Office Of Children Research Articles

Balancing power struggles: Understanding the dynamics between standards set by the government, adolescents, and staff at a therapeutic residential care facility

ABSTRACT During four days of observation at a therapeutic residential care (TRC) facility for adolescents with complex behavioral issues, we encountered a growing trend in the Norwegian child welfare system. High demand for institutional beds, along with reduced capacity in psychiatric services and the legal system, has led to increased reliance on the Duty to Assist obligation of the TRCs, administered by the Office for Children, Youth and Family Affairs (Bufetat) in Norway. This obligation is legally binding, ensuring the provision of justifiable treatment. Our observations of staff interactions and documentation analysis of an adolescent, Peter, revealed that staff’s ability to deliver appropriate care and manage high-risk situations is constrained by governmental standards set through law and regulation. Through the theoretical lens of power and discretion, we found that the combination of forced treatment at open institutions, with a strong emphasis on user involvement, creates a power struggle. Without clear practice standards, staff are left to rely on their own competencies in managing conflicts, resulting in inconsistent and unpredictable interactions. This inconsistency increases the likelihood that Peter will resist the care and treatment being offered.

Factors associated with harmful practices of rape and early marriage, legal issues, and challenges in some selected districts in the South Gondar Zone, Amhara region in Ethiopia

Harmful societal practices, like child marriage and rape, are widely prevalent in Ethiopia. The reasons for society's rules are fluid and depend on the socio-cultural orientation of the people. The research aimed to understand the factors that influence early marriage and rape and investigate challenges and legal concerns in the county's gender-based violence laws. The study used a descriptive-qualitative approach with multiple cases. As a method of data collection coupled with a guide, twelve in-depth interviews with local elders, nine key informant interviews with victim women, girls, and parents, and three focus group discussions (one in each district) with law practitioners, harmful practice prevention team members, and gender-based violence officers from the women and children's offices were employed. The study found that high unemployment, distant school placement, cultural norms and values, and economic and social insecurity are the determinants of early marriage and rape. The study recognized challenges in crime investigation, legal and law enforcement issues, corruption, insufficient administration, and information gaps. Moreover, the study recommends creating adequate target-based awareness and capacity building for stakeholders, empowering women and their families, wisely utilizing religious leaders and the elderly, amending the country’s gender-based violence law, and punishing criminals. HOW TO REFERENCE USING ASWDNET STYLE Yosef, G. & Workneh, A. (2024). Factors associated with harmful practices of rape and early marriage, legal issues, and challenges in some selected districts in the South Gondar Zone, Amhara region in Ethiopia. African Journal of Social Work, 14(4), 185-193. https://dx.doi.org/10.4314/ajsw.v14i4.2 Visit journal website: https://ajsw.africasocialwork.net

Quality of Social Support System and Drug Use among Street Children in Starehe Sub-County, Nairobi County Kenya

The issue of drug use among street children is a global concern that demands serious attention due to its profound social and health implications, negatively impacting the intellectual, social, and physical development of the individuals involved. This study aimed to investigate the relationship between the quality of the social support system and drug use among street children in Starehe Sub-County, Nairobi County, Kenya, utilizing a correlational research design. Data were gathered from 100 street children through cluster and simple random sampling methods, selected from a target population of 30,000 in Starehe Sub-County. Additionally, information was collected from purposively sampled officials, including four from the Starehe Children's Office, eight from NGOs/FBOs operating in the sub-county, one sub-county administrator, and four ward administrators. Quantitative data collected via questionnaires underwent analysis using descriptive statistics such as means, percentages, and frequencies. The findings indicated that a lack of social connectedness in the streets contributed to substance use among street children. Strengthening existing social support systems was identified as a means for providing street children with the necessary support to steer them away from drug use. The study recommends the promotion of social support systems in Starehe Sub-County and emphasizes the importance of providing homes for street children to reduce exposure to stressful conditions that may lead to mental health problems.

