New study explores long-term impact of the fostering healthy futures for preteens program
Taussig, H. N., Fulginiti, A., Racz, S. J., Evans, R., & Katz, C. C. (2024). Long‐term impact of the fostering healthy futures for preteens program on suicide‐related thoughts and behaviors for youth in out‐of‐home care: A randomized controlled trial. American Journal of Community Psychology. https://doi.org/10.1002/ajcp.12745
Background
Suicide-related thoughts and behaviors (STB) among young people are a serious global public health concern, with increasing rates in the United States. Early STB are a robust predictor of later STB and suicide attempts, as well as adverse childhood experiences, including child maltreatment and out-of-home placement. Among those most at risk are the nearly 400,000 youth in out-of-home care in the U.S., including an overrepresentation of high-risk groups like American Indian and sexual minority youth (U.S. Department of Health and Human Services, 2023).
Despite the elevated STB risk among maltreated youth in out-of-home care, few interventions have targeted this population. Fostering Healthy Futures for Preteens (FHF-P) is a preventive intervention designed to promote wellbeing among maltreated children in out-of-home care through mentoring and skills groups. Through rigorous evaluations, FHF-P has demonstrated positive short-term effects on internalizing symptoms, mental health service use, placement stability, and delinquency (Taussig & Culhane, 2010; Taussig et al., 2012, 2019, 2021). This study examined FHF-P’s long-term impact on young adult STB.
Method
The randomized controlled trial enrolled 156 participants aged 9-11 years placed in out-of-home care in the prior year. Participants were 48.9% female, 54.1% Hispanic, 30.1% Black, and 27.1% American Indian. After a baseline screening, participants were randomized to the FHF-P intervention or control group. STB was assessed at baseline and 7-12 years later when participants were aged 18-22 (85.2% retention rate).
Intervention
FHF-P is a 30-week program with weekly 1.5-hour skills groups using a cognitive-behavioral curriculum (e.g., emotion regulation, problem-solving) and 2-4 hours of one-on-one mentoring by graduate students. Baseline STB was coded from child and caregiver reports on standardized measures. Young adult STB was self-reported lifetime history of non-suicidal self-injury, suicidal ideation, plans, and/or attempts.
Results
Logistic regressions examined FHF-P’s main effect on young adult STB and whether it moderated the impact of baseline STB, controlling for relevant covariates. At baseline, 23.1% of participants had STB. At the 7-12 year follow-up, 28.0% reported lifetime STB. Baseline STB predicted young adult STB only in the control group (OR=10.44, 95% CI [2.28, 47.78]), not the intervention group (OR=0.89, 95% CI [0.22, 3.50]). There was a non-significant 26% reduction in the odds of STB for the intervention group relative to controls (OR=0.74, 95% CI [0.32, 1.69]).
Summary
FHF-P buffered the impact of preexisting STB on long-term STB outcomes for youth in out-of-home care. While the main effect was non-significant, the moderation finding suggests FHF-P’s mentoring and skills training components targeted key mechanisms like social support, coping skills, and emotion regulation that can interrupt the trajectory from early to later STB.
