Cascading Dissemination of a Foster Parent Intervention

NCT ID: NCT04456738

Last Updated: 2020-07-02

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 704 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2000-07-31
• Study Completion Date: 2005-06-30

Brief Summary

The primary goal of this study is to test the effectiveness of KEEP (Keeping Foster Parents Supported and Trained), an intervention intended to increase supports and consultation to foster parents, and to evaluate the transferability of the proposed intervention from Oregon to the foster care system in San Diego.

Detailed Description

Children in the foster care system are growing in number, are at high risk for psychological problems, and are increasingly challenging to their foster parents. Foster parents who are trying to provide care and nurturing to these children are often doing so without benefit or meaningful or relevant consultation on developmental and mental health issues. The study tests the effectiveness of an intervention intended to increase supports and consultation to foster parents. A major aim of this study was to test the transferability of the proposed intervention from Oregon to the foster care system in San Diego in 3 regions of Health and Human Services. A cascading dissemination model will be employed, where the original developers train and supervise staff in San Diego to implement the intervention, and in the second iteration of the of the intervention, the involvement of the original developers lessened. The intervention is designed to provide foster parents with general support and specific parent management training (PMT), a well-documented and effective intervention approach. In a previous efficacy trial, PMT had positive effects with foster parents in three areas: 1) reduction of child symptoms, 2) lower rates of disruption in foster care (changes in placements for negative reasons), and 3) fewer foster parents in the PMT condition dropped out of providing foster care. Outcomes will be evaluated at multiple levels, including child symptoms, functional behavior, environments, consumer perspectives, and system using a multi-method/multi-agent strategy. Implementation fidelity will be assessed, as will contextual factors, including the organizational climate and social isolation/insularity of the foster parents. It is hypothesized that, compared to controls, foster parents in the intervention group will improve on parenting skills, feel more supported, and have less stress, which in turn will result in more positive child outcomes, including fewer reported child symptoms and higher levels of child functional behavior in three domains (i.e., home, school, with peers). Improvements in foster parent outcomes and child outcomes are both hypothesized to predict system-level outcomes, including child use of mental health services, foster parent retention, and placement disruptions. Contextual factors are expected to impact foster parent outcomes directly and child and system outcomes indirectly, through implementation fidelity.

Conditions

Child Welfare; Foster Home Care

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: DOUBLE

Study Groups

Parent Training

16 weeks of parent training in a group context with 5 to 10 relative and non-relative foster caregivers

Group Type: EXPERIMENTAL

Parent Training

Intervention Type: BEHAVIORAL

16 weeks of of parent training led by a trained group facilitator

Services as Usual

Foster care services as usual

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Parent Training

16 weeks of of parent training led by a trained group facilitator

Intervention Type: BEHAVIORAL

Other Intervention Names

Parent Management Training

Eligibility Criteria

Inclusion Criteria

• Any child between ages 5 and 12 years in relative or non-relative foster care

Exclusion Criteria

• Only medically fragile children

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 12 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

Oregon Social Learning Center

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Patricia Chamberlain, PhD

Role: PRINCIPAL_INVESTIGATOR

Oregon Social Learning Center

Locations

Child and Adolescent Services Research Center

San Diego, California, United States

Oregon Social Learning Center

Eugene, Oregon, United States

Countries

United States

References

Price JM, Chamberlain P, Landsverk J, Reid JB, Leve LD, Laurent H. Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreat. 2008 Feb;13(1):64-75. doi: 10.1177/1077559507310612.

Reference Type: BACKGROUND

PMID: 18174349 (View on PubMed)

Chamberlain P, Price JM, Reid JB, Landsverk J, Fisher PA, Stoolmiller M. Who disrupts from placement in foster and kinship care? Child Abuse Negl. 2006 Apr;30(4):409-24. doi: 10.1016/j.chiabu.2005.11.004. Epub 2006 Apr 5.

Reference Type: BACKGROUND

PMID: 16600372 (View on PubMed)

Chamberlain P, Price J, Reid J, Landsverk J. Cascading implementation of a foster and kinship parent intervention. Child Welfare. 2008;87(5):27-48.

Reference Type: BACKGROUND

PMID: 19402358 (View on PubMed)

Chamberlain P, Price J, Leve LD, Laurent H, Landsverk JA, Reid JB. Prevention of behavior problems for children in foster care: outcomes and mediation effects. Prev Sci. 2008 Mar;9(1):17-27. doi: 10.1007/s11121-007-0080-7. Epub 2008 Jan 10.

Reference Type: BACKGROUND

PMID: 18185995 (View on PubMed)

Degarmo DS, Chamberlain P, Leve LD, Price J. Foster Parent Intervention Engagement Moderating Child Behavior Problems and Placement Disruption. Res Soc Work Pract. 2009 Jul 1;19(4):423-433. doi: 10.1177/1049731508329407.

Reference Type: BACKGROUND

PMID: 20072708 (View on PubMed)

Price, J., Chamberlain, P., Landsverk, J., & Reid, J. B. (2010). KEEP foster parent training intervention: Model description and effectiveness. Child and Family Social Work, 14, 233-242.

Reference Type: RESULT

Other Identifiers

R01MH060195

Identifier Type: NIH

Identifier Source: secondary_id

View Link

KEEP60195

Identifier Type: -

Identifier Source: org_study_id