The STAR-MAMA RCT: Bilingual Mobile Health Coaching for Postpartum Weight Loss

Gestational diabetes and overweight during pregnancy are associated with future type 2 diabetes. Postpartum weight loss can reduce diabetes risk. However, effective interventions for postpartum weight loss are lacking, in particular for Latina populations, despite their disproportionate burdens of gestational diabetes, overweight, and diabetes. This was a community-based RCT. Researchers recruited pregnant individuals with gestational diabetes or BMI>25 kg/m2 from safety-net health care settings and Women, Infants, and Children offices in Northern California in 2014-2018. Of 180 individuals randomized to intervention (n=89) or control (n=91), 78% identified as Latina, 61% were primarily Spanish speaking, and 76% perceived their diabetes risk to be low. The intervention consisted of a 5-month postpartum telephone-based health coaching intervention delivered in English or Spanish. Data were collected through surveys at enrollment and 9-12 months after delivery and chart review up to 12 months after delivery. The primary outcome, weight change from prepregnancy to 9-12 months after delivery, was compared between the groups, overall and within strata defined a priori according to language (Spanish or English) and diabetes risk perception (none/slight or moderate/high). The intent-to-treat estimated intervention effect was +0.7 kg (95% CI= -2.4 kg, +3.8 kg; p=0.67). In stratified analyses, intervention effects remained nonsignificant but varied in direction: effects were favorable among English speakers and those with higher perceived diabetes risk, and unfavorable among Spanish speakers and those with lower perceived risk. Analyses were conducted in 2021-2022. A postpartum health coaching intervention, designed for low-income Latina women at increased risk for diabetes, did not reduce postpartum weight gain. Intervention effects were nonsignificantly more favorable among English speakers versus Spanish speakers, and among those who perceived their diabetes risk to be high versus low. This study is registered at www. gov NCT02240420.

Maternal Experiences with Discussing Complementary Feeding in Primary Care.

Complementary feeding practices promote healthy eating habits and food preferences later in life. Little is known about how US pediatricians communicate infant feeding practices to caregivers or how caregivers respond to this information. The purpose of this study is to explore mothers’ experiences and perceptions of the complementary feeding recommendations they receive in primary care settings. English- and Spanish-speaking mothers of infants were recruited from Special Supplemental Nutrition for Women, Infants, and Children offices in Rhode Island, US, and snowball sampling. Semi-structured telephone interviews were conducted to investigate mothers’ discussions with pediatricians about complementary feeding and their overall impressions of wellness visits. Thematic analysis was informed by the Fundamentals of Care theoretical framework. The mean age of the sample (n = 13) was 30.5 years and 62% self-identified as Latina. Four themes emerged from the analysis: (1) wellness visits are mostly positive experiences, (2) not all infant feeding recommendations are easy to follow, (3) alternative sources of infant feeding recommendations can be just as helpful, and (4) there is room for improvement at wellness visits. Improving the content, delivery, and cultural relevance of infant feeding recommendations in primary care settings with more specific and tailored information may promote adherence to evidence-based practices.

A Study of the Relationship between the Quality of Social Support System and Drug Use among Street Children in Starehe Sub-County, Nairobi County Kenya

The study aimed at examining the relationship between the quality of the social support system and drug use among street children in Starehe Sub-County, Nairobi County Kenya. The specific objectives of the study were to: explore the relationship between psychosocial health and drug use among street children and the relationship between the quality of social support system and drug use among street children in Starehe Sub-County, Nairobi County Kenya. This study adopted the correlational research design. Data were collected from 100 street children. These were sampled using cluster and simple random sampling techniques from a target population of 30,000 in Starehe Sub-County of Nairobi County. In addition, data was collected from purposively sampled four officials from the Starehe Children's Office, eight officials of NGO/FBO operating in the sub-county, 1 sub-county administrator, and 4 ward administrators from the Sub-County. The qualitative data collected using questionnaires were analyzed using descriptive statistics like mean, percentage, and frequencies, as well as inferential statistics such as Pearson correlation and regression analysis. The findings obtained were presented using charts and tables. The qualitative data collected using interviews were analyzed thematically. The findings were then presented in prose. The findings show that the independent variables are psychosocial health and quality of social support. Pearson correlation showed that there was a significant relationship between drug use and all the independent variables (psychosocial health, r=0.503, p<0.05 and quality of social support system, r=0.538, p<0.05. The findings show that the measures put in place to enhance the mental health of street children made had significant influences on their drug use. Strengthening the existing social support systems meant that street children could get the support needed to steer them away from drug use. The study recommends that it is important to promote the social support systems in the Starehe sub-county. There is also a need to provide street children with homes to reduce exposure to stressful conditions that could lead to mental health problems.

