Prevention Program for Problem Behaviors in Girls in Foster Care

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00239837
Recruitment Status : Completed
First Posted : October 17, 2005
Results First Posted : March 31, 2014
Last Update Posted : January 8, 2016
National Institute of Mental Health (NIMH)
National Institute on Drug Abuse (NIDA)
Information provided by (Responsible Party):
Leslie D. Leve, Oregon Social Learning Center

Brief Summary:
This study will determine the efficacy of a parent-involved intervention in preventing problem behavior in middle school girls who are currently in foster care.

Condition or disease Intervention/treatment Phase
Juvenile Justice Involvement Drug Abuse Behavioral: Middle School Success Intervention (MSS) Phase 1

Detailed Description:

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.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Preventing Problems for Girls in Foster Care
Study Start Date : December 2003
Actual Primary Completion Date : December 2009
Actual Study Completion Date : April 2013

Arm Intervention/treatment
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

Primary Outcome Measures :
  1. Delinquency [ Time Frame: Measured at Month 36 ]
    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.

  2. Tobacco Use [ Time Frame: Measured at Month 36 ]
    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.

  3. Marijuana Use [ Time Frame: Measured at Month 36 ]
    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.

Secondary Outcome Measures :
  1. Mental Health Problems [ Time Frame: Measured at Months 12 and 24 ]
    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.

  2. Participation in Risky Sexual Behaviors [ Time Frame: Measured at Month 36 ]
    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.

  3. Social Competence [ Time Frame: Measured at Months 6, 12 ]
    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.

  4. Placement Changes [ Time Frame: Measured at Months 6 and 12 ]
    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.

  5. Decision Making [ Time Frame: Measured at age 15-17 ]
    "Cups" task (Weller et al., 2007). On each trial, participants see 2 arrays with equal number of X cups (2, 3, or 5) each. On gain trials, participants informed that under each cup in one array is 1 quarter, and the other array includes 1 cup with Y quarters (either 2, 3, or 5), but the other cups have 0 quarters. Choosing from the riskless side leads to a sure gain of 1 quarter while choosing the risky side can lead to gain of Y quarters or no quarters. On loss trials, participants shown that choosing cup from 1 array will lead to 1 quarter taken away while choosing cup from other array will lead to no quarters or Y quarters taken. Cups task consists of 54 trials of 3 trials each of all combinations of 2 levels of domain (gain, loss). Expected Value Sensitivity (EV) calculated by subtracting proportion of risky choices made when EV actually favored the sure choice from proportion of risky choices made on trials where EV favored risky option. Score can range from -1.0 to -1.0.

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Ages Eligible for Study:   10 Years to 12 Years   (Child)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Living in a foster home or receiving kinship care
  • Are about to enter middle school
  • Oregon resident
  • Guardian willing to provide informed consent
  • Female

Exclusion Criteria:

  • male
  • not in foster care
  • not living in Oregon

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00239837

United States, Oregon
Oregon Social Learning Center
Eugene, Oregon, United States, 97401
Sponsors and Collaborators
Oregon Social Learning Center
National Institute of Mental Health (NIMH)
National Institute on Drug Abuse (NIDA)
Principal Investigator: Leslie Leve, PhD Oregon Social Learning Center

Publications of Results:

Other Publications:
Responsible Party: Leslie D. Leve, Senior Fellow, Oregon Social Learning Center Identifier: NCT00239837     History of Changes
Other Study ID Numbers: R01MH054257 ( U.S. NIH Grant/Contract )
R01MH054257 ( U.S. NIH Grant/Contract )
R21DA027091 ( U.S. NIH Grant/Contract )
First Posted: October 17, 2005    Key Record Dates
Results First Posted: March 31, 2014
Last Update Posted: January 8, 2016
Last Verified: December 2015

Keywords provided by Leslie D. Leve, Oregon Social Learning Center:
Foster Care

Additional relevant MeSH terms:
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders