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.

Not if – but how – to defund the police: Response to our critics

Not if – but how – to defund the police: Response to our critics

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.

Young Parents and Digital Technologies: Navigating Pathways to Enhance Agency for Vulnerable Mothers

Mothering and motherhood can be a very challenging experience in the 21st century, where cultural pressures, on the one hand, and health experts’ regular parenting surveillance, on the other, continue to influence mothering decisions and practices. The socially constructed “good mother” discourses and associated pressures/influences can be amplified for vulnerable mothers who may feel marginalized from or judged by the broader society. This article presents findings from a study that involved interviews with ten young mothers and 12 staff working at a leading family welfare agency supporting young parents in Melbourne, Australia. The study examined how digital technology could promote a sense of agency for vulnerable mothers as well as barriers and enablers of accessing digital knowledge and online parenting support. In addition, the study explored how technology could assist community organizations’ staff in helping their clients better. This paper argues that, overall, digital technologies can positively influence the experience of mothering and can empower vulnerable mothers by increasing their access to various sources of support. Furthermore, our findings suggest that technology can enhance community and family service providers’ practice, opening possibilities for a more supportive relationship with clients by empowering them and increasing agency over their situation.

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.

Creating a family centre by categorising clients in a steering group meeting interaction

This paper studies the creation of organisations via people processing (Prottas 1979), taking as its case study a new and developing family centre that aims to offer various social and health services under the same roof. The study draws on ethnomethodology, meaning that organisations are herein understood as being created and continuously produced in and through interaction. The data consist of 11 audio-recorded meetings from the centre’s steering group, which includes managers from different service fields and welfare agencies. In analysing the creation of the centre through people processing, this paper scrutinises how the meeting participants orient themselves toward and produce the centre’s client categories, what characteristics they connect to these categories, and how they do boundary work regarding which categories belong or not to the centre’s target groups. The meeting participants produce three different family based client categories. The first category is ordinary families, those without any special problems who just pop into the centre to see other people. These families are distinguished from the second category, best matching families, who are defined as having problems that would benefit from the integrated, multi-professional work conducted at the centre. The third category, families with too specific needs, refers to client groups whose service needs are at least partly beyond the centre’s expertise and resources. The centre needs these people-processing activities to make sense of its mission, clients and co-partners; this ongoing reasoning process allows the emerging centre to exist and find its place in the local service system.

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.

Child welfare triage: Use of screening threshold analysis to evaluate intake decision-making

ObjectiveChild welfare agencies across the U.S. investigate a high number of reports of maltreatment with low rates of substantiation. Investigations take time, resources, and increased involvement with families, yet maltreatment is largely not confirmed by these investigations. The primary goal of this article was to establish a baseline understanding of the screening accuracy of the Indiana Department of Child Services’ centralized intake unit. MethodsA screening threshold analysis (STA) was utilized to measure decisional outcomes of the intake decisions at the Indiana Department of Child Services’ central intake unit. All reports made from July 2016 to June 2018 were filtered into a 2X2 matrix and used to produce a ROC curve. We also regressed false positive and false negative rates against the screening rate using report level data aggregated to county level. ResultsWith a screening rate of 92.87%, we found an AUC of 0.558. While the intake unit quite accurately identified reports on which maltreatment was confirmed or services were provided in the study (94.6%), the unit was poor at correctly identifying reports on which maltreatment was not confirmed or services were not provided (8.5%). When analyzed at the sub-jurisdictional level false positive rates were found to have a positive correlation with screening rate slightly stronger than the corresponding negative correlation of the false negative rate. ConclusionsOur findings indicate that the agency’s intake system is risk averse, resulting in high false positive rates. This highlights concerns that agency resources may be inappropriately directed towards investigation and away from intervention, in turn necessitating testable decision making changes to reduce false positive errors.

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.

Bridging the Gap in the Delivery of Cancer Care in Low- and Middle-Income Nations

Cancer continues to be one of the global causes of concern, as each year the number of reported cases continues to rise. The available global trends of cancer are a clear indicator of the fact that people are deprived of cancer care and it is predominantly because of the inequality and inequity, which has become an undeniable aspect. Acknowledging the impact of cancer on the individual, family, and the community in terms of impairment in the quality of life and financial load, it is the responsibility of the policy makers to improve the delivery of cancer care. This calls for the need that international welfare agencies and funding partners should join their hands together with an aim to strengthen the prevention, care, and research and development domain of cancer care, especially in low-resource settings. To conclude, despite being a global cause of concern, the care offered to cancer care patients has not been uniform worldwide and a wide range of disparities have been observed. There arises the need to take concerted actions to ensure the delivery of comprehensive care to cancer patients with an intention to minimize their suffering and improve their prognosis.

Elder Abuse – A Review

Elder abuse is a general term used to describe harmful treatment to ward an elderly person. This includes physical abuse, emotional abuse, sexual abuse, financial exploitation and neglect. Elder abuse is a global public health and human rights problem that is predicted to increase as many countries experience a rapid growth in their population of older adults. Elder abuse undermines an older person's well-being and is associated with range of serious health consequences. Elder abuse is recognised worldwide as a serious problem yet quantitative syntheses of prevalence studies are rare. We aimed to quantify and understand prevalence variation at the global and regional levels. In pooled logistic regression, age, race, poverty, functional disability, and cognitive impairment were identified as risk factors for reported elder mistreatment. Additionally, the onset of new cognitive impairment was also associated with elder abuse and neglect. Because the mechanism of elder mistreatment case-finding in this study was a social welfare system protective services, the influence of race and poverty as risk factors is likely to be overestimated due to reporting bias. Elder mistreatment is now recognized internationally as a pervasive and growing problem, urgently requiring the attention of health care systems, social welfare agencies, policymakers, and the general public. In this article, we provide an overview of global issues in the field of elder abuse, with a focus on prevention.

“She’s Always Been a Fighter for Me”: Indigenous Mothers as Advocates and Defenders of Their LGBTIQSB + Children

There is no research into the experiences of Indigenous LGBTIQSB + young people and their mothers in the country now known as Australia. Based on a series of nine narrative interviews with young LGBTIQSB + people living in New South Wales, this article is the first to discuss Indigenous LGBTIQSB + children’s relationship with their Indigenous mothers. Indigenous mothers have been framed in ways that justified targeted settler state interventions situated within broader racialised biopolitical governance practices and the regulation of Indigenous lives. The findings of this research project provide a counter narrative to the current framing of Indigenous mothers and families as dysfunctional and in need of intervention by state and welfare agencies. Indigenous LGBTIQSB + young people speak to their experiences of coming out and the ways their Indigenous mothers defended, affirmed and advocated for them. Participants spoke of how Indigenous mothers provided them with protective skills and strategies that allowed them to effectively navigate close and extended familial and community contexts. This article demonstrates the significance of Indigenous mothering practices and values for the wellbeing of their LGBTIQSB + children.