Research

The evidence base for the KEEP model is extensive, including six randomized controlled trials (RCTs) funded by NIMH and NIDA since 2000, multiple independent evaluations of national and international implementations across varied cultural contexts, and numerous publications in peer-reviewed journals.

KEEP Outcomes

  • Children & Adolescents

    • Lower rates of emotional and behavioral challenges
    • Shorter lengths of stay in care
    • Lower rates of placement disruptions for youth with multiple previous placements
    • More frequent reunification with family
    • Less substance use (for adolescents)
    • Lower rates of health-risking sexual behavior (for adolescents)

  • Resource & Kinship Parents

    • Higher rates of positive parenting
    • Lower rates of harsh discipline
    • Reduced parent stress
    • Spillover of positive effects to other children in the home

  • Child Welfare System/Workforce

    • Longer tenure for foster parents providing care
    • Youth spend fewer days in care

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"I enjoyed every session that I participated in. The leaders were engaging and kept it entertaining while also teaching us great methods of how to help our children grow with positive social skills."

KEEP Resource Parent

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"I know I’m not alone and there are other people who are going through the same situation I am. Thank you all for letting me be a part of this KEEP group."

KEEP Resource Parent

Current KEEP Research

We continue to improve, refine, and evaluate the KEEP program. We currently have four federally-funded research projects underway.

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KEEP Connecting Kin, 2023

Principal Investigators: Stacey Tiberio, Ph.D.
Funding Source: Administration for Children, Youth, and Families (ACYF) and Office of Planning, Research, and Evaluation (OPRE)
Description: This study aims to evaluate whether scaling out and adapting the KEEP intervention for families experiencing informal kinship care can (a) prevent problems before they rise to the level where child welfare system involvement is necessary, and (b) improve youth well-being and placement stability, parenting outcomes, and service utilization in the short and long term.

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REACHing Optimal Mental Health via Culturally Specific Adaptations to KEEP, 2022

Principal Investigators: Stacey Tiberio, Ph.D., Rohanna Buchanan, Ph.D. 
Funding Source: National Institute of Mental Health (NIMH)
Description: The REACH study investigates the potential of culturally-specific adaptations of the KEEP intervention to reduce mental health disparities and improve long-term outcomes for sexual, gender, racial, and ethnic minority youth in Oregon.

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KEEP Connecting Kin, 2022

Principal Investigators: Patti Chamberlain, Ph.D., Stacey Tiberio, Ph.D., Rohanna Buchanan, Ph.D. 
Funding Source: Administration for Children, Youth, and Families (ACYF)
Description: The purpose of this study is to evaluate ways to improve supports and access to financial, social, and community resources for Oregon’s kinship families outside of Child Welfare.

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Intervening in the Lives of Youth with Foster Care Involvement, 2020

Principal Investigators: Stacey Tiberio, Ph.D., Katherine Pears, Ph.D.
Funding Source: National Institute of Mental Health (NIMH)
Description: This project uses sophisticated data analysis which includes seven dual-focused caregiver–youth randomized control trials of the KEEP intervention designed specifically for youth in foster care, examining both immediate and long-term mental health effects in youth.

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Building the KEEP Evidence Base

Milestones from 2000-2023
Explore the building blocks of the KEEP Evidence Base

2023    Tiberio, S.S., Pears, K.C., Buchanan, R. et al. An Integrative Data Analysis of Main and Moderated Crossover Effects of Parent-Mediated Interventions on Depression and Anxiety Symptoms in Youth in Foster Care. Prevention Science, https://doi.org/10.1007/s11121-023-01524-2

2019    Buchanan, R., Bennett, K., Chamberlain, P. KEEP SAFE: Supporting the Caregiver-Teen Relationship to Improve Health Outcomes for Teens in Child Welfare. CW 360, 24.

2019    Price, J.M., Roesch, S., & Burce, C. M. The effects of the KEEP foster parent training intervention on child externalizing and internalizing problems. Developmental Child Welfare, 1(1), 5-21.

2017    Buchanan, R., Chamberlain, P., & Smith, D. K. Treatment Foster Care Oregon for Adolescents. Evidence-Based Psychotherapies for Children and Adolescents, 177.