Relationship between Access to Counselling Services and Drug Use among Street Children in Starehe Sub-County, Nairobi County, Kenya

Life in the streets is not easy. It has immense negative effects on the psychosocial health of street children resulting in substance use. This study set out to assess the relationship between access to counselling services and drug use among street children in Starehe Sub-County, Nairobi County Kenya. This study was on the Problem Behaviour Theory (PBT) and adopted the correlational research design. Data collection was from 100 street children. These were sampled using cluster and simple random sampling techniques from a target population of 30,000 in Starehe Sub-County of Nairobi County. In addition, data collection was from purposively sampled four officials from the Starehe Children Office, eight officials of NGO/FBO operating in the sub-county, 1 sub-county administrator, and 4 ward administrators from the Sub-County. The qualitative data collected using questionnaires were analyzed using descriptive statistics like mean, percentage, and frequencies, as well as inferential statistics such as Pearson correlation and regression analysis. The findings presentation was using charts and tables. Analysis of the qualitative data collected using interviews was thematically and the findings use prose presentation. The findings show that access to counselling services had a significant influence on their drug use. Strengthening the existing social support systems meant that street children could get the support needed to steer them away from drug use. The study recommends that there is a need to strengthen behaviour counseling, support groups, and, sober social networks for street children. The government and non-governmental organizations should come up with programs for supporting access to counseling services and training some of the street children to prop up their abilities to offer peer-counseling services to their colleagues.

The EPA's Commitment to Children's Environmental Health: History and Current Challenges.

Children's environmental health (CEH) has a 25-year history at the US Environmental Protection Agency (EPA), during which the agency has advanced CEH through research, policy, and programs that address children's special vulnerability to environmental harm. However, the Trump administration took many actions that weakened efforts to improve CEH. The actions included downgrading or ignoring CEH concerns in decision-making, defunding research, sidelining the Children's Health Protection Advisory Committee, and rescinding regulations that were written in part to protect children. To improve CEH, federal environmental statutes should be reviewed to ensure they are sufficiently protective. The administrator should ensure the EPA's children's health agenda encompasses the most important current challenges and that there is accountability for improvement. Guidance documents should be reviewed and updated to be protective of CEH and the federal lead strategy refocused on primary prevention. The Office of Children's Health Protection's historically low funding and staffing should be remedied. Finally, the EPA should update CEH data systems, reinvigorate the role of the Children's Health Protection Advisory Committee, and restore funding for CEH research that is aligned with environmental justice and regulatory decision-making needs. (Am J Public Health. 2022;112(1):124-134. https://doi.org/10.2105/AJPH.2021.306537).

Breastfeeding Outcomes, Self-Efficacy, and Satisfaction Among Low-Income Women With Late-Preterm, Early-Term, and Full-Term Infants

ObjectiveTo assess breastfeeding exclusivity and rate of breastfeeding, breastfeeding self-efficacy, and satisfaction with breastfeeding after hospital discharge among low-income women with late-preterm and early-term infants compared with women with full-term infants. DesignProspective, comparative, with repeated measures. SettingFour Midwestern U.S. Special Supplemental Nutrition Program for Women, Infants, and Children offices. ParticipantsParticipants included 270 mother–infant dyads. MethodsWe assessed breastfeeding exclusivity, rate of breastfeeding, and breastfeeding self-efficacy at 2 weeks, 2 months, and 5 months and satisfaction with breastfeeding at 5 months after birth or when participants stopped breastfeeding. ResultsMore than 50% of women in each subgroup were non-Hispanic White. Late-preterm and early-term infants had lower breastfeeding exclusivity rates than full-term infants across the three time points (40%, 51%, and 65% at 2 weeks, p = .029; 22.5%, 34%, and 58% at 2 months, p < .001; and 7%, 15%, and 28.46% at 5 months, p < .001, respectively). The overall exclusive breastfeeding rate for all groups was 55.93% at 2 weeks, 44.07% at 2 months, and 20.37% at 5 months; 55.56% continued any breastfeeding at 5 months. Breastfeeding self-efficacy during the first 5 months after birth, satisfaction with breastfeeding, level of education, and attending breastfeeding classes were positively correlated with breastfeeding exclusivity. We found significantly less exclusive breastfeeding, lower breastfeeding self-efficacy, and lower satisfaction with breastfeeding among participants with late-preterm and early-term infants compared to those with full-term infants. ConclusionOngoing professional breastfeeding support for women is needed to improve and promote breastfeeding exclusivity and continuation among their late-preterm and early-term infants.

