Child Welfare Research Articles

Sovrappeso e obesità in età pediatrica: un intervento pragmatico nelle cure primarie

Paediatric clinics are in a unique position to detect chronic diseases, identify at-risk individuals, educate families and implement early preventive interventions. This article aims to provide evidence on how and with what strategies the AUSL of Reggio Emilia has built a programme to combat overweight and obesity in childhood by involving a network of services, starting with paediatricians. A variety of approaches have been taken to address the problem of promoting healthy lifestyles. The BMIF project (Very Fit Children) focuses on early detection and treatment of overweight children using motivational interviewing to help families change their lifestyles. First, second and third level interventions provide treatment for children with obesity according to defined care pathways. Anticipatory guides on responsive feeding and the BeBa (Children's Wellbeing) app promote healthy lifestyles. Effectiveness and equity were the guiding principles for the choices made. This required time and a significant effort, but it also resulted in greater support from both operators and decision-makers.

Participation in practice in child welfare: processes, benefits and challenges

ABSTRACT Internationally, there has been a significant focus in policy and practice on the participation of children and young people in decisions that affect them, underpinned by respect for their rights under Article 12 of the UNCRC. While children’s participation has become a core focus for practice improvement in child welfare services, there is a dearth of practical examples of how participation is implemented in organisations. In this paper, we provide a reflective case study of participation in practice in the Youth Advocate Programme (YAP) in Ireland, a large non-profit child welfare organisation. YAP Ireland works with young people who are considered ‘high risk’ using a strength-based approach in a wraparound service that is family-driven and youth-guided. Drawing on qualitative interviews and focus groups with young people, parents, advocates, and staff and management, we describe and critically analyse YAP’s approach to participation. Critical factors in practice include a commitment to participation in policy, practice and culture at all levels of the organisation and scaffolding of participation by staff. Challenges include ensuring that participation principles are upheld consistently across the organisation and resourcing participation.

Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages

BackgroundIn many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda.MethodsWe carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization’s HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data.ResultsA total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children’s health as poor. Many factors were associated with perceived children’s health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers.ConclusionThis study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities.

The Role of Informal Social Networks in Supporting Parents With Learning Disabilities: A Systematic Review

ABSTRACTBackgroundParents with learning disabilities are often assessed as lacking the capacity to parent effectively; however, ecological models of parenting indicate that support from informal social networks (ISNs) can help them successfully maintain family life. This systematic review examined evidence regarding (1) parent and child outcomes associated with support from ISNs and (2) perceptions of the roles of ISNs for parents with learning disabilities.MethodsPeer‐reviewed quantitative and qualitative literature was identified through a search of six databases, and a narrative synthesis was subsequently conducted.ResultsTwenty‐six articles were included in the review. Findings of the quantitative synthesis provided preliminary evidence for a positive relationship between support from ISNs and parental mental health, positive parenting practices and child wellbeing. The qualitative synthesis indicated that parents benefited from ISNs through their provision of practical and emotional support and learning skills. Network characteristics that divided supportive from unsupportive members were also identified.ConclusionParents with learning disabilities receive the same positive outcomes from ISNs as other parents, although unique contextual and social challenges may affect their experiences. Future research should explore interventions to build ISNs of parents with learning disabilities that acknowledge their existing strengths as parents and community members.

Tiaki Taoka, designing a Kāi Tahu Māori organisation to work with child protection

In 2019 Aotearoa New Zealand added an amendment to the child protection legislation that required the state to partner with Māori. This paper looks at a case study of the development of one of the services developed under the legislative amendment. Section 7 AA, Tiaki Taoka. Tiaki Taoka was designed as a Māori service response for Kāi Tahu, the iwi, tribe of the greater area of Te Waipounamu (the South Island). The service was mandated by Kāi Tahu and funded through the state to provide partial child protection services devolved from the state. The design was “by Māori, for Māori and of Māori” culturally nuanced in Kāi Tahu knowledge and experience. The co-design of the service model, Te Rereka Toroa, with Kāi Tahu community is shared alongside important relational work with the child protection system, Oranga Tamariki. Tensions in Māori and state relationships are provided with a critique on the maintenance of power and control by the colonial state and the current political challenges.

Why train? Compatible and incompatible institutional logics in violence prevention and management training

A critical component of ensuring safe workplaces is training in preventing and managing violent behavior. This article examines the institutional logics underpinning such training programs, investigating their design, rationale, and impact on everyday practices within human services. Despite extensive research on the content, effects, and experiences of these training programs, there is a notable gap in understanding the rationale behind their development. This study aims to fill this gap by exploring why violence prevention and management training is structured as it is and how institutional logics affect training and practice. This research identifies seven institutional logics that shape these programs through an in-depth qualitative analysis of three Norwegian human service training programs – encompassing mental health care, child welfare services, and Norway’s national welfare agency. Some of the logics are complementary. Others are incompatible, leading to significant practical implications. Data collection included qualitative document analysis and interviews with representatives from the training communities. The study contributes to a better understanding of the factors influencing the training program design and influence, not the least, by underscoring their duality as measures of improving service delivery and ensuring safe working conditions.

