•  

Intervention Summary

Back to Results Start New Search

Family Expectations

Family Expectations is a skills-based, relationship education program for low-income couples who are expecting a baby or have just had a baby, with new parents participating at varied levels until their baby is 1 year old. The program is designed to increase family well-being by strengthening and improving the quality of the couple's relationship, increasing their use of constructive conflict management behaviors while avoiding the use of destructive behaviors, and improving each partner's ability to successfully coparent the child.

Family Expectations has three components:

  • Relationship skills education. The Becoming Parents Program curriculum is the core of the education component, which includes adapted key elements of the Prevention and Relationship Enhancement Program. Two or more educators trained in the curriculum model facilitate 6-10 weekly group workshops. The workshops are 3-5 hours each, for a total of 30 hours, with a focus on healthy communication skills and the educational topics of self-care (e.g., recognizing postpartum depression), infant care and development, coparenting, communicating about money, trust and commitment, and considering marriage. The workshops teach couples about communication, conflict management, problem solving, friendship, building support systems, fun, and commitment.
  • Family support. Each couple is provided with a family support coordinator, who meets with them individually, assessing the couple's basic family needs through the use of a structured tool covering 14 domains of family functioning. On the basis of the results of the needs assessment, the couple is referred to a range of community services and programs. These can include supports related to housing, employment, education, transportation, child care, treatment for substance abuse and/or depression, and additional parenting education. The same family support coordinator also reinforces key concepts and skills learned from the curriculum, helps couples establish goals and track their progress toward them, and encourages ongoing attendance in and completion of the workshop series.
  • Extended activities. Couples can participate in other educational opportunities after they complete the 30-hour core curriculum. These additional activities extend learning in three primary areas: relationship skills, baby development and needs, and healthy family life.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes Review Date: April 2013
1: Quality of relationship with partner
2: Conflict management behaviors
3: Depressive symptoms
Outcome Categories Family/relationships
Mental health
Social functioning
Ages 18-25 (Young adult)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Outpatient
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History Family Expectations was first implemented in 2005 at one site in Oklahoma City, Oklahoma. Approximately 4,300 couples have participated in the program. It is currently being piloted in a university setting in Orlando, Florida.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations Program materials have been translated into Spanish.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Selective

Quality of Research
Review Date: April 2013

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Devaney, B., & Dion, R. (2010, August). 15-month impacts of Oklahoma's Family Expectations program. Princeton, NJ: Mathematica Policy Research.

Supplementary Materials

Gaubert, J. M., Gubits, D., Alderson, D. P., & Knox, V. (2012, August). The Supporting Healthy Marriage evaluation: Final implementation findings. OPRE report 2012-12 (Report submitted to the Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services). New York, NY: MDRC.

Wood, R. G., McConnell, S., Moore, Q., Clarkwest, A., & Hsueh, J. (2010, May). The Building Strong Families project. Strengthening unmarried parents' relationships: The early impacts of Building Strong Families. Princeton, NJ: Mathematica Policy Research.

Outcomes

Outcome 1: Quality of relationship with partner
Description of Measures The quality of relationship with partner was assessed using a survey that contained the following items:

  • A single item related to relationship happiness. Using a scale ranging from 0 (completely unhappy) to 10 (completely happy), participants rated their overall relationship happiness.
  • Twelve items related to support and affection. Using a scale ranging from 1 (strongly disagree) to 4 (strongly agree), participants indicated their agreement with a series of statements about the support and affection in their relationship (e.g., "My partner shows love and affection for me," "My partner respects me," "My partner encourages or helps me do things that are important to me").
Key Findings A study was conducted with low-income, unmarried couples who were expecting a baby or had a baby who was younger than 3 months old. Couples were randomly assigned to the Family Expectations group or the control group, which only completed assessments. At the 15-month follow-up, couples who received Family Expectations had greater relationship happiness (p = .01) and greater support and affection (p = .05) than couples in the control group. These results were associated with effect sizes that were small (Cohen's d = 0.21) and very small (Cohen's d = 0.16), respectively.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.7 (0.0-4.0 scale)
Outcome 2: Conflict management behaviors
Description of Measures Conflict management behaviors were assessed using a survey that contained the following items:

