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Tiberio SS, Pears KC, Buchanan R, Chamberlain P, Leve LD, Price JM, Hussong AM. An Integrative Data Analysis of Main and Moderated Crossover Effects of Parent-Mediated Interventions on Depression and Anxiety Symptoms in Youth in Foster Care. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1547-1557. [PMID: 36930405 DOI: 10.1007/s11121-023-01524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Without preventative intervention, youth with a history of foster care (FC) involvement have a high likelihood of developing depression and anxiety (DA) symptoms. The current study used integrative data analysis to harmonize data across four foster and kinship parent-mediated interventions (and seven randomized control trials) designed to reduce youth externalizing and other problem behaviors to determine if, and for how long, these interventions may have crossover effects on youth DA symptoms. Moderation of intervention effects by youth biological sex, developmental period, number of prior placements, and race/ethnicity was also examined. Youth (N = 1891; 59% female; ages 4 to 18 years) behaviors were assessed via the Child Behavior Checklist, Parent Daily Report, and Eyberg Child Behavior Inventory at baseline, the end of the interventions (4-6 months post baseline), and two follow-up assessments (9-12 months and 18-24 months post baseline), yielding 4830 total youth-by-time assessments. The interventions were effective at reducing DA symptoms at the end of the interventions; however, effects were only sustained for one program at the follow-up assessments. No moderation effects were found. The current study indicates that parent-mediated interventions implemented during childhood or adolescence aimed at reducing externalizing and other problem behaviors had crossover effects on youth DA symptoms at the end of the interventions. Such intervention effects were sustained 12 and 24 months later only for the most at-risk youth involved in the most intensive intervention.
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Affiliation(s)
- Stacey S Tiberio
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA.
| | - Katherine C Pears
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Rohanna Buchanan
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Patricia Chamberlain
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Leslie D Leve
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - Joseph M Price
- Department of Psychology, San Diego State University, San Diego, USA
| | - Andrea M Hussong
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Chapel Hill, USA
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Evans R, MacDonald S, Trubey R, Noyes J, Robling M, Willis S, Boffey M, Wooders C, Vinnicombe S, Melendez-Torres GJ. Interventions targeting the mental health and wellbeing of care-experienced children and young people in higher-income countries: Evidence map and systematic review. Syst Rev 2023; 12:111. [PMID: 37393358 PMCID: PMC10315047 DOI: 10.1186/s13643-023-02260-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/26/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The mental health and wellbeing of care-experienced children and young people (i.e. foster care, kinship care, residential care) is poorer than non-care-experienced populations. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise the international evidence base for interventions targeting subjective wellbeing, mental health and suicide amongst care-experienced young people aged ≤ 25 years. METHODS For the first phase of the review, we constructed an evidence map identifying key clusters and gaps in interventions and evaluations. Studies were identified through 16 electronic databases and 22 health and social care websites, in addition to expert recommendations, citation tracking and screening of relevant systematic reviews. We charted interventions and evaluations with a summary narrative, tables and infographics. RESULTS In total, 64 interventions with 124 associated study reports were eligible. The majority of study reports were from the USA (n = 77). Interventions primarily targeted children and young people's skills and competencies (n = 9 interventions), the parental functioning and practices of carers (n = 26), or a combination of the two (n = 15). While theoretically under-specified, interventions were largely informed by theories of Attachment, Positive Youth Development, and Social Learning Theory. Current evaluations prioritised outcomes (n = 86) and processes (n = 50), with a paucity of study reports including theoretical descriptions (n = 24) or economic evaluations (n = 1). Interventions most frequently targeted outcomes related to mental, behavioural or neurodevelopmental disorders, notably total social, emotional and behavioural problems (n = 48 interventions) and externalising problem behaviours (n = 26). There were a limited number of interventions targeting subjective wellbeing or suicide-related outcomes. CONCLUSIONS Future intervention development might focus on structural-level intervention theories and components, and target outcomes related to subjective wellbeing and suicide. In accordance with current methodological guidance for intervention development and evaluation, research needs to integrate theoretical, outcome, process and economic evaluation in order to strengthen the evidence base. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020177478.
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Affiliation(s)
- Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK.
| | - Sarah MacDonald
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Rob Trubey
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Simone Willis
- Specialist Unit for Review Evidence, Cardiff University, Cardiff, UK
| | - Maria Boffey
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK
| | | | - Soo Vinnicombe
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
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Macdonald G, Livingstone N, Hanratty J, McCartan C, Cotmore R, Cary M, Glaser D, Byford S, Welton NJ, Bosqui T, Bowes L, Audrey S, Mezey G, Fisher HL, Riches W, Churchill R. The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis. Health Technol Assess 2018; 20:1-508. [PMID: 27678342 DOI: 10.3310/hta20690] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION This study is registered as PROSPERO CRD42013003889. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Geraldine Macdonald
- Institute of Child Care Research, School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, UK.,School for Policy Studies, University of Bristol, Bristol, UK
| | - Nuala Livingstone
- Institute of Child Care Research, School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, UK
| | - Jennifer Hanratty
- Institute of Child Care Research, School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, UK
| | - Claire McCartan
- Institute of Child Care Research, School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, UK
| | - Richard Cotmore
- Evaluation Department, National Society for the Prevention of Cruelty to Children (NSPCC), London, UK
| | - Maria Cary
- King's Health Economics, King's College London, London, UK
| | - Danya Glaser
- University College London and Great Ormond Street Hospital for Sick Children, London, UK
| | - Sarah Byford
- King's Health Economics, King's College London, London, UK
| | - Nicky J Welton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Tania Bosqui
- Institute of Child Care Research, School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, UK
| | - Lucy Bowes
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Suzanne Audrey
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Gill Mezey
- Population Health Sciences and Education, St George's, University of London, London, UK
| | - Helen L Fisher
- King's Health Economics, King's College London, London, UK
| | - Wendy Riches
- Riches and Ullman Limited Liability Partnership, London, UK
| | - Rachel Churchill
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Mires CB, Lee DL, McNaughton D. "Every child that is a foster child is marked from the beginning": The home-school communication experiences of foster parents of children with disabilities. CHILD ABUSE & NEGLECT 2018; 75:61-72. [PMID: 28889915 DOI: 10.1016/j.chiabu.2017.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 06/07/2023]
Abstract
This study investigated the perceptions of foster parents of children with disabilities concerning their interactions with school personnel. We conducted semi-structured interviews with 7 foster parents of 6 children with disabilities (age range=5-16). A qualitative analysis of the interviews resulted in the identification of five thematic areas, including foster parent perceptions of: (a) the role of the foster parent, (b) the efficacy of the foster parent in helping the child learn, (c) invitations to involvement from the school (d) invitations to involvement from the child, and (e) foster child experiences in the school system. Marked differences were found in the perceptions of the perceptions in foster parents of elementary and secondary age students. It is clear that foster parents who take on an active role in their child's education experienced positive relationships with their child's school. Foster parents who take a passive role in their partnerships with the schools experienced increased difficulty maintaining motivation to continue in their efforts to increase collaboration and involvement with the schools. They indicated a sense of anger, distrust, and even hostility towards the schools. Based on the findings, recommendations are provided for improving home-school relationships, and addressing obstacles to successful school partnerships with foster families.
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Affiliation(s)
- Carolyn B Mires
- Department of Special Education, Bridgewater State University, Hart Hall, Room 220, 90 Burrill Avenue, Bridgewater, MA 02325, United States.
| | - David L Lee
- The Pennsylvania State University, 215 CEDAR Building, University Park, PA 16802-3109, United States.
| | - David McNaughton
- 227A CEDAR Building, Department of Educational and School Psychology and Special Education, and Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, 16802, United States.
