Prevention of behavior problems among preschool children in foster care through group-based foster caregiver training at the time of placement

Cincinnati Childrens Hosp Med Ctr, Cincinnati OH

Investigators

Abstract

Project Summary Most children in foster care experience multiple forms of maltreatment, increasing risk for behavior problems (e.g., aggression, noncompliance, suspensions/expulsions from preschool or daycare). The foster care system is over-burdened and crisis-response oriented, limiting capacity to focus on prevention of behavior problems with foster caregivers and children. The Chicago Parent Program (CPP) is an evidence-based 12-session program (11 concurrent weeks, 1 one-month booster) with demonstrated significant and sustained improvements in consistent discipline, parenting self-efficacy, and child behavior problems 1 year following training. If available to foster caregivers, CPP could prevent or reduce behavior problems in foster youth, decrease caregiver stress, increase self-efficacy and consistent discipline with caregivers, and prevent unnecessary placement changes. However, adaptations to the existing program are necessary. The goal of this study is to conduct a clinical trial of CPP adapted for foster caregivers of young children. This will be accomplished through three aims: Aim 1: Adapt CPP to meet the unique needs of children ages 2-5 years who are placed with foster caregivers (CPP-FC) and pilot delivery coordinated with mandated healthcare visits (2 groups, 6-8 families). CPP content will be adapted (e.g., additional content targeting trauma and child maltreatment, modified discussion of vignettes, additional role-play targeting specific foster care scenarios). A stakeholder adaptation team, including 6 caregivers, has been established to guide development of enhanced content. Aim 2: Assess the impact of CPP-FC on caregiver stress & confidence in managing child behavior. Families (N = 300) will be randomized to CPP-FC or usual care, with assessments at baseline, 3 months (end of training) and 6 months. CPP-FC is expected to reduce caregiver stress and increase confidence. Aim 3: Assess the impact of CPP-FC on child behavior. Observations of structured interactions between caregivers and children at baseline and 3-months will be collected along with caregiver reports of child behaviors at baseline, 3 months, and 6 months. CPP-FC is expected to decrease child behavior problems and result in fewer placement changes. If hypotheses are confirmed, this study will provide an evidence-based model to prevent behavior problems in young foster children that could be spread to other institutions.