Prevention Science

, Volume 19, Issue 5, pp 652–662 | Cite as

Predictors of Participation in the Family Check-Up Program: a Randomized Trial of Yearly Services from Age 2 to 10 Years

  • Justin D. Smith
  • Cady Berkel
  • Katherine A. Hails
  • Thomas J. Dishion
  • Daniel S. Shaw
  • Melvin N. Wilson


A key challenge of community-based prevention programs is engaging families in the context of services settings involving children and families. The Family Check-Up (FCU) program is designed to engage families in parenting support appropriate to their level of need by use of assessment-enhanced motivational interviewing. This study involved families screened for risk who were seeking services at women, infant, and children’s offices in three geographical regions (N = 731). Families in the randomized intervention group (N = 367) were offered the FCU yearly, from age 2 through 10. The results of multivariate modeling indicated that caregivers reporting high levels of perceived caregiving stress (i.e., depression, low parenting satisfaction, daily hassles) participated at a higher rate in two critical components (feedback and follow-up support interventions) of the FCU program over the 8-year trial period than caregivers reporting lesser degrees of stress. The implications of these findings are discussed in the context of family-centered programs for the prevention of child behavior problems and directions for future research.


Participation Engagement Family Check-Up Parenting stress Retention 



This research was supported by National Institute on Drug Abuse grant DA016110 to Thomas Dishion, Daniel Shaw, and Melvin Wilson. Justin Smith and Cady Berkel were supported by National Center for Chronic Disease Prevention and Health Promotion of the Centers of Disease Control and Prevention grant DP006255. Justin Smith was also supported by National Institute on Drug Abuse grant DA027828 to C. Hendricks Brown. The authors also gratefully thank Charlotte Winter and Shannon McGill for assistance with the data management, the Early Steps team in Eugene, Pittsburgh, and Charlottesville, and the families who have participated in the study.

Conflict of Interest

Thomas Dishion is the developer of the Family Check-Up program. Justin Smith, Cady Berkel, Katherine Hails, Daniel Shaw, and Melvin Wilson have no conflicts of interest or financial relationships relevant to this article to disclose.

Ethical Approval

All procedures performed in this study were approved by the Institutional Review Boards of the Arizona State University, the University of Oregon, the University of Pittsburgh, and the University of Virginia and were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11121_2016_679_MOESM1_ESM.docx (85 kb)
ESM 1 (DOCX 85 kb)


