Putting Families First: Early Impact of Family First Prevention Services on Family Well-Being

Background and Purpose: The Family First Prevention Services Act (FFPSA), enacted in 2018, marked a landmark shift in federal child welfare policy. By enabling Title IV-E funds to support evidence-informed and community-based prevention services, the law aims to keep families safely together and reduce the need for foster care placement. This study presents early outcomes from implementation in one Midwestern state under a public-private model of child welfare service delivery. The findings offer critical insight into how FFPSA-supported programs are influencing family functioning, child well-being and caregiver mental health.

Methods: Drawing on administrative and standardized assessment data, the study analyzes outcomes for families referred to FFPSA-funded services between October 2019 and June 2024. The sample includes families served by 15 community-based agencies delivering 12 distinct prevention programs. Data was sourced from the state’s Family and Child Tracking System (FACTS), which captures referral information, service delivery details and family outcomes over time.

To assess change in family well-being, a suite of validated instruments was used. Child functioning was measured using the Strengths and Difficulties Questionnaire (SDQ) and Ages & Stages Questionnaire: Social-Emotional (ASQ:SE-2). Caregiver outcomes were evaluated using the Parent Sense of Competency Scale (PSOC), Depression Anxiety Stress Scale (DASS-21), Drug Abuse Screening Test (DAST-10), and Alcohol Use Disorders Identification Test (AUDIT). Linear mixed modeling was employed to assess within-person change over time while retaining families with partial data and addressing missingness using maximum likelihood estimation.

Results: Results demonstrate significant improvements across multiple domains. Among children (n = 2,019), scores on the SDQ indicated reductions in emotional symptoms (β = -1.04, p<0.001), conduct problems (β = -0.57, p<0.001), and overall difficulties (β = -1.81, p<0.001). Prosocial behavior scores improved (β = 0.48, p<0.001), while ASQSE scores (n = 540) showed a small, non-significant increase (β = 0.22). Caregiver outcomes were similarly encouraging. Parenting satisfaction (β = 2.41, p<0.001) and efficacy (β = 2.37, p<0.001) significantly improved among 2,610 participants, yielding a total increase of 4.80 points in perceived parenting competence. Mental health indicators among caregivers (n = 1,210) showed declines in stress (β = -3.99, p<0.001), anxiety (β = -3.01, p<0.001), and depression (β = -3.44, p<0.001). Measures of substance use also declined (AUDIT: β = -2.09, p<0.001); (DAST-10: β = -1.46, p<0.001).

Conclusions and Implications: These results suggest that FFPSA-funded, community-based prevention services can meaningfully enhance the well-being of both children and caregivers. Improvements in parenting capacity, mental health and child functioning reflect the potential of early voluntary interventions to reduce risk factors associated with child welfare involvement. As states continue to implement FFPSA, these findings provide early evidence supporting the law’s premise that family preservation is both a desirable and achievable goal when supported by timely, accessible services grounded in evidence.