Getting Tough on International Child Abduction

International child abduction, typically undertaken by one of the child's parents, has become an increasing problem in recent years, particularly in the United States. Parents have encountered serious difficulties in repatriating an abducted child. The 1980 Hague Convention on the Civil Aspects of International Child Abduction, signed by the U.S. and many other countries, establishes an international procedure for pursuing claims of child abduction. The Office of Children's Issues of the Bureau of Consular Affairs of the U.S. Department of State is the Central Authority that administers the Convention and its implementing legislation for the United States. In the author's view (and his alone), the Office of Children's Issues has not been sufficiently vigorous in seeking sanctions against countries that do not comply with the Convention. Even after Congress passed legislation in 2014 specifically directing the State Department to apply increasingly severe sanctions against noncompliant countries (the Sean and David Goldman Act), the State Department has still essentially failed to do so. Brazil is one signatory to the Hague Convention that the State Department itself has determined to be consistently noncompliant with the Convention since 2013. Yet the State Department has failed to impose significant sanctions on Brazil, among other countries.

Offline: The UK's child health emergency

Offline: The UK's child health emergency

Catherine Karr: improving paediatric respiratory health

Catherine Karr, Professor of Pediatrics and Environmental and Occupational Health Sciences at the University of Washington (UW) in Seattle, WA, USA, aims to improve child respiratory health, including among remote communities in Washington state. As a paediatric environmental medicine specialist and environmental epidemiologist, her work has centred on the environmental disparities that impact on child health. “Exposure to environmental pollutants, indoor or outdoor, can really affect children's health”, says Karr. According to Ruth Etzel, Director of the US Environmental Protection Agency's Office of Children's Health Protection, Washington, DC, USA, Karr “personifies the best of a new breed of physician-scientists that are patient-centred, community-centered, and justice-centred”.

Breastfeeding Support: A Geographic Perspective on Access and Equity.

Clinical lactation professionals, breastfeeding peer counseling, and mother-to-mother support are important sources of information and guidance for helping mothers initiate and maintain breastfeeding in the early weeks, months, and years postpartum. However, there is limited information concerning the geographic barriers that mothers face when seeking this support. Research aim: This study aimed to identify the geographic barriers to breastfeeding support, delineate gaps in access, assess inequities in the distribution of local support, and highlight the underlying differences in access and equity for different demographic and socioeconomic groups. The locations of formal breastfeeding support resources were collected for the state of Ohio for 2016 and were combined with demographic and socioeconomic estimates and derived transportation catchment areas to conduct an analysis of spatial access and equity. Significant geographic gaps in formal breastfeeding support exist within the state of Ohio. Although urban areas benefit from a higher density of support options, including a wide variety of clinical experts and mother-to-mother support groups, inequities in exurban and rural areas were more strongly aligned with socioeconomic status than geography. In particular, the Special Supplemental Nutrition Program for Women, Infants, and Children offices in rural Ohio offer breastfeeding support to income-qualifying mothers but cannot address the needs of mothers who do not qualify. Spatial analytical approaches facilitate a more nuanced view of access and equity to breastfeeding support options, helping to both decompose important structural differences in the state of Ohio and identify locations that could benefit from additional breastfeeding support resources.

Predictors of Participation in the Family Check-Up Program: a Randomized Trial of Yearly Services from Age 2 to 10 Years.

