Predicting variation in responsiveness to the family check-up in early childhood: a mixture model approach
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Description
The present study applied latent class analysis to a family-centered prevention
trial in early childhood to identify subgroups of families with differential responsiveness to the Family Check-up (FCU) intervention. The sample included 731 families of 2-year- olds randomized to the FCU or control and followed through age five with yearly follow up assessments (Dishion et al., 2014; Shaw et al., 2015). A two-step mixture model was used to examine whether specific constellations of family characteristics at age 2 (baseline) were related to intervention response at age 3, 4, and 5. The first step empirically identified latent classes of families based on a variety of demographic and adjustment variables selected on the basis of previous research on predictors of response to the FCU and parent training in general, as well as on the clinical observations of FCU implementers. The second step modeled the effect of the FCU on longitudinal change in children's problem behavior in each of the empirically derived latent classes. Results suggested a five-class solution, where a significant intervention effect of moderate-to- large size was observed in one of the five classes. The families within the responsive class were characterized by child neglect, legal problems, and mental health issues. Pairwise comparisons revealed that the intervention effect was significantly greater in this class of families than in two other classes that were generally less at risk for the development of disruptive behavior problems, and post hoc analyses partially supported these results. Thus, results indicated that the FCU was most successful in reducing child problem behavior in the highly distressed group of families. We conclude by discussing the potential practical utility of these results and emphasizing the need for future research to evaluate this approach's predictive accuracy.
trial in early childhood to identify subgroups of families with differential responsiveness to the Family Check-up (FCU) intervention. The sample included 731 families of 2-year- olds randomized to the FCU or control and followed through age five with yearly follow up assessments (Dishion et al., 2014; Shaw et al., 2015). A two-step mixture model was used to examine whether specific constellations of family characteristics at age 2 (baseline) were related to intervention response at age 3, 4, and 5. The first step empirically identified latent classes of families based on a variety of demographic and adjustment variables selected on the basis of previous research on predictors of response to the FCU and parent training in general, as well as on the clinical observations of FCU implementers. The second step modeled the effect of the FCU on longitudinal change in children's problem behavior in each of the empirically derived latent classes. Results suggested a five-class solution, where a significant intervention effect of moderate-to- large size was observed in one of the five classes. The families within the responsive class were characterized by child neglect, legal problems, and mental health issues. Pairwise comparisons revealed that the intervention effect was significantly greater in this class of families than in two other classes that were generally less at risk for the development of disruptive behavior problems, and post hoc analyses partially supported these results. Thus, results indicated that the FCU was most successful in reducing child problem behavior in the highly distressed group of families. We conclude by discussing the potential practical utility of these results and emphasizing the need for future research to evaluate this approach's predictive accuracy.