The prevalence of wordings on Adverse Childhood Experiences in child welfare assessments in a sample of young people in secure institutional care

ABSTRACT In Sweden, young people with behaviours considered norm-breaking and destructive by society are placed in secure institutional care. While these young people’s behaviour is frequently debated, there is little knowledge about their family and home conditions. This study aims to identify writings (i.e. wordings, sentences, etc.) referring to Adverse Childhood Experiences (ACEs) in child welfare assessments of a sample (n = 84) of young people placed in secure institutional care. The documentation was analysed by applying manifest quantitative content analysis using ACEs established in previous research as deductive categories. In addition, wordings related to the legal grounds for placement were also identified. The analysis shows that the burden of child abuse and household dysfunction is large in the sample. Compared to population-based prevalence studies, the current study presents much higher numbers, with almost 90% of the cases containing writings with reference to at least one ACE category and 38–50% referring to four or more. The findings constitute an important contribution to research on young people in secure care, by adding knowledge about adversity during childhood as a crucial part of these young people’s needs and challenges.

Exploring harmful traditional practices and its associated factors among puerperal mothers who delivered in public health facilities in southwestern Ethiopia

Harmful traditional practices are deeply ingrained beliefs and behaviors within a society that significantly impact the well-being of mothers and children. In Ethiopia, there is limited awareness and comprehension concerning the prevalence of harmful traditional practices in the puerperal period. The underlying reasons for engaging in harmful cultural practices during this period at the community level remain inadequately studied. The main aim of this research is to investigate the prevalence of harmful traditional practices during the puerperal period and its associated factors in public health facilities of southwestern Ethiopia, 2023. A mixed-methods community-based cross-sectional approach was undertaken from June 1st to July 31st, 2023. The study utilized the 24 kebeles in the Ilubabor and Buno Bedele Zones of Southwest Ethiopia. Three hundred twenty puerperal mothers in selected kebeles found in Ilubabor and Buno Bedele zones met inclusion criteria during the data collection period. We used a pretested semi-structured questionnaire, supplemented by in-depth interviews and focused group discussions with purposively selected 18 mothers. We utilized backward multiple logistic regressions were utilized to evaluate the interplay between various factors, with statistical significance set at a P-value below 0.05. This finding disclosed that the prevalence of harmful traditional practices during the puerperal period was 76.3%. Factors such as educational status (AOR = 3.47, CI = 1.57–9.27), rural residency (AOR = 2, CI = 1.51–4.88), absence of antenatal care in the last pregnancy (AOR = 6.42, CI = 2.33–8.74), and the place of delivery for the most recent child (AOR = 1.7, CI = 1.15–4.07) were significantly associated with these practices. The findings underscore a substantial prevalence of harmful traditional practices among mothers during the puerperal period. It is imperative for the Zonal Health department, in collaboration with relevant stakeholders, to actively combat these practices within rural communities and healthcare facilities.

Maternal labor supply and children's emotional well-being

Maternal labor supply and children's emotional well-being

The COVID-19 restrictions, child services and the well-being of children in South Africa

Covid-19 posed little danger to children. Nevertheless, the South African government imposed lockdown measures that impeded children’s education, play and food. Schools were closed, feeding schemes were halted and organised sports were banned. In this study of South African children’s experience during the 2020–22 pandemic, we use the capabilities approach, particularly Nussbaum’s ten capabilities, to assess how the lockdown measures affected their development. The one-dimensional nature of the government response was evident in its focus on physical health and safeguarding adults and the health system, at the expense of children’s well-being. Children were masked and their voices were not heard. Despite being far less at risk of illness or death than adults, children and young people were disproportionately affected by government regulations. Children from low-income environments were particularly severely affected.

Impact Findings From a Randomized Controlled Trial of a Supportive Housing Demonstration Programme for Homeless, Child Welfare–Involved Families

ABSTRACTA “Housing First” approach to homelessness, showing promise for single adults, might also be effective for families whose homelessness combined with other challenges bring them to the attention of the child welfare system. This paper reports impact findings from the evaluation of a randomized, controlled trial in San Francisco that tested the effectiveness of an intervention designed to provide permanent housing and supportive services to such families, with the goal of safely reducing the use of foster care. Compared with families in the control group (33 families with 60 children), we found no significant impact on the likelihood of out‐of‐home placement up to 2 years after randomization. For families whose children were already in foster care, children in the treatment group (43 families with 63 children) reunified faster than those in the control group (42 families with 68 children), although nearly always before being housed. There was no difference between groups in time to case closure or likelihood of subsequent child welfare involvement. We discuss these findings in the context of important implementation challenges that have implications for further testing this intervention in tight housing markets.

