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Family Check-Up (FCU)

Topic Areas
Scientific Rating
Child Welfare Relevance
Parent Training Programs that Address Behavior Problems in Children and Adolescents
1  — Well-Supported by Research Evidence
Medium

About This Program

Target Population: Caregivers of children 2-17 years old in the middle class or lower socioeconomic level

For children/adolescents ages: 2 – 17

For parents/caregivers of children ages: 2 – 17

Program Overview

The FCU model is a family-centered intervention that promotes positive family management and addresses child and adolescent adjustment problems. The intervention does this through reductions in coercive and negative parenting and increases in positive parenting. The FCU has two phases: 1) An initial assessment and feedback; 2) Parent management training (Everyday Parenting) which focuses on positive behavior support, healthy limit setting, and relationship building. The intervention is tailored to address the specific needs of each child and family and can be integrated into many service settings including public schools; the Women, Infants, and Children (WIC) program; home visiting; primary health care; and community mental health. The FCU is appropriate for families with children from age 2 through 17 and for prevention and treatment needs. As a health promotion and prevention strategy, the FCU can be brief (2 to 3 sessions).

As a treatment approach, follow-up sessions and services can range from 3 to 15 direct contact hours using the Everyday Parenting Curriculum. Phase 2 follow-up may also include family counseling, individualized services for parent and children, or other support services. Everyday Parenting is a skills-based curriculum designed to support development of positive parenting skills. The curriculum is modular, and sessions can be tailored to the family's specific needs and readiness based on the Family Check-up Assessment.

Program Goals

The goals of the Family Check-Up (FCU) model are:

  • Improve children's social and emotional adjustment by providing assessment- driven support for parents to encourage and support positive parenting, and to reduce coercive conflict
  • Reduce young children's behavior problems at school
  • Reduce young children's emotional distress
  • Increase young children's self-regulation and school readiness
  • Improve parent monitoring in adolescence
  • Reduce parent-adolescent conflict
  • Reduce adolescent depression
  • Reduce antisocial behavior and delinquent activity
  • Improve grades and school attendance

Logic Model

The program representative did not provide information about a Logic Model for Family Check-Up (FCU).

Essential Components

The essential components of the Family Check-Up (FCU) model includes:

  • A health maintenance model that uses a child and family assessment to drive clinical intervention divided into two phases:
    • Phase I of the FCU model: Assessment and Feedback
      • A 1-hour clinical interview (session 1) between provider and parent/family. The goals of the interview are to:
        • Explain Family Check-Up process
        • Explore strengths, problem areas, and concerns
        • Identify concerns and issues family wants to address in the intervention
        • Frame concerns into issues of parenting and family management
        • Develop rapport
        • Motivate family to engage in FCU process and positive behavior changes
      • A child and family assessment that is multimethod (videotaped observation and questionnaires) and integrates data from multiple reporters (parent, child, and teacher, if applicable)
      • A 1-hour feedback session between provider and parent/family which includes:
        • Presenting parent with feedback that integrates data from all of the content areas that were assessed during the child and family assessment and information from the initial interview
        • Showing audio or video clip data from the assessment as illustrations of strengths and areas for improvement
        • Exploring with the family data-driven menu of potential follow-up interventions (including parent management training via Everyday Parenting)
    • Phase 2 of the FCU model: Parent Management Training via Everyday Parenting:
      • Sessions between the provider and parent or provider and family that use behavioral intervention strategies for parent to learn
        • Positive behavior support strategies
        • Limit-setting and monitoring skills
        • Parent-child relationship-building skills
      • The data-driven menu of potential follow-up interventions may also include:
        • Family counseling
        • Individualized services for parent and children
        • Other support services if the child and family assessment indicated a need for these services
    • FCU providers who:
      • Meet with a family, in the family's home or another setting convenient to them (e.g., school, clinic, doctor's office), to gather information and instill a sense of hope and readiness for change
      • Integrate Motivational Interviewing and comprehensive assessment to inform intervention
      • Tailor dosage and processes to client needs
      • Use a manual to facilitate intervention delivery
      • Have instructional videos available to facilitate their learning of the model and delivery of the model
      • Are evaluated on fidelity and competence to the model using empirically validated assessments
      • Are required to meet fidelity and competence benchmarks to become certified in the model
      • Participate in ongoing group and individual consultation sessions

    Program Delivery

    Child/Adolescent Services

    Family Check-Up (FCU) directly provides services to children/adolescents and addresses the following:

    • Disruptive behavior, risk-taking behavior, depressed or anxious mood, substance abuse

    Parent/Caregiver Services

    Family Check-Up (FCU) directly provides services to parents/caregivers and addresses the following:

    • Caregivers who are concerned about their child's well-being
    Services Involve Family/Support Structures:

    This program involves the family or other support systems in the individual's treatment: The FCU is a service designed to address the needs of the family as a whole. The family and other support systems are always included in the assessment and considered when deciding on an intervention plan.

