Systematically Adapted Delivery of the Family Check-Up

Study Overview
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Brief Summary
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Early childhood disruptive behavior problems lead to significant costs to families and society, but can be reduced with behavioral parent training interventions. To increase the public health impact of these interventions, their feasibility, accessibility, and acceptability in high-need, underserved communities must be ensured. This pilot project will systematically adapt and pilot-test the delivery model of an existing effective parent training intervention for implementation in rural Appalachia, a region with many documented health disparities, high levels of poverty, and shortages of mental health providers. Community health workers in 5 rural Appalachian counties will be trained to deliver a behavioral parent training intervention. Each worker will deliver the intervention to 4 parent-child dyads.

Official Title
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Systematically Adapted Delivery of the Family Check-Up in Underserved Communities

Conditions
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Parenting, Child Behavior, Implementation

Intervention / Treatment
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* Behavioral: behavioral parent training
* Behavioral: interventionist training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents: aged 18+ years, custodial guardian of child, can speak/read/understand English Children: ages 3-5 years, lives full time in custodial guardian's home Community health workers: aged 18+ years, currently employed at a partnering health department, able to speak/read/understand English Exclusion Criteria: Parents: has already accessed behavioral health services for the child, reports suicidal ideation or intent to harm self or others, participated in formative research for this study Children: diagnosed with a severe developmental condition (i.e., significant developmental delay, autism, debilitating neurological condition) Community health workers: none

Ages Eligible for Study
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Minimum Age: 3 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Community Health Workers<br>Community health workers will complete a 5-day interventionist training to deliver a behavioral parent training intervention. | Behavioral: interventionist training<br>* Interventionists are trained in the delivery of the Family Check-Up program and deliver sessions to families in their community<br>|
| Other: Parent-Child Dyads<br>Parents and children will receive a behavioral parent training intervention delivered by community health workers. | Behavioral: behavioral parent training<br>* Parents receive up to 6 sessions of the Family Check-Up program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility: Enrollment | Percentage of invited parents who enroll in the study (obtained from process records) | 2 weeks after final parent-child dyad completes the study | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility: Number of sessions completed | Number of sessions completed by each parent-child dyad (obtained from process records) | 2 weeks after final parent-child dyad completes the study | 
| Feasibility: Interventionist-reported fidelity | Fidelity Checklist (completed by community health workers) | following each behavioral parent training intervention session | 
| Feasibility: Parent satisfaction | European Parent Satisfaction Scale about Early Intervention (EPASSEI) (completed by parents) | 10 weeks after parent baseline | 
| Interventionist satisfaction | Therapist Satisfaction Index (completed by community health workers) | 2 weeks after final parent-child dyad completes study | 
| Interventionist evidence-based practice attitudes | Evidence-Based Practice Attitude Scale-50 (completed by community health workers) | 2 weeks after final parent-child dyad completes study | 
| Interventionist self-efficacy | Counselor Activity Self-Efficacy Scale (completed by community health workers) | 2 weeks after final parent-child dyad completes study |