  1. Anderson, E. A., Kohler, J. K., & Letiecq, B. L. (2002). Low-income fathers and “Responsible Fatherhood” programs: A qualitative investigation of participants’ experiences. Family Relations, 51, 148–155. doi: 10.1111/j.1741-3729.2002.00148.x.CrossRefGoogle Scholar
  2. Baker, C. N., Arnold, D. H., & Meagher, S. (2011). Enrollment and attendance in a parent training prevention program for conduct problems. Prevention Science, 12, 126–138. doi: 10.1007/s11121-010-0187-0.CrossRefPubMedGoogle Scholar
  3. Chiapa, A., Smith, J. D., Kim, H., Dishion, T. J., Shaw, D. S., & Wilson, M. N. (2015). The trajectory of fidelity in a multiyear trial of the Family Check-Up predicts change in child problem behavior. Journal of Consulting and Clinical Psychology, 83, 1006–1011. doi: 10.1037/ccp0000034.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Conger, R. D., Wallace, L. E., Sun, Y., Simons, R. L., McLoyd, V. C., & Brody, G. H. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179–193. doi: 10.1037/0012-1649.38.2.179.CrossRefPubMedGoogle Scholar
  5. Connell, A. M., Bullock, B. M., Dishion, T. J., Shaw, D. S., Wilson, M. N., & Gardner, F. E. M. (2008). Family intervention effects on co-occurring early childhood behavioral and emotional problems: A latent transition analysis approach. Journal of Abnormal Child Psychology, 36, 1211–1225.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Connell, A. M., Dishion, T. J., Yasui, M., & Kavanagh, K. (2007). An adaptive approach to family intervention: Linking engagement in family-centered intervention to reductions in adolescent problem behavior. Journal of Consulting and Clinical Psychology, 75, 568–579. doi: 10.1037/0022-006X.75.4.568.CrossRefPubMedGoogle Scholar
  7. Dishion, T. J., & Andrews, D. W. (1995). Preventing escalation in problem behaviors with high-risk young adolescents: Immediate and 1-year outcomes. Journal of Consulting and Clinical Psychology, 63, 538–548.CrossRefPubMedGoogle Scholar
  8. Dishion, T. J., Brennan, L. M., Shaw, D. S., McEachern, A. D., Wilson, M. N., & Jo, B. (2014). Prevention of problem behavior through annual Family Check-Ups in early childhood: Intervention effects from home to early elementary school. Journal of Abnormal Child Psychology, 42, 343–354. doi: 10.1007/s10802-013-9768-2.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Dishion, T. J., Hogansen, J., Winter, C., & Jabson, J. M. (2004). The coder impressions inventory. Eugene, OR: Unpublished coding manual. Available from the Child and Family Center, 6217 University of Oregon. 97403.Google Scholar
  10. Dishion, T. J., Shaw, D. S., Connell, A., Gardner, F. E. M., Weaver, C., & Wilson, M. (2008). The Family Check-Up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79, 1395–1414. doi: 10.1111/j.1467-8624.2008.01195.x.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41, 327–350. doi: 10.1007/s10464-008-9165-0.CrossRefPubMedGoogle Scholar
  12. Fergusson, D. M., Grant, H., Horwood, L. J., & Ridder, E. M. (2005). Randomized trial of the Early Start program of home visitation. Pediatrics, 116, e803–e809. doi: 10.1542/peds.2005-0948.CrossRefPubMedGoogle Scholar
  13. Garvey, C., Julion, W., Fogg, L., Kratovil, A., & Gross, D. (2006). Measuring participation in a prevention trial with parents of young children. Research in Nursing & Health, 29, 212–222. doi: 10.1002/nur.20127.CrossRefGoogle Scholar
  14. Gomby, D. S., Culross, P. L., & Behrman, R. E. (1999). Home visiting: Recent program evaluations: Analysis and recommendations. The Future of Children, 9, 4–26. doi: 10.2307/1602719.CrossRefPubMedGoogle Scholar
  15. Hawkins, J. D., Jenson, J. M., Catalano, R. F., Fraser, M. W., Botvin, G. J., Shapiro, V., . . . Stone, S. (2015). Unleashing the Power of Prevention. Retrieved from Washington, DC: National Academies PressGoogle Scholar
  16. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. doi: 10.1080/10705519909540118.CrossRefGoogle Scholar
