Cascading Dissemination of a Foster Parent Intervention
Condition: Child Welfare; Foster Home Care
Study type: Interventional

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.
    

Intervention name(s): Parent Training
Intervention type(s): Behavioral
Intervention description(s): 16 weeks of of parent training led by a trained group facilitator
Other intervention name(s): Parent Management Training
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: child behavior; parent training