Outcomes

Family Foundations is a programme proven to help couples maintain strong family bonds, reduce stress and raise healthy, well-adjusted children. It was developed and researched by Mark Feinberg, Ph.D. during his time as a clinical psychologist, family therapist and prevention scientist at Penn State University and has undergone In the UK, Family Foundations has been piloted through a DWP programme and externally evaluated.

There are multiple evaluations of the Family Foundations programme demonstrating sustained intervention effects on parenting and child outcomes. There has also been an evaluation of a 2-year trial of the programme in the UK.

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Theory of Change

The programme focuses on the co-parenting relationship to assist parents to work together supportively to promote healthy family relationships. The Family Foundations logic model, supported by empirical research, posits that improved parental self- regulation will help parents better manage environmental stressors and reduce parental stress, thereby improving parenting quality.

Parents work on improving their communication skills and conflict resolution strategies and learn to respond sensitively to their child. Parenting strategies also include an understanding of temperament, fostering children’s self-regulation and promoting attachment security. Enhancement of the co-parenting relationship positively impacts upon the child’s capacity to self-regulate and improve social and academic competence.

Evidence-based

Family Foundations includes educational and support materials for families which are proven to be effective. This is what sets our programme apart from other products and services for new families: we are committed to an evidence-based approach.

We rely on research studies to indicate whether or not our programmes are actually beneficial. Just as we want to know the medicines doctors are prescribing have been tested and found effective, we also think health-promoting programmes should be supported by rigorous research.

Family Foundations is featured in the Early Intervention Foundation Guidebook, with a strength of evidence rating of 3 (out of 4), and was an ’exemplar’ in a recent Yale University systematic review of parenting interventions. If you are a commissioner thinking about how FF stacks up against other approaches, check out the EIF’s commissioner guide Reducing the impact of inter-parental conflict on children, published in September 2017.

Two RCT’s carried out in collaboration with the programme developer have been shown to demonstrate the highest level of evidence for the Family Foundation programme. Further analyses of these RCT’s have shown sustained child and parent outcomes.

Impact

Child outcomes:

  • Infants in the intervention group had a longer duration of attention and reports by father of greater soothability at age 6 months.
  • Intervention children displayed significantly higher levels of self- soothing at age one.
  • Intervention boys displayed lower levels of behaviour problems, emotional and externalising problems.
  • Intervention children demonstrated better social competence and greater attentional control.
  • Significant improvement in sleep with less nighttime waking at two year follow up.

Outcomes for mums and dads:

  • Significant decline in maternal depression and anxiety at six months post intervention.
  • Significant positive effect for both mother and father report of co-parental support and for father report of parenting-based closeness at six months post intervention.
  • Parents demonstrated less co-parental competitive behaviours one year post intervention.
  • Fathers showed higher levels of co-parental warmth and less parenting negativity at one year post intervention.
  • Intervention parents demonstrated significantly higher levels of positive parenting at one year post intervention.
  • Significantly greater triadic relationship quality at two years post intervention.
  • Reduced family violence (couple and parent-child aggression) in families with an infant aged one.

A process evaluation of a two-year UK trial of the programme in 12 local authorities (Garratt, 2014) reported the following outcomes:

  • Couples valued the course, with fathers reporting high levels of satisfaction with all aspects of the course.
  • Facilitators valued inter- agency working and the opportunity to work with other professionals.
  • The report emphasises the need for health and early years services to work in collaboration to obtain the best outcomes.

Key References

Feinberg, M.E., Jones, D.E., Roettger, M.E., Solmeyer, A. & Hostetler, M.L. (2014). Long-Term Follow-Up of a Randomized Trial of Family Foundations: Effects on Children’s Emotional, Behavioral, and School Adjustment. Journal of Family Psychology 28, (6), 821– 831.

Jones, D.E., Feinberg, M.E., Hostetler, M.L., Roettger, M.E., Paul, I.M. & Ehrenthal, D.B. (2018). Family and Child Outcomes 2 Years After a Transition to Parenthood Intervention. Family Relations 67, 270–286.

Garrat, J. (2014). Laying the right foundations: Supporting team parenting through pre and post- natal support.  Experiences and observations from a two-year trial of the Family Foundations parenting programme in the UK. International Journal of Birth and Parent Education, 1,(3), p.43.