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Hayes C, Tongs C, Bhaskara A, Buus N. Qualitative studies of the lived experiences of being in foster care: A scoping review protocol. BMJ Open 2023; 13:e069623. [PMID: 36854595 PMCID: PMC9980361 DOI: 10.1136/bmjopen-2022-069623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
UNLABELLED The aim of this scoping review is to provide an overview of the existing qualitative research concerning the lived experiences of children and young people currently in foster care. INTRODUCTION Lived experience of foster care is an area of limited research. Studies tend to focus on foster caregiver retention rates, education performance outcomes, evaluations and policy development. Although these studies are important, they provide little insight into the everyday lives of those currently in foster care, which is likely to influence these previous areas of research. METHODS AND ANALYSIS The scoping review will be guided by Arksey and O'Malley's approach to scoping studies. A systematic database search of PubMed, CINAHL and PsycINFO will be conducted followed by a systematic chain search of referenced and referencing literature. English-language peer-reviewed qualitative studies of children and young people currently in foster care will be included. We will exclude studies linked to transitioning out of foster care and studies with samples mixed with other types of out-of-home care. Mixed-methods studies will be excluded in addition to programme, treatment or policy evaluations. Following removal of duplicates, titles and abstracts will be screened, followed by a full-text review. Two researchers will independently screen references against inclusion and exclusion criteria using Covidence software. The quality of the included studies will be assessed by two independent reviewers using the appropriate Critical Appraisal Skills Programme checklist. ETHICS AND DISSEMINATION Information gathered in this research will be published in peer-reviewed journals and presented at national and international conferences relevant to foster care services and quality improvement. Reports will be disseminated to relevant foster care agencies, where relevant. Ethical approval and informed consent are not required as this protocol is a review of existing literature. Findings from the included studies will be charted and summarised thematically in a separate manuscript.
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Affiliation(s)
- Claire Hayes
- Nursing, Monash University, Clayton, Victoria, Australia
| | - Christian Tongs
- Psychology, Victoria University, Melbourne, Victoria, Australia
| | - Adella Bhaskara
- Lighthouse Foundation, Melbourne, Victoria, Austalia
- Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Niels Buus
- Nursing, Monash University, Clayton, Victoria, Australia
- Department of Regional Health, University of Southern Denmark, Odense, Denmark
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Green R, Hatzikiriakidis K, Tate R, Bruce L, Smales M, Crawford‐Parker A, Carmody S, Skouteris H. Implementing a healthy lifestyle program in residential out-of-home care: What matters, what works and what translates? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2392-2403. [PMID: 35261102 PMCID: PMC10078628 DOI: 10.1111/hsc.13773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/09/2022] [Accepted: 02/09/2022] [Indexed: 06/12/2023]
Abstract
The Healthy Eating, Active Living Matters (HEALing Matters) program is being scaled up across residential out-of-home care (OOHC) in Victoria, Australia and is providing young people with the knowledge, skills and resources to promote better health through healthy eating and activity. HEALing Matters was piloted as the HEAL program, a dual-intervention program that aimed to provide young people living in residential care with education and opportunities to improve their eating and physical activity habits, while simultaneously building the capacity of their carers to promote, encourage and role model healthy lifestyle behaviours. Qualitative findings indicated that HEAL resulted in increased participation in community sport, increased availability of sports equipment, healthy meal preparation and healthy food availability and improvements in perceived young person self-esteem and independent living skills. Findings also revealed some limitations of the program. Following the pilot, a participatory methodological approach was used to better understand how to align the HEAL program with individual and community needs. This approach engaged diverse stakeholders to better understand the barriers and enablers, address limitations, identify key intervention points and build trust and a shared vision to co-design the HEALing Matters program. HEALing Matters is now delivered within a framework that is informed by attachment, trauma and resilience theories. This paper outlines the HEALing Matters journey from what matters, to what works, to what translates in relation to a healthy eating and active living intervention in OOHC.
