The Family Check-up Online: Disseminating Evidenced Based Interventions for Families through a Telehealth Model of Service Delivery

Introduction

Multiple randomized trials support the efficacy of parenting interventions for reducing behavioral risk. However, despite their effectiveness, few parents engage in these programs because they are difficult for schools to deliver without infrastructure supports provided, especially in disadvantaged areas. Furthermore, rural schools are less likely than urban settings to have the support in place for program delivery, creating health disparity and lack of access for rural families. As a result, most families never receive parenting support or skill-based training, and these programs are often not sustainable after the end of the research study.

One solution to this problem is to deliver programs in an online format. The Family Check-Up (FCU) is a brief, cost-effective intervention that has been successfully delivered in schools and has now been adapted online. Our prior research on the FCU suggests that middle school youths demonstrated intervention effects on problem behavior and school engagement, as well as on a variety of nonacademic outcomes.

Methods

In this study, we adapt the FCU intervention to an online program for middle school youths and families, including both rural and urban schools. The FCU Online was developed as both a stand-alone web-based intervention and a coach supported intervention for use in schools. 300 youth/families from 9 participating middle schools (more than 70% economically disadvantaged and fewer than than 50% passing state testing with proficiency) were included in this study. Students were randomly assigned to 1 of 3 conditions: control (school as usual); web-based only; or coach. The coach version provided several sessions of support for families within a telehealth format.

Results

Preliminary analyses on pretest–posttest data indicate that compared with control families (school as usual), parents assigned to intervention reported significant improvements (ps < .05) on the following key outcomes: child health behavior (d = .45), child social/emotional behavior (d = .35), parenting self-efficacy (d = 41), and parenting confidence in dealing with problem behaviors (d = .37). FCU Online program usage data indicate that the parents were highly engaged in the website, with a mean number of logins of 3.6 times. Each of the four parenting modules was visited two or more times on average, and the mean total time of website use was 1 hour, 33 minutes. Hence, the preliminary data suggest that the FCU Online program was engaging for the parents and resulted in meaningful changes across relevant outcomes.