Risk factors for unintentional injury hospitalisation among Aboriginal and non-Aboriginal children in Australia's Northern Territory: A data linkage study.

Unintentional injuries are a leading cause of hospitalisation for children. This study investigated the incidence and associated risk factors for unintentional injury hospitalisation (UIH) among Aboriginal and non-Aboriginal children aged under 5 years in Australia's Northern Territory. This was a retrospective cohort study using linked data from a perinatal register, hospital admissions, school enrolment and child protection services. The outcome variable was a first UIH. Potential risk factors included gender, pregnancy and birth outcomes, maternal education level, child protection service contact and geographic remoteness. Modified Poisson regression was used for multivariate modelling. A cohort of 21,189 children (54.0% Aboriginal) born between 2000 and 2010 were followed to the age of 5 years. The overall incidence of first UIH was 25.8 per 1,000 person-years, which was 28.6% higher among Aboriginal than non-Aboriginal children (28.8 and 22.4 per 1000 person-years, respectively). Risk factors identified in the full model included: being male (incidence rate ratio (IRR) 1.26, 95%CI: 1.17-1.36); living in a remote (IRR 1.26, 95%CI: 1.14-1.40) or very remote area (IRR 1.44, 95%CI: 1.29-1.59); having a notification or substantiated notification for abuse (IRR 1.42, 95%CI: 1.27-1.58 and IRR 1.60, 95%CI: 1.41-1.82, respectively); or neglect (IRR 1.32, 95%CI: 1.17-1.48 and IRR 1.28, 95%CI: 1.11-1.47, respectively). After adjustment, there was no difference in UIH rates between Aboriginal and non-Aboriginal children. In both stratified models, being male, living in remote or very remote areas and having a notification or substantiated notification for child maltreatment were identified as risk factors. Our study found high UIH incidence rates and evidence for an association between UIH and child maltreatment. This suggests child maltreatment and UIH have shared determinants and points to the need for clinicians to be aware of the overlap between these conditions and the importance of cross-agency collaboration in prevention and management.

Functional difficulty among children in Malaysia – findings from the National Health and Morbidity Survey (NHMS) 2019

IntroductionData on child functioning and disability are important for public policy development which aimed at reducing child disability prevalence and strengthening the provision of appropriate and timely health care services. This study reports the prevalence of functional difficulty in Malaysian children aged 2–17 years and its associated sociodemographic factors and epilepsy.MethodsData on children aged 2–17 years (n = 4576) were generated from the National Health and Morbidity Survey (NHMS) 2019, a population-based cross-sectional survey. Functional difficulty in children was assessed using the United Nations Children’s Fund (UNICEF)/Washington Group on Disability Statistics (WG) Child Functioning Module (CFM). The questionnaires were administered to the parents or guardians of the children via face-to-face interviews. Functional difficulty, defined as having difficulty in at least one domain, was examined for its prevalence and associations with sociodemographic variables and the epilepsy variable in children using descriptive analysis and multiple logistic regression.ResultsThe overall prevalence of functional difficulty among children aged 2–17 years was 4.7%. Multiple logistic regression analysis revealed that older children, children from households whose heads of household had a lower education level and children who have epilepsy were significantly more likely to experience functional difficulty (p < 0.05). Children of Chinese ethnicity were less likely to experience functional difficulty compared to children of Malay ethnicity.ConclusionsThis study provides baseline findings on the prevalence of functional difficulty among children in Malaysia using nationally representative data. Although the prevalence was relatively low, the information is important for the planning of strategies to improve the development and well-being of children in Malaysia and for achieving the Sustainable Development Goals (SDGs).

Judge dismisses ADA retaliation claim

The plaintiff was a Black woman with anxiety and depression who worked for Oklahoma Human Services in the capacity of a child welfare specialist.

Beyond child abuse: the array of family problems brought to the child welfare system

ABSTRACT The majority of children referred to child protective services (CPS) system are not suspected of physical or sexual abuse but face other risks, often captured under neglect. This population-based study analyzed data for 145,745 children referred to the Pennsylvania’s child welfare system in 2021. Parental substance use (28%), child behavioral concerns (24%), and unmet material needs (23%) were the most common allegations. Half of referrals included multiple concerns, but only 34% were valadated, indicating service intervention. Child behavioral health was the most frequent standalone concern (14%). Increasing access to mental health and substance use treatment may reduce CPS referrals.

