The income to needs ratio is reported for each caregiver/child dyad (n=89), not individually for the child and the caregiver.	2.6 ratio STANDARD_DEVIATION 4.01 • n=50 Participants • The income to needs ratio is reported for each caregiver/child dyad (n=89), not individually for the child and the caregiver.	2.4 ratio STANDARD_DEVIATION 3.5 • n=89 Participants • The income to needs ratio is reported for each caregiver/child dyad (n=89), not individually for the child and the caregiver.
Caregiver Education < High School	4 Participants n=39 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	10 Participants n=50 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	14 Participants n=89 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers
Caregiver Education High School/GED	12 Participants n=39 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	15 Participants n=50 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	27 Participants n=89 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers
Caregiver Education Some College/AA	8 Participants n=39 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	9 Participants n=50 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	17 Participants n=89 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers
Caregiver Education Bachelor's Degree	8 Participants n=39 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	9 Participants n=50 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	17 Participants n=89 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers
Caregiver Education Graduate Degree	7 Participants n=39 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	7 Participants n=50 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers	14 Participants n=89 Participants • Caregiver education is reported only for the caregiver (total N=89), not individually for the child and the caregiver. CA+CFI=39 caregivers CA only=50 caregivers
Everyday Stressors Index	32.6 scores on a scale STANDARD_DEVIATION 6.9 • n=39 Participants • Everyday Stressors Index is reported for each caregiver/child dyad (total N=89), not individually for the child and the caregiver. CA+CFI = 39 caregiver/child dyad CA only = 50 caregiver/child dyad	34.7 scores on a scale STANDARD_DEVIATION 9.3 • n=50 Participants • Everyday Stressors Index is reported for each caregiver/child dyad (total N=89), not individually for the child and the caregiver. CA+CFI = 39 caregiver/child dyad CA only = 50 caregiver/child dyad	33.8 scores on a scale STANDARD_DEVIATION 8.4 • n=89 Participants • Everyday Stressors Index is reported for each caregiver/child dyad (total N=89), not individually for the child and the caregiver. CA+CFI = 39 caregiver/child dyad CA only = 50 caregiver/child dyad
Eyberg Child Behavior Inventory	157.1 units on a scale STANDARD_DEVIATION 34.2 • n=39 Participants • Eyeberg Child Behavior Inventory is reported for each caregiver/child dyad (total N=89), not individually for the child and the caregiver. CA+CFI = 39 caregiver/child dyad CA only = 50 caregiver/child dyad	149.2 units on a scale STANDARD_DEVIATION 27.2 • n=50 Participants • Eyeberg Child Behavior Inventory is reported for each caregiver/child dyad (total N=89), not individually for the child and the caregiver. CA+CFI = 39 caregiver/child dyad CA only = 50 caregiver/child dyad	152.9 units on a scale STANDARD_DEVIATION 30.7 • n=89 Participants • Eyeberg Child Behavior Inventory is reported for each caregiver/child dyad (total N=89), not individually for the child and the caregiver. CA+CFI = 39 caregiver/child dyad CA only = 50 caregiver/child dyad