A Targeted Prevention Approach to Reducing Child Emotional and Behaviour Problems
Condition: Emotional Problems; Behavior Problems
MeSH terms: Problem Behavior
Study type: Interventional

Summary: 
      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: 
      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.
    

Intervention name(s): Family Check Up
Intervention type(s): Behavioral
Intervention description(s): 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.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: preschool mental health; emotional and behaviour problems