KEEP (Keeping Foster and Kin Parents Supported and Trained) - Detailed Report

• Foster/kinship family attends weekly parent support and training group sessions.
• Foster/kinship family groups are conducted by a trained facilitator and co-facilitator.
• Foster/kinship family receives supervision in behavior management methods.
• Foster/kinship family group sessions are structured so that the curriculum content is integrated into group discussions.
• Foster/kinship family receives weekly Parent Daily Report Checklist calls by either the facilitator or co-facilitator to trouble shoot problems the foster parent was having in implementing the assignment, and to collect data on the child's problem behaviors during the past day.
• If foster/kinship family misses a parent-training session, the material from the missed session is delivered during a home visit at a time convenient for the foster parent.

KEEP is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. For more information on the rating of a "3 - Promising Research Evidence," please see the Scientific Rating Scale.

Chamberlain, P., Moreland, S., & Reid, K. (1992). Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children. Child Welfare, 71(5):387-401.

Type of Study: Randomized Control Trial
Number of Participants: 72 foster families
Population:

Age Range: children 4-7 yrs old; parents about 40 years old
Ethnicity: Caucasian (86%); African American (6%); Hispanic (4%)
Status: Unknown

Location/Institution: Oregon counties
Summary: (To include comparison groups, outcomes, measures, notable limitations) 72 foster families from 3 counties in Oregon were randomly assigned to intervention and 2 control conditions. The intervention consisted of enhanced training for parents in the form of group sessions, behavior management techniques, and telephone support. Intervention parents also received an additional monthly stipend. One comparison group received the stipend only and the control group received care as usual. Families were assessed at 3 weeks, and at 3, 6, and 9 months. Assessments included the Parent Daily Report (of problem behaviors), dropout rates, a staff impression survey rating parents' skills and personal strengths and stable foster placements versus removal to restricted group care. (18 children were returned to their families, but the decision was not based on factors related to their foster condition.) Intervention parents reported lower rates of child problem behaviors, had fewer placement disruptions, and fewer foster parents dropped out of providing care.
Length of post-intervention follow-up: Unknown

Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P. A., & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409-424.

Type of Study: Control Group
Number of Participants: N= 246
Population:

Age Range: Children 5-12 years old; adults 19-81 yrs old
Ethnicity: Children: Caucasian (25%); African American (19%); Hispanic (31%); Asian and Pacific Islander (<1%); Native American (1%). Foster parents: Caucasian (36%); African American (23%); Hispanic, (33%); Asian and Pacific Islander (2%); Native American (1%)
Status: Children in the foster care system

Location/Institution: Oregon and San Diego counties
Summary: (To include comparison groups, outcomes, measures, notable limitations) This study only used children from the control group (foster care as usual). Children with fewer that 6 problem behaviors per day were less likely to disrupt from care than those with 6 or more and increases in behaviors were related to liner increases in the probability to disrupt. One outcome paper is submitted but not yet in press. A second and third are in preparation; will be submitted by December 2006.
Length of post-intervention follow-up: Unknown.

Chamberlain, P., Price, J., Leve, L. D., Laurent, H., Landsverk, J. A., & Reid, J. B. (2008). Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science, 9, 17-27.

Type of Study: Randomized Control Trial
Number of participants: 700 parents
Population:

Age Range: Parents: Intervention average, 49.86; Control average, 47.29. Children: Intervention average, 8.88; Control average, 8.72
Race/Ethnicity: Parents: 25% African American, 3% Asian/Pacific Islander, 27% Caucasian, 37% Latino, 1% Native American, 6% Mixed ethnic Children: 21% African American, 33% Latino, 22% Caucasian, 22% Mixed ethnic, 1% Asian American, 1% Native American.
Status (e.g., foster care, CW): Foster and kinship parents

Location/Institution: San Diego, California
Summary: (To include comparison groups, outcomes, measures, notable limitations) Parents were randomly assigned to receive 16 weeks of training, supervision and support or to casework services as usual. The intervention used was KEEP (Keeping Foster Parents Trained and Supported), which is based on Multidimensional Treatment Foster Care (MTFC). Child behavior problems were measure using the Parent Daily Report Checklist (PDR) at baseline and termination (5 months post-baseline). Based on the baseline measure, families were split into high and low risk groups for analysis. High risk children were those with more than six reported behavior problems at baseline. The parent also completed an interview including measures of positive reinforcement and discipline. Results showed higher levels of positive reinforcement and accompanying lower levels of children's behavior problems for the intervention group. Effects were strongest for the high risk group.
Length of post-intervention follow-up: None.

