Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes

Authors
Lester, P. Liang, L. Milburn, N. Mogil, C. Woodward, K. Nash, W. Aralis, H. Sinclair, M. Semaan, A. Klosinski, L. Beardslee, W. Saltzman, W.
Publication year
2016
Citation Title
Evaluation of a family-centered preventive intervention for military families: Parent and child longitudinal outcomes
Journal Name
Journal of the American Academy of Child & Adolescent Psychiatry
Journal Volume
55
Issue Number
1
Page Numbers
14-24
DOI
10.1016/j.jaac.2015.10.009
Summary
The study examined the effectiveness of a family-centered preventive intervention for military families. Each family received mental health interventions over eight sessions, and their mental health status were assessed at intake, completion, one month and six months after the program. Results showed improvement in psychological health in both parents and children, and the benefits of the intervention maintained six months after the program finished.
Key Findings
Compared with intake, both military and civilian parents had lower levels of depression and anxiety symptoms after the intervention.
Similarly, both male and female children experienced an improvement in emotional and behavioral symptoms and prosocial behaviors as a result of the intervention.
Benefits of the intervention were sustained six months after the program.
Implications for Program Leaders
Provide additional family-centered mental health interventions to military families
Improve the retention rate of families over time by building stronger alliance, offering more individuallytailored services, etc.
Provide outreach services to military families, noting the availability of potentially useful services and the benefit of getting help early before problems potentially get worse
Implications for Policy Makers
Continue to help military families to receive necessary mental health interventions
Encourage awareness campaigns regarding the importance of family-centered preventive intervention
Recommend routine screening for mental health problems in both military/civilian parents and their children
Methods
The longitudinal study recruited Active Duty military families at 15 military installations in the United States and Japan who were enrolled in the Families OverComing Under Stress (FOCUS) intervention program between July 2008 and December 2013; 2,615 out of 3,431 families completed or partially completed the study.
Intervention was delivered to the families over eight sessions.
Both parental and child psychological health symptoms were assessed at intake, program exit, and follow-up at one month, and follow-up at six months; longitudinal regression models were used to assess the changes in participants’ psychological health over time.
Participants
The sample included 2,615 families (1,426 military parents, 2,073 civilian parents, and 3,810 children).
The average age for parents was 33 years (SD = 6.17), and the average age for children was 7 years (SD = 3.52); about 67% of the Service member parents were male, whereas 1% of the civilian parents were male.
Race and military information of the participants were absent in the article.
Limitations
The study was based on an existing data set, therefore the design did not allow for drawing causation conclusions.
Information about parental characteristics (e.g., marital status) were limited in the data set, so some confounding factors were not controlled for.
Data on deployment cycle were not available, therefore it is unknown how deployment might influence the effect of intervention.
Avenues for Future Research
Use a randomized controlled trial to assign families to different experimental conditions, so that the effect of intervention could be better studied
Collect more comprehensive data about the participants, such as their marital and socioeconomic status
Link the deployment data with the intervention data to better study the effect of deployment on mental health intervention outcomes
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Population Focus
Military Component
Abstract
Objective: This study evaluates the longitudinal outcomes of Families OverComing Under Stress (FOCUS), a family-centered preventive intervention implemented to enhance resilience and to reduce psychological health risk in military families and children who have high levels of stress related to parental wartime military service. Method: We performed a secondary analysis of evaluation data from a large-scale service implementation of the FOCUS intervention collected between July 2008 and December 2013 at 15 military installations in the United States and Japan. We present data for 2,615 unique families (3,499 parents and 3,810 children) with completed intake and at least 1 postintervention assessment. Longitudinal regression models with family-level random effects were used to assess the patterns of change in child and parent (civilian and military) psychological health outcomes over time. Results: Improvement in psychological health outcomes occurred in both service member and civilian parents. Relative to intake, parental anxiety and depression symptoms were significantly reduced postintervention, and these reductions were maintained at 2 subsequent follow-up assessments. In addition, we identified an improvement over time in emotional and behavioral symptoms and in prosocial behaviors for both boys and girls. We observed reductions in the prevalence of unhealthy family functioning and child anxiety symptoms, as well as parental depression, anxiety, and posttraumatic stress symptoms from intake to follow-up. Conclusion: Longitudinal program evaluation data show sustained trajectories of reduced psychological health risk symptoms and improved indices of resilience in children, civilian, and active duty military parents participating in a strength-based, family-centered preventive intervention.
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