Promising - One study
Randomized Controlled Trial
Date: This profile was posted on September 16, 2014
Formerly known as Middle School Success, it is a multi-component intervention to prevent delinquency and substance abuse among girls in foster care transitioning from elementary to middle school. This program is rated Promising. It was associated with a significant decline in tobacco, marijuana, and overall substance use as well as delinquent behavior. However, there was no impact on girls’ alcohol use, association with delinquent peers, or overall delinquent behavior.
Program Goals/Target Population
KEEP SAFE (formerly known as Middle School Success) is a multicomponent intervention aimed at building prosocial skills and promoting placement stability among youths in foster care. The goals of the program are to prevent delinquency and substance abuse. The intervention targets girls in foster care transitioning from elementary school to middle school.
Program Components/Program Theory
The intervention contains two components (one that concentrates on the caregivers and one on the girls). The first component consists of six sessions of group-based caregiver training. The sessions for the caregivers concentrates on developing a behavioral reinforcement system—which encourages adaptive behaviors in the home, school, and community—and on improving parenting skills as a means of increasing child placement stability. In addition to the summer group sessions, follow-up intervention services (i.e., ongoing training and support) are provided to the caregivers once a week for 2 hours at a time in the form of group foster parent meetings during the first year of middle school.
The second component consists of six group-based skill training sessions for the girls. During the summer, the girls complete a curriculum that is designed to increase their social skills for positive peer relationships, increase their self-confidence, and decrease their susceptibility to negative peer influence. All of the sessions are highly structured and include specific content and directions for each activity. The sessions include an introduction to the session topic, role plays, and a game or activity through which the girls practiced the new ability. The girls then receive weekly individual coaching sessions during their first year of middle school. The coaching sessions serve to provide ongoing social support and training.
The design and content of the program is informed by developmental theories that point to prosocial skills and placement stability for youths in foster care which influence their susceptibility to emotional and behavioral difficulties during early adolescence and, in turn, more serious forms of problem behavior in late adolescence. Previous research also identified early adolescence as an important period for developing prosocial skills because of the physical and social changes that children experience during the middle-school years (Carlo et al. 1999).
All training and curriculum sessions are led by program staff. One facilitator and one co-facilitator lead caregiver sessions. One facilitator and three assistants lead the girls’ curriculum sessions. The coaches are recent female college graduates.
The evaluation of the KEEP SAFE (also known as Middle School Success) intervention conducted by Kim and Leve (2011) found mixed results overall. At the 36-month follow-up, the treatment group reported significantly less tobacco use, marijuana use, delinquent behavior, and overall substance use compared with the control group. However, there were no significant differences in reports of alcohol use, association with delinquent peers, and overall delinquent behavior.
Kim and Leve (2011) found a significant difference between the treatment and control groups in tobacco use at the 36-month follow-up. Girls in the treatment group who participated in the intervention reported lower levels of tobacco use in the past year than girls in the control group.
There was no significant difference in alcohol use at the 36-month follow-up between the treatment and control groups.
There was a significant difference between the treatment and control groups in marijuana use at the 36-month follow-up. Girls in the treatment group reported lower levels of marijuana use in the past year than girls in the control group.
There was also a significant difference between the treatment and control groups in delinquent behavior at the 36-month follow-up. Girls in the treatment group reported committing less delinquent behavior in the past year than girls in the control group.
Association with Delinquent Peers
There was no significant difference between the treatment and control groups in association with friends involved in delinquent acts at the 36-month follow-up.
Composite Substance Use
There was a significant difference between the treatment and control groups in composite substance use at the 36-month follow-up. Girls in the treatment group reported less frequent substance use in the past year than girls in the control group.
There was no significant difference between the treatment and control group groups in composite delinquency at the 36-month follow-up.
Kim and Leve (2011) evaluated KEEP SAFE (formerly known as Middle School Success), a delinquency prevention intervention for girls in foster care. The evaluation randomly assigned participants from a pool of 145 girls to a treatment group that received the intervention or to a control group that received the usual services provided by the child welfare system. The pool of eligible participants consisted of 10 to 12-year-old girls in major metropolitan areas of the Pacific Northwest who were in foster care and who were in their final year of elementary school. Eligible girls were referred to the study by child welfare staff members.
The final sample consisted of 100 girls (treatment group=48 girls, control group=52 girls) with a mean age of 11.54 years. The composition of the sample was 63 percent European Americans, 14 percent multiracial, 9 percent African Americans, 10 percent Latinos, and 4 percent Native Americans. There were no differences between the treatment and control groups on demographic characteristics, severity levels for physical and sexual abuse, and foster care characteristics (number of placement changes and type of care). Girls in the treatment condition did have higher levels of severity in neglect than those in the control condition. This difference was not related to any of the outcome measures and therefore the mean severity in neglect was not included in analyses of program effects.
Outcome measures were girls’ self-reported levels of tobacco use, alcohol use, marijuana use, composite substance use (tobacco, alcohol, and marijuana), delinquent behavior, association with delinquent peers, and composite delinquency (delinquent behavior and association with delinquent peers). Follow-up assessments took place at 6, 12, 24, and 36 months after the baseline assessment.
There is no cost information available for this program.
Interventionists are supervised on a weekly basis. In supervision, videotaped sessions are reviewed and feedback is provided to ensure fidelity to the program as designed by Chamberlain and colleagues (2006).
Evidence-Base (Studies Reviewed)
These sources were used in the development of the program profile:Study 1
Kim, Hyoun K., and Leslie D. Leve. 2011. "Substance Use and Delinquency Among Middle School Girls in Foster Care: A 3-Year Follow-Up of a Randomized Controlled Trial." Journal of Consulting and Clinical Psychology
These sources were used in the development of the program profile:
Carlo, Gustavo, Richard A. Fabes, Deborah Laible, and Kristina Kupanoff. 1999. "Early Adolescence and Prosocial/Moral Behavior II: The Role of Social and Contextual Influences." The Journal of Early Adolescence
Chamberlain, Patricia, Leslie D. Leve, and Dana K. Smith. 2006. “Preventing Behavior Problems and Health-Risking Behaviors in Girls in Foster Care.” International Journal of Behavioral and Consultation Therapy
Smith, Dana K., Leslie D. Leve, and Patricia Chamberlain. 2011. "Preventing Internalizing and Externalizing Problems in Girls in Foster Care as They Enter Middle School: Impact of an Intervention." Prevention Science