  17. Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19, 629–645. doi: 10.1007/s10826-009-9350-2.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Johnston, C., & Mash, E. J. (1989). A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18, 167–175. doi: 10.1207/s15374424jccp1802_8.CrossRefGoogle Scholar
  19. Leijten, P., Shaw, D. S., Gardner, F. E. M., Wilson, M. N., Matthys, W., & Dishion, T. J. (2014). The Family Check-Up and service use in high-risk families of young children: A prevention strategy with a bridge to community-based treatment. Prevention Science, 16, 397–406. doi: 10.1007/s11121-014-0479-x.CrossRefGoogle Scholar
  20. Leventhal, T., & Brooks-Gunn, J. (2000). The neighborhoods they live in: The effects of neighborhood residence on child and adolescent outcomes. Psychological Bulletin, 126, 309. doi: 10.1037//0033-2909.126.2.309.CrossRefPubMedGoogle Scholar
  21. Lunkenheimer, E. S., Dishion, T. J., Shaw, D. S., Connell, A. M., Gardner, F. E. M., Wilson, M. N., & Skuban, E. M. (2008). Collateral benefits of the Family Check-Up on early childhood school readiness: Indirect effects of parents’ positive behavior support. Developmental Psychology, 44, 1737–1752. doi: 10.1037/a0013858.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Mendez, J. L., & Westerberg, D. (2012). Implementation of a culturally adapted treatment to reduce barriers for Latino parents. Cultural Diversity and Ethnic Minority Psychology, 18, 363–372. doi: 10.1037/a0029436.CrossRefPubMedGoogle Scholar
  23. Morawska, A., & Sanders, M. (2006). A review of parental engagement in parenting interventions and strategies to promote it. Journal of children’s services, 1, 29–40. doi: 10.1108/17466660200600004.CrossRefGoogle Scholar
  24. Murry, V. M., Brown, P. A., Brody, G. H., Cutrona, C. E., & Simons, R. L. (2001). Racial discrimination as a moderator of the links among stress, maternal psychological functioning, and family relationships. Journal of Marriage and Family, 63, 915–926. doi: 10.1111/j.1741-3737.2001.00915.x.CrossRefGoogle Scholar
  25. Muthén, B. O., du Toit, S. H. C., & Spisic, D. (1997). Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes. Unpublished technical paper. Retrieved from
  26. Muthén, L. K., & Muthén, B. O. (2014). Mplus user’s guide (Version 7.2). Los Angeles, CA: Muthén & Muthén.Google Scholar
  27. Nievar, M. A., Van Egeren, L. A., & Pollard, S. (2010). A meta-analysis of home visiting programs: Moderators of improvements in maternal behavior. Infant Mental Health Journal, 31, 499–520. doi: 10.1002/imhj.20269.CrossRefPubMedGoogle Scholar
  28. Nix, R. L., Bierman, K. L., McMahon, R. J., & Conduct Problems Prevention Research Group. (2009). How attendance and quality of participation affect treatment response to parent management training. Journal of Consulting & Clinical Psychology, 77, 429–438. doi: 10.1037/a0015028.CrossRefGoogle Scholar
  29. NRC/IOM. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Retrieved from Washington, D.C.Google Scholar
  30. Orrell-Valente, J. K., Pinderhughes, E. E., Valente, E., Laird, R. D., Bierman, K. L., Coie, J. D., & McMahon, R. J. (1999). If it’s offered, will they come? Influences on parents’ participation in a community-based conduct problems prevention program. American Journal of Community Psychology, 27, 753–783.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Patterson, G. R., & Chamberlain, P. (1994). A functional analysis of resistance during parent training therapy. Clinical Psychology: Science and Practice, 1, 53–70.Google Scholar
  32. Paulsell, D., Avellar, S., Sama Martin, E., & Del Grosso, P. (2011). Home visiting evidence of effectiveness review: Executive summary. Retrieved from sites/default/files/opre/homvee_executivesummary_rev10_15_2011.pdf
  33. Peacock, S., Konrad, S., Watson, E., Nickel, D., & Muhajarine, N. (2013). Effectiveness of home visiting programs on child outcomes: A systematic review. BMC Public Health, 13, 1–14. doi: 10.1186/1471-2458-13-17.CrossRefGoogle Scholar
  34. Peters, S., Calam, R., & Harrington, R. (2005). Maternal attributions and expressed emotion as predictors of attendance at parent management training. Journal of Child Psychology & Psychiatry, 46, 436–448. doi: 10.1111/j.1469-7610.2004.00365.x.CrossRefGoogle Scholar
