Behavior Problem
Conditions
Keywords
foster care, child behavior, parenting skills, behavioral health
Brief summary
The primary objective of this study is to tailor the Chicago Parent Program, an evidence-based parent training program, for the foster care setting and pilot the content in two cohorts of foster and kinship caregivers (Gross et al., 2009).
Detailed description
This study involves the administration of an evidence-based prevention program to prevent and reduce behavior problems in young children (the Chicago Parent Program; CPP). CPP will be tailored by creating additional handouts, discussion questions, and topics that contextualize CPP material to foster care, to meet the needs and social norms of foster and kinship caregivers. The CPP-FC 12-session curriculum will be delivered to two cohorts of foster and kinship caregivers virtually. Data for this study will come from multiple sources, including caregiver participant report and a review of existing electronic databases at CCHMC.
Interventions
The Chicago Parent Program for Foster Care FC consists of a 12-session parent training program that focuses on building caregiver-child relationships, behavioral management strategies, managing caregiver stress, and skill maintenance.
Sponsors
Study design
Eligibility
Inclusion criteria
* Must be a licensed foster caregiver or kinship caregiver to a child ages 2 years to 8 years * Must be in good standing with the foster care agency * Must be English-speaking
Exclusion criteria
* Not having a foster child ages 2 - 8 years in the home * Caregiver is unable to commit to participating in CPP-FC * This foster child age 2 - 8 years was placed in the home more than 45 days prior to enrollment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Perceived Stress Scale | Pre Intervention and 18 weeks | The Perceived Stress Scale is a 14-item self-report measure of how unpredictable, uncontrollable, and overloaded individuals find their life circumstances. All items are rated on a 5-point scale, ranging from 0 (Never) to 4 (very often). Some items are reverse-scored. Responses are summed to yield a total score (range 0 - 56), with higher scores indicating greater perceived stress. |
| Change in Child Adjustment & Parent Efficacy Scale | Pre Intervention and 18 weeks | The Child Adjustment & Parent Efficacy Scale, Total Intensity subscale is a 27-item measure of child behavior and emotional problems. Item responses are rated on a 4-point scale, ranging from 0 (Not true of my child at all) to 3 (True of my child very much/Most of the time). Twenty-four items are summed to yield a Behavior Problems score (range 0-72), and three items are summed to yield an Emotional Problems score (range 0-9). Behavioral and Emotional Problems scores can be summed for a Total Intensity score (range 0-81). Higher scores indicate a higher level of problems. |
| Change in Parenting Sense of Competence Scale | Pre Intervention and 18 weeks | The Parenting Sense of Competence Scale is a 17-item questionnaire that measures overall parenting satisfaction and competence. Items are measured on a 6-point scale, with responses ranging from 1 (Strongly disagree) to 6 (Strongly agree). Some items are reverse-scored. Items are summed to yield a total scale (range 17-102) and two subscales: parental self-efficacy (range 8-48) and parental satisfaction (range 9-54). Higher scores indicate higher levels of parental self-efficacy and parental satisfaction. |
| Change in Eyberg Child Behavior Inventory | Pre Intervention and 18 weeks | The Eyberg Child Behavior Inventory, a 36-item measure that assesses child behavior problems. Each item has 2 parts that make up 2 subscales: Intensity and Problem. Intensity items are rated on a 7-point scale, from 1 (Never) to 7 (Always), and Problem items are Yes/No responses. Items from each scale are summed to yield raw scores and converted to T-scores (M=50, SD=10). Higher Intensity scores indicate more frequent displays of the child behaviors, and higher Problem scores indicate the parent perceives the behaviors as more problematic. T-scores above 60 indicate elevated behavior problems. |
| Strengths and Difficulties Questionnaire | Pre Intervention and 18 weeks | The Strengths and Difficulties Questionnaire (SDQ) is a 25-item questionnaire that assesses child behavior. Items are rated on a 3-point scale and responses range from 0 (Not true) to 2 (Certainly true). Some items are reverse-scored. Items are summed to yield 5 subscales: Emotional Problems, Conduct Problems, Hyperactivity, Peer Problems, and Prosocial (ranges 0 -10). A total score (range 0-40) is calculated using the sum of all the subscales, except Prosocial. Higher scores in each subscale and the total score indicate more child behavior problems. |
