Effectiveness of the Family Foundations Co-parenting Education Program

By Sarah Hokason

Bottom-Line First: Several studies have shown the effectiveness of the Family Foundations co-parenting education program. A just-released study shows that an online version, Military Family Foundations, also has positive outcomes. This blog reviews a set of studies on this program showing specific positive outcomes for individuals, couples, parents, and children.

The transition to parenthood is a time filled with change and stress for couples. How couples manage this stress can have a significant impact on individual, couple, co-parenting, parenting, and child outcomes. Because this is such an important time for families, it is an ideal time for an educational intervention. The Family Foundations (FF) program is an educational program targeted to couples who are expecting a child. The curriculum includes a handful of classes before the birth and several more after to help parents adjust during the transition. A little different from other CRE programs that focus primarily on the couple romantic relationship, this curriculum focuses on strengthening the co-parenting relationship, an important aspect of the couple relationship. Many of the same kinds of communication skills are taught but mostly in the context of the co-parenting relationship.

Eleven published articles over the past 12 years from three longitudinal research projects have demonstrated the effectiveness of the FF program, showing that the curriculum benefits individuals, couples, co-parenting relationships, parenting relationships, and children. Below are brief summaries of their findings.

One research project looked at a sample of 169 couples (82% married, 91% white), randomly assigned to an FF treatment group or a control group.[1] Follow-up data was gathered when the child was six months, one year, three years, and between five and seven years. Significant outcomes were found for participants in the treatment group compared to the control group at all follow-up assessments.

  • At childbirth, treatment-group mothers had lower levels of adverse birth outcomes.[2] This included a healthier birth weight, a healthier gestation length, and a lower likelihood of a c-section delivery.
  • At 6 months, treatment group couples reported better co-parental support, parenting-based closeness, and positive co-parenting; lower levels of dysfunctional interaction with their children; longer duration of orienting and greater soothability for children; and larger decreases in depression and anxiety (for mothers).[3]
  • At 1 year, treatment-group couples showed lower levels of co-parental competition and triangulation, higher levels of co-parental warmth (for fathers) and higher levels of inclusion (for mothers), more warmth to partners and less negative communication, higher levels of positive parenting and lower levels of parental negativity, and higher levels of self-soothing for children.[4]
  • At 3 years, treatment-group couples reported lower parenting stress and higher parenting efficacy; more positive outcomes in overall co-parenting; better parenting outcomes, including lower levels of overactivity, laxness, and physical punishment; and fewer behavior problems for children.[5]
  • Another follow-up took place between 5-7 years, but there was significant loss of the sample by then, which suggest the results may be less reliable.[6] Treatment-group children displayed lower levels of internalizing behaviors, and treatment group sons showed lower levels of externalizing behaviors.

Another research project, with a sample of 399 couples expecting their first child (87% married, 81% white), randomized participants between an FF treatment group and a control group.[7] Data were collected when the child was 10-months old, and again when the child was 2-years old. Again, significant positive effects were found for treatment group participants compared to the control-group participants.

  • At birth, the impact of financial stress, depression, and anxiety on birth weight and length of stay at the hospital was evaluated.[8] Results showed that the negative effect of stress, depression, and anxiety on birth outcomes reduced for the FF treatment-group participants.
  • At 10 months, the treatment group showed better co-parenting and couple relationship quality and displayed more positive parenting behavior.[9] Couples in the treatment group also reported lower levels of worry and anxiety; better outcomes for the child, including sleeping outcomes, duration of orienting, and soothability; and even lower levels of family violence.
  • At 2 years, the treatment group had lower levels of co-parenting and parenting negativity and higher parent-partner-child relationship quality.[10] Parents in the treatment group also reported their child having lower levels of internalizing behaviors and fewer times waking in the night. Several of these outcome effects were moderated by couple negative communication style, meaning that less negative communication between the parents was associated with better parenting and child outcomes.
  • Another article looked at mediators at the 2-year follow-up.[11] The four mediators – co-parenting negativity, parenting stress, parental depression, and parenting stress – were found to mediate the intervention impact on child externalizing behaviors. That is, the FF program produced positive parenting outcomes at 10 months which in turn were related to children’s reduced levels of externalizing behaviors at 2 years.

A third research project looked at an online version of FF specifically aimed at military couples called Military Family Foundations (MFF).[12] MFF introduces a few new factors to the Family Foundations program. First, it focuses on military families who face unique stressors such as frequent relocations, long separations, employment challenges for spouses, and even soldier death. Second, this adapted curriculum is online. Online interventions can be useful when people are busy and have irregular schedules, when people are far away from where the intervention is taking place, or when spouses are separated (such as when a spouse is deployed).

This pilot study used a sample of 56 military couples who were living together (93% married, 71% white) and expecting their first child. Couples were randomly assigned to either a control group or a MFF treatment group. Overall, the researchers found positive results at the 6-months follow-up survey for the treatment group compared to the control group.

  • Treatment groups had higher levels of co-parenting closeness and support and improved management of relationship conflict (for mothers). Mothers and fathers in the treatment group reported lower levels of depression and reported that infants showed less sadness and distress and were easier to sooth.
  • However, participants in the treatment group had lower participation levels than in other FF

Altogether, these findings are promising, and they paint a clear picture of the effectiveness of FF. Not only does this program demonstrate positive outcomes during the transition to parenthood, it also shows long-term outcomes for the whole family. In addition, the program is effective in-person and shows promise for online delivery.

