Pragmatism in modeling peer influence: dynamics,outcomes, and change processes

This paper reviews the model-building approach to developmental psychopathology as it applies to understanding the influence of peers on adolescent problem behavior. Considerable longitudinal evidence suggests that deviant peer involvement is prognostic of escalations in various forms of problem behavior, including substance use, delinquent behavior, and violence. Most convincing, however, are data from randomized intervention trials that show alarming iatrogenic effects for aggregating high-risk peers. This paper shows that intervention research can also clarify the role of parents in reducing deviant peer involvement. Results from a 4-year prevention trial are reported for a community sample of multiethnic middle school youth. Random assignment to family-centered services in a school Family Resource center produced reduced growth in deviant peer involvement. The extensiveness of the parenting intervention was correlated with reduced growth in deviant peer involvement, especially among high-risk youth. Findings are discussed with respect to developmental theory and the design of future intervention trials that clarify the role of adults in structuring the emerging adolescents' world of peers.     

Effects of the Family Check-Up 4 Health on Parenting and Child Behavioral Health: A Randomized Clinical Trial in Primary Care

The Family Check-Up 4 Health (FCU4Health) is an adaptation of the Family Check-Up (FCU) for delivery in primary care settings. While maintaining the original FCU’s focus on parenting and child behavioral health, we added content targeting health behaviors. This study evaluated whether the adapted FCU maintained positive effects on parenting (positive behavior support, limit setting, parental warmth) and child behavioral health (self-regulation, conduct problems, emotional problems). Pediatric (6–12 years) primary care patients with a BMI?≥?85^th%ile (n?=?240) were recruited from primary care clinics in Phoenix. Children were 75% Latino, 49% female, and 73% Medicaid recipients. This type 2 effectiveness-implementation hybrid trial compared families randomized to FCU4Health (n?=?141) or usual care (n?=?99). FCU4Health was delivered over a period of 6 months. This study focuses on a priori secondary outcomes included parenting and child behavioral health targets of the original FCU, assessed at baseline and 3, 6, and 12 months. Significant improvements were found for the FCU4Health condition, compared to usual care, in parenting from baseline to the 3-month assessment [β?=?.17 (.01; .32)]. Parenting predicted improvements in child self-regulation at 6-months [β?=?.17 (.03; .30)], which in turn predicted reductions in conduct problems [β?=?? .38 (? .51; ? .23)] and emotional problems [β?=?? .24 (? .38; ? .09)] at 12 months. Ethnicity and language of delivery (English or Spanish) did not moderate these effects. The FCU4Health can improve parenting and child behavioral health outcomes when delivered in primary care.

Trial Registration Trial registration number: NCT03013309 ClinicalTrials.gov

     

Facilitators and Barriers in Cross-Country Transport of Evidence-based Preventive Interventions: a Case Study Using the Family Check-Up

Prevention Science - This study is a qualitative analysis of facilitators and barriers in the dissemination of Family Check-Up (FCU), a U.S.-developed preventive intervention in Sweden. The FCU is...     

Preventing High-Risk Sexual Behavior in Early Adulthood with Family Interventions in Adolescence: Outcomes and Developmental Processes

Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up, FCU) were later assessed for the intervention’s effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N?=?998 adolescents and their families) were randomly assigned to a family-centered intervention in sixth grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23 % of the intervention families engaged in the FCU and approximately 18 % engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Furthermore, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed.     

Premature adolescent autonomy: parent disengagement and deviant peer process in the amplification of problem behaviour

Premature autonomy describes a developmental dynamic where parents of high-risk adolescents reduce their involvement and guidance when confronted with challenges of problem behaviour and the influence of deviant friendships. This dynamic was tested on the sample of Oregon Youth Study boys (N=206), whose family management practices and friendships were observed on videotaped interaction tasks. Latent growth curve models were used to examine longitudinal trends between deviant friendship interactions and family management. Direct observations of deviant friendship process at age 14 were associated with degradation in family management during adolescence. A comparison of antisocial and well-adjusted boys clarified that parents of antisocial boys (started early and persisted) decreased family management around puberty, in comparison to parents of well-adjusted boys who maintained high levels of family management through adolescence. In predicting late adolescent problem behaviour, there was a statistically reliable interaction between family management degradation and deviant peer involvement in adolescence in support of the premature autonomy hypothesis. Adolescent males involved in deviant friendships, and whose parents decreased their family management, were most likely to use marijuana and commit antisocial acts at age 18. The implications for interventions that target adolescents are discussed.     

