Prevention Program for Problem Behaviors in Girls in Foster Care
Juvenile Justice Involvement
Behavioral: Middle School Success Intervention (MSS)
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
|Official Title:||Preventing Problems for Girls in Foster Care|
- Delinquency [ Time Frame: Measured at Month 36 ] [ Designated as safety issue: No ]36 items from the general delinquency scale from the Self-Report Delinquency Scale (SRD; Elliott, Huizinga, & Ageton, 1985). Units on a scale. Girls were asked to rate how many times they had committed various delinquent acts (e.g., damaging or destroying properties, and stealing) in the past year, using an open-ended format. The mean of frequencies across these items was used to represent the level of delinquency for girls. The general delinquency scale scores ranged from 0 to 24 (full scale) and from 0 to 13 (log transformed). Higher scores indicate higher levels of delinquency.
- Tobacco Use [ Time Frame: Measured at Month 36 ] [ Designated as safety issue: No ]The girls were asked how many times in the past year they had smoked cigarettes or chewed tobacco. The response scale ranged from 1 (never) through 9 (daily). Units on a scale.
- Marijuana Use [ Time Frame: Measured at Month 36 ] [ Designated as safety issue: No ]The girls were asked how many times in the past year they had used marijuana. The response scale ranged from 1 (never) through 9 (daily). Units on a scale. Log transformed.
- Mental Health Problems [ Time Frame: Measured at Months 12 and 24 ] [ Designated as safety issue: No ]Internalizing and externalizing symptoms at 12 and 24 months were measured with caregiver report on the Achenbach System of Empirically Based Assessment (ASEBA). This widely used checklist for psychopathological behaviors includes scales for behaviors such as Anxious/Depressed; Withdrawn; Somatic Complaints; Thought Problems; Attention Problems; Aggressive Behavior; Rule-Breaking Behavior; and Intrusive. The ASEBA has been shown to have both construct and content validity in the literature. For the present study, raw scores for the internalizing and externalizing symptoms subscales were used. Scores at 12 and 24 months were combined and averaged (mean). Units on a scale. Range = 0-66. Higher scores indicate higher levels of internalizing or externalizing problems.
- Participation in Risky Sexual Behaviors [ Time Frame: Measured at Month 36 ] [ Designated as safety issue: Yes ]Eight items from the girls' in-person interviews were used to assess health risking sexual behavior at the 36-month followup. The girls reported on items such as touching a boy's body above or below the waist, having sexual intercourse, having sex with someone who they just met, or having sex with someone using drugs in the past 12 months. Positive answers to these items were totaled to represent the cumulative number of health-risking sexual behaviors. The frequency of the cumulative number of risky sexual acts ranged from 0 to 7. Units on a scale. Higher scores indicate more health-risking sexual behaviors.
- Social Competence [ Time Frame: Measured at Months 6, 12 ] [ Designated as safety issue: No ]Prosocial behavior was measured with a subscale from the Parent Daily Report (PDR; Chamberlain & Reid, 1987). The PDR was administered individually by telephone to foster parents on 3 consecutive or closely spaced days (1-3 days apart) at each assessment. A trained interviewer asked the foster parent whether a list of prosocial behaviors took place during the previous 24 hr (yes/no format). The prosocial scale was computed based on nine items, such as "cleans up after herself" and "do a favor for someone." The PDR was designed to avoid the potential bias of aggregate recall of frequency estimates. Studies have reported concurrent and predictive validity of the PDR checklist. The scores were averaged (mean) across calls from 3 days. Scores on prosocial behavior at 6 and 12 months were averaged and the mean across both time points was used in analysis. Units on a scale. Range = 0-9. Higher scores indicate more prosocial behavior.
- Placement Changes [ Time Frame: Measured at Months 6 and 12 ] [ Designated as safety issue: No ]Child welfare system records were collected at each assessment to determine the girls' placement changes (including the number and type of changes). Placement changes since the start of the study through 12 months were summed for each girl. The number of placement changes ranged from 0 to 7 during this period. Units on a scale. Higher scores indicate more placement changes.
- Decision Making [ Time Frame: Measured at age 15-17 ] [ Designated as safety issue: No ]"Cups" task (Weller et al., 2007). On each trial, participants are shown two arrays with an equal number of X cups (2, 3, or 5) each. On gain trials, they are informed that under each cup in one array has one quarter, and that the other array includes one cup with Y quarters (either 2, 3, or 5), but the other cups have 0 quarters. Choosing from the riskless side will lead to a sure gain of one quarter while choosing from the risky side can lead to a gain of Y quarters or no quarters. Similarly, on loss trials, participants are shown that choosing a cup from one of the array will lead to one quarter being taken away from their bank while choosing a cup from the other array will lead to no quarters or Y quarters taken away. The Cups task consists of 54 trials of 3 trials each of all combinations of 2 levels of domain (gain, loss), 3 levels of probability (i.e., number of cups; .20/.33/.50) and 3 levels of outcome magnitude for the risky option ($.50/.75/1.25).
|Study Start Date:||December 2003|
|Study Completion Date:||April 2013|
|Primary Completion Date:||December 2009 (Final data collection date for primary outcome measure)|
Experimental: Middle School Success Intervention (MSS)
Middle School Success Intervention (MSS): Participants receive the preventative intervention
Behavioral: Middle School Success Intervention (MSS)
This is a 10-month, psychosocial intervention for foster parents and girls, with administration of the intervention beginning the summer before entry into middle school. The intervention consists of: (1) six summer Pride groups for the girls, (2) six summer parenting intervention sessions for the foster parents; (3) weekly foster parent training and support sessions for foster parents during the first year of middle school; and (4) weekly individual skills training for the girls during the first year of middle school.
Other Name: KEEP SAFE
No Intervention: Foster Care Services as Usual
Foster Care Services as Usual: Participants continue with usual foster care
The transition from elementary school to middle school presents a complex set of challenges for adolescents. These include increased expectations for time management and self-monitoring, renegotiation of rules and boundaries with parents, increased peer influence, and pubertal changes. For children in foster care, this transition is further complicated by issues such as a possible history of maltreatment, unpredictable changes in their living situations, and difficulty explaining their foster care background to peers and teachers. Such issues may be more serious for girls in foster care. Social problems for these girls in middle school can lead to a number of negative effects, including delinquency, substance abuse, poor school performance, mental health problems, and participation in risky sexual behavior. Despite such risks, adolescent girls are less likely to receive specialty mental health or school-based services than their male counterparts. This study is aimed at determining the effectiveness of a preventive intervention for preadolescent girls living in foster/kinship care. The intervention targets include preventing delinquency, initiation of substance use, participation in risky sexual behavior, school truancy and failure, and mental health problems.
Participants were randomly assigned to receive either the preventive intervention or usual foster care services in the summer before entering middle school (typically sixth grade). The preventive intervention consisted of weekly training and support sessions for both participants and their foster or kin parents. The sessions began at study start and continued throughout participants' first year in middle school. Participants' relationship development, delinquency, school behavior and performance, sexual behavior, and substance use were assessed through questionnaires. Parenting practices were assessed through interviews. Assessments were conducted at study entry and at Months 6, 12, and 24, and 36. A new, follow-up assessment on the girls' decision making was conducted at age 14-16.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00239837
|United States, Oregon|
|Oregon Social Learning Center|
|Eugene, Oregon, United States, 97401|
|Principal Investigator:||Leslie Leve, PhD||Oregon Social Learning Center|