Here are some implications of these studies:

  • Target one subsystem to benefit the whole family. The FF program focuses in on the co-parenting relationship, yet we see outcomes impacting childbirth, parental mental health, the couple relationship, the parental relationship, and children’s health. Though most couple relationship education focuses on strengthening the couple relationship, having programs with a somewhat different emphasis can lead to positive outcomes at every level of family functioning. In addition, having these different programs can draw in more participants. Some people may not be interested in a relationship education class but would consider a parenting class or another option. Many family life education classes focus on skills and techniques that are applicable in many relationships. Regardless of the focus of the class, there can be a host of benefits in different areas of family life.
  • Examine the timing of programs. The FF program is offered right at the transition to parenthood, a time of change and stress when new skills and resources can be especially important. Other programs, such as marriage preparation classes aimed towards engaged couples, target the couple during other important times of change. Maybe there are other times when families are facing major stressors where we could deliver specific family life education programs so that families can have the support when they most need it.
  • Consider the potential of online delivery. The pilot study of MFF shows that online interventions can be a cost effective and efficient way to support military families and other families that might have a hard time accessing traditional family life education programs (e.g., rural families). This could be especially beneficial during this time of pandemic. Face-to-face programs might consider developing online delivery options. There may be some people who would not attend a face-to-face program but would participate in an online option. Online delivery of relationship and co-parenting education programs has the potential to reach in-need or hard-to-reach populations.
  • Find  ways to increase participation rates and consider using trained coaches. The study of MFF had very low completion rates. For online programs to have their maximum impact, we may need to find ways to increase program completion in the future. Maintaining participants’ focus is critical. Compared to face-to-face interventions, it is easier for couples to access online interventions, but it is also easier for them to walk away. The low-level investment makes online interventions more accessible, but it also creates fewer barriers to dropping out. While there are many ways to increase participation rates, one option to think about is using trained coaches. Some online programs provide coaches that occasionally check in with participants to discuss the things they are learning and to support them in completing the program. Studies have found that having coaches significantly increases completion rates.[13] Of course, providing coaches will also increase the cost of the program, so there is a trade-off, but coaching can help more participants to get the most benefit from the program.

 

Endnotes:

[1] Feinberg, M. E., Jones, D. E., & Kan, M. L. (2010). Effects of family foundations on parents and children: 3.5 years after baseline. Journal of Family Psychology, 24(5), 532–542. https://doi.org/10.1037/a0020837

[2] Feinberg, M. E., Roettger, M., Jones, D. E., Paul, I. M., & Kan, M. L. (2015). Effects of a psychosocial couple-based prevention program on adverse birth outcomes. Maternal and Child Health Journal, 19, 102–111. https://doi.org/10.1007/s10995-014-1500-5

[3] Feinberg, M. E., & Kan, M. L. (2008). Establishing Family Foundations: Intervention effects on coparenting, parent/infant well-being, and parent-child relations. Journal of Family Psychology, 22(2), 253–263. https://doi.org/10.1037/0893-3200.22.2.253

[4] Feinberg, M. E., Kan, M. L., & Goslin, M. C. (2009). Enhancing coparenting, parenting, and child self-regulation: Effects of family foundations 1 year after birth. Prevention Science, 10, 276–285. http://doi.org/10.1007/s11121-009-0130-4

[5] Feinberg, M. E., Jones, D. E., & Kan, M. L. (2010). Effects of family foundations on parents and children: 3.5 years after baseline. Journal of Family Psychology, 24(5), 532–542. https://doi.org/10.1037/a0020837

[6] 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. https://doi.org/10.1037/fam0000037

[7] Feinberg, M. E., Jones, D. E., Hostetler, M. L., Roettger, M. E., Paul, I. M., & Ehrenthal, D. B. (2016). Couple-focused prevention at the transition to parenthood, a randomized trial: Effects on co-parenting, parenting, family violence, and parent and child adjustment. Prevention Science17(6), 751–764. https://doi.org/10.1007/s11121-016-0674-z

[8] Feinberg, M. E., Jones, D. E., Roettger, M. E., Hostetler, M. L., Sakuma K.-L., Paul, I. M., & Ehrenthal, D. B. (2016). Preventative effects on birth outcomes: Buffering impact of maternal stress, depressions, and anxiety. Maternal and Child Health Journal, 20, 56–65. https://doi.org/10.1007/s10995-015-1801-3

[9] Feinberg, M. E., Jones, D. E., Hostetler, M. L., Roettger, M. E., Paul, I. M., & Ehrenthal, D. B. (2016). Couple-focused prevention at the transition to parenthood, a randomized trial: Effects on co-parenting, parenting, family violence, and parent and child adjustment. Prevention Science17(6), 751–764. https://doi.org/10.1007/s11121-016-0674-z

[10] 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. http://doi.org/10.1111/fare.12309

[11] Feinberg, M. E., & Jones, D. J. (2018). Experimental support for a family systems approach to child development: Multiple mediators of intervention effects across the transition to parenthood. Couple and Family Psychology: Research and Practice, 7, 63–75. https://doi.org/10.1037/cfp000010063

[12] Feinberg, M. E., Boring, J., Le, Y., Hostetler, M. L., Karre, J., Irvin, J., & Jones, D. E. (2020). Supporting military family resilience at the transition to parenthood: A randomized pilot trial of an online version of Family Foundations. Family Relations, 69, 109–124. https://doi.org/10.1111/fare.12415

[13] Knopp, K., & Rhoades, G. (2018). Effectiveness of online relationship interventions in a randomized controlled trial. Presentation at the Association of Behavioral and Cognitive Therapies, Washington D.C., November 16.; Rothman, K., Roddy, M. K., & Doss, B. D. (2019). Completion of a stand‐alone versus coach‐supported trial of a web‐based program for distressed relationships. Family Relations, 68, 375–389. https://doi.org/10.1111/fare.12378