  • Eight items related to constructive conflict management behaviors. Using a scale ranging from 1 (never) to 4 (often), participants indicated how frequently they used constructive conflict management behaviors with their partner (e.g., "Even when arguing, we can keep a sense of humor," "We are pretty good listeners, even when we have different positions on things").
  • Nine items related to destructive conflict management behaviors. Using a scale ranging from 1 (often) to 4 (never), participants indicated how frequently they used destructive conflict management behaviors with their partner (e.g., "When we argue, one of us withdraws and refuses to talk about it anymore," "Little arguments turn into ugly fights with accusations, criticisms, name calling or bringing up past hurts").
Key Findings A study was conducted with low-income, unmarried couples who were expecting a baby or had a baby who was younger than 3 months old. Couples were randomly assigned to the Family Expectations group or the control group, which only completed assessments. At the 15-month follow-up, couples who received Family Expectations had greater use of constructive conflict management behaviors (p = .01) and greater avoidance of destructive conflict management behaviors (p = .05) than couples in the control group. These results were associated with very small effect sizes (Cohen's d = 0.10 and 0.14, respectively).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.7 (0.0-4.0 scale)
Outcome 3: Depressive symptoms
Description of Measures Depressive symptoms were assessed using the 12-item Center for Epidemiologic Studies Depression scale (CES-D). Using a scale ranging from 0 (never or rarely experienced) to 3 (most or all of the time), participants reported the frequency with which they experienced 12 specific depressive symptoms during the past week (e.g., having a poor appetite; having difficulty concentrating or sleeping; feeling fearful, sad, or lonely). Item scores are summed to produce a total score ranging from 0 to 36, with higher scores indicating a greater frequency of depressive symptoms.
Key Findings A study was conducted with low-income, unmarried couples who were expecting a baby or had a baby who was younger than 3 months old. Couples were randomly assigned to the Family Expectations group or the control group, which only completed assessments. At the 15-month follow-up, mothers in couples who received Family Expectations had a lower frequency of depressive symptoms than those in the control group, as indicated by the CES-D total score (4.52 vs. 5.95; p = .01). This result was associated with a small effect size (Cohen's d = 0.22). There were no significant differences between fathers in the Family Expectations and control groups in regard to depressive symptoms.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
29% White
28% Race/ethnicity unspecified
24% Black or African American
20% Hispanic or Latino

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Quality of relationship with partner 3.5 3.5 3.5 4.0 3.5 4.0 3.7
2: Conflict management behaviors 3.5 3.5 3.5 4.0 3.5 4.0 3.7
3: Depressive symptoms 4.0 4.0 3.5 4.0 3.5 4.0 3.8

Study Strengths

The measures had acceptable psychometric properties. A number of efforts were used to ensure intervention fidelity; for example, the program used a standard curriculum, 40 hours of training were provided to program staff, supervisors provided 10 hours of observation and oversight of program staff, and orientation and training were provided to program staff over 2 weeks. The study had low attrition, randomly assigned couples to a study condition, and included intent-to-treat analyses. Appropriate analyses were conducted.

Study Weaknesses

A confounding factor that might have impacted the study findings was the average dosage level across study participants who received the program.

Readiness for Dissemination
Review Date: April 2013

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Becoming Parents Program. (2012). Power of two: PowerPoint deck [CD-ROM]. Seattle, WA: Author.

Becoming Parents Program. (n.d.). Recommended reading: Transition to parenthood. Seattle, WA: Author.

Becoming Parents Program. (n.d.). Steps for consoling your baby. Seattle, WA: Author.

Becoming Parents Program. (n.d.). Terms of agreement governing participation in the Becoming Parents Program: Instructor training and use of related materials. Seattle, WA: Author.

Cowan, C. P., & Cowan, P. A. (1995). Interventions to ease the transition to parenthood: Why they are needed and what they can do. Family Relations, 44(4), 412-423.

