Healthy Families America effectiveness: a comprehensive review of outcomes

This paper reviews 33 evaluations of Healthy Families America sites, with emphasis on 15 studies that include a control or comparison group. Outcome domains include child health and development, maternal life course, parenting, and child maltreatment. Parenting outcomes (e.g., parenting attitudes) show the most consistent positive impacts. Mixed results in other domains indicate the need for in-depth research to identify factors associated with better outcomes. Several factors that may contribute to differences in outcomes are discussed, including site implementation and quality, differences in family risk levels, and recent augmentations to program design. The paper also highlights two large-scale evaluations, one community-wide (Hampton, Virginia) and one statewide (Indiana), to illustrate exemplary evaluation approaches found in HFA research. Overall, HFA's continuing evolution has been positively impacted by researcher-practitioner partnerships.     

An effective pedagogy for child welfare education

ABSTRACT

Preparing social workers for child welfare practice with the complexly traumatized children now in the system has created the need for schools of social work to integrate trauma content into the curriculum. This article presents findings of an evaluation of a child welfare course designed to prepare MSW level trauma-informed child welfare practitioners. Findings indicate that students in 29 schools of social work not only significantly increased their confidence in working with traumatized children and families but also are significantly more prepared to work toward these three child welfare goals of safety, permanency, and well-being.     

Critical Experiential Learning in the Native American Community for Title IV-E Students: A Pilot Evaluation

This article describes the development, implementation of, and outcomes associated with a specialized seminar designed to increase contextual and historical knowledge necessary for work with Native American families in the child welfare system and to increase students' personal and professional growth in this capacity. Findings from a 2-year pilot evaluation revealed that students' knowledge significantly increased over time compared with that of their non-participating peers. Seminar participation also led to personal and professional growth. Findings suggest that critical experiential learning significantly enhances traditional pedagogy for graduate social workers preparing to work in child welfare, a field plagued with disparity.     

Stopping the Cycle of Child Abuse and Neglect: A Call to Action to Focus on Pregnant and Parenting Youth in and Aging Out of the Foster Care System

Each year, a significant number of adolescents become pregnant in the United States, with more than half of these pregnancies resulting in live births. Adolescent parenting is associated with poor outcomes, including increased risk of child maltreatment. Youth “aging out” of the foster care system may be at greater risk of maltreating their children due to their experiences of child maltreatment, a lack of social support, and little preparation for parenthood. This article examines current programs and policies targeting pregnant and parenting youth aging out and presents a research agenda that focuses on pregnancy prevention and positive parenting.     

The “Fragility of Goodness”: Black Parents’ Perspective about Raising Children in Toronto,Winnipeg, and St. John’s of Canada

How does one measure ‘goodness’ when all ethical choices lead to evil outcomes? To answer this question, this essay uses Martha Nussbaum’s fragility of goodness, critical race theory, and data from a SSHRC-funded study, in which we critically examine the parenting experiences of Black families in Canada. Findings suggest how racist ideas in Canada function as “color-blind” laws and policies that affect the everyday lives of Black people including their parenting practices. Our study calls on child welfare services in Canada to develop a comprehensive understanding of Black parenting practices, perhaps enabling more Black children to remain home safely.     

Development of a Quality Assurance and Continuous Quality Improvement (CQI) Model in Public Child Welfare Systems

The purpose of this article is to review the development and implementation of a revised quality assurance and continuous quality improvement (CQI) model for the child welfare system in one Mid-Atlantic state, and the contribution of this new process to measuring the quality of child welfare practices. This revised CQI model in the state includes a broader scope of assessing practice and outcomes, as well as compliance, and engages internal and external partners in the process. This study is the first to describe the state’s revised CQI implementation process and examine preliminary outcomes in a statewide child welfare system. Findings indicate that the revised model was able to identify the factors that contributed to improving outcomes for children and families and to develop a greater understanding of the aggregate data across the state. This study will contribute to the comprehensive understanding of the model and provide implications for future quality assurance practices.     

Exploratory Factor Analysis and Reliability of the Child Welfare Trauma-Informed Individual Assessment Tool

This article presents the development and psychometric analysis of the Child Welfare Trauma-Informed Individual Assessment Tool, an instrument designed to measure the extent to which child welfare service providers employ trauma-informed practices with the children and families that they serve. Using the responses of 213 front-line child welfare workers, exploratory factor analysis was used on a seventeen-item scale, resulting in a four-factor model. Based on the results of this analysis, implications for potential uses of the instrument are discussed, and specifications for additional evaluation of the measure's validity are outlined.     