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Dickes A, Kemmis-Riggs J, McAloon J. Methodological Challenges to the Evaluation of Interventions for Foster/Kinship Carers and Children: A Systematic Review. Clin Child Fam Psychol Rev 2017; 21:109-145. [DOI: 10.1007/s10567-017-0248-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kemmis-Riggs J, Dickes A, McAloon J. Program Components of Psychosocial Interventions in Foster and Kinship Care: A Systematic Review. Clin Child Fam Psychol Rev 2017; 21:13-40. [DOI: 10.1007/s10567-017-0247-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Haggerty KP, Barkan SE, Skinner M, Ben Packard W, Cole JJ. Feasibility of Connecting, a Substance-Abuse Prevention Program for Foster Teens and their Caregivers. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2016; 7:639-659. [PMID: 27891209 PMCID: PMC5120679 DOI: 10.1086/686986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To test the feasibility, usability, and proximal outcomes of Connecting, an adaptation of a low-cost, self-directed, family-based substance use prevention program, Staying Connected with Your Teen, with foster families in a randomized, waitlist control pilot study. METHOD Families (n = 60) fostering teens between 11 and 15 years of age were recruited into the study and randomly assigned into the self-administered program with telephone support from a family consultant (n = 32) or a waitlist control condition (n = 28). RESULTS Overall satisfaction with the program was high, with 100% of parents reporting they would recommend the program to other caregivers and reporting being "very satisfied" or "satisfied with the program. Program completion was good, with 62% of families completing all 91 specified tasks. Analyses of proximal outcomes revealed increased communication about sex and substance use (posttest1 OR = 1.97, and 2.03, respectively). Teens in the intervention vs. the waitlist condition reported lower family conflict (OR=.48), and more family rules related to monitoring (OR = 4.02) and media use (OR = 3.24). Caregivers in the waitlist group reported significant increases in the teen's positive involvements (partial eta sq = 17% increase) after receiving the intervention. CONCLUSIONS Overall, program participation appeared to lead to stronger family management, better communication between teens and caregivers around monitoring and media use, teen participation in setting family rules, and decreased teen attitudes favorable to antisocial behavior. This small pilot study shows promising results for this adapted program.
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Affiliation(s)
- Kevin P. Haggerty
- Social Development Research Group, School of Social Work, University of Washington
| | - Susan E. Barkan
- Partners for Our Children, School of Social Work, University of Washington
| | - Martie Skinner
- Social Development Research Group, School of Social Work, University of Washington
| | - W. Ben Packard
- Social Development Research Group, School of Social Work, University of Washington
| | - Janice J. Cole
- Social Development Research Group, School of Social Work, University of Washington
- Partners for Our Children, School of Social Work, University of Washington
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Plasticity of risky decision making among maltreated adolescents: Evidence from a randomized controlled trial. Dev Psychopathol 2016; 27:535-51. [PMID: 25997770 DOI: 10.1017/s0954579415000140] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood maltreatment has lasting negative effects throughout the life span. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls' ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n = 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and nonmaltreated age and socioeconomic status matched girls living with their biological parent(s) (n = 80) completed a decision-making task (at age 15-17) that assessed risk taking and sensitivity to expected value, an index of advantageous decision making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to nonmaltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects.
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Mendle J, Leve LD, Van Ryzin M, Natsuaki MN. Linking Childhood Maltreatment with Girls' Internalizing Symptoms: Early Puberty as a Tipping Point. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2014; 24:689-702. [PMID: 25419091 PMCID: PMC4236856 DOI: 10.1111/jora.12075] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Early pubertal timing in girls is one of the most frequently replicated antecedents of adolescent emotional distress. Yet understanding the impact of pubertal timing in psychosocial development has presented something of a conundrum for developmentalists, as earlier physical maturation may often be preceded by a range of early adversities and life stressors. The present paper disentangles these associations by investigating childhood maltreatment, adolescent internalizing symptoms, and perceived pubertal timing in girls who were residing in foster care at study entry (N = 100, M = 11.54 years old at Time 1). Girls were assessed at two time points two years apart. There were no significant direct effects of maltreatment on internalizing symptoms; rather, childhood sexual abuse predicted earlier perceived pubertal development at study onset which, in turn, was associated with higher levels of internalizing symptomatology. These higher levels of internalizing symptoms persisted over the two years of the study. This distinctive role for early pubertal timing - even within a sample subject to stressors and risks which far exceed the developmental norm - confirms the unique salience of pubertal timing in emotional adjustment, and suggests that the heightened sexual circumstances of puberty may be especially disturbing for girls whose lives have already been traumatically disrupted by inappropriate and unwanted sexual experiences.
