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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02800603
Other study ID # FCU
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date August 18, 2017
Est. completion date June 30, 2020

Study information

Verified date August 2020
Source McMaster University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of the study is to evaluate the first Canadian implementation project of the Family Check up (FCU), an evidence-based prevention and early intervention model that engages families and communities in reducing the burden of childhood emotional and behaviour problems (EBP).


Description:

The aim of this study is to establish and evaluate the first Canadian implementation project of the FCU as an evidence-based prevention and early intervention model that engages families and communities in reducing the burden of childhood EBP. These objectives will be achieved in two foundational phases. During Phase 1, the clinical and systems infrastructure required to deliver, sustain and ultimately scale up the FCU will be built. During Phase 2, a 1:1 randomized controlled trial (RCT) will be conducted. The RCT will involve 280 participating caregiver-child dyads to examine the effects of the FCU as a targeted prevention intervention within the Canadian context, as delivered to caregivers and children aged 2-4 years at high risk of persistent childhood EBP.

Phase 1: Training, and Implementation: The REACH Institute at Arizona State University has developed an efficient model for international implementation of the FCU. They will help implement the intervention within McMaster Children's Hospital (MCH), train MCH therapists as FCU consultants, and two trainers. All therapists will be credentialed as FCU consultants by REACH through a process of supervision, consultation and monitoring of therapeutic fidelity.

Phase 2: Investigators will conduct a 1:1 randomized controlled trial of 280 children aged 2-4 years into either the FCU (n=140) or community control (CC, n=140). All 280 participants will undergo screening and a baseline FCU assessment before randomization. Once randomized, the FCU group will be provided with a feedback visit and up to 6 optional sessions of the Everyday Parenting (EDP) curriculum over 16 weeks. The CC group will receive general information about currently available community services in Hamilton. At 6 months, both groups will undergo light assessments. At 12 months both groups will repeat the baseline assessment, and the FCU group will have 1-2 FCU visits.


Recruitment information / eligibility

Status Completed
Enrollment 207
Est. completion date June 30, 2020
Est. primary completion date June 30, 2020
Accepts healthy volunteers No
Gender All
Age group 2 Years to 4 Years
Eligibility Inclusion Criteria: Screening eligibility criteria include:

1. Custodial caregivers of a child aged 2 years, 0 months to 4 years, 11 months.

2. Definition of "at-risk" for child EBP as measured by (a) OR (b):

- Elevated child EBP as indexed by above-population mean total scores on Strengths and Difficulties Questionnaire (SDQ), plus one of the following family or contextual risk factors

- Caregiver challenges: teen parent status, caregiver mental health problems (as indexed by K6 psychological distress scale), lone caregiver

- Sociodemographic risk factors (as indexed by the 2014 Ontario Child Health Study (OCHS) demographics questionnaire): family income below low-income cut-off (LICO), caregiver with less than grade 12 education, caregiver on social assistance.

- Families who score within norms on caregiver or sociodemographic risk AND child SDQ scores fall within the "high" range, indicating significant burden of EBP (and thus increased risk of persistent, severe problems over time).

3. Caregivers with sufficient knowledge of English needed for assessment measures

4. Caregivers capable of giving informed, written consent

Exclusion Criteria:

1. Children with suspected severe to profound developmental delay

2. Current enrolment in another clinical intervention trial

3. Caregiver or child with a serious medical condition that, based on Investigator judgment, might interfere with the conduct of the study, confound interpretation of the study results, or endanger their own well-being

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
Family Check Up
The FCU is an ecologically sensitive, evidence-based, targeted intervention that aims to reduce child EBP. Features of the FCU: 1) Assessment-driven: a multi-method, multi-informant assessment in which the consultant reviews strengths and difficulties across domains of contextual risk, family functioning and child health. A tailored intervention plan is then created based on results 2) Motivational interviewing: Caregivers engage in self-assessment about motivation and barriers to addressing factors that may perpetuate risk. The consultant and caregiver work to establish a menu of services 3) The family may be offered up to 6 sessions of the "Everyday Parenting" curriculum. The FCU has demonstrated effectiveness and cultural sensitivity across multiple US settings.

Locations

Country Name City State
Canada McMaster University Hamilton Ontario

Sponsors (5)

Lead Sponsor Collaborator
McMaster University Arizona State University, Hamilton Health Sciences Corporation, Simon Fraser University, University of Calgary

Country where clinical trial is conducted

Canada, 

References & Publications (39)

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Connell A, Bullock BM, Dishion TJ, Shaw D, Wilson M, Gardner F. Family intervention effects on co-occurring early childhood behavioral and emotional problems: a latent transition analysis approach. J Abnorm Child Psychol. 2008 Nov;36(8):1211-25. doi: 10.1007/s10802-008-9244-6. — View Citation

Dishion TJ, Brennan LM, Shaw DS, McEachern AD, Wilson MN, Jo B. Prevention of problem behavior through annual family check-ups in early childhood: intervention effects from home to early elementary school. J Abnorm Child Psychol. 2014;42(3):343-54. doi: 10.1007/s10802-013-9768-2. — View Citation

Dishion TJ, Shaw D, Connell A, Gardner F, Weaver C, Wilson M. The family check-up with high-risk indigent families: preventing problem behavior by increasing parents' positive behavior support in early childhood. Child Dev. 2008 Sep-Oct;79(5):1395-414. doi: 10.1111/j.1467-8624.2008.01195.x. — View Citation

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Gill AM, Hyde LW, Shaw DS, Dishion TJ, Wilson MN. The Family Check-Up in early childhood: a case study of intervention process and change. J Clin Child Adolesc Psychol. 2008 Oct;37(4):893-904. doi: 10.1080/15374410802359858. — View Citation

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Gratz, K.L., & Roemer, L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment 26(1): 41-54, 2004.

