A group-based parent training program for foster and kinship parents of children to support their wellbeing and prevent placement breakdowns.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness from this review. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Targeted and specialist
- Continuing care
Australian Study
Risk of Bias
Cost
Target Age Group
About
Keeping Foster and Kin Parents Supported and Trained® (KEEP®) is a 16-week group-based parent training program for foster and kinship parents of children (KEEP® Standard) and teenagers (KEEP® SAFE). KEEP® aims to increase the parenting skills of foster and kinship carers in responding to children's difficulties and supports foster families by promoting child wellbeing and preventing placement breakdowns.
Aims
- Reduce placement disruptions for youth
- Reduce length of stay in care
- Increase family reunification
- Reduce substance use for adolescents
- Improve parenting skills
- Improve tenure for foster parents providing care
- Reduce days in care.
Impact
Evidence suggests that KEEP® was effective in improving out-of-home care and child mental health behaviour. Foster parents reported better chances of a positive exit with parent-child reunification and reduced placements changes. Parents reported reduced behaviour problems of more than one child in the same household 4 months post-baseline.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Out-of-home care | Yes | Not found | Not found |
| Child | Mental health/behaviour | Yes | Not found | Not found |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
KEEP® has an evidence rating of Supported.
This means that KEEP® has evidence from at least 2 randomised controlled trials (RCT) and/or quasi-experiments (QE) demonstrating positive, short-term impact on at least one child and family outcome.
This assessment is based on 2 research outputs from one primary study. Another RCT (Price et al., 2015) was identified but did not count towards the evidence due to concerns with study quality. KEEP® has not received a Well-supported rating as it has not yet replicated its results in another RCT or QE with a different population or setting.
| Study design |
Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | 1 |
| Quasi-experiment | 1 |
The evidence has some concerns with risk of bias.
The quality of evidence of the QE is low and results should be interpreted with caution.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- The study was conducted in San Diego, United States.
Sample
- The study involved 700 foster families (359 intervention, 341 control).
- Children who had been in either a kin or non-kin foster care placement for a minimum of 30 days were eligible for the study. Children and youth were aged 5 to 12 and displayed a range of mental health problems.
- Participants identified as Latino (33%), White (22%), mixed ethnic (22%), African American (21%), Asian American (1%) and Native American (1%). There was a higher percentage of African American participants in the intervention group than the control group.
Implementation
Delivery model, mode and setting
- KEEP® is delivered both in-person and virtually, to groups of 7 to 12 foster or kin parents. It also involves weekly 10-minute phone calls to individual foster or kin parents.
- The program is typically conducted in a range of settings including the adoptive home, birth family home, foster/kinship home, outpatient clinic, provider or residential care.
Target cohort
- Caregivers of children aged 4 to 12 in foster or kinship care placements.
- Children with externalising and internalising problems, trauma, mental health problems or problems in school and with peers.
Program delivery
- KEEP® can be delivered by case workers or other staff who are well trained and supervised weekly. In many child welfare settings, the program is delivered by case workers.
- Group leaders draw from an established protocol manual, but they tailor each session to the specific needs, circumstances, and priorities of participating parents and their children.
- Each week, the group leaders gather specific information about the children’s current behaviours by telephone. This information is then incorporated into the weekly sessions to make sure the group is both current and relevant.
- Foster/kin parents attend weekly parent support and training group sessions conducted by a trained facilitator and co-facilitator.
- A weekly phone call monitors child adjustment and parent stress.
- Foster/kin parents receive supervision in behaviour management methods.
- All sessions are video-recorded and recordings are reviewed prior to consultation.
Duration and intensity
- KEEP® is delivered over 16 weekly sessions of 90 minutes duration.
Guides and manuals
- There are program manuals for group facilitators and foster parents.
- The Fidelity Adherence Rating (FAR) is used to code sessions for fidelity. Each KEEP® session is recorded and uploaded to the web-based fidelity system. The data from the fidelity system is used to create monthly reports that are sent to sites and to system leaders.
Additional information
- The KEEP® Supporting Foster and Kinship Families website has more information about the program, outcomes and implementation.
Staffing
- A bachelor’s degree or higher level of education is preferred for staff delivering KEEP®.
Training
- Practitioners require 37 hours of program training and booster training is recommended.
- Certified group leaders undergo 5 days of comprehensive training and 6 to 12 months of ongoing contact with the implementation team.
To our knowledge, KEEP® is not available and has not been implemented in Australia.
Cost
We were unable to locate any information on the cost of KEEP®.
References
Studies identified and included in the review
- Price, J.M., et al. (2008). Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment 13(1): 64-75.
- Price, J.M., et al. (2012). Effectiveness of the KEEP foster parent intervention during an implementation trial. Children and Youth Services Review 34(12): 2487-2494.
Studies identified but not counted towards the evidence rating due to study quality
- Price JM, et al. (2015). Effects of the KEEP foster parent intervention on child and sibling behaviour problems and parental stress during a randomized implementation trial. Prevention Science 16(5): 685-695