Predictors of Initiation and Completion of a Self-Directed Prevention-Based Program with Foster Families

Introduction: Teens in foster care experience elevated rates of health risking behaviors. However, foster families experience a wide range of barriers to using prevention programs. Although prevention program developers and implementers would benefit from knowing what individual characteristics predict program initiation and completion, very little research has been conducted on predictors of program uptake and completion among foster caregivers. We report on predictors of program initiation and completion within the randomized trial of Connecting, a family-based, prevention intervention adapted from Staying Connected with Your Teen to better meet the needs of teens in foster care and their caregivers. The program is self-directed in order to be more accessible and flexible. Weekly telephone contacts with a family consultant help to troubleshoot barriers and motivate completion.

Method: Foster caregivers (n=110) with teens ages 11 to 16 who did not have serious substance use, behavior problems or criminal justice involvement were randomly assigned to the intervention after recruitment. Data from family consultants' (FC) and caregivers' (CG) surveys pre and post intervention are used to examine predictors of program initiation (doing any program activities) and completion (doing 60% or more). Bivariate associations and logistic regressions are used to examine associations between teen and CG characteristics at baseline and program initiation and completion. Effect sizes and statistical significance will be reported, and responses to open ended questions about barriers to completion will be shared. Teen characteristics include age, gender, ethnicity, and length of current placement. CG characteristics include relationship to teen (kincare), age, ethnicity, substance use, family size, and employment.

Preliminary Results: Of the 110 randomly assigned families, 97 (88%) initiated the program. Fifty-eight (52%) families completed 60%+ of the 94 program activities. Bivariate associations indicate that CGs who had full-time employment were more likely to complete (70% vs. 48%) as were those with a spouse/partner (68% vs 47%). Logistic regressions indicate CGs who smoke cigarettes are less likely to initiate (B=-1.77, p=.04) or complete (B=-1.63, p=.02). Lack of time and other stressors were the primary reasons given for not completing.

Discussion: Family based prevention programs have been found to be effective in preventing teen substance use and other problems. Adapting such programs for use in foster families requires attention to the particular issues and barriers foster caregivers face. A self-directed program with phone support overcomes some barriers, however most caregivers still report having very little time for program activities.