A key challenge of community-based prevention programs is engaging families in the context of services settings involving children and families. The Family Check-Up (FCU) program is designed to engage families in parenting support appropriate to their level of need by use of assessment-enhanced motivational interviewing. This study involved families screened for risk who were seeking services at women, infant, and children's offices in three geographical regions (N = 731). Families in the randomized intervention group (N = 367) were offered the FCU yearly, from age 2 through 10. The results of multivariate modeling indicated that caregivers reporting high levels of perceived caregiving stress (i.e., depression, low parenting satisfaction, daily hassles) participated at a higher rate in two critical components (feedback and follow-up support interventions) of the FCU program over the 8-year trial period than caregivers reporting lesser degrees of stress. The implications of these findings are discussed in the context of family-centered programs for the prevention of child behavior problems and directions for future research.

Snacks are not food: low‐income mothers’ definitions and feeding practices around child snacking

Snacking among US children has increased in recent decades and is a key source of “empty” calories, but is ambiguously defined and poorly understood from a parenting perspective. This qualitative research examined low‐income mothers’ definitions and feeding practices around child snacking. Seven focus groups were conducted with 32 low‐income, African American mothers of preschoolers who were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children offices in Philadelphia, PA. Three coders analyzed transcripts using a constant comparative method to elucidate major themes. More than half of mothers were obese and reported education beyond high school. Roughly 1/5 reported household food insecurity. Results revealed that mothers did not view snacks as food. Snacks were described as being cold, convenient, and appealing to children, but involving less nourishment and structure than meals. Mothers used snacks to manage their children's behavior and to satisfy their own hedonic eating. Feeding strategies centered on limiting children's access by locking cabinets, offering small individual packages, and limiting the number of snacks in sight. These findings suggest that low‐income mothers view snacks as powerful hedonic tools for child behavior management that involve less planning and lower expectations for nutrition than meals. Supported by USDA 2011–68001‐30148.

Race‐Conscious Adoption Choices, Multiraciality, and Color‐blind Racial Ideology

Analysis of interview data illustrates how White adoptive parents rationalize choices regarding adoptee race. Parents who were willing to adopt children of color stressed unwillingness to adopt Black children. The preference for adopting multiracial children goes against the prevalent method of racial classification, hypodescent, by defining multiracial as distinct from Black, assuming that multiracial children would not experience racism. Those who adopted children of color also relied on racial classifications of hypodescent and challenged color‐blind ideology by recognizing the importance of race. They also defined race in terms of perceived race versus birth parent racial identity. Findings have implications for how agencies, social workers, and counselors portray various groups as well as prepare, counsel, and support adoptive and multiracial families.

Early Daycare Attendance Increase the Risk for Respiratory Infections and Asthma of Children

Objectives: To study the impact of daycare attendance on airways infections and “allergic” symptoms of children aged 1–8 years in Northeast Texas. Methods: Self-administrated questionnaires were distributed to parents through Women, Infants and Children offices, daycare centers, elementary schools, clinic centers, hospitals, and churches. The health outcomes consisted of “allergic” symptoms, and respiratory tract disorders. Questions on child care included; type of daycare settings (proxy for the number of children in daycare), time spent at daycare centers per week, and age of entry to a daycare center.Results: A total of 3766 children participated in this study, giving a response rate of 71%. Daycare attendance was associated with more frequent respiratory tract infections and “allergic” symptoms, compared to home care. A dose–response relationship between time spent at daycare centers and prevalence of respiratory tract disorders and asthma and allergies was observed. Earlier age exposure at daycare centers was a risk factor for rhinitis up to 7–8 years.Conclusions: Daycare attendance had a substantial negative influence on health status of children aged 1–8 years in Northeast Texas.

Legislating child restraint usage –Its effect on self-reported child restraint use rates in a central city