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Barkan SE, Salazar AM, Estep K, Mattos LM, Eichenlaub C, Haggerty KP. Adapting an evidence based parenting program for child welfare involved teens and their caregivers. CHILDREN AND YOUTH SERVICES REVIEW 2014; 41:53-61. [PMID: 26052172 PMCID: PMC4454497 DOI: 10.1016/j.childyouth.2014.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The scarcity of caregivers and the unique vulnerability of teens involved with the child welfare system necessitate effective strategies for ensuring that caregivers are prepared and supported in the important role they play with children and youth within the child welfare system. They are in a position, through the establishment of a strong, positive, supportive connection with the youth, to potentially minimize the impacts of recent trauma and interrupt a negative trajectory by preventing the youth's initiation of high-risk behavior. In this paper we describe the process used to systematically adapt Staying Connected with Your Teen™, an evidence-based, prevention-focused parenting program found in other studies to reduce the initiation of teens' risky behaviors, for use with foster teens and their relative or foster caregivers. This work has been guided by the ADAPT-ITT framework developed by Wingood and DiClemente (2008) for adapting evidence-based interventions. Qualitative work conducted in Phase 1 of this study identified the need for the development of a trusted connection between foster youth and their caregivers, as well as tools for helping them access community resources, social services, and educational supports. This paper describes the process used to develop new and adapted program activities in response to the needs identified in Phase 1. We conducted a theater test with dyads of foster youth and their caregivers to get feedback on the new activities. Findings from the theater test are provided and next steps in the research are discussed which include examining program usability, fidelity, feasibility, and testing this new prevention program that has been tailored for child welfare involved youth and their caregivers. This intervention program has the potential to fill an important gap in the availability of preventive programming for caregivers of teens in foster care.
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Affiliation(s)
- Susan E. Barkan
- Partners for Our Children, School of Social Work, University of Washington, Box 359476, Seattle, WA 98195, USA
| | - Amy M. Salazar
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA
| | - Kara Estep
- Partners for Our Children, School of Social Work, University of Washington, Box 359476, Seattle, WA 98195, USA
- Kara Estep is now at Institute for Health Metrics and Evaluation, University of Washington Box 358210 Seattle, WA 98121
| | - Leah M. Mattos
- Partners for Our Children, School of Social Work, University of Washington, Box 359476, Seattle, WA 98195, USA
- Leah Mattos is now at Children’s Administration, Department of Social and Health Services, Tacoma, WA 98405
| | - Caroline Eichenlaub
- Partners for Our Children, School of Social Work, University of Washington, Box 359476, Seattle, WA 98195, USA
| | - Kevin P. Haggerty
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA
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Kim HK, Pears KC, Leve LD, Chamberlain PC, Smith DK. Intervention Effects on Health-Risking Sexual Behavior Among Girls in Foster Care: The Role of Placement Disruption and Tobacco and Marijuana Use. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2013; 22:370-387. [PMID: 24043921 DOI: 10.1080/1067828x.2013.788880] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The present study examined the effects of the Middle School Success intervention (MSS), a program to promote healthy adjustment in foster girls, on their health-risking sexual behavior, using a randomized controlled trial (RCT) design. As hypothesized, girls in the intervention condition (n = 48) showed significantly lower levels of health-risking sexual behavior than did girls in the control condition (n = 52) at 36 months postbaseline. Further path analysis indicated that this intervention effect was fully mediated through its effects on girls' tobacco and marijuana use. Findings highlight the importance of providing preventive intervention services to foster girls during early adolescence.