| Change in Parental Stress Scale | Pre Intervention and 18 weeks | The Parental Stress Scale is an 18-item questionnaire that assesses parental stress relating to parental sensitivity to the child, child behavior, and quality of the parent-child relationship. Items are rated on a 5-point scale, ranging from 1 (Strongly disagree) to 5 (Strongly agree). Some items are reverse-scored. Items are summed to yield a total score (range 18-90), with higher scores indicating higher levels of parental stress. |
| Change in Group Environment Scale | Week 7, Week 11, Week 19 | The Group Environment Scale is a 25-item measure that assesses the dimensions of intervention group environments. Items are rated on a 5-point scale, with responses ranging from 1 (Strongly disagree) to 5 (Strongly agree). Items are averaged to yield three subscales: Cohesiveness, Implementation and Preparedness, and Counterproductive Activity. Higher scores on the Cohesiveness Scale (range 1-5) indicate more group cohesiveness. Higher scores on the Implementation and Preparedness Scale (range 1-5) indicate greater group implementation quality. Higher scores on the Counterproductive Activity Scale (range 1-5) indicate more counterproductive group activities. |
Countries
United States
Participant flow
Recruitment details
Participants were recruited based on the age of an index foster child and the duration of placement of the foster child at two foster care consultation clinic locations within a single academic medical center between May 2023 and July 2023. The first participant was enrolled on May 16, 2023, and the last participant was enrolled on July 14, 2023.
Participants by arm
| Arm | Count |
|---|---|
| Chicago Parent Program for Foster Care Caregiver parent training sessions.
Chicago Parent Program for Foster Care: The Chicago Parent Program for Foster Care FC consists of a 12-session parent training program that focuses on building caregiver-child relationships, behavioral management strategies, managing caregiver stress, and skill maintenance. | 16 |
| Total | 16 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Lost to Follow-up | 6 |
Baseline characteristics
| Characteristic | Chicago Parent Program for Foster Care |
|---|---|
| Age, Continuous | 49.43 years STANDARD_DEVIATION 15.73 |
| Child Adjustment & Parent Efficacy Scale Behavior Problems Scale | 25.74 units on a scale STANDARD_DEVIATION 17.12 |
| Child Adjustment & Parent Efficacy Scale Emotional Problems Scale | 2.06 units on a scale STANDARD_DEVIATION 1.37 |
| Child Adjustment & Parent Efficacy Scale Total Intensity Scale | 27.79 units on a scale STANDARD_DEVIATION 18.63 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 14 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Eyberg Child Behavior Inventory Intensity Scale T-Score | 53.00 T-score STANDARD_DEVIATION 13.73 |
| Eyberg Child Behavior Inventory Problem Scale T-Score | 47.19 T-score STANDARD_DEVIATION 10.04 |
| Parental Stress Scale | 34.56 units on a scale STANDARD_DEVIATION 11.9 |
| Parenting Sense of Competence Scale Parental Satisfaction Scale | 38.33 units on a scale STANDARD_DEVIATION 7.99 |
| Parenting Sense of Competence Scale Parental Self-Efficacy Scale | 35.25 units on a scale STANDARD_DEVIATION 6.31 |
| Parenting Sense of Competence Scale Total Scale | 73.98 units on a scale STANDARD_DEVIATION 12.09 |
| Perceived Stress Scale | 16.44 units on a scale STANDARD_DEVIATION 8.3 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 8 Participants |
| Race (NIH/OMB) More than one race | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 6 Participants |
| Region of Enrollment United States | 16 participants |
| Sex: Female, Male Female | 15 Participants |
| Sex: Female, Male Male | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 16 |
| other Total, other adverse events | 0 / 16 |
| serious Total, serious adverse events | 0 / 16 |
Outcome results
Change in Child Adjustment & Parent Efficacy Scale
The Child Adjustment & Parent Efficacy Scale, Total Intensity subscale is a 27-item measure of child behavior and emotional problems. Item responses are rated on a 4-point scale, ranging from 0 (Not true of my child at all) to 3 (True of my child very much/Most of the time). Twenty-four items are summed to yield a Behavior Problems score (range 0-72), and three items are summed to yield an Emotional Problems score (range 0-9). Behavioral and Emotional Problems scores can be summed for a Total Intensity score (range 0-81). Higher scores indicate a higher level of problems.