    Recommended Intensity:

    Phase 1- Family Check-Up: Three sessions, approximately one-hour each at 1-2 weeks apart. Phase 2-Everyday Parenting sessions: Intensity can vary. Recommended intensity is 1 one-hour session every two weeks for a minimum of 4 sessions.

    Recommended Duration:

    1-4 months depending on the individual needs of the family

    Delivery Settings

    This program is typically conducted in a(n):

    • Adoptive Home
    • Birth Family Home
    • Foster / Kinship Care
    • Hospital
    • Outpatient Clinic
    • Community-based Agency / Organization / Provider
    • School Setting (Including: Day Care, Day Treatment Programs, etc.)

    Homework

    Family Check-Up (FCU) includes a homework component:

    In Phase 2, families are given worksheets to guide their practice of new positive behavior support, limit-setting, monitoring, and relationship-building skills. These worksheets are available in the Everyday Parenting manual.

    Languages

    Family Check-Up (FCU) has materials available in languages other than English:

    Spanish, Swedish

    For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

    Resources Needed to Run Program

    The typical resources for implementing the program are:

    • Only one provider is needed to deliver the intervention to a family.
    • Providers may meet with a family in their home or in a private room in another setting. It is strongly recommended that the interview and family interaction task used as part of the assessment be video-recorded. (It may be audio-recorded if video is not an option.) A video or audio recording device is needed to record the family interaction task and intervention sessions that are evaluated for fidelity/competence and used for supervision purposes.
    • Intervention manuals and videos used in training and intervention delivery are made available to all trained providers.
    • A computer or tablet (e.g., iPad) is not required but reduces time required for participant to complete and provider to score questionnaires administered in the child and family assessment.

    Manuals and Training

    Prerequisite/Minimum Provider Qualifications

    The FCU has been implemented by community practitioners in schools, community health centers, and government agencies. The required skill level is master's level (MSW, MS, MA, and M.Ed.) with some clinical experience. Paraprofessionals may be trained as providers; however, this requires more intensive posttraining consultation.

    Manual Information

    There is a manual that describes how to deliver this program.

    Training Information

    There is training available for this program.

    Training Contact:
    Training Type/Location:

    Three training options are offered: in-person, online, and hybrid. Training in the FCU is available through the combination of an e-learning course and virtual, interactive training; through an e-learning course and in-person workshop, and through an in-person workshop only. In-person workshops are offered at Arizona State University (in Tempe, AZ) or may be conducted onsite for a contracting agency. Training in Everyday Parenting is available through all of the above modalities as well.

    Number of days/hours:

    Practitioners complete 16-32 hours of training pre-implementation, depending on the training option chosen, with approximately 5-10 hours of consultation post-training to become certified in the model. Certification is not mandatory, however post-training consultation for provider to maintain fidelity to the intervention model is highly recommended.

    Additional Resources:

    There currently are additional qualified resources for training:

    Anne Gill
    University of Pittsburgh, Department of Psychology
    Pittsburgh, PA
    amgst35@pitt.edu

    Daniel Shaw
    University of Pittsburgh, Department of Psychology
    Pittsburgh, PA
    casey@pitt.edu

    Tracie Stufft
    University of Pittsburgh, Department of Psychology
    Pittsburgh, PA
    tae3@pitt.edu

    Adriana Alejandra Chung
    University of Pittsburgh, Department of Psychology Pittsburgh
    PA AAC96@pitt.edu

    Implementation Information

    Pre-Implementation Materials

    There are no pre-implementation materials to measure organizational or provider readiness for Family Check-Up (FCU).