  35. Qi, C. H., & Kaiser, A. P. (2003). Behavior problems of preschool children from low-income families: Review of the literature. Topics in Early Childhood Special Education, 23, 188–216. doi: 10.1177/02711214030230040201.CrossRefGoogle Scholar
  36. Radloff, L. S. (1977). The CES-D scale. Applied psychological measurement, 1, 385–401.CrossRefGoogle Scholar
  37. SAMHSA. (2015). National registry of evidence-based programs and practices (
  38. Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. E. M. (2009). Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Development and Psychopathology, 21, 417–439. doi: 10.1017/S0954579409000236.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Shelleby, E. C., & Shaw, D. S. (2014). Outcomes of parenting interventions for child conduct problems: A review of differential effectiveness. Child Psychiatry & Human Development, 45, 628–645. doi: 10.1007/s10578-013-0431-5.CrossRefGoogle Scholar
  40. Shelleby, E. C., Shaw, D. S., Cheong, J., Chang, H., Gardner, F. E. M., Dishion, T. J., & Wilson, M. N. (2012). Behavioral control in at-risk toddlers: The influence of the Family Check-Up. Journal of Clinical Child & Adolescent Psychology, 41, 288–301.CrossRefGoogle Scholar
  41. Smith, J. D., Dishion, T. J., Shaw, D. S., & Wilson, M. N. (2013). Indirect effects of fidelity to the Family Check-Up on changes in parenting and early childhood problem behaviors. Journal of Consulting and Clinical Psychology, 81, 962–974. doi: 10.1037/a0033950.CrossRefPubMedGoogle Scholar
  42. Smith, J. D., Knoble, N., Zerr, A. A., Dishion, T. J., & Stormshak, E. A. (2014). Multicultural competence and the Family Check-Up: Indirect effect on adolescent antisocial behavior through family conflict. Journal of Clinical Child & Adolescent Psychology, 43, 400–414. doi: 10.1080/15374416.2014.888670.CrossRefGoogle Scholar
  43. Smith, J. D., Montaño, Z., Dishion, T. J., Shaw, D. S., & Wilson, M. N. (2015). Preventing weight gain and obesity: Indirect effects of a family-based intervention in early childhood. Prevention Science, 16, 408–419. doi: 10.1007/s11121-014-0505-z.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Spoth, R., & Redmond, C. (1993). Study of participation barriers in family-focused prevention: Research issues and preliminary results. International Quarterly of Community Health Education, 13, 365–388. doi: 10.2190/69lm-59kd-k9ce-8y8b.CrossRefGoogle Scholar
  45. The National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment. (2001). Blueprint for Change: Research on Child and Adolescent Mental Health. Washington, DC.Google Scholar
  46. White, R. M. B., Roosa, M. W., Weaver, S. R., & Nair, R. L. (2009). Cultural and contextual influences on parenting in Mexican American families. Journal of Marriage and Family, 71, 61–79. doi: 10.1111/j.1741-3737.2008.00580.x.CrossRefPubMedPubMedCentralGoogle Scholar
  47. Winslow, E. B., Bonds, D., Wolchik, S., Sandler, I., & Braver, S. (2009). Predictors of enrollment and retention in a preventive parenting intervention for divorced families. The Journal of Primary Prevention, 30, 151–172. doi: 10.1007/s10935-009-0170-3.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Yoshikawa, H., Aber, J. L., & Beardslee, W. R. (2012). The effects of poverty on the mental, emotional, and behavioral health of children and youth: Implications for prevention. American Psychologist, 67, 272–284. doi: 10.1037/a0028015.CrossRefPubMedGoogle Scholar

Copyright information

© Society for Prevention Research 2016

Authors and Affiliations

  • Justin D. Smith
    • 1
  • Cady Berkel
    • 2
  • Katherine A. Hails
    • 3
  • Thomas J. Dishion
    • 1
    • 4
  • Daniel S. Shaw
    • 3
  • Melvin N. Wilson
    • 5
  1. 1.Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.REACH InstituteArizona State UniversityArizonaUSA
  3. 3.University of PittsburghPittsburghUSA
  4. 4.Oregon Research InstituteOregonUSA
  5. 5.University of VirginiaVirginiaUSA

Personalised recommendations