Preventing Behavior and Health Problems in Foster Teens

Study Overview
=================
Brief Summary
-----------------
The primary goal of this study is to test the efficacy of two levels of the KEEP intervention with adolescents and their foster and kin parents in the San Diego Child Welfare System.

Detailed Description
-----------------
The cost of child welfare services in the U.S. has been estimated at $20 billion per year. During the past decade, the number of teenagers in foster care has nearly doubled. Numerous studies have documented that these adolescents are at high-risk for developing serious problems, including substance use, participation in health-risking sexual behaviors, involvement in the juvenile justice system, serious educational problems and school drop-out, failed placements/foster care drift and homelessness. Yet, there is little research on the characteristics of interventions that can be used to guide the improvement of services for this vulnerable population of youngsters. The proposed study extends our previous research with adolescents referred for serious behavioral and emotional problems and research with elementary-aged children in foster care to a test of the efficacy of a preventive intervention for adolescents placed with foster and kin care providers in the San Diego County Child Welfare System. Two hundred and forty adolescents and their foster/kin care providers will participate (i.e., 60 in a foster/kin parent training only condition, 60 in a parent training plus youth skill training condition, and 120 in a casework as usual control condition). In addition to testing the efficacy of the two levels of intervention, the investigators propose to examine the effects of the intervention on a set of youth behavioral and health-related outcomes. Parenting mediators to be tested include positive parenting, parental supervision, and non-harsh discipline. Youth mediators are social competence, commitment to school, and knowledge about norms related to health-risking behaviors including substance use and high-risk sexual behavior. In addition, theoretical hypotheses about the effects of early risk/adversity factors to youth outcomes will be examined, and an economic analysis will be conducted to examine the relative benefits and costs associated with the two levels of intervention.

Official Title
-----------------
Preventing Behavior and Health Problems in Foster Teens

Conditions
-----------------
Parent Management Training

Intervention / Treatment
-----------------
* Behavioral: Parent Training
* Behavioral: Youth Skills Training


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Any child between ages 12 and 16 years in relative or non-relative foster care Exclusion Criteria: Only medically fragile children

Ages Eligible for Study
-----------------
Minimum Age: 12 Years
Maximum Age: 16 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Services As Usual<br>Foster care services as usual | |
| Experimental: Parent and Youth Training<br>16 Weeks of Parent Training in group context with 5 to 10 relative and non-relative foster caregivers; Youth training with skills coaches | Behavioral: Parent Training<br>* 16 weeks of parent training led by a trained group facilitator<br>* Other names: KEEP;Behavioral: Youth Skills Training<br>* 16 weeks of one-on-one sessions with a trained youth skills coach<br>* Other names: Skills Coaching;|
| Experimental: Parent Training<br>16 weeks of parent training with 5 to 10 relative and non-relative foster caregivers | Behavioral: Parent Training<br>* 16 weeks of parent training led by a trained group facilitator<br>* Other names: KEEP;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduction in child behavior problems as assessed by the Parent Daily Report (PDR) |  | Baseline, 6 Months, 12 Months, 18 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Placement Disruptions from Foster Placement |  | 6 Months, 12 Months, 18 Months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
behavior problems, foster care, parent training, youth skills training