Time frame: Pre Intervention and 18 weeks
Population: N = 16 participants completed The Child Adjustment \& Parent Efficacy Scale at Pre Intervention and n = 10 participants completed The Child Adjustment \& Parent Efficacy Scale at 18 Weeks.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Change in Child Adjustment & Parent Efficacy Scale | Total Intensity Scale Sample Mean at 18 Weeks | 24.61 score on a scale | Standard Deviation 15.63 |
| Chicago Parent Program for Foster Care | Change in Child Adjustment & Parent Efficacy Scale | Total Intensity Scale Mean Difference from Pre Intervention to 18 Weeks | -4.59 score on a scale | Standard Deviation 14.83 |
| Chicago Parent Program for Foster Care | Change in Child Adjustment & Parent Efficacy Scale | Behavior Problems Scale Sample Mean at 18 Weeks | 24.52 score on a scale | Standard Deviation 14.8 |
| Chicago Parent Program for Foster Care | Change in Child Adjustment & Parent Efficacy Scale | Behavior Problems Scale Mean Difference from Pre Intervention to 18 Weeks | -4.18 score on a scale | Standard Deviation 14.27 |
| Chicago Parent Program for Foster Care | Change in Child Adjustment & Parent Efficacy Scale | Emotional Problems Scale Sample Mean at 18 Weeks | 1.90 score on a scale | Standard Deviation 1.37 |
| Chicago Parent Program for Foster Care | Change in Child Adjustment & Parent Efficacy Scale | Emotional Problems Scale Mean Difference from Pre Intervention to 18 Weeks | -0.40 score on a scale | Standard Deviation 1.17 |
Change in Eyberg Child Behavior Inventory
The Eyberg Child Behavior Inventory, a 36-item measure that assesses child behavior problems. Each item has 2 parts that make up 2 subscales: Intensity and Problem. Intensity items are rated on a 7-point scale, from 1 (Never) to 7 (Always), and Problem items are Yes/No responses. Items from each scale are summed to yield raw scores and converted to T-scores (M=50, SD=10). Higher Intensity scores indicate more frequent displays of the child behaviors, and higher Problem scores indicate the parent perceives the behaviors as more problematic. T-scores above 60 indicate elevated behavior problems.
Time frame: Pre Intervention and 18 weeks
Population: N = 16 participants completed The Eyberg Child Behavior Inventory at Pre Intervention and n = 10 participants completed The Eyberg Child Behavior Inventory at 18 Weeks.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Change in Eyberg Child Behavior Inventory | Intensity Scale T-Score Sample Mean at 18 Weeks | 53.70 T-score | Standard Deviation 12.49 |
| Chicago Parent Program for Foster Care | Change in Eyberg Child Behavior Inventory | Intensity Scale T-Score Mean Difference from Pre Intervention to 18 Weeks | -2.10 T-score | Standard Deviation 10.24 |
| Chicago Parent Program for Foster Care | Change in Eyberg Child Behavior Inventory | Problem Scale T-Score Sample Mean at 18 Weeks | 48.80 T-score | Standard Deviation 6.97 |
| Chicago Parent Program for Foster Care | Change in Eyberg Child Behavior Inventory | Problem Scale T-Score Mean Difference from Pre Intervention to 18 Weeks | 0.50 T-score | Standard Deviation 9.63 |
Change in Group Environment Scale
The Group Environment Scale is a 25-item measure that assesses the dimensions of intervention group environments. Items are rated on a 5-point scale, with responses ranging from 1 (Strongly disagree) to 5 (Strongly agree). Items are averaged to yield three subscales: Cohesiveness, Implementation and Preparedness, and Counterproductive Activity. Higher scores on the Cohesiveness Scale (range 1-5) indicate more group cohesiveness. Higher scores on the Implementation and Preparedness Scale (range 1-5) indicate greater group implementation quality. Higher scores on the Counterproductive Activity Scale (range 1-5) indicate more counterproductive group activities.