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Leve LD, Harold GT, Chamberlain P, Landsverk JA, Fisher PA, Vostanis P. Practitioner review: Children in foster care--vulnerabilities and evidence-based interventions that promote resilience processes. J Child Psychol Psychiatry 2012; 53:1197-211. [PMID: 22882015 PMCID: PMC3505234 DOI: 10.1111/j.1469-7610.2012.02594.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND An increasing number of children are placed in foster care (i.e., a kin or nonkin family home other than the biological parent) due to experiences of physical, sexual, emotional, or psychological abuse, and/or neglect. Children in foster care are at increased risk for a host of negative outcomes encompassing emotional, behavioral, neurobiological, and social realms. METHODS Areas of risk and vulnerability among foster children are described, including emotional and behavioral deficits, impaired neurobiological development, and social relationship deficits. Evidence suggesting the significance of family placement changes and prenatal exposure to substances as contributing mechanisms is presented. Based on a systematic search of the PsycINFO database (to March 2012), eight efficacious evidence-based interventions for foster families are summarized. FINDINGS Although the development of evidence-based interventions that improve outcomes for foster children has lagged behind the delivery of interventions in other service sectors (e.g., mental health and educational sectors), several interventions across childhood and adolescence offer promise. Service system constraints offer both challenges and opportunities for more routine implementation of evidence-based interventions. CONCLUSIONS Given the increased likelihood of poor outcomes for foster children, increased efforts to understand the pathways to vulnerability and to implement interventions shown to be effective in remediating risks and improving outcomes for this population are indicated. Evaluation of efficacious interventions in countries outside of the United States is also needed.
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Affiliation(s)
- Leslie D Leve
- Oregon Social Learning Center, Eugene, OR 97401, USA.
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Miles JNV, Weden MM. Is the intergenerational transmission of smoking from mother to child mediated by children's behavior problems? Nicotine Tob Res 2012; 14:1012-8. [PMID: 22318694 PMCID: PMC3529605 DOI: 10.1093/ntr/ntr328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 12/28/2011] [Indexed: 01/12/2023]
Abstract
INTRODUCTION A previous paper used latent class analysis to assign individuals to 1 of 4 adolescent/young adult smoking trajectory classes and then established an association between maternal smoking before, during, and after pregnancy and these classes. In this paper, we examine one possible pathway for this relationship: that maternal smoking during pregnancy may set off a behavioral trajectory which increases the likelihood of problem behaviors generally, of which smoking is one manifestation. METHODS We used the Behavior Problems Index measure from age 8 through age 12 as a potential mediator. We used a path analysis modeling approach within a multinomial logistic regression (using Mplus) to estimate direct and indirect effects (via behavioral problems) between maternal smoking pattern and child trajectory class. RESULTS We found small but statistically significant indirect effects via behavioral problems from maternal smoking to child smoking trajectory for membership in all 3 smoking classes, relative to the nonsmoking trajectory, indicating partial mediation. Mediated effects were associated with maternal smoking after pregnancy, no statistically significant mediated effects were found for smoking before or during pregnancy. CONCLUSIONS The results provided no evidence that the effects of maternal smoking during pregnancy on child smoking trajectory are mediated by problem behavior. Effects from smoking after birth to child smoking trajectory appear to be partially mediated by problem behavior, supporting a behavioral rather than physiological effect of smoking during pregnancy but not ruling out more complex physiological pathways.
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Affiliation(s)
- Jeremy N V Miles
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA.
