Testing an Adaptation of the Family Check up to Promote Sleep, Physical Activity and Emotion Regulation Skills Among Emerging Adolescents in a Primary Care Setting

Even though several evidence-based interventions have been developed to address problem behavior of at-risk youth, identifying real-world delivery contexts for offering and engaging at-risk youth in such interventions presents a challenge. The current paper discusses the use of a pediatric platform to engage at-risk emerging adolescents in a preventive intervention targeted at health promotion. Capitalizing on challenges associated with the transition to adolescence, including physical, social and academic, the current study sought to promote skills in three areas critical for successfully meeting these challenges: sleep, physical activity, and emotion regulation. Using an adaptation of the Family Check-Up (FCU; Dishion & Stormshak, 2007), a sample of 165 emerging adolescents was followed in relation to outcomes one and two years after initial contact with families. The FCU combines aspects of motivational interviewing, family management skills and brief child-focused modules on sleep, physical activity and emotion regulation to both engage families and provide parents and youth with new skills in a relatively brief manner. Using a randomized control design, it was hypothesized that families assigned to the intervention would show enhanced sleep quality, physical activity, and emotion regulation skills relative to controls at the follow‐ups, as well as improvements in problem behavior.

Families were predominantly recruited from pediatric clinics serving low‐income families in an ethnically diverse urban community (84% African American). Following initial in-home assessments, families were randomly assigned to intervention or control, and then seen one and two years later.  Engagement rates were relatively high at the initial assessment, with 65% of families attending at least two meetings (M=3.72 sessions), and even higher one-year later: 79% (M=3.89 sessions).  The presentation will review efforts made to both initially engage families and improve on engagement rates at the second wave (e.g., convening focus groups).

In terms of the effectiveness on youth outcomes, at the one-year follow-up (N = 143) both male and female adolescents in the intervention group showed significant improvement in sleep night waking (F=6.648, p=.011) and total antisocial behavior (F=5.809, p=.017), as well as improvements in child explosiveness for girls identifying emotion regulation as a goal (F=5.119, p=.009).Preliminary analyses on a subset of 100 families at the two-year follow-up (ongoing) also indicate improvements on children’s affective dysregulation (F=4.06, p=.047, d=.5) and sleep night waking (F=4.09, p=.046, d=.4).  The study will be discussed in terms of implications for incorporating preventive interventions in real-world service delivery contexts.