Child Welfare Agencies Research Articles

Ethical Need for a Fertility Decision-Aid for Transgender Adults of Reproductive Age

Ethical Need for a Fertility Decision-Aid for Transgender Adults of Reproductive Age

Barriers and facilitators to implementing evidence-based interventions in the context of a randomized clinical trial in the United States: a qualitative study

BackgroundEvidence-based interventions, which are typically supported by data from randomized controlled trials (RCTs), are highly valued by providers of human services like child welfare. However, implementing such interventions in the context of a randomized clinical trial is a complex process, as conducting an RCT adds extra tasks for providers and complicating factors for provider organizations. Utilizing the Exploration, Preparation, Implementation, and Sustainment Framework, this study examines factors that facilitate or impede success in the implementation of evidence-based interventions in the context of a largescale trial of SafeCare,® a child maltreatment intervention.MethodsQualitative data were obtained as part of a larger mixed-methods study involving a cluster randomized trial comparing SafeCare to usual services for caregivers within nine child welfare agencies across four states. Between May and October 2017, individual interviews were conducted with a purposive sample of 21 child welfare administrators and 24 supervisors, and 19 focus groups were conducted with 84 providers. Data were coded iteratively and grouped into themes.ResultsSeveral interconnected themes centered on facilitators and barriers to SafeCare implementation in the context of a randomized clinical trial. Facilitators included: (1) Benefits afforded through RCT participation; (2) Shared vision and sustained buy-in across system and organizational levels; and (3) Ongoing leadership support for SafeCare and the RCT. Barriers that hindered SafeCare were: (1) Insufficient preparation to incorporate SafeCare into services; (2) Perceived lack of fit, leading to mixed support for SafeCare and the RCT; and (3) Requirements of RCT participation at the provider level.ConclusionsThese data yield insight into an array of stakeholder perspectives on the experience of implementing a new intervention in the context of a largescale trial. This research also sheds light on how the dynamics of conducting an RCT may affect efforts to implement interventions in complex and high-pressure contexts. Findings highlight the importance of aligning knowledge and expectations among researchers, administrators of organizations, and supervisors and providers. Researchers should work to alleviate the burdens of study involvement and promote buy-in among frontline staff not only for the program but also for the research itself.

Adapting private family time in child protective services decision‐making processes

AbstractThe Family Group Conference (FGC) is grounded in a rights‐based framework, whereby children and their families have the right and responsibility to be primary decision‐makers when child protection issues arise, and the statutory agency has the responsibility to convene the entitled members of the family network to lead the decision‐making. A distinct core component of FGC—private family time (PFT)—allows families to discuss the information and formulate their responses and plans privately during conferencing. This paper describes how a large child welfare agency in the United States adapted PFT in two ways: (1) including a parent advocate (PA) and (2) abbreviating the amount of time allowed for this discussion. Given the lack of empirical research on the PFT component, this qualitative exploratory study sought to understand the functions and perceived impacts of PA‐supported PFT during initial child protective services (CPS) conferences at which decisions of child removal or placement were being contemplated. PFT served multiple beneficial functions and impacted families in several positive ways: families gained greater awareness of safety concerns, felt empowered and confident in the preferred safety and service plan, became increasingly engaged and involved in the case decision‐making process and ultimately felt less apprehensive.

Stay just a little bit longer: A scoping review of foster parent engagement in the U.S