2017    Final evaluation conducted by the Consortium consisting of Oxford Research, CEBR (CBS) and PwC on behalf of the National Board of Health Evaluation of the test of the method "Keeping foster parents trained and supported (KEEP).” Oxford Research.

2017    Kim, H. K., Buchanan, R., & Price, J. M. Pathways to preventing substance use among youth in foster care. Prevention Science, 18(5), 567-576.

2016    Greeno, E. J., Lee, B. R., Uretsky, M. C., Moore, J. E., Barth, R. P., & Shaw, T. V. Effects of a foster parent training intervention on child behavior, caregiver stress, and parenting style. Journal of Child and Family Studies, 25(6), 1991-2000.

2016    Greeno, E. J., Uretsky, M. C., Lee, B. R., Moore, J. E., Barth, R. P., & Shaw, T. V. Replication of the KEEP foster and kinship parent training program for youth with externalizing behaviors. Children and Youth Services Review, 61, 75-82.

2016    Roberts, R., Glynn, G., & Waterman, C. ‘We know it works but does it last?’ The implementation of the KEEP foster and kinship carer training programme in England. Adoption & Fostering, 40(3), 247-263.

2015    Price, J. M., Roesch, S., Walsh, N. E., & Landsverk, J. Effects of the KEEP foster parent intervention on child and sibling behavior problems and parental stress during a randomized implementation trial. Prevention Science, 16(5), 685-695.

2013    Buchanan, R., Chamberlain, P., Price, J. M., & Sprengelmeyer, P. Examining the equivalence of fidelity over two generations of KEEP implementation: A preliminary analysis. Children and Youth Services Review, 35(1), 188-193.

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

2012    Price, J. M., Roesch, S. C., & Walsh, N. E. Effectiveness of the KEEP foster parent intervention during an implementation trial. Children and Youth Services Review, 34(12), 2487-2494.

2011     Kim, H. K., & Leve, L. D. 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.

2009   DeGarmo, D. S., Chamberlain, P., Leve, L. D., & Price, J. Foster parent intervention engagement moderating child behavior problems and placement disruption. Research on Social Work Practice, 19(4), 423-433.

2008   Chamberlain, P., Price, J., Leve, L. D., Laurent, H., Landsverk, J. A., & Reid, J. B. Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science, 9(1), 17-27.

2008   Chamberlain, P., Price, J., Reid, J., & Landsverk, J. Cascading implementation of a foster and kinship parent intervention. Child Welfare, 87(5), 27.

2008   Price, J. M., Chamberlain, P., Landsverk, J., Reid, J. B., Leve, L. D., & Laurent, H. Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment, 13(1), 64-75.

2006   Chamberlain, P., Leve, L. D., & Smith, D. K. Preventing behavior problems and health-risking behaviors in girls in foster care. International Journal of Behavioral Consultation and Therapy, 2(4), 518.

1992    Chamberlain, P., Moreland, S., & Reid, K. Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children. Child Welfare: Journal of Policy, Practice, and Program.

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KEEP Development

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KEEP RCTs

  • A study in San Diego, CA, involving 700 children in foster care, demonstrates the proportion of positive reinforcement mediates child behavior problem outcomes
  • San Diego effectiveness trial (RCT): KEEP reduces child behavior problems (PDR) for the focal child and for siblings in the same household
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Replication Trials

  • Replicating the KEEP RCT in San Diego, findings indicate that KEEP reduces child behavior problems when delivered by a community agency
  • Replication study in Maryland shows a significant decrease in child behavior problems for children in KEEP families
  • Findings based on data from 572 youth in the UK indicate that the effects of KEEP are sustained over time
  • A replication study conducted in Denmark, based on data for 64 children, demonstrates that foster parents are less stressed with child behaviors after KEEP
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KEEP SAFE RCTs

  • Fewer internalizing and externalizing problems for girls in KEEP SAFE
  • Reduced substance use for middle school girls involved in KEEP SAFE
  • Girls involved in KEEP SAFE have significantly lower levels of health-risking sexual behavior
  • KEEP SAFE: Outcome data on 259 youth. Reduced substance use for youth via improved quality of relationships with caregivers and fewer associations with deviant peers
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Cascading Implementation

  • Data from KEEP implementation sites show no significant difference in scores on fidelity ratings in the first generation (G1) trained by the developer and the second generation (G2) trained by G1
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