Substance Use, Child Abuse, Child Neglect, Fathers, Father-Child Relations
Conditions
Brief summary
Montefiore will engage fathers in families at risk of substance misuse in the Bronx and neighboring communities. Families will be referred from Bronx and neighboring community-based child welfare systems, substance use disorder (SUD) treatment providers, and medical providers if identified at risk of substance use concerns and will be randomly assigned to receive services as usual as part of the comparison group, or to receive enhanced services as part of the program group. Enhanced services include: (1) Motivational Enhancement; (2) referral to Healthy, Empowered, Resilient, and Open (HERO) Dads fatherhood engagement program; (3) Contingency Management; and (4) Case Management.
Interventions
BEHAVIORALMotivational Enhancement
Evidence-based adaptation of Motivational Interviewing (MI), designed to target ambivalence to change and create internal motivation to engage in substance abuse treatment
BEHAVIORALHERO Dads Fatherhood Program
Use the 24/7 Dad fatherhood curriculum, delivered by Montefiore HERO Dads, with an additional 4-session employment education curriculum and 3-session parent coaching to reinforce individual skills learned in fatherhood curriculum. Curriculum designed to increase awareness, knowledge, and skills for parenting and co-parenting.
BEHAVIORALContingency Management
To improve attendance at services and abstinence outcomes.
BEHAVIORALCase Management
Referrals to substance use disorder (SUD) treatment and engagement, mental health resources, public assistance resources, connection to the Office of Childhood Services and other case management needs.
Sponsors
Montefiore Medical Center
Albert Einstein College of Medicine
Mathematica Policy Research, Inc.
New York State Office of Children and Family Services
New York State Office of Addiction Services and Supports
New York City Human Resources Administration (HRA)
Children's Bureau - Administration for Children and Families
New York City Administration for Children's Services
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
A 2:1 treatment:comparison randomization scheme is planned. Statistical Analysis System (SAS) will be used to generate the scheme and block randomization will be used to ensure the ratio. Randomization will not be stratified. The rationale for this is that it is believed participant characteristics would be similar across different enrollment resources (i.e., different enrollment sites). The evaluator and statistician, who do not have access to the participants or their records, will be generate the randomization scheme.
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* is a custodial or non-custodial father * speaks English or Spanish * has at least one child under the age of 18, * someone in the family is identified as at-risk for substance use through: self-report of illicit substance use in the family, the presence of an SUD diagnosis in the family, a clinician/provider identified substance use risk, or the presence of a substance-related indicated child welfare allegation in the family
Exclusion criteria
* The placement of all children in the family in foster care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Child well-being | Baseline and 6 Month followup | Child well-being will be assessed by the Child Behavior Checklist. This is a standardized self-report measure widely used in the measure of child behavior and child well-being. Separate forms are used for children aged 1.5-5, and 6-18. The questionnaire is completed by the caregiver using a series of Likert scales (0=absent, 1=sometimes, 2=often occurs). There are 113 questions, measuring a series of internalizing (e.g., anxious/ depressed, depressed, somatic complaints) and externalizing (e.g., attention problems, rule-breaking behavior, aggression) symptoms over the prior 6-months. Raw scores are standardized into t-scores, with elevated scores reflecting greater symptomatology when compared to a gender and aged normed population. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Father engagement based on the Child-Parent Relationship Scale, Short form (CPRS-SF) | Baseline and 6 Month followup | Father engagement will be measured by the Child-Parent Relationship Scale, Short form (CPRS-SF). The CPRS-SF is a 15-item self-report measure assessing the current relationship between parent and child. Items are rated on a 5-point Likert scale ranging from 1 ("definitely does not apply") to 5 ("definitively applies"). Ratings are averaged into groups of items corresponding to conflict items (8 items) and closeness (7 items) subscales for this study. Higher scores indicate higher levels of the specific construct (i.e., more conflict or more closeness). Higher conflict score reflects higher negativity; higher closeness score reflects warmth, affection, and open communication. |
| Father engagement based on the Inventory of Father Involvement, Short form (IFI-SF) | Baseline and 6 Month followup | Father engagement will also be measured by the Inventory of Father Involvement, Short Form (IFI-SF). The IFI-SF is a 26-item measure of father involvement, focusing on the following subscales: discipline and teaching responsibility, school encouragement, providing, time and talking together, praise and affection, developing talents, reading/homework, supporting the coparent, and attentiveness. Items are rated using a 7-point Likert scale ranging from 0 ("Very Poor") to 6 ("Excellent"). For this study, scores are averaged, yielding a score of 0-6 overall. Higher scores indicate higher levels of perceived father involvement. |
| Father engagement based on the Parenting Alliance Inventory (PAI) | Baseline and 6 Month followup | Father engagement will also be measured by the Parenting Alliance Inventory (PAI). The PAI is a 20-item scale that assesses the co-parenting relationship between parents. Items are rated using a 5-point Likert scale ranging from 1 ("Strongly Disagree") to 5 ("Strongly Agree"); for this study, scores are averaged for a range of 1-5. Higher scores indicate a stronger, more positive, and cooperative partnership. |
| Father behavioral health based on the Addiction Severity Index (ASI, adapted) | Baseline and 6 Month followup | Father behavioral health will be measured by the Addiction Severity Index (ASI, adapted). The ASI is a self-report measure addressing potential problems associated with substance use. This study will use only the drug and alcohol section. The drug and alcohol section of the ASI consists of a severity assessment where the participant is asked to rate the severity of their drug and alcohol addiction, over the past 30 days, using a numeric computation with many components. This measure summarizes the patient's need for treatment. Results for each component will be summarized by study arm. |
| Father behavioral health based on the Center for Epidemiological Studies Depression Scale (CESD, adapted) | Baseline and 6 Month followup | Father behavioral health will also be measured by the Center for Epidemiological Studies Depression Scale (CESD, adapted). This study uses a 12-item short form of this self-report scale is designed to measure depressive symptomatology in adult populations. Items are rated using a 4-point Likert scale ranging from 0 ("Rarely or none of the time (i.e., \<1 day)") to 3 ("Most or all of the time (i.e., 5-7 days)"), yielding an overall possible score of 0-36 for this adaptation. Higher scores indicate more clinically significant depressive symptoms. |
| Father behavioral health based on the Trauma Symptom Checklist-40 (TSC-40) | Baseline and 6 Month followup | Father behavioral health will also be measured by the Trauma Symptom Checklist-40 (TSC-40). The TSC-40 evaluates symptomatology in adults associated with childhood or adult traumatic experiences. It measures aspects of posttraumatic stress and other symptom clusters found in some traumatized individuals. In this study, the parent will respond based on their own behavioral symptoms. The TSC-40 consists of 40 items across six domains (anxiety, depression, dissociation, sexual abuse trauma index, sexual problems, and sleep disturbance) wherein parents self-report trauma-related symptoms on a 4-point frequency scale ranging from 0 ("Never") to 3 ("Often"), yielding a total score of 0-120, such that higher scores are indicative of higher distress. |
Countries
United States
Contacts
CONTACTAnita Jose, PhD
CONTACTAlessandra de Marchena, LCSW
PRINCIPAL_INVESTIGATORScott Wetzler, PhD
Montefiore Medical Center
Outcome results
None listed