Price, J. M., Chamberlain, P., Landsverk, J., Reid, J., Leve, L., & Heidemarie, L. (2008). Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment, 13,64-75.

Type of Study: Randomized Control Trial
Number of participants: 700 parents
Population:

Age Range: Children 5-12 years
Race/Ethnicity: Parents: 25% African American, 3% Asian/Pacific Islander, 27% Caucasian, 37% Latino, 1% Native American, 6% Mixed ethnic Children: 21% African American, 33% Latino, 22% Caucasian, 22% Mixed ethnic, 1% Asian American, 1% Native American.
Status (e.g., foster care, CW): Foster and kinship parents

Location/Institution: San Diego, CA
Summary: (To include comparison groups, outcomes, measures, notable limitations) (Note: This study uses the same sample as Chamberlain, et al., 2008 above.) Parents were randomly assigned to receive 16 weeks of training, supervision and support or to casework services as usual. The intervention used was KEEP (Keeping Foster Parents Trained and Supported), which is based on Multidimensional Treatment Foster Care (MTFC). Child exits from foster care were defined as occurring within 200 days of baseline and were based on foster parent report. Positive exits were defined as reunion with a parent or relative or adoption. Negative exits included another foster placement, more restrictive placement or running away. Analyses regarding the KEEP intervention found that those in the intervention group were nearly twice as likely to experience a positive exit, but were no more or less likely to experience a negative exit. However, children with a higher number of placements prior to the beginning of the study were more likely to have negative placements if they were in the control group but not if they were in the intervention group, which suggested a mitigating effect. The authors note that 70% of the sample experienced no change in placement during the study period.
Length of post-intervention follow-up: None.

Chamberlain, P., Price, J., Reid, J. B., & Landsverk, J. (2008). Cascading implementation of a foster and kinship parent intervention. Child Welfare, 87(5), 27-48.

Type of Study: Randomized controlled trial
Number of participants: 700
Population:

Age Range: Mean age: 48.6 years (range, 19–81 years)
Race/Ethnicity: Latino (37%), Caucasian (27%), African American (26%), multiethnic (6%), Asian/Pacific Islander (3%), and Native American (1%).
Status (e.g., foster care, CW): Foster/kinship parents in San Diego County

Location/Institution: San Diego County, CA
Summary: (To include comparison groups, outcomes, measures, notable limitations)Most foster parents in the United States are required to participate in training, yet no empirical support exists for the training’s effectiveness. During the past two decades, high-quality clinical trials have documented that parent management training (PMT) programs produce positive outcomes for children and families in clinical and school settings; yet, these advances have not transferred to foster/kinship parents. This study tests the effectiveness of a PMT-based treatment with 700 foster/kinship parents in San Diego County. Child behavioral outcomes were measured using the parent daily report (PDR) checklist. In this study, PDR data were collected from foster and kin parents for three days at baseline and three days at treatment termination. No differences existed between the behavior rates reported by intervention parents and those reported by control parents at baseline. At treatment termination, however, foster/kin parents in the KEEP intervention condition reported significantly fewer child behavior problems than those in the control condition. In addition, these changes in child behavior were found to be mediated by changes in parenting behavior. At the five-month postbaseline interview, foster parents who participated in the KEEP groups showed an increase in the proportion of positive reinforcements relative to discipline parenting practices, and this increase predicted a decrease in child problem behaviors. Children of parents in the KEEP group were also found to have higher rates of reunification with biological or adoptive families and fewer placement disruptions than those in the control condition.
Length of post-intervention follow-up: None

Chamberlain, P., Moreland, S., & Reid, K. (1992). Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children. Child Welfare, 71(5):387-401.

Chamberlain, P., Price, J., Leve, L. D., Laurent, H., Landsverk, J. A. & Reid, J. B. (2008). Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science, 9, 17-27.

Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P.A., & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409-424.

Price, J. M., Chamberlain, P., Landsverk, J., Reid, J., Leve, L., & Heidemarie, L. (2008). Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment, 13,64-75.