Evidence Based Practices in Family First Prevention Services Act State Plans: A Policy Surveillance

Background: The Family First Prevention Services Act (FFPSA, 2018) permits states’ use of federal funding for specified prevention-based services, assuming they meet or exceed the “promising practice” minimal standard of research evidence, specified in the Title IV-E evidence-based clearinghouse. For children with behavioral health needs, who frequently experience child welfare involvement, research points to this law as an opportunity to expand the uptake of evidence-based practices (EBPs) for such children. However, the extent to which this policy is being leveraged to deliver EBPs to children with behavioral health needs is currently unknown. This study assesses how FFPSA funding was being used to scale up evidence-supported treatments for children with behavioral health needs, documenting the range of evidence-supported treatments states offered, as well as the types of youth populations, problems, and outcomes targeted in these programs.

Methods: To claim newly available federal funding under FFPSA, states develop and submit five-year plans for their prevention programming, for federal review and approval. Plans must detail the proposed EBPs, targeted populations, and determination of eligibility. State plans filed with the Children’s Bureau between 2018-2024, both approved and pending , were collected from the National Conference of State Legislatures public database. State plan documents were initially reviewed by hand to generate a list of codes, focusing on EBPs, target populations (age ranges, presenting problems), and outcomes targeted by states. This was refined and clarified through research team discussions . Second coding was applied using excel to develop a codebook, then documents were imported into a qualitative analysis software (NVivo) for the final round of coding. Reports on code co-occurrence and code applications for each state were generated.

Findings: The analytic sample included 44 state FFPSA plans. The most common population targeted were parents (40 states), with young children under age 6 the second most targeted population (35). School age children (ages 7 to 17) were targeted in 25 state plans, while the needs of young adults (ages 18 to 21) were addressed in 23 state plans. Eligibility for FFPSA-funded programming was mostly through an open child welfare case (30 states), history of children welfare involvement, or maltreatment reports (28). Other eligibility pathways included justice system involvement (18), substance use (13), or behavioral issues (13). The most common outcomes for children targeted by EBPs were behavioral and emotional functioning (20 states) and child safety (19), while the most common outcomes targeted for parents were parent/caregiver emotional health (19) and positive parenting practices (20). The most selected EBPs included Parents as Teachers (offered in 28 state plans), Healthy Families America (24), Multisystemic Therapy (23), and Parent-Child Interaction Therapy and Parent-Child Interaction Therapy (both offered in 21 state plans).

Conclusion: The analyses reveal FFPSA supported programming primarily targets parents and young children, and frequently require active open cases with child welfare authorities for service receipt. Moreover, FFPSA interventions target child safety and behavioral concerns as often as they target parent mental health and parenting practices. The policy implications of this research will be discussed.