Despite the growing need for quality foster homes, retaining foster parents continues to be a challenge. A significant burden is placed on child welfare agencies to recruit, train, and retain quality foster parents to ensure available homes for children in need. To synthesize what is known about foster parent engagement, this article describes the modifiable factors impacting foster parent satisfaction, commitment, and retention. This scoping review engaged in a comprehensive exploration of the literature by mapping out the extent, range, and nature of foster parent engagement, screening studies based on inclusion and exclusion criteria, and summarizing findings. Twenty-three articles met inclusion criteria. Three themes emerged as factors impacting foster parent engagement: (1) training, (2) resources, and (3) relationships. Eight studies evaluated unspecified training and three studies examined evidenced-informed training interventions. Resources were explored in ten studies and included concrete resources such as respite, financial assistance, and transportation. Relationships, categorized as professional social support (n = 15) and personal social support (n = 16), were also studied. A notable finding of this scoping review is the importance of relationship building across foster care stakeholders. Specifically, strengthened relationships between foster parents and caseworkers improved outcomes across all components of foster care engagement (satisfaction, commitment, and retention). Further studies are needed to understand the ways in which specialized training and social support improve foster parent engagement over time.

Incorporating multiple data sources to assess changes in organizational capacity in child welfare systems

Three federally funded Child Welfare Capacity Building Centers provide services to build the organizational capacity of public child welfare agencies to help meet federal requirements, improve practice, and improve outcomes for children and families. The aim of this study was to explore capacity outcomes in five dimensions – resources, infrastructure, knowledge and skills, culture and climate, and engagement and partnership – achieved by child welfare jurisdictions who received Center services. Analyses describe the capacities targeted for improvement and the amount and type of services provided by Centers; assess the relationship between services and capacity increase; and explore whether that relationship differs depending on the jurisdiction’s level of foundational capacity. Data collected through surveys and a service delivery tracking system reflect the perspectives of service recipients and service providers. Results reveal jurisdictions typically targeted capacity outcomes in the dimensions of knowledge and skills and infrastructure and received an average of 28 hours of direct services to support their capacity-building efforts. Dosage of service was positively associated with achievement of capacity outcomes, though no interaction was found between service dosage and foundational capacity in the effect on outcomes. Methodological lessons learned and implications for future evaluations of organizational capacity building efforts are offered.

Sustainability of a Child Mental Health Intervention in Child Welfare Services: Case study

From an implementation science lens, sustaining interventions in large, heterogeneous organizations such as child welfare requires attunement to the inner and outer contexts in which the innovative practice is delivered. This case study describes how one child welfare agency sustained implementation of a modified child mental health intervention since Spring 2019 after formal supports were removed and provides a retrospective look at their experiences. Using qualitative data from interviews with a key informant, this case study employed a priori codes from an existing sustainability framework to organize and understand factors of innovation, adopters, leadership and management, inner context and process, outer context, and outcomes. Findings offer insights for child welfare agencies to consider when sustaining an intervention without research supports, including the intervention’s alignment with the agency’s culture and mission, the agency’s ability to adapt and embed the intervention, and child welfare leadership and staff buy-in to the intervention. Implications for policy, practice, and research are discussed.

Child welfare workers satisfaction and wellbeing during the COVID-19 pandemic: Perspectives of agency staff in Ohio

BackgroundThe COVID-19 pandemic has impacted the lives of children and families, created additional stressors, and increased risks for maltreatment. The pandemic has changed the way child welfare agencies operate, requiring changes to policies and practice. Minimal research has considered the effects of the COVID-19 pandemic on child welfare workers wellbeing and job satisfaction. ObjectiveThis mixed-methods research study seeks to understand CPS staff satisfaction, variables impacting satisfaction, and challenges that increased since the pandemic began for child welfare workers in Ohio. Participants and settingA sample of staff members (n = 267) from 50 CPS agencies across Ohio participated in the study. MethodsThis mixed-methods study used logistic regression, chi square analyses, and thematic analysis to analyze the data from a survey sent to child welfare agencies in Ohio. ResultsCaring for minor children, primary role at work, and years in child welfare were significantly associated with job satisfaction. Those working in foster care/placement, adoption/permanency, family support/visitation, kinship were 7.57 times more likely than those doing intake/investigation work to be satisfied with their job (p = .007). Thematic analysis of staff issues that increased during the pandemic resulted in six themes: Stress and Anxiety, Feeling Overwhelmed, Burnout, All, Motivation, and Isolation and Disconnection. ConclusionsThe COVID-19 pandemic has created additional stressors for child welfare staff. Practice implications are discussed to help increase job satisfaction, staff wellbeing, and mitigate turnover.

