Family Checkup for Kinship Familes of African American Children: A Cultural Adaption and Pilot Study

Background and Purpose: Children placed out-of-home due to child maltreatment are often known to have socio-emotional, behavioral, and psychological problems. These problems challenge caregivers, especially kin caregivers, who deal with the consequences of the behavioral health problems of the children in their care on a daily basis. African American children are disproportionately placed in kinship care, specifically with kin caregivers who have pressing service needs given their relatively poor physical and mental health, and low economic status. Surprisingly, there are few culturally tailored interventions that have undergone rigorous efficacy and effectiveness testing for improving the behavioral health of African American children in kinship families. The long-term goal of this proposed research is to develop and optimize the Family CheckUp (FCU) intervention for the population of African American children placed in African American kinship families to better meet their unique needs. The FCU is an empirically supported intervention that aims to strengthen family functioning and improve child behavioral health. The first step towards the long-term goal is this proposed pilot study, which is a preliminary examination addressing the cultural adaptation of the FCU in the African American community and methodological issues necessary for the future conduct of an efficient and effective intervention in a large-scale study.

Methods: This pilot study involves two stages. In the first stage, we delivered the FCU intervention in a cultural adaptation group of 15 kinship families. We then revised this intervention based on the African American families’ unique values, beliefs, traditions, and parenting practices. Qualitative feedback was gathered at the end of each contact and improvements were made as part of the adaptation. In the second stage, the culturally tailored intervention was delivered using a randomized control trial (RCT) with pretest-posttest. Among 30 African American kinship families, 15 families were randomly assigned into the experimental group, and15 families were randomly assigned into a waitlist control group. The Mann-Whitney test (a non-parametric test) was used to analyze the quantitative data. Qualitative data were analyzed using Atlas.ti.

Results: Findings from the qualitative feedback shows that participants were overall satisfied with the FCU program and found it helpful in terms of parenting. Adaptations to the program were made based on cultural preferences. These adaptations are described, along with a presentation of promising intervention effects. Strengths and limitations of the pilot will be discussed.

Conclusions and Implications: This study calls for more attention to the population of African American kinship families and provides empirical support in terms of the cultural adaptation of an intervention in a disproportionally racially represented population. This study also provides a timely response to the new emphasis of the Family First Prevention Services Act (P.L. 115-123) which strengthens evidence-based services such as in-home parenting training for kinship families. Empowering kin caregivers will prevent children from more severe behavioral health concerns and more disruptions of kinship placements.