Objective To assess the effect of the newly enacted child passenger safety law, Wisconsin Act 106, on self-report of proper restraint usage of children in Milwaukee's central city population. Method A prospective, non-randomized study design was used. The settings used were (a) a pediatric urban health center, and (b) two Women, Infants and Children offices in Milwaukee, Wisconsin. Participants included 11,566 surveys collected over 18 months that spanned the pre-legislation and post-legislation time periods from February 2006 through August 2008. Results The study set out to assess appropriate child passenger restraint. The results showed that the changes in adjusted proper restraint usage rates for infants between the pre-law, grace period, and post-fine periods were 94%, 94%, and 94% respectively. For children 1–3 years old, the adjusted proper usage rates were 65%, 63%, and 59%, respectively. And for children 4–7 years old, the rates were 43%, 44% and 42%, respectively. There was a significant increase in premature booster seat use in children who should have been restrained in a rear- or forward-facing car seat (10% pre-law, 12% grace period, 20% post-fine; p < 0.0005). There was no statistically significant change over time in unrestrained children (2.1%, 1.7%, 1.7%, p = 0.7, respectively). Conclusions The passage of a strengthened child passenger safety law with fines did not significantly improve appropriate restraint use for 0–7 year olds, and appropriate use in 1–7 year olds remained suboptimal with a majority of urban children inappropriately restrained. Although the number of unrestrained children decreased, we identified an unintended consequence of the legislation – a significant increase in the rate of premature belt-positioning booster seat use among poor, urban children. Impact on Industry The design of child restraint systems maximizes protection of the child. Increasing reports of misuse is a call to those who manufacture these child passenger restraints to improve advertising and marketing to the correct age group, ease of installation, and mechanisms to prevent incorrect safety strap and harness placement. To ensure accurate and consistent use on every trip, car seat manufacturers must ensure that best practice recommendations for use as well as age, weight, and height be clearly specified on each child restraint. The authors support the United States Department of Transportation's new consumer program that will assist caregivers in identifying the child seat that will fit in their vehicle. In addition, due to the increase in premature graduation of children into belt-positioning booster seats noted as a result of legislation, promoting and marketing booster seat use for children less than 40 pounds should not be accepted. Child passenger safety technicians must continue to promote best practice recommendations for child passenger restraint use and encourage other community leaders to do the same.

Child Fatalities in New York City: An Assessment of Child Protective Service Practice

This article describes the results of two exploratory studies conducted in New York City that used reports of child fatality investigations conducted by the New York State Office of Children and Family Services. It describes the characteristics of children who died as a result of maltreatment and the quality of the child fatality investigations, risk and safety assessments, and protective services responses. Three groups are the focus: children who died while living with families not previously referred to the public child welfare agency; children who died while living with families previously referred to the public child welfare agency; and all children in foster care. The studies found that safety and risk assessments often were not conducted appropriately when children were initially reported to child protective services and when the safety of surviving siblings was at issue; there often was insufficient attention to the elevation of risk as a result of the presence of multiple risk factors in families; and foster parents often did not receive adequate information about health conditions that posed significant risks for children in their care. This article advances practice and policy recommendations for strengthening responses to families who are at high risk and identifies future research directions.

Acute Illness Utilization Patterns Before and After Telemedicine in Childcare for Inner-City Children: A Cohort Study

The ready access provided by telemedicine benefits families and society but might increase total healthcare utilization with uncertain implications for costs. The objective of this study was to assess the net impact on healthcare utilization of introducing into inner-city childcare a telemedicine model designed to manage acute illness. A cohort study was done using comparable periods before and after introduction of telemedicine for all qualifying children (n = 112) using three innercity childcare centers. Because the utilization histories of these children differed in length, we chose child-months as the unit of analysis. Acute illness visits were ascertained for 1806 child-months among the 112 qualifying children. Following telemedicine startup, children's office and emergency department (ED) visits for illness fell by 1.73 and 0.20/child/year, respectively, replaced by telemedicine visits at 1.07/year. These observations could be misleading, however, because of the possibility of confounding factors. For example, the cohort aged during observation, and illness visits fall with age. Accordingly, in multivariate analysis we adjusted for season of the year, age, and within-child correlation. In this analysis, reduction in illness utilization overall tended toward an increase (rate ratio = 1.26, p = 0.13). The worst-case estimate (based on upper 95% confidence interval for rate ratio) for increase in illness utilization was 3.38 visits/child/year, and the most likely case was an increase of 1.26. Assuming (1) the worst-case effect (largest increase) on overall utilization and (2) reimbursement for ED, office, and telemedicine visits of 350 dollars, 45 dollars, and 45 dollars, respectively, the healthcare system would break even on telemedicine if it replaced 0.50 ED visits per child annually.