Building a specialized model of care for youth involved in sex trafficking in child welfare: A systematic review and interviews with experts-by-experience

BackgroundSex trafficking of youth involved in the child welfare system is a critical global issue; however, there are limited counter-trafficking programs designed to specifically meet the needs of this population. ObjectiveThe present study aimed to identify components essential to building a model of care for youth involved in sex trafficking in child welfare. The specific goals of this investigation were to: 1) systematically review the literature for programs implemented with child-welfare involved youth at risk of or involved in sex trafficking, and 2) examine convergent and divergent evidence through interviews with experts-by-experience (i.e., survivors and child welfare personnel). Participants and setting13 child welfare workers and 6 survivors of sex trafficking. MethodsSystematic review identified articles that included programs and interventions for youth involved in sex trafficking in child welfare. Interviews with experts-by-experience were analysed through reflexive thematic analysis. Content analysis was used to examine convergent and divergent evidence between the two noted methods of inquiry (systematic review and interviews with experts). ResultsFindings from the systematic review support a model of care comprised of two overarching components: 1) wraparound supports, and 2) trained caregivers and supported foster homes. Thematic analyses also revealed that experts thought that an appropriate model of care would require child welfare agencies to take a preventative stance, such as conducting early coordinated risk assessments on all youth in care. Convergent with the literature, experts noted the need for enhanced wraparound supports and specific training for caregivers and service providers. ConclusionsComponents essential to building a model of care for youth at risk of or involved in sex trafficking in child welfare were extracted and discussed based on the evidence gathered.

Examining the effects of antidiscrimination laws on children in the foster care and adoption systems

AbstractHow are children affected when states prohibit child welfare agencies from discriminating against same‐sex couples who wish to foster or adopt? This question stands at the heart of a debate between governments that seek to impose such antidiscrimination requirements and child welfare agencies that challenge them on religious freedom grounds. Yet until now there has been no reliable evidence on whether and how antidiscrimination rules for these agencies impact children. We have conducted the first nationwide study of how child outcomes vary when states adopt such antidiscrimination rules for child welfare agencies. Analyzing 20 years of child welfare data (2000–2019), we estimate that state antidiscrimination rules both (1) modestly increase children's success at finding foster and permanent homes, and (2) greatly reduce the average time to place children in such homes. These effects vary among subgroups, such that children who are most likely to find a home are generally not affected by state antidiscrimination requirements, whereas children who are least likely to find a home (primarily older children and children with various disabilities) benefit substantially from antidiscrimination measures. We estimate that the effect of antidiscrimination rules is equivalent to 15,525 additional children finding permanent homes and 360,000 additional children finding foster homes, nationwide, over a period of 20 years. Overall, the project offers two key contributions: First, it provides empirical grounding for some of the most heated constitutional and political battles of the culture wars. Second, it advances empirical legal studies by bringing machine learning causal inference to law.

Development and validation of a predictive risk model for runaway among youth in child welfare

Existing predictive risk models in child welfare tend to focus on child protection and prevention of youth’s entry to the child welfare system. Less explored is the potential contribution of predictive risk models to improve the care and meet the placement needs of youth in the child welfare system. This study demonstrated how an empirical model predicted youth’s risk for running away from child welfare placement to inform preventive interventions for youth in care. We used administrative data on youth’s demographic, child welfare, and clinical characteristics to develop a Cox proportional-hazards model. The model predicted time-to-first runaway among 8,255 legal custody spells of 12- to 17-years-olds in the care of the public child welfare agency of one large Midwestern state over an eight-year period. We validated the model internally using 200 bootstrap resamples from the development sample, and externally using a more recent, but smaller sample of 1,836 legal custody spells for youth whose information was not used to develop the model. Internal validation indicated stable predictor estimates, significant predictors that corroborate with relevant empirical literature on runaway, and strong discriminative ability and prediction accuracy (bias-adjusted c-statistic = 0.78). Through external validation, we demonstrated one preventive application of the model by predicting the risk of running away within the first 90 days of a legal custody spell. The model maintained the expected relationships between model-based predicted risks of runaway and actual runaway, as evidenced by accuracy metrics of precision and recall. We conclude by describing how child welfare agencies can apply predictive risk models such as ours to identify youth’s placement needs and estimate system capacity to prevent runaway.