Family Expectations. (2010). Supervision training: Family Expectations [PowerPoint slides]. Oklahoma City, OK: Author.

Family Expectations. (2011). Family Expectations: Mother eligibility form. Oklahoma City, OK: Author.

Family Expectations. (2012). Family Expectations: Baseline information form. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Family Expectations [Recruitment training PowerPoint slides]. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Family Expectations: Couple welcome guide. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Family Expectations: Having or just had a baby? [Booklet]. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Family Expectations: The two of you want what is best for your baby: What is best for the baby is the two of you! [Brochure]. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Family Expectations: We will help you provide the best possible start for you and your baby [Flyer]. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Family Expectations: What is Family Expectations? [Flyer]. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Office visits training: Family support unit: Family Expectations [PowerPoint slides]. Oklahoma City, OK: Author.

Family Expectations. (n.d.). Strengths-based training: Family Expectations [PowerPoint slides]. Oklahoma City, OK: Author.

Jordan, P., & Frei, A. (2011). Becoming Parents Program: Couple's manual: Power of two. Seattle, WA: Becoming Parents Program.

Jordan, P., & Frei, A. (2012). Becoming Parents Program: Leader's manual: Power of two. Seattle, WA: Becoming Parents Program.

Jordan, P. L. (1990). Laboring for relevance: Expectant and new fatherhood. Nursing Research, 39(1), 11-16.  Pub Med icon

Additional implementation materials:

  • Description of Target Participants
  • Extended Activities Listing With Attendance
  • Handouts:
    • Family Expectations Couple Goal Plan
    • Family Expectations Initial Family Assessment
    • Family Expectations Organization Chart
    • Family Expectations Program Consent
    • Family Expectations Values Tip Sheet
    • Hospitality and Customer Service Tip Sheet
  • Job descriptions:
    • Bilingual Family Support Coordinator
    • Community Relations & Intake Specialist
    • Crib Assistant
    • Data and Systems Supervisor
    • Data Entry Specialist
    • Data Research Specialist
    • Direction of Center Based Services
    • Education Services and Recruitment Manager
    • Education Services Supervisor
    • Educational Services Coordinator
    • Family Life Educator
    • Family Support Coordinator
    • Family Support Manager
    • Family Support Supervisor
    • Front Desk Receptionist--Evenings and Saturdays
    • Host Couple
    • Lead Administrative Specialist
    • Lead Community Relations/Intake Specialist
    • Project Specialist
  • Key Components of the Family Expectations Program
  • Marketing Materials
  • Office Visits With Family Support Coordinators Tip Sheet
  • Staff Flexibility Tip Sheet
  • Suggested Staffing and Staffing Requirements
  • Working With Low-Income Expectant Couples Tip Sheet

Additional training materials:

  • Family Expectations Staff Required Training Grid
  • FE Intimate Partner Violence Training Plan
  • General MIS Procedures Training
  • Training and Support Resources
  • Training Content Outlines

Additional quality assurance materials:

  • BPP Quality Assurance Checklist: Commitment
  • BPP Quality Assurance Checklist: Speaker-Listener Technique
  • Classroom Checklist Suite 110
  • Family Expectations Cohort Evaluation Form
  • Family Expectations EA Evaluation Form
  • Family Expectations Post-Test
  • Family Expectations Record of Individual Supervision for Staff
  • Family Expectations Supervisor Observation Form
  • FCS Quality Assurance Log
  • FE Additional Information Form
  • Management Information System (MIS)
  • Quality Assurance (Education Services)
  • Quality Assurance Guidelines
  • Supervision of Staff
  • 2012 Quarter Two: CQI Review Summary

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.8 3.8 3.8 3.8

Dissemination Strengths

Program materials are comprehensive and include everything a site needs to implement the program. Tips on how to create a welcoming environment for participants and how to meet the needs of culturally diverse families are available. The leader's manual provides all materials needed to deliver each group session, as well as presentation tips and information on how to deal with difficult situations that may arise. The couple's manual is easy to follow and includes tip sheets and handouts that reinforce the information presented during each session. Training is required for all staff and includes information on program policies and procedures, the data management system, recruitment, family support, and how to access community resources. Several checklists, forms, and logs are available for staff to support fidelity monitoring. Leader observation forms for use by supervisors are available. Baseline and ongoing couples assessments are provided to support outcome monitoring. The developer requires the use of a data collection and information tracking system to organize participant assessment data for quality assurance purposes.