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Parenting quality and children's mental health: biological mechanisms and psychological interventions. Curr Opin Psychiatry 2012; 25:301-6. [PMID: 22634522 DOI: 10.1097/yco.0b013e328354a1c5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW The quality of parenting that children receive can have a profound influence on their development and mental health. This article reviews articles published from late 2010 onwards that address the effects of parenting on the child's physiological and genetic systems, and how interventions can improve children's security of attachments, antisocial behaviour and other outcomes across a range of settings. RECENT FINDINGS Biological indices of stress, such as C-reactive protein, show that prenatal anxiety is a significant determinant of later outcomes for children, and abusive parenting of young children has lasting biological effects into adulthood. Increasingly, specific genes, especially those that code for neurotransmitter synthesis and functions, are being identified that moderate parenting effects. Furthermore, animal studies suggest that harsh parenting affects the expression of genes by epigenetic processes.Parenting programmes are effective in increasing the security of infant children's attachments, and reducing conduct problems/antisocial behaviour in childhood, and they can be effective at a population level in preventing abuse. These programmes are now widening their reach to cover a broader range of children's outcomes such as literacy and obesity. SUMMARY We are learning much more about the biological impact of poor parenting and the need for interventions that are crafted to improve the quality of parent-child relationships in many settings. Hopefully, they will also ameliorate the biological effects of poor parenting.
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Pears KC, Kim HK, Leve LD. Girls in Foster Care: Risk and Promotive Factors for School Adjustment Across the Transition to Middle School. CHILDREN AND YOUTH SERVICES REVIEW 2012; 34:234-243. [PMID: 22389543 PMCID: PMC3290132 DOI: 10.1016/j.childyouth.2011.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Girls in foster care may face difficulties across the transition to middle school. Latent growth curve modeling was employed to examine trajectories and predictors of academic competence and aggression from and against peers for 75 girls in foster care from the end of elementary school to the 2(nd) year of middle school. Across the transition to middle school, academic competence increased. Poor self-regulation was associated with decreased academic competence, and higher caregiver support was associated with increased academic competence. Frequency of aggression from peers decreased across the transition, with perceived school competence predicting smaller decreases. Aggression against peers dropped initially and then increased to pretransition levels by the end of the 2(nd) year of middle school. Lower caregiver support was associated with higher rates of aggression against peers at the end of the 1(st) year of middle school. The results are discussed in terms of implications for interventions for girls in foster care.
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Karnik NS. Pragmatic research for a messy world. J Am Acad Child Adolesc Psychiatry 2011; 50:1208-9. [PMID: 22115141 DOI: 10.1016/j.jaac.2011.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 09/27/2011] [Indexed: 11/28/2022]
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Kim HK, Leve LD. Substance use and delinquency among middle school girls in foster care: a three-year follow-up of a randomized controlled trial. J Consult Clin Psychol 2011; 79:740-50. [PMID: 22004305 DOI: 10.1037/a0025949] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The present study evaluated the efficacy of the Middle School Success intervention (MSS) for reducing substance use and delinquency among girls in foster care, using a randomized controlled trial design. The program was designed to fill a service gap during the summer prior to the middle school transition and to prevent delinquency, substance use, and related problems. METHOD One hundred girls in foster care and their caregivers were randomly assigned either to the intervention (n = 48) or to a regular foster care control (n = 52) condition. The girls completed a baseline (T1) assessment and follow-up assessments at 6 months (T2), 12 months (T3), 24 months (T4), and 36 months (T5) postbaseline. Caregivers participated in assessments from T1 through T4. This study is a follow-up to Smith, Leve, and Chamberlain's (2011) study, which examined immediate outcomes at T2. RESULTS Girls in the intervention condition showed significantly lower levels of substance use than did girls in the control condition at 36 months postbaseline. The group difference was only marginally significant for delinquency. Further analyses indicated significant indirect effects of the intervention through increased prosocial behaviors that led to decreased internalizing and externalizing symptoms and then to lower levels of substance use. The direct effect of the intervention on substance use remained significant in the presence of the indirect effects. For delinquency, the intervention had positive effects mainly through increased prosocial skills. CONCLUSIONS Findings highlight the importance of providing preventive intervention services for early adolescent girls in foster care.
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Affiliation(s)
- Hyoun K Kim
- Oregon Social Learning Center, Eugene, OR 97401, USA.
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