The Family Check-Up Online: A Telehealth Model for Delivery of Parenting Skills to High-Risk Families With Opioid Use Histories

Abstract

Growing opioid misuse in the United States has resulted in more children living with an adult with an opioid use history. Although an abundance of research has demonstrated a link between opioid misuse and negative parenting behaviors, few intervention efforts have been made to target this underserved population. The Family Check-Up (FCU) has been tested in more than 25 years of research, across multiple settings, and is an evidence-based program for reducing risk behavior, enhancing parenting skills, and preventing the onset of substance use. It is designed to motivate parents to engage in positive parenting practices and to change problematic parenting and has been tested across a variety of ages including early childhood and adolescence. It is highlighted in NIDA’s Principles of Substance Use Prevention for Early Childhood: A research-based guide as one of only three effective selective prevention programs for substance abuse among families with young children. Recently, we developed an online version of the FCU that has now been adapted for early childhood and families with opioid use histories. The online platform and telehealth model allow for wide-scale dissemination, ease of training with community providers, and increased public health reach for families in remote, rural areas. This is particularly important when targeting families with opioid misuse and addiction because there are high rates of addiction in remote areas, yet few services available. In this article, we describe the FCU Online and review new content in the model that targets a population of young adult parents with substance abuse histories, including opioid use. New modules include content focused on harm reduction for this high-risk population of parents, such as safety in the home, substance use while parenting, and managing conflict with partners and friends.

Engaging primary care clinicians in the selection of implementation strategies for toddler social-emotional health promotion in community health centers.

“…Compared to services as usual, FCU has been shown to improve irritability in toddlerhood, which mediated effects on behavioral problems at school age (Smith et al, 2019). FCU can be delivered face-to-face or via telehealth and is acceptable and effective among racially and ethnically diverse families (Smith, Knoble, et al, 2014; Stormshak et al, 2021).…”

What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program.

“…In order to tailor programs to family or parent needs, it is crucial to understand the differential impact of various program formats on targeted outcomes. Over the past decade or more, research has demonstrated the effectiveness of online prevention programs as alternatives to in-person versions (e.g., Franke et al, 2020), and the COVID-19 pandemic has only underscored the urgency for research into virtual program delivery via both self-directed online and telehealth (online synchronous individual provider-delivered) formats (e.g., Stormshak et al, 2021). In the military setting, most families—particularly those in the Reserve Component (i.e., the National Guard and Reserves)—do not live in military communities and may face difficulties accessing military family resources within driving distance, underscoring the importance of testing delivery modalities for this population that do not require families to be present in person.…”

A vision for implementing equitable early mental health and resilience support in pediatric primary care: A transdiagnostic, developmental approach.

“…As illustrated in Figure 2 and elaborated below, parenting interventions foster develop MH and well-being as a form of "resilience inoculation." Improving early selfregulation strengthens children's capacity to "bounce back" from stressors and function adaptively in a pro-resilience cascade-building children's frustration tolerance, perspective taking, and other skills-resulting in more rewarding experiences and family outcomes (Connell & Stormshak, 2023;Stormshak et al, 2021).…”

“…EBIs strengthen child and family capabilities for adaptive and flexible interactions and constructive management of emotions and behavior, strengthening emotion socialization processes (see, e.g., Hawks et al, 2020). Caregivers acquire proactive and confident regulation-promoting parenting skills that scaffold child development of “self-regulation muscles.” As illustrated in Figure 2 and elaborated below, parenting interventions foster develop MH and well-being as a form of “resilience inoculation.” Improving early self-regulation strengthens children’s capacity to “bounce back” from stressors and function adaptively in a pro-resilience cascade—building children’s frustration tolerance, perspective taking, and other skills—resulting in more rewarding experiences and family outcomes (Connell & Stormshak, 2023; Stormshak et al, 2021).…”