Support needed by parents when a child's mental well-being is threatened-A qualitative study of views of experts-by-experience.

In situations where a child's mental well-being is threatened, the parents also need support. The available support has been perceived as insufficient by both parents and professionals. To explore the views of experts-by-experience of the support needed by parents when a child's mental well-being is threatened. A qualitative study with a phenomenological approach was conducted in Finland. The data were collected in six focus group interviews during the autumn of 2022. The participants (n = 26) were adult experts-by-experience who had experienced either mental well-being challenges in their own childhood (before the age of 18 years) or experienced the mental well-being challenges of a child from the role of a parent. The data were analysed using inductive content analysis. The support needed by parents insituations where the mental well-being of their child is at risk consists of support for parenting, support for sharing and support for surviving. Parents whose child's mental well-being is at risk, need support both for their own well-being and for their ability to support their child's well-being. Support is needed not only from professionals but also from peers.

Exploring metacompetence in child welfare simulation training: toward a holistic model

ABSTRACT Holistic competence involves two distinct constructs: procedural competencies and metacompetencies A framework developed by Tufford and colleagues (2017), suggests four domains of metacompetence: skills in action, deepened perspectives on diversity, managing affective intensity in the moment, and openness to learning. This exploratory evaluation study was guided by the research question, in what ways does Illinois child welfare simulation training address the four domains of metacompetence? Findings indicted that relevant knowledge and skill development for each domain are supported in the training. More nuanced evaluation could better assess procedural and metacompetence and more fully operationalize holistic competence for child welfare professionals.

Strong association between high burden of soil-transmitted helminthiasis and household transmission among Malaysian Negritos, urging anthelmintic treatment beyond children

The Orang Asli (OA), Malaysia’s indigenous minority, continue to experience ongoing soil-transmitted helminth (STH) infections despite efforts including the Resettlement Programme (RPS). This study explores STH epidemiology and associated risks of moderate-to-heavy infections among 259 indigenous Negritos across four states in Peninsular Malaysia. Stool samples, anthropometrics, haemoglobin levels (finger-prick) and sociodemographic and environmental-sanitation factors via pretested questionnaires were collected. Parasitological examinations (direct faecal smear, formol-ether concentration, and Kato-Katz techniques) were thoroughly performed. The study revealed a 63.3% overall STH prevalence, with Trichuris trichiura (57.9%) being the most common, followed by Ascaris lumbricoides (35.5%) and hookworm (8.9%). Moderate-to-heavy infections were observed in 39.3% for T. trichiura and 48.9% for A. lumbricoides, with mixed infections of these two species being the most prevalent (50.6%). The risk for moderate-to-heavy infection increased significantly if other household members were infected (P < 0.001). Adults and adolescents also showed high infection rates, with no significant differences with children’s groups. These findings emphasize the need for anthelmintic treatment across all age groups and strategize local policies targeting older groups of the OA community to control ongoing transmission and reduce the STH burden and protect the future well-being of OA children, who deserve a healthier future.

The Three-Dimensional Chess for Parents Facing a Child Protective Services Investigation: Navigating the Child Welfare Exception to the Constitution

The Three-Dimensional Chess for Parents Facing a Child Protective Services Investigation: Navigating the Child Welfare Exception to the Constitution

The role of child nutrition counselling, gender dynamics, and intra-household feeding decision-making on child dietary diversity in semi-arid northern Ghana

Every child has the right to proper nutrition. As such, child nutrition counselling is recommended to improve child dietary diversity and reduce malnutrition. However, there is limited empirical evidence on how child nutrition counselling, gender dynamics, and intra-household feeding decisions play a role and translate to child dietary diversity in rural contexts. Informed by theoretical conceptions from Health Belief Model (HBM) and Gender and Development (GAD) framework, we analyzed cross-sectional data from 517 smallholder households in Ghana's semi-arid Upper West Region to investigate the relationship between child nutrition counselling, gender dynamics, intra-household feeding decision-making, and their impact on child dietary diversity. Results from ordered logistic regression show that households that received child nutrition counselling reported higher child dietary diversity. Joint intra-household feeding decisions were associated with higher child dietary diversity. Households with good self-rated childcare, engaged in home gardening, and higher wealth, as well as those in the Waala ethnic group, were more likely to have high child dietary diversity. A decrease in household head age was linked to increased high child dietary diversity. On the other hand, female-headed households, Brifo ethnic groups, and those in the Wa East and Wa West districts were less likely to experience high child dietary diversity. Implementing interventions and policies prioritizing nutrition education in the Upper West Region and similar sub-Saharan African contexts is recommended. Strategies like scaling up child nutrition counselling, food demonstrations, mother-to-mother support nutrition outreach, and mobile nutrition clinics can empower women and improve children's well-being.