Child maltreatment reporting during the initial weeks of COVID-19 in the US: Findings from NCANDS

BackgroundAfter the national COVID-19 emergency declaration in the U.S. in March 2020, child welfare agencies observed large reductions in maltreatment reporting. ObjectiveTo quantify the impact of the COVID-19 pandemic on child maltreatment reporting nationally to inform policy for future emergencies. Participants and settingAdministrative data from the National Child Abuse and Neglect Data System (NCANDS) for 48 states for federal fiscal years (FFYs) 2017 through 2020. MethodsAnalyses focused on reports to child protective services (CPS) between weeks 12 and 24 of calendar years 2017 through 2020 (mid-March through mid-June). Report sources of screened in and substantiated reports were compared with those during the prior year. Likelihood of a report being substantiated in 2020 compared with 2019 based on report source was calculated using odds ratios. ResultsIn 2020, CPS screened in 39 % fewer reports than during the same period in 2019 and the proportion of reports substantiated increased from 18 to 22 %. Reports from all report sources decreased, especially from education personnel (90 % decrease) and child daycare providers (65 % decrease). The odds for substantiation were significantly higher during 2020 than in 2019 for reports from all but three sources. ConclusionDuring the initial weeks following the national COVID-19 emergency declaration, the number of reports to CPS declined sharply at the national level and across all states, primarily in association with a large reduction in referrals from education sentinels. Explanations for the increase in percent of substantiation in the context of reduction of reports are considered.

A conceptual model to guide collaborative reflective practice and values-driven child welfare decision-making

Child welfare professionals make critical decisions at every stage of a family’s involvement with the child welfare system. Values, both explicit and implicit, play a meaningful role in complex decisions related to safety, foster care, well-being, and permanency. The promise of critical reflective practice and values-driven decision-making offers a stronger application of social work values which may in turn promote systems change efforts that endeavor to advance more equitable outcomes for children and families. This conceptual article discusses the role of social work values and principles in supporting decision-making efforts aimed at protecting children and reducing racial, ethnic, and socioeconomic disproportionalities in child and family outcomes. We present a three-point conceptual model and use the structured decision-making model as an example for how child welfare agencies can include values and collaborative reflective practice in decision-making within the child welfare system.

Impact of Safe@Home on Placement and Permanency Outcomes: Results of a Quasi-Experimental Study.

This study assessed the effectiveness of Safe@Home, an in-home intervention to (1) prevent out-of-home placement for children at imminent risk of placement, and (2) minimize time in out-of-home care for children already in foster care. Using Coarsened Exact Matching, children who received Safe@Home were matched to a comparison group of children served before Safe@Home was available in their community. All children were determined by the child welfare agency to be unsafe and in need of immediate intervention. The matched samples (Safe@Home n = 510, Comparison n = 851) showed strong baseline equivalence on child age, race/ethnicity, previous history of child welfare involvement, and safety threats. Children who received Safe@Home experienced lower rate of out-of-home placements, higher rate of permanency with a parent (sustained for 12months after the end of Safe@Home), fewer days in out-of-home care, and shorter time to case closure relative to children who received treatment as usual. There was no effect of Safe@Home on post-permanency outcomes of maltreatment and entry or re-entry after case closure.

