Clinical trial NCT06294392: KEEP Connecting Kin
Official title: KEEP Connecting Kin: Improving Outcomes for Informal Kinship Care Families Via an In-Home Parenting and Peer-Support Program
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Internalizing Behavior
Externalizing Behavior
Child Permanency
Parenting
Parent Stress
Service Utilization
Lead sponsor: Oregon Social Learning Center
Sponsor class: OTHER
Collaborators: name: Office of Planning, Research & Evaluation
First posted: 2024-03-05
Enrollment: 192
Sex: ALL
Minimum age (years): 4
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Informal kinship caregivers will be randomly assigned to receive the KEEP-CK program either immediately or after waiting 10 months using a randomized blocked design. Blocking factors include: (a) the length of time that the child has been living in informal kinship care (\<=6 months, 7 months to \<2 years, or \>=2 years); (b) child age (4 to 12 years, or 13+ years); and (c) low (or not low) resource families, defined by an annual household income below (or above) 150% of the federal poverty level.
Primary purpose: PREVENTION

Brief summary: The current study provides a unique opportunity to conduct a summative evaluation of the KEEP Connecting Kin (KEEP-CK) program by leveraging extant relationships with Oregon's Child Welfare System (CWS), Self-Sufficiency Program (SSP), and our community partners to address the needs of informal kinship families and the youth in their care. Specifically, a randomized "services-as-usual" (SAU) waitlist control design plus qualitative methods will be used to evaluate the immediate (post-intervention) and sustained (10 month) impacts of the KEEP-CK program on child, adult, and service utilization outcomes, and prevention of entry into the CWS.

Detailed description: In the 2022 Oregon census, it was estimated that for every child placed in kinship foster care, there are 14 children being raised by kin outside of the child welfare system (CWS), with \~37,000 children being raised by kin and \~17,000 of those by grandparents. Kin caregivers, in particular those who are informal or voluntary, have fewer supports compared to non-relative (foster) caregivers and kin caregivers who are licensed by the CWS. Kin families are far less likely to access and utilize services in multiple systems. Thus, there is a great need to provide kin families with resources and keep youth who are living in kinship care out of the CWS.

"Keeping Parents Supported and Trained" (KEEP) was initially developed to focus on foster and kinship families involved in the CWS. In three prior NIH-funded randomized controlled trials, KEEP has shown positive impacts on youth and parent outcomes, and placement stability. KEEP has been scaled-up statewide in Oregon for CWS-involved families. The current study will focus on informal kinship care, thereby adding to an emerging body of evidence on the benefits of providing enhanced parenting and peer support to families by scaling-out the KEEP program to serve kin families outside of the CWS. This research builds on an initial study, "KEEP Connecting Kin" (KEEP-CK), where KEEP was adapted for informal kin, currently underway with participant recruitment ending in October 2023.

The proposed study (KEEP-CK#2) leverages our on-going relationships with state leadership in the CWS and SSP, and our community partners delivering KEEP-CK in Study #1 statewide in Oregon. In Study #2, a randomized "services-as-usual" (SAU) waitlist control design plus qualitative methods will be used to conduct a summative evaluation of the KEEP-CK program by recruiting N = 192 kinship families to examine the immediate (post-intervention) and sustained (10 month) impacts of the program on child, adult, and service utilization outcomes and prevention of entry into the CWS. Research questions include:

Aim 1 (impact on child and adult outcomes): The KEEP-CK program is posited to improve child and adult outcomes at the end of the intervention, and such effects are posited to be sustained at 6 months after the end of the intervention (10 months post baseline), compared to those who received SAU. Targeted child outcomes include (a) child well-being (i.e., behavioral and emotional functioning, including child internalizing and externalizing behaviors) and (b) child permanency (i.e., placement stability and permanency of placements). Targeted adult outcomes include (c) parenting practices and (d) parent/caregiver stress.

Aim 2 (impact on use of services): The KEEP-CK program is posited to increase parents' access to and use of services from multiple systems (e.g., Oregon Kinship Navigator, financial, educational, mental health, medical, legal) at post-intervention and follow-up compared to those who received SAU.

Aim 3 (impact on prevention of entry into the CWS): The KEEP-CK program is posited to reduce the likelihood that youth who are living in kinship care enter into the CWS by the 10-month follow-up assessment, compared to youth whose kinship caregivers received SAU.

Aim 4 (parent and youth perspectives): Qualitative methods will be used to evaluate families' satisfaction with and perspectives on the impact of KEEP-CK on child and adult outcomes.

Eligibility criteria: Inclusion Criteria:

* Informal kinship caregivers in Oregon are defined as relatives or fictive kin who are caring for children between the ages of 4 to 18 years outside of the child welfare system with no birth/step parent living in the home.

Exclusion Criteria:

* Informal kinship caregivers in Oregon who have previously participated in a KEEP or KEEP-CK group, or have a partner living in their home who has previously participated in a KEEP or KEEP-CK group.
* Focal child is not between the ages of 4-18 years at the baseline assessment.
* Focal child has been adopted by the kinship parent at the baseline assessment.
* Focal child is not living with the kinship caregiver full time (e.g., babysitting/weekends/vacations) at the baseline assessment.
* Focal child is in child welfare at the baseline assessment.
* Focal child is living with the kinship caregiver in a certified foster home at the baseline assessment.
* Focal child has a developmental disability or delay that impairs their ability to be responsive to the parenting content of KEEP-CK.

Primary outcomes:
measure: Mean change in youth well-being (i.e., behavioral and emotional functioning, including child internalizing and externalizing behaviors)
timeFrame: Baseline, and 4- and 10-months post-baseline
measure: Mean change in child permanency (i.e., placement stability and permanency of placements)
timeFrame: Baseline, and 4- and 10-months post-baseline
measure: Mean change in parenting practices and parent/caregiver stress.
timeFrame: Baseline, and 4- and 10-months post-baseline
measure: Mean change in parent/caregiver stress.
timeFrame: Baseline, and 4- and 10-months post-baseline
measure: Mean change in parenting practices.
timeFrame: Baseline, and 4- and 10-months post-baseline
measure: Mean change in parents' use of services from multiple systems (financial, educational, mental health, medical, legal)
timeFrame: Baseline, and 4- and 10-months post-baseline
Secondary outcomes:
Other outcomes:
Locations:
city: Eugene
country: United States
facility: Oregon Center Learning Center
state: Oregon
Study officials:
affiliation: Oregon Social Learning Center
name: Stacey Tiberio, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: