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Promising Program Seal

KEEP SAFE

Blueprints Program Rating: Promising

A six-session group-based intervention, facilitated by paraprofessionals, for youth in foster care as they transition to middle school to prevent internalizing and externalizing problems that may lead to more serious longer term outcomes such as delinquency, substance use, and high-risk sexual behavior. Foster parents also attend a six-session program.

Program Outcomes

  • Illicit Drug Use
  • Positive Social/Prosocial Behavior
  • Sexual Risk Behaviors
  • Tobacco

Program Type

  • Foster Care and Family Prevention
  • Parent Training
  • Skills Training

Program Setting

  • Social Services

Continuum of Intervention

  • Selective Prevention (Elevated Risk)

Age

  • Early Adolescence (12-14) - Middle School

Gender

  • Female only

Race/Ethnicity

  • All Race/Ethnicity

Endorsements

  • Blueprints: Promising

Program Information Contact

Patricia Chamberlain
Oregon Social Learning Center
10 Shelton McMurphey Boulevard
Eugene, OR 97401-4928

Program Developer/Owner

  • Patricia Chamberlain and Leslie Leve
  • Oregon Social Learning Center

Brief Description of the Program

The KEEP SAFE (Middle School) program begins during the summer prior to middle school entry and consists of two parallel components (both led by paraprofessionals): a six-session group-based intervention for the foster-care youth and a six-session, group-based intervention for the foster parents. The groups meet twice weekly for 3 weeks during the summer. Facilitators teach youth about setting goals, establishing positive relationships with peers and adults, building confidence, and developing decision-making. Problem-solving skills and opportunities are also provided so they can practice positive behaviors. A ceremony is conducted at the end of the summer in which the youth proclaim their goals and commitments to each other and their foster parents. Sessions for foster parents focus on maintaining stability in the home, preparing the youth for middle school, and developing behavioral reinforcement techniques and realistic expectations. Parents are given homework assignments designed to encourage them to practice their new skills at home. Continued sessions (i.e., ongoing training and support) are provided to foster parents (group-based) and youth (one-on-one sessions) once a week for two hours during the first year of middle school.

See: Full Description

Outcomes

Intervention girls, relative to control girls, demonstrated significant effects for:

  • Internalizing and externalizing problem behaviors at six months.
  • Prosocial behavior combined across the 6-month and 12-month assessments.
  • Placement stability at the 12-month posttest.
  • Substance use at 36 months beyond baseline (2 years post-intervention).
  • Health-risking sexual behavior at 36 months beyond baseline (2 years post-intervention).
  • Small to moderate mediating effects of prosocial, internalizing, and externalizing behaviors on long-term outcomes of substance use.
  • Small to moderate mediating effect of tobacco and marijuana use on long-term health-risking sexual behavior.

Race/Ethnicity/Gender Details

Although a program for foster-care boys and girls, the KEEF SAFE program was evaluated with foster care girls. In the girls-only trial, the race distribution of the sample was 63% White, 10% Latino, 9% African American, 4% Native American, and 14% multiracial. The analysis did not examine results by race and ethnicity.

Risk and Protective Factors

Risk Factors
  • Individual: Stress
  • Peer: Interaction with antisocial peers
  • Family: Family conflict/violence, Family history of problem behavior, Neglectful parenting, Parent stress, Poor family management
Protective Factors
  • Individual: Problem solving skills, Prosocial involvement, Rewards for prosocial involvement, Skills for social interaction
  • Peer: Interaction with prosocial peers
  • Family: Opportunities for prosocial involvement with parents, Rewards for prosocial involvement with parents

Training and Technical Assistance

The training model for KEEP SAFE facilitators closely parallels the services that the facilitator will provide to the foster parents. The initial 5-day training is experiential, and the trainees conduct a KEEP SAFE group though all of the sessions with colleagues. In this way the content of the KEEP SAFE curriculum is reviewed along with discussions about group process, logistics, and supervision.

Following the initial training, each KEEP SAFE group meeting is recorded and uploaded to a secure website. Weekly consultations with the facilitator are used to highlight issues with program fidelity, to support the delivery of the program content with accuracy, and to assist with questions specific to the current group of foster parents. We have found that by the conclusion of a third group, most facilitators feel comfortable with the material and the delivery of the material to a group of foster parents. It is following the third group that facilitators may opt to apply for certification. If the fidelity benchmarks are achieved, the facilitator may continue to hold KEEP SAFE without weekly consultations. A certified facilitator will have quarterly checks of program fidelity, with support plans developed only if difficulties are noted.

Certified facilitators are eligible to received further training in the delivery of the 5-day initial training course and consultation as a trained trainer. Such trainers also receive support in their first training, and in the coding of recorded sessions for intervention fidelity. Such trainers can enhance the sustainability of the practice by training others within their organization.

Brief Evaluation Methodology

This randomized controlled trial of the program was conducted with girls in foster care from two counties (one urban, one rural) in Oregon. Researchers recruited foster girls who were finishing elementary school between 2004 and 2007. They were randomized into one of two groups – the KEEP SAFE (Middle School) intervention (n=48) or the control group (n=52), which received standard services from local child welfare organizations.

Data were collected at five points in time: baseline, six months, 12 months (program completion), and one and two years post-intervention. A five- to seven-year post-intervention assessment is ongoing.

The effects of the program on internalizing, externalizing, and prosocial behavior were examined at six months, as well as pathways through which the program may have affected delinquency, health-risking sexual behavior, foster-care placement stability, and substance use over the course of two years after program completion.

Peer Implementation Sites

Britany Binkowski
Assistant to the Commissioner 
Office of Child Welfare Reform
UBS Tower, 10th Floor 
315 Deaderick St., Nashville, TN 37243 
o. 615-741-1405
c. 615-708-9084
Britany.Binkowski@tn.gov

Sylvia Rowlands
Senior Vice-President
Evidence-Based Programs
590 Avenue of the Americas
New York, New York  10011
(212) 660-1342
sylvia.rowlands@NYFoundling.org

References

Smith, D., Leve, L., Chamberlain, P. (2011). Preventing internalizing and externalizing problems in girls in foster care as they enter middle school: Immediate impact of an intervention. Prevention Science, 12(3), 269-277.

Kim, H. & Leve, L. (2011). Substance use and delinquency among middle school girls in foster care: A three-year follow-up of a randomized controlled trial. Journal of Consulting and Clinical Psychology, 79(6), 740-750.

Kim, H. K., Pears, K. C., Leve, L. D., Chamberlain, P. C., & Smith, D. K. (2013). Intervention effects on health-risking sexual behavior among foster care girls: The role of placement disruption and substance use. Journal of Child and Adolescent Substance Abuse, 22(5), 370-387.