The more the better: Adherence to programme elements of Families First in the Netherlands reduces the risk of out-of-home placement

Abstract

In this study of Families First (FF) we examined the extent to which practitioners adhere to the FF model, and whether this adherence leads to better prevention of out-of-home placement (OHP) of children. We analysed data of 4,493 families who received the regular variant of FF, and of 972 families who received the variant for mildly mentally retarded children, and checked whether the treatment met predetermined quality-of-care aspects. Ten of these aspects represent programme elements of FF, two pertain to reaching the target group and preventing out-of-home placement. Results show that, in general, both variants of FF reached the target group (94%), that in many cases out-of-home placement could be avoided (88%), and that practitioners' adherence to the ten programme elements was high (86%). The results support the adherence hypothesis for both FF variants: more adherence to the model increases the chances of preventing out-of-home placement. Moreover, for FF-regular it appears that a group of potentially effective programme elements only starts contributing to the prevention of OHP if there is compliance with four effective elements. Implications of the results are discussed and a research agenda is suggested for future research on the relationship between adherence and outcomes of FF.