Profiles and Predictors of Family Engagement in the Family Check-up Program and Community Services during the Early Steps Multisite Trial

Research indicates that as few as 20% of children with significant mental health disorders in the United States actually receive services (Kataoka, Zhang, & Wells, 2002). Community-based prevention programs face the challenge of engaging at-risk children and families that are in need of intervention and increasing motivation to complete program and follow through with recommended support services. The Family Check-Up (FCU; Dishion & Stormshak, 2007) is unique among evidence-based prevention programs in that it leverages and interfaces with existing social services to support families. FCU providers use a comprehensive assessment and Motivational Interviewing techniques to prioritize goals and elicit families’ motivation to pursue the appropriate services, rendering higher likelihood of participating in those services. Leijten and colleagues (2014) evaluated community service usage for families in the Early Steps trial, a randomized controlled multisite trial of the FCU for young children (N = 731), and found that families assigned to the FCU condition accessed significantly more services in the community at age 7.5 (following trial participation from ages 2 to 5) compared to control families. Further, research indicates that variability in engaging in the FCU over time in the Early Steps trial corresponds to the degree of improvement in child behavior problems for ages 2–5 (Dishion et al., 2014). However, no studies have comprehensively examined engagement in the FCU program and community services across the entirety of the Early Steps trial. Using data from the Early Steps trial for children ages 2 to 10.5, we will describe families’ engagement in the various components of the FCU intervention program (assessment, feedback, parent support sessions) and related community-based social services. Preliminary analyses indicate higher levels of engagement in the FCU in the preschool ages (2–3), which steadily declines over time into later childhood. Caregiver depression is significantly related to engagement in the FCU; child behavior problems at baseline were not. Engagement rates in follow-up support services provided by the FCU provider were moderated by family poverty status. We will also evaluate the impact of other family sociodemographic and ecological characteristics and child factors as predictors of involvement in the different components of the FCU program and various community services and compare the use of community services among families assigned to the FCU with families assigned to the control condition. The results will inform future efforts to reach families in need of services and increase engagement by addressing barriers to participation.