Time frame: Week 7, Week 11, Week 19
Population: N = 2 participants completed The Group Environment Scale at Week 7, n = 4 participants completed The Group Environment Scale at Week 11, and n = 7 participants completed The Group Environment Scale at Week 19.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Implementation and Preparedness Scale Sample Mean at 11 Weeks | 4.71 score on a scale | Standard Deviation 0.55 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Cohesiveness Scale Sample Mean at 7 Weeks | 4.44 score on a scale | Standard Deviation 0.44 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Cohesiveness Scale Sample Mean at 11 Weeks | 4.48 score on a scale | Standard Deviation 0.4 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Cohesiveness Scale Sample Mean at 19 Weeks | 4.30 score on a scale | Standard Deviation 0.51 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Cohesiveness Scale Mean Difference from 7 Weeks to 11 Weeks | 0.19 score on a scale | Standard Deviation 0.09 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Cohesiveness Scale Mean Difference from 11 Weeks to 19 Weeks | 0.16 score on a scale | Standard Deviation 0.52 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Implementation and Preparedness Scale Sample Mean at 7 Weeks | 4.55 score on a scale | Standard Deviation 0.26 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Implementation and Preparedness Scale Sample Mean at 19 Weeks | 4.40 score on a scale | Standard Deviation 0.52 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Implementation and Preparedness Scale Mean Difference from 7 Weeks to 11 Weeks | 0.41 score on a scale | Standard Deviation 0.19 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Implementation and Preparedness Scale Mean Difference from 11 Weeks to 19 Weeks | 0.11 score on a scale | Standard Deviation 0.75 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Counterproductive Activity Scale Sample Mean at 7 Weeks | 4.83 score on a scale | Standard Deviation 0.24 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Counterproductive Activity Scale Sample Mean at 11 Weeks | 4.77 score on a scale | Standard Deviation 0.32 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Counterproductive Activity Scale Sample Mean at 19 Weeks | 4.43 score on a scale | Standard Deviation 0.79 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Counterproductive Activity Scale Mean Difference from 7 Weeks to 11 Weeks | -0.42 score on a scale | Standard Deviation 0.35 |
| Chicago Parent Program for Foster Care | Change in Group Environment Scale | Counterproductive Activity Scale Mean Difference from 11 Weeks to 19 Weeks | 0.04 score on a scale | Standard Deviation 0.48 |
Change in Parental Stress Scale
The Parental Stress Scale is an 18-item questionnaire that assesses parental stress relating to parental sensitivity to the child, child behavior, and quality of the parent-child relationship. Items are rated on a 5-point scale, ranging from 1 (Strongly disagree) to 5 (Strongly agree). Some items are reverse-scored. Items are summed to yield a total score (range 18-90), with higher scores indicating higher levels of parental stress.
Time frame: Pre Intervention and 18 weeks
Population: N = 16 participants completed The Parental Stress Scale at Pre Intervention and n = 10 participants completed The Parental Stress Scale at 18 Weeks.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Change in Parental Stress Scale | Total Scale Sample Mean at 18 Weeks | 36.00 score on a scale | Standard Deviation 12.24 |
| Chicago Parent Program for Foster Care | Change in Parental Stress Scale | Total Scale Mean Difference from Pre Intervention to 18 Weeks | 0.80 score on a scale | Standard Deviation 4.47 |
Change in Parenting Sense of Competence Scale
The Parenting Sense of Competence Scale is a 17-item questionnaire that measures overall parenting satisfaction and competence. Items are measured on a 6-point scale, with responses ranging from 1 (Strongly disagree) to 6 (Strongly agree). Some items are reverse-scored. Items are summed to yield a total scale (range 17-102) and two subscales: parental self-efficacy (range 8-48) and parental satisfaction (range 9-54). Higher scores indicate higher levels of parental self-efficacy and parental satisfaction.
