A Pilot Feasibility and Effectiveness Trial of the Family Check-up Parenting Intervention with Spanish Pre-Adolescents and Their Families: A Cultural Adaptation and Feasibility Study to Enhance Evidence-Based Intervention Research in Spain

There is strong research support for the effectiveness and feasibility of family-centered, evidence-based programs (EBP’s) to prevent the developmental and negative effects of youth problem behaviors (Mrazek & Haggerty, 1994; Dishion & Stormshak, 2007). Despite this support, there is a relatively low rate of disseminating existing EBP’s to diverse nations and cultures, and there is even less research being conducted to evaluate the existing efforts towards dissemination and uptake (Sanders, 2010). Youth problem behavior prevention is a burgeoning area of psychological study in Spain, yet there is a little utilization of evidence-based prevention approaches within Spanish psychology (Vera, Ezpeleta, Granero, & de la Osa, 2010). The broad goal of this study was to enhance the research in the area of EBP testing and disseminating within the international sector. Specifically, the study aimed to culturally embed and evaluate the uptake within the Spanish cultural context of a family-centered EBP for preventing problem behavior in adolescence and adulthood.

The study utilized a pretest/posttest with follow-up, randomized experimental control group design to conduct a pilot feasibility and effectiveness trial of the Family Check-Up model, an EBP with over 20 years of research supporting its effectiveness in preventing problem behavior during adolescence for diverse cultural samples (Dishion, Light & Yasui, 2005; Fosco, Stormshak, Dishion & Winter, 2012). Participants included 17 youth (ages 9-12) and their parents from Seville, Spain who were randomly assigned to receive the Family Check-Up intervention (FCU) or to be in the waitlist-control group. A multimodal, multiagent approach was used to (1) examine intervention feasibility and uptake, and (2) to examine differences in (a) youth conduct and internalizing problems, (b) positive parenting, (c) parental limit setting, and (e) family problem solving based on intervention group assignment.

Results from mixed effects repeated analysis of variance analyses revealed that the Family Check-Up intervention was effective in reducing problem behaviors and internalizing problems for children in the intervention group, and that it was effective in improving parental limit setting, positive parenting, and family problem solving in the intervention group. For example, there was a significant interaction from pretest to posttest by group assignment for therapist-coded observational reports of parental limit setting, Wilks Lambda = .54, F(1, 15) = 12.63, p< .01, partial eta squared = .46. Parents in the intervention group improved their ability to set positive limits, while the waitlist-control group made no improvements. Qualitative themes also suggested that both advisory committee and parent participants experienced both the intervention research and the intervention model as positive and helpful in preventing behavior problems and supporting parenting skills development.

The results of this study contribute to existing research on the cultural adaptation of evidence-based prevention programs and to international dissemination of programs. Implications of culturally sensitive, community-based methods of intervention testing in international settings are discussed.