Dissemination Weaknesses

The program materials are provided in a dense binder that is cumbersome and overwhelming. The content and level of the technical assistance and consultation available are not described. There is no comprehensive protocol that explains the use of all quality assurance materials available to improve program delivery.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
2-day, on-site initial Family Expectations training (includes all program materials and handouts, training on the MIS data collection and information tracking system, and follow-up technical assistance as needed) $75-$275 per hour, depending on trainer and site needs, plus trainer travel expenses Yes
4-day, on-site Becoming Parents Program leader training, (includes leader's manual with materials for couples, PowerPoint presentation on CD-ROM, microphone magnet, and DVDs)
  • Up to 25 participants: $25,000 for the first 12 participants, then $1,500 per additional participant, plus trainer travel expenses
  • More than 25 participants: contact the developer for a custom quote
Yes
Additional Becoming Better Parents leader training materials
  • $206.47 per leader's manual
  • $147.48 per PowerPoint presentation on CD-ROM
  • $117.99 per DVD set (Couple Clips and Infant Clips)
  • $58.99 per Baby's World DVD
  • $2.36 per microphone magnet
No
Additional on-site Becoming Parents Program implementation technical assistance (up to 16 hours) $4,800 for up to 3 leaders No
Becoming Parents Program community of practice cohort (includes monthly calls and an online forum) $10 per leader per month No
Coaching and consultation $130-$190 per hour, depending on coach, method of delivery (on-site or by phone), and site needs, plus trainer travel expenses if necessary No
Becoming Parents Program couple's material set (includes couple's manual, handouts, and magnet)
  • 1-10 sets: $39 per set
  • 11-49 sets: $37 per set
  • 50 or more sets: $35.10 per set
Yes
PREPARE/ENRICH Assessment $35 per couple No, but implementers must use a relationship assessment
PREPARE/ENRICH Assessment training
  • $225 for online self-training
  • $175 or more for on-site training, depending on instructor
No
Family Expectations marketing materials Free No
MIS data collection and information tracking system $3,700-$7,700 per month, depending on the adaptations needed No, but implementers must use a tracking system
Quality assurance materials Free No

Additional Information

Discounts are available for bulk purchases of the PREPARE/ENRICH Assessment. Information on PREPARE/ENRICH Assessment training is available from Life Innovations (http://www.prepare-enrich.com/training).

Replications

Selected citations are presented below. An asterisk indicates that the document was reviewed for Quality of Research.

* Devaney, B., & Dion, R. (2010, August). 15-month impacts of Oklahoma's Family Expectations program. Princeton, NJ: Mathematica Policy Research.

Gaubert, J. M., Gubits, D., Alderson, D. P., & Knox, V. (2012, August). The Supporting Healthy Marriage evaluation: Final implementation findings. OPRE report 2012-12 (Report submitted to the Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services). New York, NY: MDRC.

Hsueh, J., Alderson, D. P., Lundquist, E., Michalopoulos, C., Gubits, D., Fein, D., et al. (2012, February). The Supporting Healthy Marriage evaluation: Early impacts on low-income families. OPRE report 2012-11 (Report submitted to the Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services). New York, NY: MDRC.

Wood, R. G., McConnell, S., Moore, Q., Clarkwest, A., & Hsueh, J. (2010, May). The Building Strong Families project. Strengthening unmarried parents' relationships: The early impacts of Building Strong Families. Princeton, NJ: Mathematica Policy Research.

Contact Information

To learn more about implementation or research, contact:
Mary Myrick, APR
(405) 848-2171
info@publicstrategies.com

David Kimmel, Ph.D., M.P.A.
(405) 848-2171
info@publicstrategies.com

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

Web Site(s):