Program Profile: Young Adult Family Check-Up (YA-FCU)

The program focuses on the relationship between young adults and their parents to prevent substance misuse and other high-risk behaviors and enhance protective factors such as improving communication and strengthening familial relationships, encouraging healthy peer and romantic relationships, and promoting self-efficacy. The program is rated Ineffective. It made no statistically significant impact on reducing the risk level for a problematic transition into young adulthood.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals

The Young Adult Family Check-Up (YA-FCU) focuses on relationships between young adults (around age 20) and their parents to prevent substance misuse and other high-risk behaviors while simultaneously enhancing protective factors such as improving communication and strengthening the parent–young adult relationship, encouraging healthy peer and romantic relationships for the young adults, and promoting self-efficacy. YA-FCU was adapted from Family Check-Up (FCU) for Adolescents, which is a family-centered preventive intervention delivered to middle school students and is designed to reduce problem behaviors in youth and improve youth mental health by including family engagement in change. This program is offered to young adults who previously participated in the FCU for Adolescents program during middle school. 

Program Components

YA-FCU uses a multimodal approach to assess family functioning, using self-report and observational data collection, during interactive sessions (the first two components of the program, described below). Assessment-driven feedback is used to motivate parents to improve parenting practices in supervision, positive parenting, and managing behavior. This feedback is provided to parents and young adults by way of a collaborative, strengths-based approach that is parent centered and focused on motivation enhancement. The comprehensive assessment and feedback are then used to inform targeted intervention that is tailored to address a family’s specific needs and goals. The YA-FCU feedback structure creates a process that embraces the family system as a contextually important influence on a young adult’s motivation and behavioral change, while also recognizing the developmental need for autonomy and young adults’ capacity to be change agents (Stormshak et al., 2019).

The YA-FCU program is a three-component intervention. First, the intervention begins with an initial interview with parents and young adults. Second, after the interview, a videotaped family interaction task includes a series of prompts for the parents and young adults to discuss developmentally relevant content such as financial and housing issues, interpersonal relationships, and substance use. Third, a trained family consultant leads a two-part, 2-hour feedback session, with parents and young adults first, and then with only the young adults. The family consultant’s goal is to encourage changed behavior and reduce overall risk behavior in the parents and young adults. The first hour of the feedback session concentrates on providing feedback to the parents and young adults together. In this part of the session, the family consultant provides feedback to families based on the videotaped family interaction task completed in the previous component. Feedback is discussed across three categories: 1) daily living, 2) relationships, and 3) health and behavior. A summary of the family’s strengths are reviewed, as they relate to goals for the young adult and the parents’ role in supporting that goal attainment. Barriers to the goals also are considered in terms of stressors such as a lack of financial resources.

The second hour of the feedback session focuses on providing confidential feedback to the young adult participants by themselves. In this part of the session, the family consultant uses motivational interviewing and gives feedback across five categories: 1) substance use; 2) risk behavior; 3) sexual and dating behavior; 4) coping skills; and 5) physical and emotional health. Together the young adult and the family consultant create a plan for progress with goals based on the young adult’s priorities and motivations. The family consultant offers a list of options for next steps, including additional resources specific to the individual plan for progress. 

Study

Stormshak and colleagues (2019) conducted a longitudinal study to examine the effectiveness of Young Adult Family Check-Up (YA-FCU) program on reducing young adult risk behavior. In an earlier study conducted by Stormshak and colleagues (2011), families in Oregon were randomly assigned to either receive Family Check-Up (FCU) for Adolescents [treatment group] or school as usual (comparison group) during sixth grade (in middle school).  A total of 593 families were recruited, with 386 randomly assigned to the FCU for Adolescents treatment group and 207 randomly assigned to the business-as-usual comparison group. Participants were followed annually into high school. The original study sample was 51 percent male and 49 percent female, with 36 percent identifying as white, 19 percent biracial, 18 percent Hispanic/Latino, and 15 percent Black. 

In the 2019 study, young adults and parents from the original sample were recruited 1 year after high school. Of the 386 participants originally assigned to the intervention condition in middle school, 134 were recruited to participate in YA-FCU. A total of 138 of the 207 originally assigned to the comparison condition in middle school was recruited for the current study. These young adults and their families were not offered the program. 

Participants were assessed at an average age of 20 (Wave 1, n = 441) and again at age 21.5 (Wave 2, n = 415). Those who participated in the YA-FCU did not statistically significantly differ from those who did not participate at this wave by sex, race, or substance use.

Parents and young adults were asked to complete a survey that included the Young Adult Risk Scale, which was adapted from an earlier instrument developed by colleagues at the Oregon Research Institute (Metzler et al. 1998) and from the Child and Family Center Youth Questionnaire (Child and Family Center 2001). The young adult risk construct was measured with a summative risk score indexing participants from low to high risk, using items selected to assess markers of a problematic transition to young adulthood. Dichotomous items were used to indicate with yes or no whether a risk marker was present. There were 44 marker items covering the domains of vocational risk (for example unemployment, dropped out of school, never held a paid job); alcohol, marijuana, and illicit drug risk (e.g., alcohol and drug use, drug abuse, addictive drug use, drug interference with normal functioning); sexual behavior risk (e.g., unprotected sex, sex while under the influence); and socio?emotional and behavioral risk (e.g., internalizing and externalizing behavior problems). Approximately 1 year later, all young adults were invited to complete follow-up questionnaires.

An intent-to-treat analysis was used to examine change in young adult risk behavior approximately 1 year after receiving the YA-FCU versus change in the comparison group. The analysis conducted was specified as pre?post autoregressive or analysis of covariance prediction models using structural equation modeling. The results were presented in the form of standardized regression estimates (controlling for pretest levels of total risk). The authors conducted a dose-response analysis to determine whether higher levels of YA-FCU would produce greater reductions in risk. 

Stormshak and colleagues (2019) conducted a dose-response analysis to determine whether higher levels of Young Adult Family Check-Up (YA-FCU) would produce greater reductions in risk. Dosage was measured as the log of total hours treated during the young adult intervention phase. 

The observed variable mean dosage was 1.92 total hours for those receiving the YA-FCU, with a range from 0 to 17.18 hours. The analysis indicated that the greater the number of hours engaged in the YA-FCU, the greater the decrease on the Young Adult Risk Scale total score. This finding was statistically significant.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Child and Family Center. 2001. “CFC Youth Questionnaire.” Unpublished instrument. Eugene, Oregon: Child and Family Center.

Metzler, Carol W., Anthony Biglan, Dennis V. Ary, and Fuzhong Li. 1998. “The Stability and Validity of Early Adolescents’ Reports of Parenting Practices Constructs.” Journal of Family Psychology 12:600–619. 

Stormshak, Elizabeth A., Arin M. Connell, Marie-Hélène Véronneau, Michael W. Myers, Thomas J. Dishion, Kathryn Kavanagh, and Allison S. Caruthers. 2011. An Ecological Approach to Promoting Early Adolescent Mental Health and Social Adaptation: Family-Centered Intervention in Public Middle Schools. Child Development, 82:209–25.

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Interactive Programs for Preventing Marijuana Use in Middle School Students

This practice consists of skill-building and interaction-based activities integrated into school-based programs for grades 6–8 that are aimed at preventing marijuana use among adolescents ages 12–14. This practice is rated Effective for preventing marijuana use.

Evidence Ratings for Outcomes

Drugs & Substance Abuse - Marijuana

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?