Training Child Welfare Professionals to Support Healthy Couple Relationships: Examining the Link to Training Transfer

Integrating healthy relationship and marriage education (RME) into child welfare services is a relatively recent initiative. Guided by the theoretical work in child welfare training evaluation, the current study describes the development and testing of a new RME training for child welfare professionals. Based on data collected from 272 trainees, results from structural equation modeling indicate a linear association between learner attitudes and newly acquired knowledge and skills to perceptions of training usefulness, which, in turn, influenced implementation of RME skills with clients. Implications for the delivery and evaluation of programming, in general and specific to RME, are shared.     

Assessing Risk of Placement Instability to Aid Foster Care Placement Decision Making

Placement stability is of critical importance to the well-being of children in foster care and has an impact on other key outcomes. Placement decision-making that matches children with placement resources is often cited as a practice that impacts placement stability, but little research exists to inform this practice. The focus of this research is on a child assessment tool that was developed to determine the appropriate level of care, which serves as one component of a web-based matching system that pulls together child and placement information used to inform the placement decision. The research examines the relationship between the child assessment subscale domains and placement stability for first and subsequent placement decisions and evaluates the stability of placements made in and outside of the indicated level of care.     

Bullying in Childhood,Externalizing Behaviors,and Adult Offending: Evidence From a 30-Year Study

This study examined the developmental processes linking childhood bullying to criminal offending in adulthood, using data from a 30-year longitudinal study. The linkages between bullying in childhood and three criminal offending outcomes in adulthood were estimated both before and after control for a range of confounding factors. A series of protective factors that potentially mediated these linkages were also examined. The results of the study showed that while the majority of the association between childhood bullying and adult offending could be explained by confounding factors including childhood externalizing behavior, there was evidence for direct linkages from bullying to violent offending and arrest/conviction. There was little evidence to suggest mediation of the associations. The results suggest that bullying prevention requires interventions aimed specifically at bullying behavior.     

Effective Implementation Strategies of Differential Response in Child Welfare: A Comparative Case Analysis

Differential response is a growing approach in child welfare that aims to maintain children safely in their homes when possible. This study examined how the implementation of differential response varies between counties with improved child safety outcomes compared to counties with poorer outcomes. Data was collected from nine counties through semi-structured focus groups with workers and interviews with supervisors. Results indicated that counties with improved outcomes had integrated the following implementation strategies: use of comprehensive assessment protocols; integrated supervisory support and on-going coaching of effective practices; and increased mobilization of resources, including enduring supports for parents, supports to help families meet basic needs and culturally responsive services for families.     

LGBTQ Youth in the Child Welfare System: An Overview of Research,Practice, and Policy

LGBTQ youth are largely overrepresented in the child welfare system. The experiences of LGBTQ youth have largely been overlooked. LGBTQ youth often encounter a number of challenges and disparities as they navigate the child welfare system. Many report experiences of discrimination, marginalization, and an overall lack of acceptance. The permanency and placement options have historically been limited for many LGBTQ youth, often leading to an over reliance on congregate settings and aging out of foster are. The current article provides a synthesis of the existing research on the experiences and outcomes of LGBTQ youth in care, as well as an exploration of the policy and practice initiatives aimed at creating a more inclusive system of care.     

Aggressive,Delinquent, and Violent Outcomes of School Bullying: Do Family and Individual Factors Have a Protective Function?

Bullying perpetration at school is a long-term predictor of aggression, delinquency, and violence. Most research concentrates on risk factors for such developments, whereas protective factors have been rarely addressed. Therefore, the present study investigates potentially protective effects of family and child characteristics in a prospective longitudinal design. The sample contained 519 youngsters (253 boys and 266 girls) from the Erlangen-Nuremberg Development and Prevention Study. Bullying perpetration was measured at age 9.0 years, mothers’ and children's reports on family and individual characteristics were collected at age 10.6, and outcomes in self-reported aggressive/violent offending and mother-reported aggressive and delinquent behavior were collected at age 13.7. Hierarchical regression analyses revealed main effects and interactions. The latter suggest buffering protective effects of consistent discipline in parenting and children's intelligence, positive attitude to school, prosocial behavior skills, low hyperactivity/inattention, and an anxious/depressive mood. The findings varied across the two outcome measures and with regard to gender. Implications for further research and prevention practice are discussed.     

