Implementation of the Family Check Up: Reach and Adoption in Primary Care

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Research has shown that children who exhibit problem behaviors in early childhood will oftentimes continue to experience these issues into adolescence, leading to an increase in negative social and health outcomes such as substance abuse and delinquency. The Family Check Up (FCU) is a proven, targeted intervention that seeks to address these problems at a young age in order to reduce the risk of these negative behaviors continuing into adolescence. The intervention consists of 3 components: 1) an initial interview in which the behavioral health consultant gets to know the family; 2) an assessment that consists of questionnaires and videotaped family interactions; and 3) a feedback session during which the family is provided with feedback unique to their particular situation, as well as appropriate solutions to these issues. The FCU has been shown to be effective in school-based settings in past studies; this study represents the first to test the feasibility of offering the FCU in a pediatric primary care practice. The aims of the study are based upon the RE-AIM framework (Reach; Effectiveness; Adoption; Implementation; and Maintenance), a Decision and Implementation (DamdI) science model that will assist in the evaluation of the utility of the FCU in the pediatric primary care setting. This particular project is focusing on two elements of the framework, Reach and Adoption. The FCU was implemented at East Tennessee State University’s (ETSU) Pediatrics Clinic beginning on January 19th, 2015. The parents of patients between the ages of 4 and 5 years old are given the Pediatric Symptom Checklist (PSC-17), a screener which helps to identify children who may be at risk for emotional and behavioral problems. If a child scores 15 or higher on the PSC-17, they are invited to participate in the components of the FCU. Research is ongoing, with 23 out of 31 patients (74.2%) completing the PSC-17 at their well-child visit. The results of the screeners thus far show that with the average score on the PSC-17 is 6.57, with the lowest score being 0 and the highest score being 19. Only 1 patient scored ≥ 15 on the PSC-17 thus far, possibly indicating the need for an expansion of the inclusion criteria for the remainder of the study. The final results of the project will indicate the rate of Reach and Adoption within the ETSU Pediatrics Clinic as well as provide evidence as to the most successful way to reach a specific population with an evidence-based intervention.


Johnson City, TN

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