Organizational complexity within private child welfare agencies in the United States and impact on agency performance outlook

This paper studies the performance outlook of private child welfare agencies (PCWAs) from a complexity theory lens. We argue that even though these agencies play a key role in delivering safety net services for families, while navigating dynamic environments, there is little empirical evidence identifying concrete complexity factors (i.e., inter-dependence, unpredictability and self-organization) and examining their impact on agency performance. To address this gap, we first conceptualize PCWAs as complex systems as they exhibit the three factors of interest. Then, we operationalize inter-dependence as the number and diversity of services provided, fiscal unpredictability based on managerial report, and self-organization as agency use of inter-organizational ties requiring heavy investment of agency resources. This study presents results from a survey data analysis of 229 PCWA managers in six states in the United States. Results show PCWAs efforts to adapt to organizational complexity can also pose a burden in meeting the needs of consumers and frontline staff. Nonetheless, external accountability through accreditation and a transformational leadership style that is characterized by compassion and attention to front-line workers’ individual needs and goals may be promising strategies to manage the inter-dependent and self-organizing nature of private child welfare systems.

Using the Core Components of a Public Health Framework to Create a Child and Family Well-being System: Example from a National Effort, Thriving Families, Safer Children.

Thriving children require safe, stable, nurturing relationships and environments. When caregivers have the resources and support they need, at the appropriate time, and in culturally meaningful ways, they can structure environments and experiences for their children that optimize development. However, all too many caregivers and children experience trauma and adversity that consistently threaten such environments. The USA currently lacks a universal system of care and support for children and families leaving the child welfare system as the only option for many families to get help. This forces child welfare agencies to address problems and issues they are ill-equipped to address. In this paper, we review how a new national effort in the USA, Thriving Families, Safer Children is integrating the core components of a public health framework to create a child and family well-being system across the country. Case study examples are provided from 4 Thriving Families, Safer Children sites. Thriving Families, Safer Children sites are utilizing the core components of a public health framework to address social and structural determinants of health including systemic racism, with a strong focus on changing systems and contexts, through participatory methods of engaging those with lived expertise, to ensure the service context where families can get what they need, when they need it, with an emphasis on promoting race equity. Efforts to transform child welfare through the Thriving Families, Safer Children movement are aligned with the core components of a public health framework.

Examining the effects of the Eckerd rapid safety feedback process on the occurrence of repeat maltreatment among children involved in the child welfare system

BackgroundThe Eckerd Rapid Safety Feedback Process (ERSF) is an approach to child welfare practice that combines predictive risk modeling (PRM) with real-time quality assurance and staff coaching during a child protective services investigation. During the case investigation, quality assurance (QA) reviewers provide guidance to staff by assessing key dimensions of their investigative practices and providing coaching sessions as needed. ObjectiveTo determine to what degree ERSF reduced the incidence of children who experienced high severity physical, sexual, or neglect maltreatment (HS-CAN) among children known to a state child welfare agency, within 12 months of the agency's involvement in a previous investigation. MethodsThis multi-year quasi-experimental study evaluated the impact of the ERSF Process on risk of repeat high severity maltreatment among children and youth identified by a PRM algorithm as high risk for experiencing repeat maltreatment and receiving the additional QA intervention, compared to those receiving the usual standard of care. ResultsThe ERSF Process did not lower the rate of HS-CAN among children identified as high risk. The joint odds ratio for receiving ERSF given being high risk was 1.05, i.e. a point estimate indicating higher probability of future HS-CAN. ConclusionsIn this statewide implementation of ERSF, we did not find a positive effect of this particular PRM-based intervention. Future maltreatment, even within 12 months of a prior investigation, may be too distal an outcome for a PRM and QA process designed to produce a high-quality CPS investigation and safety plan.

Promoting racial equity and antiracist practice in child welfare: perceptions of public child welfare administrators

ABSTRACT There is much discussion in the literature regarding the role public child welfare has played in disproportionately intervening with children and families of color, and debate regarding how this has impacted their wellbeing and the role systemic racism has played. The voice of individuals serving as regional and state-level administrators of public child welfare agencies regarding this topic and how to address existing inequities has been missing in this dialogue. This paper reports on semi-structured interviews conducted with sixteen such administrators regarding where they have observed these issues in their agencies and a wide array of strategies they believe have the best likelihood of promoting racial equity and antiracist practice in the child welfare system, with some describing approaches currently being implemented. Participants discussed what they need from community and university partners to support this work.