Time frame: Pre Intervention and 18 weeks
Population: N = 16 participants completed the Parenting Sense of Competence Scale at Pre Intervention and n = 10 participants completed the Parenting Sense of Competence Scale at 18 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Change in Parenting Sense of Competence Scale | Total Scale Sample Mean at 18 Weeks | 72.60 score on a scale | Standard Deviation 10.7 |
| Chicago Parent Program for Foster Care | Change in Parenting Sense of Competence Scale | Total Scale Mean Difference from Pre Intervention to 18 Weeks | -0.10 score on a scale | Standard Deviation 11.63 |
| Chicago Parent Program for Foster Care | Change in Parenting Sense of Competence Scale | Parental Satisfaction Scale Sample Mean at 18 Weeks | 38.50 score on a scale | Standard Deviation 8.42 |
| Chicago Parent Program for Foster Care | Change in Parenting Sense of Competence Scale | Parental Satisfaction Mean Difference from Pre Intervention to 18 Weeks | 0.70 score on a scale | Standard Deviation 6.38 |
| Chicago Parent Program for Foster Care | Change in Parenting Sense of Competence Scale | Parental Self-Efficacy Scale Sample Mean at 18 Weeks | 34.10 score on a scale | Standard Deviation 7.67 |
| Chicago Parent Program for Foster Care | Change in Parenting Sense of Competence Scale | Parental Self-Efficacy Mean Difference from Pre Intervention to 18 Weeks | -0.80 score on a scale | Standard Deviation 8.68 |
Change in Perceived Stress Scale
The Perceived Stress Scale is a 14-item self-report measure of how unpredictable, uncontrollable, and overloaded individuals find their life circumstances. All items are rated on a 5-point scale, ranging from 0 (Never) to 4 (very often). Some items are reverse-scored. Responses are summed to yield a total score (range 0 - 56), with higher scores indicating greater perceived stress.
Time frame: Pre Intervention and 18 weeks
Population: N = 16 participants completed the Perceived Stress Scale at Pre Intervention and n = 10 participants completed the Perceived Stress Scale at 18 Weeks.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Change in Perceived Stress Scale | Sample Mean at 18 Weeks | 14.70 score on a scale | Standard Deviation 8.41 |
| Chicago Parent Program for Foster Care | Change in Perceived Stress Scale | Mean Difference from Pre Intervention to 18 Weeks | 0.20 score on a scale | Standard Deviation 8.78 |
Strengths and Difficulties Questionnaire
The Strengths and Difficulties Questionnaire (SDQ) is a 25-item questionnaire that assesses child behavior. Items are rated on a 3-point scale and responses range from 0 (Not true) to 2 (Certainly true). Some items are reverse-scored. Items are summed to yield 5 subscales: Emotional Problems, Conduct Problems, Hyperactivity, Peer Problems, and Prosocial (ranges 0 -10). A total score (range 0-40) is calculated using the sum of all the subscales, except Prosocial. Higher scores in each subscale and the total score indicate more child behavior problems.
Time frame: Pre Intervention and 18 weeks
Population: N = 10 participants completed The Strengths and Difficulties Questionnaire at 18 Weeks.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chicago Parent Program for Foster Care | Strengths and Difficulties Questionnaire | Emotional Problems Scale Sample Mean at 18 Weeks | 2.40 score on a scale | Standard Deviation 2.22 |
| Chicago Parent Program for Foster Care | Strengths and Difficulties Questionnaire | Conduct Problems Scale Sample Mean at 18 Weeks | 2.60 score on a scale | Standard Deviation 1.96 |
| Chicago Parent Program for Foster Care | Strengths and Difficulties Questionnaire | Hyperactivity Scale Sample Mean at 18 Weeks | 5.70 score on a scale | Standard Deviation 3.47 |
| Chicago Parent Program for Foster Care | Strengths and Difficulties Questionnaire | Peer Problems Scale Sample Mean at 18 Weeks | 3.60 score on a scale | Standard Deviation 1.84 |
| Chicago Parent Program for Foster Care | Strengths and Difficulties Questionnaire | Prosocial Problems Scale Sample Mean at 18 Weeks | 6.00 score on a scale | Standard Deviation 2.05 |
| Chicago Parent Program for Foster Care | Strengths and Difficulties Questionnaire | Total Scale Sample Mean at 18 Weeks | 14.30 score on a scale | Standard Deviation 7.76 |