Summary
Youth with a history of foster care involvement (FCI) have a 200–400% greater chance of
reporting a lifetime or past year mental health (MH) problem (Havlicek, Garcia, & Smith, 2013),
and are 3.5 times more likely to commit suicide (Katz et al., 2011), than their peers. There are
few preventive interventions specifically designed for these youth, and those that exist have
generally examined effects on less specific, immediate “problem” behaviors rather than
long-term specific MH disorders. The current proposal uses integrative data analysis (IDA) to
harmonize data across seven dual-focused caregiver–youth randomized control trials of
interventions designed specifically for FCI youth that shared underlying theories of change
(yielding an ethnically diverse combined sample of 1,925 youth at baseline and over 6,500
person-by-time assessments that cover multiple periods of youth development from ages 5–
15 years at baseline). This study addresses key questions about both crossover and long-term
intervention effects on multiple MH outcomes in FCI youth that no one study has examined in
the past or could answer alone. Efficacy of the interventions on both symptoms and diagnoses
of five classes of MH outcomes (depression and anxiety, suicidality, thought problems and
psychosis, posttraumatic stress disorder, and aggression and violence) will be examined.
Increased sample size will also allow for examination of the impact of interventions on low base
rate MH outcomes (e.g., suicidality, psychoticism). Using IDA to leverage multiple datasets, the
current proposal could positively impact the lives of FCI youth by enabling us to understand if
and for how long (Aim 1) preventative interventions implemented early in life may have
positive impacts on FCI youth MH, as well as the mechanisms through which (i.e.,
improved parenting skills and decreased youth emotional and behavioral dysregulation; Aim 2)
and for which subpopulations those interventions might be most efficacious (i.e., for
females versus males, in the developmental period in which the MH outcome typically manifests
[e.g., childhood for violence and aggression, and early to late adolescence for all other MH
outcomes], for FCI youth who have experienced more placement changes and received greater
intervention dosage, and by ethnic subgroups; Aim 3).
