Prevention of behavior problems among preschool children in foster care through group-based foster caregiver training at the time of placement

Project Summary
Most children in foster care experience multiple forms of maltreatment, increasing risk for behavior problems
(e.g., aggression, noncompliance, suspensions/expulsions from preschool or daycare). The foster care system
is over-burdened and crisis-response oriented, limiting capacity to focus on prevention of behavior problems
with foster caregivers and children. The Chicago Parent Program (CPP) is an evidence-based 12-session
program (11 concurrent weeks, 1 one-month booster) with demonstrated significant and sustained
improvements in consistent discipline, parenting self-efficacy, and child behavior problems 1 year following
training. If available to foster caregivers, CPP could prevent or reduce behavior problems in foster youth,
decrease caregiver stress, increase self-efficacy and consistent discipline with caregivers, and prevent
unnecessary placement changes. However, adaptations to the existing program are necessary. The goal of
this study is to conduct a clinical trial of CPP adapted for foster caregivers of young children. This will be
accomplished through three aims: Aim 1: Adapt CPP to meet the unique needs of children ages 2-5 years
who are placed with foster caregivers (CPP-FC) and pilot delivery coordinated with mandated
healthcare visits (2 groups, 6-8 families). CPP content will be adapted (e.g., additional content targeting
trauma and child maltreatment, modified discussion of vignettes, additional role-play targeting specific foster
care scenarios). A stakeholder adaptation team, including 6 caregivers, has been established to guide
development of enhanced content. Aim 2: Assess the impact of CPP-FC on caregiver stress & confidence
in managing child behavior. Families (N = 300) will be randomized to CPP-FC or usual care, with
assessments at baseline, 3 months (end of training) and 6 months. CPP-FC is expected to reduce caregiver
stress and increase confidence. Aim 3: Assess the impact of CPP-FC on child behavior. Observations of
structured interactions between caregivers and children at baseline and 3-months will be collected along with
caregiver reports of child behaviors at baseline, 3 months, and 6 months. CPP-FC is expected to decrease
child behavior problems and result in fewer placement changes. If hypotheses are confirmed, this study will
provide an evidence-based model to prevent behavior problems in young foster children that could be spread
to other institutions.

Grant Number: 5R01HD105727-04
NIH Institute/Center: NIH
Principal Investigator: Sarah Beal