    Formal Support for Implementation

    There is formal support available for implementation of Family Check-Up (FCU) as listed below:

    The REACH (Research and Education Advancing Children's Health) Institute was created at Arizona State University to provide the needed technical assistance and support to sites implementing the FCU. Doctoral and MA-level clinicians who are experts in the model provide ongoing consultation and supervision, which can include:

    • Review of videotape intervention sessions using an empirically validated measure of fidelity and competence to rate providers' delivery of the model
    • Weekly individual meetings
    • Assistance with integrating assessment data to develop a case conceptualization, complete a Family Feedback Form, and create a data-driven menu of follow-up services

    Systematic monitoring of clinical and implementation outcomes with feedback is also offered to sites, providers, and families using an online system and digital platform that can be adapted to the individual needs of implementation sites.

    An online system to facilitate coding of the family interaction task is also available. Additionally, there is a HIPAA-compliant online portal for uploading videos of intervention sessions to have a consultant/clinical supervisor review and help score family interaction tasks.

    A password-protected, secure web-based system and digital platform for both survey data collection and for monitoring implementation and clinical outcomes is available. This system can be accessed by providers, supervisors, consultants, FCU Implementation team members, or administrators to enter data on implementation or outcomes and to get reports on these data. This system, which can be accessed via any web-enabled device, can also be used to complete the child and family assessment questionnaires.

    Fidelity Measures

    There are fidelity measures for Family Check-Up (FCU) as listed below:

    The COACH rating form is used to assess provider fidelity to the model and quality of implementation. The COACH assesses the provider on 6 dimensions:

    • Conceptually accurate in the model
    • Observant and responsive to family's context and needs
    • Active in structuring sessions to optimize effectiveness
    • Careful when teaching and providing corrective feedback
    • Hope and motivation
    • Client engagement

    Providers are trained in the use of the COACH as part of the FCU training. Providers can use the COACH to self-monitor their delivery of the model and prevent program drift. A detailed manual for using the COACH is given to all providers and supervisors at training.

    Coaching and training is available to onsite supervisors so they can become reliable using the COACH and certified as supervisors to promote FCU sustainability at the implementation site.

    Please contact the program representative listed at the end of this entry for more information and copies of these assessments.

    Implementation Guides or Manuals

    There are implementation guides or manuals for Family Check-Up (FCU) as listed below:

    All implementation materials are available on FCU's website under the Resources tab, which is accessible to all participants in FCU's training programs.

    There are manuals for both the FCU and the associated Everyday Parenting program. The Everyday Parenting manual is publicly available for purchase (https://www.researchpress.com/books/538/everyday-parenting). The FCU manual is given to participants in the FCU training workshops and online learning programs.

    Instructional videos demonstrating expert providers delivering components of the model are available on the FCU website.

    As part of training in the FCU, providers receive online access to all materials needed for implementing the FCU.

    Research on How to Implement the Program

    Research has been conducted on how to implement Family Check-Up (FCU) as listed below:

    • Smith, J. D., Dishion, T. J., Moore, K. J., Shaw, D. S., & Wilson, M. N. (2013). Video feedback in the Family Check-Up: Indirect effects on observed parent–child coercive interactions. Journal of Clinical Child & Adolescent Psychology, 42(3), 405-417.
    • Smith, J. D., Stormshak, E. A., & Kavanagh, K. (2015). Results of a pragmatic effectiveness implementation hybrid trial of the Family Check-Up in community mental health agencies. Administration and Policy in Mental Health and Mental Health Services Research, 42(3), 265-278.
    • Spirito, A., Sindelar-Manning, H., Colby, S. M., Barnett, N. P., Lewander, W., Rohsenow, D. J., & Monti, P. M. (2011). Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department: results of a randomized clinical trial. Archives of Pediatrics & Adolescent Medicine, 165(3), 269-274.

    Relevant Published, Peer-Reviewed Research

    Child Welfare Outcome: Child/Family Well-Being

    When more than 10 research articles have been published in peer-reviewed journals, the CEBC reviews all of the articles as part of the rating process and identifies the 10 most relevant articles, with a focus on randomized controlled trials (RCTs) and controlled studies that have an impact on the rating. The 10 articles chosen for Family Check-Up (FCU) are summarized below:

    Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F., & Arnds, K. (2006). Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the Family Check-Up in early childhood. Journal of Consulting and Clinical Psychology, 74(1), 1–9. https://doi.org/10.1037/0022-006X.74.1.1

    Type of Study: Randomized controlled trial
    Number of Participants: 120

    Population:

    • Age — Children: Mean=24.1 months (Approximately 2 years), Adults: Mean=27.2 years (18–45 years)
    • Race/Ethnicity — Children: Not specified; Adults: 48% African American, 40% Caucasian, and 12% Biracial
    • Gender — Children: 100% Male; Adults: 100% Female
    • Status — Participants were enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Pittsburgh, Pennsylvania

    Summary: (To include basic study design, measures, results, and notable limitations)
    The purpose of the study was to test the effectiveness of the Family Check-Up (FCU) in sustaining maternal involvement and preventing the exacerbation of child conduct problems among at-risk toddler-age boys. Participants were randomized either to FCU or to a control group. Measures utilized include the Beck Depression Inventory, a measure of child inhibition, the Child Behavior Checklist for Ages 1.5-5 (CBCL), and the Home Observation for Measurement of the Environment (HOME) Inventory. Results indicate that FCU was associated with reductions in disruptive behavior and greater maternal involvement and was particularly effective for children at greater risk for a persistent trajectory of conduct problems. Limitations include reliance on self-report measures and lack of generalizability of the results to female children.

    Length of controlled postintervention follow-up: 2 years.

    Connell, A., Bullock, B. M., Dishion, T. J., Shaw, D., Wilson, M., & Gardner, F. (2008). Family intervention effects on co-occurring early childhood behavioral and emotional problems: A latent transition analysis approach. Journal of Abnormal Child Psychology, 36(8), 1211–1225. https://doi.org/10.1007/s10802-008-9244-6

    Type of Study: Randomized controlled trial
    Number of Participants: 731

    Population:

    • Age — Children: 2 years; Adults: Not specified
    • Race/Ethnicity — Not specified
    • Gender — Children: Not specified; Adults: 100% Female
    • Status — Participants were enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Metropolitan Pittsburgh, Pennsylvania; suburban Eugene, Oregon and rural Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The purpose of the study was to examine changes in early emotional and behavioral problems in children resulting from participation in the Family Check-Up (FCU) program. Participants were randomized either to FCU or to a nonintervention control group. Measures utilized include a demographics questionnaire and the Child Behavior Checklist for Ages 1.5 to 5 (CBCL). Results indicate that children in the FCU group were more likely to move from the comorbid or internalizing group to the normative group by age 4. Few intervention effects were seen from age 2 to 3 years, while more pronounced intervention effects were found from age 3 to age 4. Limitations include possible rater bias and reliability of measurement tool to assess early internalizing problems.

    Length of controlled postintervention follow-up: 2 years.

    Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008). The Family Check-Up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79(5), 1395–1414. https://doi.org/10.1111/j.1467-8624.2008.01195.x

    Type of Study: Randomized controlled trial
    Number of Participants: 731

    Population:

    • Age — Children: 2–4 years (Mean = 29.9 months at the age 2 assessment); Adults: Not specified
    • Race/Ethnicity — Children: Not specified; Adults: 50% European American, 28% African American, 13% Hispanic American, 13% Biracial, and 9% Other
    • Gender — Children: 49% Female; Adults: 100% Female
    • Status — Participants were enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Metropolitan Pittsburgh, Pennsylvania; suburban Eugene, Oregon; and rural Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The study used the same sample as Connell et al. (2008). The purpose of the study was to examine changes in early emotional and behavioral problems in children resulting from participation in a family-centered intervention. Participants were randomized either to the Family Check-Up (FCU) or to a nonintervention control group. Measures utilized include a demographics questionnaire, a maternal indicator for depression, the Eyberg Child Behavior Inventory, and the Child Behavior Checklist for Ages 1.5-5 (CBCL). Results indicate that there were decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the FCU group improved on direct observation measures of caregivers’ positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children’s early problem behavior. Limitations include modest effect size and reliance on parental report of child behavior.

    Length of controlled postintervention follow-up: 1+ years.

    Lunkenheimer, E. S., Dishion, T. J., Shaw, D. S., Connell, A. M., Gardner, F., Wilson, M. N., & Skuban, E. M. (2008). Collateral benefits of the Family Check-Up on early childhood school readiness: Indirect effects of parents' positive behavior support. Developmental Psychology, 44(6), 1737–1752. https://doi.org/10.1037/a0013858

    Type of Study: Randomized controlled trial
    Number of Participants: 731

    Population:

    • Age — Children: 2–4 years (Mean = 29.9 months at the age 2 assessment); Adults: Not specified
    • Race/Ethnicity — Children: 50% European American, 28% African American, 13% Hispanic American, 13% Biracial, and 9% Other; Adults: Not specified
    • Gender — Children: 51% Male and 49% Female; Adults: 97% Female, 2% Male, and 1% Unknown
    • Status — Participants were enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Metropolitan Pittsburgh, Pennsylvania, suburban Eugene, Oregon, and rural Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The study used the same sample as Dishion et al. (2008). The purpose of the study was to examine the longitudinal effects of the Family Check-Up (FCU) on parents’ positive behavior support and children’s school readiness competencies in early childhood. Participants were randomized either to the FCU or to a nonintervention control group. Measures utilized include parent involvement: Infant/Toddler Home Observation for Measurement of the Environment (HOME) Inventory, The Coder Impressions Inventory, a demographics questionnaire, a maternal indicator for depression, the Eyberg Child Behavior Inventory, and the Child Behavior Checklist for Ages 1.5-5 (CBCL). Results indicate that parents in families randomly assigned to the FCU showed improvements in positive behavior support from child age 2 to 3, which in turn promoted children’s inhibitory control and language development from age 3 to 4, accounting for child gender, ethnicity, and parental education. Limitations include attrition and use of self-report measures

    Length of controlled postintervention follow-up: 1+ years.

    Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. (2009). Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Development and Psychopathology, 21(2), 417–439. https://doi.org/10.1017/S0954579409000236

    Type of Study: Randomized controlled trial
    Number of Participants: 731

    Population:

    • Age — Children: 2–4 years (Mean = 29.9 months at the age 2 assessment); Adults: Not specified
    • Race/Ethnicity — Children: 50% European American, 28% African American, 13% Hispanic American, 13% Biracial, and 9% Other; Adults: Not specified
    • Gender — Children: 49% Female; Adults: 100% Female
    • Status — Participants enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Metropolitan Pittsburgh, Pennsylvania, suburban Eugene, Oregon, and rural Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The study used from the same sample as Dishion et al. (2008). The purpose of the study was to examine the efficacy of Family Check-Up (FCU) in improving maternal depression and test whether such changes if found, accounted for reductions in both child externalizing and internalizing problem behaviors. Participants were randomized either to the FCU or to a nonintervention control group. Measures utilized include a demographics questionnaire, Locke-Wallace Marital Adjustment Test (LWMAT), the Center for Epidemiological Studies on Depression Scale (CES-D), the Eyberg Child Behavior Inventory (ECBI), and the General Life Satisfaction Questionnaire. Results indicate that there were intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. Limitations include potential reporter bias.

    Length of controlled postintervention follow-up: 1 year.

    Van Ryzin, M. J., & Dishion, T. J. (2012). The impact of a family-centered intervention on the ecology of adolescent antisocial behavior: Modeling developmental sequelae and trajectories during adolescence. Development and Psychopathology, 24(3), 1139–1155. https://doi.org/10.1017/S0954579412000582

    Type of Study: Randomized controlled trial
    Number of Participants: 998

    Population:

    • Age — 12 years
    • Race/Ethnicity — 42% European American, 29% African American, 7% Latinos, 5% Asian, and 16% Other Ethnicities
    • Gender — 58% Male and 47% Female
    • Status — Participants were adolescents and their families recruited in sixth grade.

    Location/Institution: Three middle schools in a Metropolitan Community in the Northwestern United States

    Summary: (To include basic study design, measures, results, and notable limitations)
    The purpose of the study was to use an experimental, longitudinal field trial involving random assignment to the Family Check-Up (FCU) to explore the social ecology of adolescent antisocial behavior. Participants were randomly assigned at the individual level to either control or intervention classrooms in the spring of sixth grade. Measures utilized include the Child Behavior Checklist. Results indicate that FCU in middle school was associated with reductions in late adolescence antisocial behavior (age 18–19). Limitations include reliance on self-reported measures.

    Length of controlled postintervention follow-up: 1 year.

