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.
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
Current KEEP Research
We continue to improve, refine, and evaluate the KEEP program. We currently have four federally-funded research projects underway.
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.
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.
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.
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.
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
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.
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.
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 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.
- KEEP’s origins are from Treatment Foster Care Oregon, formerly known as Multidimensional Treatment Foster Care
- 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
- 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
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
- 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