Kochanska G, Murray K, Jacques TY, Koenig AL, Vandegeest KA. Inhibitory control in young children and its role in emerging internalization. Child Dev. 1996 Apr;67(2):490-507. — View Citation

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Leijten P, Shaw DS, Gardner F, Wilson MN, Matthys W, Dishion TJ. The family check-up and service use in high-risk families of young children: a prevention strategy with a bridge to community-based treatment. Prev Sci. 2015 Apr;16(3):397-406. doi: 10.1007/s11121-014-0479-x. Erratum in: Prev Sci. 2015 Apr;16(3):407. — View Citation

Lunkenheimer ES, Dishion TJ, Shaw DS, Connell AM, Gardner F, Wilson MN, Skuban EM. Collateral benefits of the Family Check-Up on early childhood school readiness: indirect effects of parents' positive behavior support. Dev Psychol. 2008 Nov;44(6):1737-52. doi: 10.1037/a0013858. — View Citation

Manenschijn L, Koper JW, Lamberts SW, van Rossum EF. Evaluation of a method to measure long term cortisol levels. Steroids. 2011 Sep-Oct;76(10-11):1032-6. doi: 10.1016/j.steroids.2011.04.005. Epub 2011 Apr 14. — View Citation

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Russell E, Koren G, Rieder M, Van Uum S. Hair cortisol as a biological marker of chronic stress: current status, future directions and unanswered questions. Psychoneuroendocrinology. 2012 May;37(5):589-601. doi: 10.1016/j.psyneuen.2011.09.009. Epub 2011 Oct 4. Review. — View Citation

Shaw DS, Connell A, Dishion TJ, Wilson MN, Gardner F. Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Dev Psychopathol. 2009 Spring;21(2):417-39. doi: 10.1017/S0954579409000236. — View Citation

Shaw DS, Dishion TJ, Supplee L, Gardner F, Arnds K. Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood. J Consult Clin Psychol. 2006 Feb;74(1):1-9. — View Citation

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Smith JD, Dishion TJ, Shaw DS, Wilson MN. Indirect effects of fidelity to the family check-up on changes in parenting and early childhood problem behaviors. J Consult Clin Psychol. 2013 Dec;81(6):962-74. doi: 10.1037/a0033950. Epub 2013 Jul 29. — View Citation

Smith JD, Knoble NB, Zerr AA, Dishion TJ, Stormshak EA. Family check-up effects across diverse ethnic groups: reducing early-adolescence antisocial behavior by reducing family conflict. J Clin Child Adolesc Psychol. 2014;43(3):400-14. doi: 10.1080/15374416.2014.888670. Epub 2014 Apr 14. — View Citation

Stalder T, Kirschbaum C. Analysis of cortisol in hair--state of the art and future directions. Brain Behav Immun. 2012 Oct;26(7):1019-29. doi: 10.1016/j.bbi.2012.02.002. Epub 2012 Feb 15. Review. — View Citation

Weaver CM, Shaw DS, Crossan JL, Dishion TJ, Wilson MN. Parent-child conflict and early childhood adjustment in two-parent low-income families: parallel developmental processes. Child Psychiatry Hum Dev. 2015 Feb;46(1):94-107. doi: 10.1007/s10578-014-0455-5. — View Citation

Willoughby MT, Blair CB, Wirth RJ, Greenberg M. The measurement of executive function at age 5: psychometric properties and relationship to academic achievement. Psychol Assess. 2012 Mar;24(1):226-39. doi: 10.1037/a0025361. Epub 2011 Oct 3. — View Citation

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* Note: There are 39 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Other Exploratory outcome - Health Service Utilization Service utilization questionnaire This will be measured at baseline, 3-, 6-, 9- and 12- months.
Other Exploratory outcome - Change in Behavioural Observations of Parenting Behavioural Observations of Parenting will be assessed using videotapes of structured interaction between the child and parent This will be measured at baseline, 6-months and 12 months.
Other Exploratory outcome - Change in Parental Emotional Regulation Difficulties in Emotion Regulation Scale (DERS) Exploratory outcomes will be measured at baseline and at 12 months.
Other Exploratory outcome - Change in Child Emotional Regulation Child emotional regulation will be assessed using videotapes of the child performing structured tasks This will be measured at baseline and at 12 months.
Other Exploratory outcome -Parent Executive Functioning Parent executive functioning will be assessed using observation of structured tasks This will be measured at baseline.
Other Exploratory outcome - Change in Child Executive Functioning Child executive functioning will be assessed using observation of structured tasks This will be measured at baseline and at 12 months.
Other Exploratory outcome - Change in Hair Cortisol Small amounts of hair will be collected from child and parents to assess hair cortisol This will be measured at baseline, 6-months and 12 months.
Primary Primary Outcome- Change in Child Externalizing Behaviors Change in Child Behavior Checklist (CBCL) scores Primary outcome will be measured at baseline, 6- and 12-months after enrollment
Secondary Secondary Outcome - Change in Parental Mental Health The Kessler-6 (K6) will be used to measure change in psychological distress over time This will be measured at baseline, 6- and 12-months
Secondary Secondary Outcome - Change in Parental Stress Parenting Daily Hassles will be used to measure changes in parental stress over time This will be measured at baseline and 12-months
Secondary Secondary Outcome - Change in Positive Parenting Practice Positive parenting practice will be coded from videotaped parent-child interactions - outcome is change in positive parenting practice over time This will be measured at baseline and 12-months
Secondary Secondary Outcome - Change in Child Compliance The Coder Impressions Inventory (COIMP) will be used to score the child's behaviour from videotaped interactions - outcome is change in behaviour over time This will be measured at baseline and 12-months
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