    Dishion, T. J., Brennan, L. M., McEachern, A., Shaw, D. S., Wilson, M. N., & Weaver, C. M. (2014). Prevention of problem behavior through annual Family Check-Ups in early childhood: Intervention effects from the home to the beginning of elementary school. Journal of Abnormal Child Psychology, 42(3), 343–354. https://doi.org/10.1007/s10802-013-9768-2

    Type of Study: Randomized controlled trial
    Number of Participants: 731

    Population:

    • Age — Children: 2–4 years (Mean=29.9 months); Adults: Not specified
    • Race/Ethnicity — Children: Not specified; Adults: 50% European American, 28% African American, 13% Biracial, and 9% Other
    • Gender — Children: Not specified; Adults: 100% Female
    • Status — Participants were enrolled in the WIC program.

    Location/Institution: Metropolitan Pittsburgh, Pennsylvania; Suburban Eugene, Oregon; and Rural Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The purpose of the study was to examine the effects of yearly Family Check-Up (FCU) and tailored parent management training on parent report of problem behavior and teacher report of oppositional behavior. Participants were randomized either to the FCU or to a nonintervention control group. Measures utilized include a demographics questionnaire, a maternal indicator for depression, and the Child Behavior Checklist for Ages 1.5-5 (CBCL). Results indicate that Intention to Treat (ITT) intervention effects were found regarding parent report at ages 2 to 5 and teacher report at age 7.5, indicating less growth in problem behavior for children in the intervention group than for those in the control group. Analysis revealed that the effect sizes on parent- and teacher-reported problem behavior increased as a function of the number of yearly FCU caregivers participated in. Limitations include considerable loss of teacher report data in 2 out of 3 sites, and lower engagement by minority families at all time points.

    Length of controlled postintervention follow-up: Varies.

    Shaw, D. S., Sitnick, S. L., Brennan, L. M., Choe, D. E., Dishion, T. J., Wilson, M. N., & Gardner, F. (2015). The long-term effectiveness of the Family Check-Up on school-age conduct problems: Moderation by neighborhood deprivation. Development and Psychopathology, 28(4, Part 2), 1471–1486. https://doi.org/10.1017/S0954579415001212

    Type of Study: Randomized controlled trial
    Number of Participants: 731 caregiver-child dyads

    Population:

    • Age — 7.5–9.5 years; Adults: Not specified
    • Race/Ethnicity — Children: Not specified; Adults: 50% European American, 28% African American, 13% Hispanic American, 13% Biracial, and 9% Other
    • Gender — Children: 49% Female; Adults: 100% Female
    • Status — Participants were enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The study used the same sample as Dishion et al. (2008). The purpose of the study was to examine whether previously established intervention effects of the Family Check-Up (FCU) on child conduct problems at age 7.5 would persist through age 9.5, and whether neighborhood deprivation would moderate these effects. The study also examined whether improvements in parent-child interaction examined during early childhood associated with the FCU would be related to later reductions in child aggression among families living in the highest risk neighborhoods. Participants were randomized to the FCU (intervention) or WIC care as usual (control) group. Measures utilized include the Teacher Report Form (TRF), the Child Behavior Checklist (CBCL), the Relationship Affect Coding System (RACS), and the Geocoded US Census data. Results indicate that FCU effects were found to be moderated by neighborhood deprivation. The effect was such that although Intent-to-treat effects were found on parenting across neighborhood risk, direct effects on child aggression were only evident for those living in neighborhoods characterized by moderate levels of deprivation. For those families living in neighborhoods characterized by more extreme neighborhood adversity, direct effects of the FCU intervention on child conduct problems were not evident. Neighborhood deprivation moderation was found regardless of whether the threshold for defining severe deprivation was set at the median, upper third, or upper fourth of the sample; intervention effects continued to be evident for the moderate-risk neighborhood group and not found for the severe-risk group. The path from positive engagement to teacher reports of child conduct problems was only significant for those living in the higher risk neighborhoods, with a marginally significant trend for the entire indirect effect from the FCU to changes in positive engagement to school-age child conduct problems. Limitations include lack of generalizability to other ethnic populations and other populations not living in urban settings, and focus primarily on aggressive behaviors.

    Length of controlled postintervention follow-up: Approximately 7.5 years.

    Chang, H., Shaw, D. S., Shelleby, E. C., Dishion, T. J., & Wilson, M. N. (2016). The long-term effectiveness of the Family Check-up on peer preference: Parent-child interaction and child effortful control as sequential mediators. Journal of Abnormal Child Psychology, 45(4), 705–717. https://doi.org/10.1007/s10802-016-0198-9

    Type of Study: Randomized controlled trial
    Number of Participants: 731 caregiver-child dyads

    Population:

    • Age — 7.5–9.5 years
    • Race/Ethnicity — 42% Caucasian, 29% African American, 16% Other 7% Latino, and 5% Asian American
    • Gender — 53% Male and 47% Female
    • Status — Participants were enrolled in the Women, Infants and Children (WIC) program.