Developing and Validating a Predictive Risk Model for Youth Placement in Residential Care to Support Decision-Making under the Family First Prevention Services Act

ABSTRACT Under the Family First Prevention Services Act, federal Title IV-E claiming requirements for youth who are placed in Qualified Residential Treatment Programs (QRTPs) are more stringent than previous criteria for residential care. Independent Qualified Individuals are required to assess the appropriateness of QRTP placements and judicial reviews must formally approve these placements. Child welfare agencies can use administrative data and empirical methods to adapt to these changes from a prevention standpoint. The current study detailed an approach for developing and validating a Cox proportional-hazards model predicting time-to-first placement in residential care among 43,770 legal spells for youth under the care of one large Midwest child welfare agency. Internal validation using 200 bootstrap resamples yielded stable predictors consistent with those in the literature, strong discriminative ability, and high prediction accuracy. External validation applied the model to examine the risk of residential care placement in the first 90 days of youth’s legal spells. This proactive risk prediction encapsulates a preventive approach preceding the 90-day timeline of QRTP assessment and court review. Results suggest that robust prediction of existing practice of residential care placement has the potential to inform caseworker-level service and placement planning, and build system-level capacity for residential and community-based care.

The Impact of COVID-19 and Immigration Enforcement on Service Delivery for Immigrant Origin Families Involved in the Child Welfare System.

This descriptive study sought to explore how child welfare agencies and community partner organizations experienced and adapted service provision for immigrant children and families during the COVID-19 pandemic. Semi-structured qualitative interviews were completed with 31 child welfare agency practitioners and community partners in 11 states who work with immigrant clients or on immigration related policies within the child welfare sector. Data were coded and analyzed using a thematic analysis approach.Results: Findings documented ongoing immigration-related fears in accessing services due to the anti-immigrant climate as well as increased scarcity of resources and basic needs stressors among immigrants served by the child welfare community during the pandemic. Results also identified child welfare systemic and structural barriers to accessing needed case supports for immigrants, in addition to innovative practice and policy adaptations to meet immigrant needs during the pandemic.COVID-19 created overwhelming challenges for already overburdened immigrant families at risk of or involved with the child welfare system. Child welfare agencies should foster collaborations with immigrant-serving community organizations who can share information and resources about COVID-19, immigration enforcement, and vaccine distribution. Agencies should adopt policies for tele-visiting that support transnational participation in virtual family visits and court hearings to create more equitable opportunities for reunification and permanency.

A national review of child welfare competency models

Child welfare agencies across the United States aim to better the outcomes of children and families. As such, agencies often implement competency models outlining the knowledge, skills, and attitudes necessary for a competent workforce, and that can guide their recruitment, hiring, training, and on-the-job performance. This article features a national review of available child welfare competency models, providing an overall state of the field, common shortcomings of competency models, and next steps to advance workforce development and evaluation. Researchers reviewed the competencies required to be a child welfare caseworker, the extent models covered core child welfare practice, and the differentiation of knowledge, skills, and attitudes. Variability, confusion, and lack of clarity among competency models led researchers to conduct the study in two phases. Phase one serves to answer the original questions regarding the state of the field, while phase two asks questions derived from the knowledge gleaned from phase one. Phase two explores whether practice and competency models contain essential components identified as best practice and if the competency models explicitly reflect the practice models. This article primarily reports on phase two of the quantitative findings based on an analysis of practice models, competency models, and their various components. A discussion follows, highlighting possible reasons for the lack of clarity, model variability, and disconnect between practice and competency models. Lastly, the article provides study limitations and the next steps in competency development in the child welfare workforce.