Engagement in mental health-focused preventive interventions is understudied. Demographic, child, and system-level predictors of engagement were explored in a study with children in foster care (N = 222, Mage = 10.3) who participated in a 30-week intervention. Attendance and engagement in mentor visits and skills groups were rated weekly. Only 4 of 21 predictors showed bivariate associations with attendance/engagement: child sex, IQ, behavior problems, and trauma symptoms. SEM models with these three variables and a measure of adverse childhood experience (ACEs), were used to develop a model of engagement. Males had poorer mentor visit and group engagement. Group attendance was positively associated with trauma symptoms and negatively associated with ACEs. Group engagement was associated with higher IQ and fewer behavior problems. A contextually-sensitive intervention can result in high engagement for a vulnerable and diverse population, yet a few child factors still impacted engagement, and when identified could be ameliorated.
Trial Registration ClinicalTrials.gov, Identifiers: NCT00809315 & NCT00810056.
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We wish to express our appreciation to the children and families who made this work possible and to the participating county departments of social services for their ongoing partnership in our joint clinical research efforts. We also thank Sara Culhane, JD, PhD, Robyn Wertheimer, LCSW, Orah Fireman, M.Ed., LCSW, and Jennifer Koch-Zapfel, LCSW for their many years of work on the FHF program. Finally, this project would not have been possible without hundreds of exceptional research assistants, project interviewers, interns/mentors, group leaders, and skills group assistants.
This project was supported by grants from the National Institute of Mental Health (1 K01 MH01972, 1 R21 MH067618, and 1 R01 MH076919, H. Taussig, PI) and funding from the Kempe Foundation, Pioneer Fund, Daniels Fund, and Children’s Hospital Research Institute. Dr. Hambrick was supported by USPHS Grant T32 MH15442, ‘Development of Psychopathology, Psychobiology & Behavior’ (UCD Institutional Postdoctoral Research Training Program). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Hambrick, E., Lee, SK., Weiler, L. et al. Engagement in a Preventive Intervention for Preadolescent Children in Foster Care: Considerations for Intervention Design. Child Psychiatry Hum Dev (2022). https://doi.org/10.1007/s10578-022-01341-8
- Preventive intervention