An Adaptive Approach to Family-Centered Intervention in Schools: Linking Intervention Engagement to Academic Outcomes in Middle and High School

This study examined the impact of an adaptive approach to family intervention in public schools on academic outcomes from age 11 to 17. Students were randomly assigned to the three-session Family Check-Up (FCU), which is designed to motivate change in parenting practices by using an assessment-driven approach and strengths-based feedback. All services were voluntary, and approximately 25% of the families engaged in the FCU. Compared with matched controls, adolescents whose parents received the FCU maintained a satisfactory GPA into high school, and intervention engagement was associated with improved attendance. The highest-risk families were the most likely to engage in the family-centered intervention, suggesting the efficacy of integrating supportive services to families in the context of other schoolwide approaches to promote the success and achievement of vulnerable students.     

Family processes and adolescent problem behavior: integrating relationship narratives into understanding development and change

OBJECTIVE: Mothers' relational schemas (RSs) regarding their adolescents were assessed using the Family Affective Attitude Rating Scale for coding 5-minute speech samples. The internal consistency and validity of positive RS and negative RS scales were also evaluated. METHOD: Data were collected from a multiethnic subsample of early-starting antisocial (n = 20) and successful (n = 20) urban adolescents and their families, using direct observations of parent-adolescent interactions, 5-minute speech samples, and questionnaires. RESULTS: The negative RS and positive RS scales were internally consistent, correlated reliably with critical and positive dimensions of 5-minute speech samples expressed emotion and with observed parent-adolescent interactions, and discriminated between antisocial and successful adolescents. Negative RS accounted for unique variance in adolescent antisocial behavior when controlling for previous problem behavior and observed coercion. A significant interaction was also found between negative RS and observed parent-adolescent dynamics when escalations in adolescent problem behavior were added to the model. CONCLUSIONS: RS narratives provided unique information in the prediction of adolescent antisocial behavior. RSs should be considered in the assessment of family dynamics and the design of interventions to prevent and treat adolescent behavior problems.     

A School-Based,Family-Centered Intervention to Prevent Substance Use: The Family Check-Up

Background/Objectives: The Family Check-Up (FCU) is a selected intervention model that can be delivered in contexts such as schools that serve at-risk children and families. It is grounded in developmental theory and targets salient risk factors for the development of later problem behavior such as substance use, family management deficits, deviant peer affiliations, and problem behavior at school. Methods: The FCU model has been implemented in schools across several randomized trials. The model includes the development of a family resource center in the schools and interventions that target youth at risk for problem behavior and substance use. Results: Twenty years of research associated with the FCU have produced outcomes that show that the model is effective for enhancing family management skills, reducing risk behavior, and reducing the long-term risk for substance use in adolescence. Conclusions and Scientific Significance: Implications for public policy and the delivery of interventions to prevent substance use in public schools and communities are discussed.     

The relations among cumulative risk, parenting, and behavior problems during early childhood

Background: This study examined relations among cumulative risk, nurturant and involved parenting, and behavior problems across early childhood. Methods: Cumulative risk, parenting, and behavior problems were measured in a sample of low‐income toddlers participating in a family‐centered program to prevent conduct problems. Results: Path analysis was utilized to examine longitudinal relations among these constructs, with results supporting an indirect effect of cumulative risk on externalizing and internalizing problems through nurturant and involved parenting. Conclusion: Results highlight the importance of cumulative risk during early childhood, and particularly the effect that the level of contextual risk can have on the parenting context during this developmental period.