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

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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.