Social Support and Maternal Depression in Predicting Engagement in the Family Check-Up Intervention Between Child Ages 2-10.5

• In Event: Poster Session 05
  In Poster Session: PS 05 Topic - Prevention and Interventions

Abstract

Family-based interventions are effective at treating and preventing child behavior problems beginning in early childhood (Dishion et al., 2008), and higher rates of engagement with parenting-focused interventions are associated with improved parenting and child outcomes (Durlak & DuPre, 2008). However, low initial engagement and maintenance of engagement pose significant challenges for intervention programs (Baker et al. 2011). As such, it is fundamental to understand family factors that predict engagement in family-based interventions, particularly among low-SES families whose children are at greater risk for earlier and more persistent trajectories of conduct problems (Shaw & Shelleby, 2014). Two proximal family factors that also have been linked to later child behavior are parental depression and social support, with the latter being relatively understudied as a factor that could be linked to engagement in family-based interventions. We hypothesized that parents with higher levels of parental depression and lower levels of social support receipt and satisfaction would be more likely to engage in the Family Check-Up (FCU) during annual check-ups in early childhood.
This study uses data from the Early Steps Multisite Study, a randomized controlled trial of the FCU intervention in urban (Pittsburgh, PA), suburban (Eugene, OR), and rural (Charlottesville, VA) communities. A sample of 731 ethnically-diverse, low-income families were recruited at child age 2 from WIC clinics based on having child, family, and/or socioeconomic risk factors for child disruptive behavior. The FCU was offered yearly between ages 2-5 and 7.5-10.5, and engagement at each year was treated as a binary outcome based on caregiver completion of the FCU’s third and most critical session—the feedback. In addition to assessing primary caregiver (PC) depressive symptoms (98% female, CES-D) and social support receipt and satisfaction (General Life Satisfaction Scale) at child age 2, child externalizing behavior problems, daily parenting hassles, site, parental education, income, and race/ethnicity were included as covariates in the multilevel logistic regression model. Multiple imputation was applied using the Blimp application (Enders, Keller, & Levy, 2016), and a Poisson regression was used to test the model.
After accounting for the significant contribution of PC education (i.e., greater FCU engagement with higher than a high school degree vs. less than a high school degree), both higher levels of received social support (b = .202, p < .001) and depression (b = .006, p = .014) predicted higher engagement in the FCU. However, social support satisfaction was not significantly related to FCU engagement (b = -.028, p = .212). The relationship between higher depressive symptoms and greater engagement supports theories of help-seeking behavior that suggest that psychological distress may act to motivate service engagement for families (Andersen, 1995; Eiraldi et al., 2006). Unexpectedly, greater received support promoted longer-term investment in the FCU intervention. As such, identifying caregivers with fewer social supports may provide a critical opportunity to address treatment barriers and improve intervention engagement.

Authors

• Luciano Dolcini-Catania, University of Pittsburgh
  Presenting Author

• Kathryn Lemery-Chalfant, Arizona State University
  Non-Presenting Author

• Melvin N Wilson, University of Virginia -Charlottesville
  Non-Presenting Author

• Daniel S. Shaw, University of Pittsburgh
  Non-Presenting Author