Educational Services for Children in Foster Care

ABSTRACT

Most literature on the education of foster youth focuses on their individual outcomes and characteristics. A small body of literature documents a lack of collaboration between the child welfare and education systems. This study explores commonalities and differences in perspectives between child welfare and education system stakeholders. It draws on findings from a multi-county exploratory study on educational services for foster youth. The findings in this study identify several systemic barriers including placement instability within the child welfare system, limited financial resources of schools, and poor inter-agency communication. In addition, differences in the perceptions of school and child welfare agency personnel regarding the needs of foster children in school, problems encountered in enrolling children in school, and the role and motives of each agency in addressing these needs and problems are identified. These differences point to both the challenges involved in improving communications and collaboration between the two systems, as well as the opportunities to improve educational services to children in foster care.     

Solution-Focused Trauma-Informed Care (SF-TIC): An Integration of Models

Trauma-informed care is a rapidly emerging approach in child welfare and is significantly aligned with the core tenets and techniques of solution-focused practice. The integration of solution-focused practices and trauma-informed care offers an alternative to the problem-solving method frequently employed in child welfare. This paper describes and demonstrates how using a Solution-Focused Trauma-Informed Care (SF-TIC) approach can shift individuals and systems from a problem-solving focus to solution building. SF-TIC provides individuals with concrete skills, language and knowledge to effectively avoid inadvertent re-traumatization. Evaluation of this approach is in its infancy and future research is warranted.     

Design and Implementation of Parent Programs for a Community-Wide Adolescent Alcohol Use Prevention Program

SUMMARY

Project Northland is a comprehensive community trial designed to evaluate programs for the primary prevention of alcohol-related problems during adolescence. It uses a community-wide model, that includes both demand and supply reduction techniques. The first phase of Project Northland (grades 6-8) was completed with the effective implementation of multiple, complementary programs including a multi-year social behavioral curriculum, intensive parental involvement components, peer leadership opportunities, and community-level changes through the formation of local task forces. This article describes the process used for developing and implementing the comprehensive parent interventions used during the first phase of the research, highlighting the elements that led to the successful implementation of the programs with very high participation rates by parents, their young adolescents, teachers, and community members.     

The evaluation of Healthy Families Arizona: a multisite home visitation program

Healthy Families Arizona is a broadly implemented home visitation program aimed at preventing child abuse and neglect, improving child health and development, and promoting positive parent/child interaction. The program began as a pilot in two sites in 1991 and by 2004 had grown to 48 sites located in urban, rural, and tribal regions of the state. The unique administrative structure of the program and collaboration between evaluation and quality assurance have helped overcome many of the problems familiar to home visitation programs. This paper describes how a systematic focus to improve processes and outcomes has positioned the program for a randomized longitudinal study. Key components of the program are described and evaluation results are presented.     

Antipsychotic Use and Foster Care Placement Stability Among Youth With Attention-Deficit Hyperactivity/ Disruptive Behavior Disorders

The objective of this study was to investigate the association between antipsychotic initiation and placement transitions among youth in foster care with attention-deficit/hyperactivity disorder and other disruptive behavior disorders (ADHD/DBD). Data were obtained from child welfare administrative records and Medicaid claims in one Mid-Atlantic state from January 1, 2010, through March 31, 2014. Cox proportional hazard model was conducted to estimate the risk of time to first placement transition during the 180-day follow-up among new antipsychotic users and propensity score matched nonusers. Results showed youth initiating antipsychotics had no significant reduction in foster placement transitions within the 180-day follow up (Hazard Ratio = 1.1; 95% CI = 0.7–1.6). Although antipsychotics are widely used for aggressive behaviors, a better understanding of clinical management of youth in foster care is needed to promote stable foster placement.     

Acting Like It Matters: A Scoping Review of Simulation in Child Welfare Training

Simulation-based training is often used to prepare health practitioners and is increasingly employed to train child welfare workers. This scoping review systematically searched the published and grey literature for studies that evaluated training for child welfare practitioners and used simulation methods that included standardized actors. Three studies met inclusion criteria, all documenting improvement in participants' use of specific skills. Other outcomes were mixed, possibly reflecting the heterogeneity of samples, study methods, measures, training of actors, theoretical frameworks, and content areas. Though results were mostly positive, the small number of studies indicates a substantial need for further research.