    Location/Institution: Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The study used the same sample as Dishion et al. (2008). The purpose of the study was to examine the longitudinal effects of the Family Check-Up (FCU) intervention beginning in toddlerhood on children’s peer preference at school-age. Participants were randomized to the intervention or control group. Measures utilized include Composite International Diagnostic Interview (CIDI), Kochanska’s Behavioral Battery of Effortful Control, Children’s Behavior Questionnaire (CBQ), the Relationship Affect Coding System (RACS), Teacher Ratings of Peers and Social Skills (TPRSK), and demographic questionnaires. Results indicate that FCU indirectly predicted peer preference by improving parent-child interaction and child effortful control. Limitations include reliance on self-reported measures; and lack of generalizability to other ethnic populations, and other populations not living in urban settings.

    Length of controlled postintervention follow-up: Approximately 5 years.

    Connell, A. M., & Dishion, T. J. (2016). Long-term effects of the Family Check-Up in public secondary school on diagnosed major depressive disorder in adulthood. Journal of Youth and Adolescence, 46(3), 570–581. https://doi.org/10.1007/s10964-016-0482-6

    Type of Study: Randomized controlled trial
    Number of Participants: 754 caregiver-child dyads

    Population:

    • Age — 28–30 years
    • Race/Ethnicity — 42% Caucasian, 29% African American, 16% Other, 7% Latino, and 5% Asian American
    • Gender — 53% Male and 47% Female
    • Status — Participants were enrolled in the Family Check-Up program from 6th grade.

    Location/Institution: Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia

    Summary: (To include basic study design, measures, results, and notable limitations)
    The purpose of the study was to utilize information from Dishion et al. (2008) to examine the long-term effects of Family Check-Up (FCU) on depression, from a school-based prevention trial of youth followed-from grades 6 (approximately age 11–12 years) through early adulthood (age 28–30). Participants were randomly assigned at the individual level to either FCU or control classrooms in the spring of sixth grade. Measures utilized include Composite International Diagnostic Interview (CIDI) and teacher questionnaire. Results indicate that the effects of intervention on depression diagnoses in adulthood were limited to youth from families low in conflict at baseline. Among low-conflict families, youth in the control group were approximately 2.5 times more likely to develop a depression diagnosis by adulthood, relative to youth in the intervention condition. However, for families high in conflict at baseline, the FCU intervention did not predict long-term reductions in the likelihood of developing depression. For academic performance (measured by grade point average), results suggest that the prevention approach was most effective for the highest risk youth at baseline (those with the lowest grade point averages). Among youth with lower grade point averages, the prevention program was associated with significant reductions in past-year depression diagnoses by adulthood, relative to youth with higher grade point averages. Results indicate that the effects of the FCU program on adult depression diagnoses do not differ for males and females. Limitations include reliance on self-reported measures, attrition, and possible baseline differences in depression across intervention and control condition as a possible explanation for apparent intervention effects.

    Length of controlled postintervention follow-up: Approximately 17 years.

    Additional References

    Dishion, T. J., & Stormshak, E. A. (2007). Intervening in children's lives: An ecological, family-centered approach to mental health care. Washington, DC: American Psychological Association.

    Dishion, T. J., Stormshak, E. A., & Kavanagh, K. (2011). Everyday Parenting: A professional's guide to building family management skills. Champaign, IL: Research Press.

    Gill, A. M., Hyde, L. W., Shaw, D. S., Dishion, T. J., & Wilson, M. N. (2008). The Family Check-Up in early childhood: A case study of intervention process and change. Journal of Clinical Child & Adolescent Psychology, 37(4), 893-904.

    Contact Information

    Chris Hazen
    Agency/Affiliation: NW Prevention Science
    Website: www.nwpreventionscience.org
    Email:
    Phone: (415) 685-0023

    Date Research Evidence Last Reviewed by CEBC: July 2023

    Date Program Content Last Reviewed by Program Staff: January 2022

    Date Program Originally Loaded onto CEBC: June 2016