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Affiliation(s)
- Rachael Green
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Kostas Hatzikiriakidis
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Ruby Tate
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Lauren Bruce
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Madelaine Smales
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Anna Crawford‐Parker
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Sarah Carmody
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Helen Skouteris
- Health and Social Care UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Warwick Business SchoolWarwick UniversityCoventryUK
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Galvin E, O’Donnell R, Avery J, Morris H, Mousa A, Halfpenny N, Miller R, Skouteris H. Residential Out-of-Home Care Staff Perceptions of Implementing a Trauma-Informed Approach: The Sanctuary Model. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:653-667. [PMID: 35035653 PMCID: PMC8747845 DOI: 10.1007/s40653-021-00427-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
The aim of this study was to explore and better understand the enablers and barriers of implementation and how these impact on the organisational successes and challenges of adopting The Sanctuary Model, as perceived by residential care staff. Following ethics approval, three semi-structured interviews and six focus groups were conducted with residential care staff between February and July, 2020. Participants identified a number of enablers, presented in the subthemes: (a) social support systems and resources; (b) shared trauma-informed knowledge and understanding; and (c) leadership and champions. These enablers influenced organisational successes in adopting: (a) the Sanctuary Commitments; (b) the S.E.L.F Framework; (c) Reflective Practice and Supervision; and (d) Trauma Theory. A number of barriers hindering implementation were identified. These were reflected in the subthemes: (a) informal practice; (b) lack of practice-based training; (c) poor introduction to young people; and (d) resources. These barriers impacted on organisational challenges faced in residential out-of-home care including: (a) The Sanctuary Model Toolkit and (b) young people's behaviour and engagement. Comparisons from this study and previous findings identified by executive and upper management staff (decision makers) are discussed. Key findings indicate that when implementing, sustaining and embedding The Sanctuary Model, organisations need to become trauma-informed rather than 'do' trauma-informed care and organisations need to "live and breathe" The Sanctuary Model Commitments, be connected and inclusive of one another, use trauma-informed language and feel safe.
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Affiliation(s)
- Emma Galvin
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Renee O’Donnell
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Julie Avery
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Heather Morris
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Helen Skouteris
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Business, Warwick University, Coventry, United Kingdom
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Smales M, Morris H, Savaglio M, Skouteris H, Green R. 'I'm dealing with all these health issues that could have been addressed when I was younger'. Delivery of health services to Australian young people in out-of-home care: Lived experiences. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1406-e1414. [PMID: 34411355 DOI: 10.1111/hsc.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/11/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
Care-experienced young people demonstrate significantly poor physical, social and mental health outcomes during and beyond their time in care, yet they have rarely been consulted or included in research examining their health needs to date. This qualitative paper explores care-experienced young people's perceptions of health in care, including accessing healthcare and interacting with health professionals. The research methodology was informed by a co-design approach through consultation with care-experienced young people. Semi-structured interviews were conducted with 10 young people. The findings revealed that: (1) the care system does not nurture young people's health; (2) young people in care experience difficulty accessing and navigating a complex health system; and (3) young people are not given a voice when it comes to their health. The findings provide key recommendations for practice, including the empowerment of young people through positive, responsive and trusting relationships to prioritise the health of young people in care.
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Affiliation(s)
- Madelaine Smales
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Heather Morris
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Melissa Savaglio
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, Warwick University, Coventry, UK
| | - Rachael Green
- Health and Social Care Unit (HSCU), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Flemington T, Fraser J, Gibbs C, Shipp J, Bryant J, Ryan A, Wijetilaka D, Marks S, Scarcella M, Tzioumi D, Ramanathan S, Clague L, Hartz D, Lonne B, Lock (Ngiyampaa) M. The Daalbirrwirr Gamambigu (Safe Children) Model: Embedding Cultural Safety in Child Protection Responses for Australian Aboriginal Children in Hospital Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5381. [PMID: 35564775 PMCID: PMC9102959 DOI: 10.3390/ijerph19095381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 02/01/2023]
Abstract
The aim of this paper is to describe the development of a model of care to embed cultural safety for Aboriginal children into paediatric hospital settings. The Daalbirrwirr Gamambigu (pronounced "Dahl-beer-weer gum-um-be-goo" in the Gumbaynggirr language means 'safe children') model encompasses child protection responses at clinical, managerial and organisational levels of health services. A review of scholarly articles and grey literature followed by qualitative interviews with Aboriginal health professionals formed the evidence base for the model, which then underwent rounds of consultation for cultural suitability and clinical utility. Culturally appropriate communication with children and their families using clinical yarning and a culturally adapted version of ISBAR (a mnemonic for Identify, Situation, Background, Assessment and Recommendation) for interprofessional communication is recommended. The model guides the development of a critical consciousness about cultural safety in health care settings, and privileges the cultural voices of many diverse Aboriginal peoples. When adapted appropriately for local clinical and cultural contexts, it will contribute to a patient journey experience of respect, dignity and empowerment.
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Affiliation(s)
- Tara Flemington
- Nursing, Midwifery and Service Reform, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jennifer Fraser
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
- Nursing, Midwifery and Education, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia
| | - Clinton Gibbs
- Health Reform, Opportunities and Transition, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joanne Shipp
- Integrated Child, Youth and Family Wellbeing, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joe Bryant
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Amanda Ryan
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Devika Wijetilaka
- Paediatrics, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Susan Marks
- Child Protection Unit, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Mick Scarcella
- Aboriginal Health, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Dimitra Tzioumi
- Child Protection Unit, The Sydney Children’s Hospitals Network, Randwick, NSW 2031, Australia;
- Child Protection and Wellbeing, Ministry of Health, St Leonards, NSW 2065, Australia
- Faculty of Medicine, School of Women’s and Children’s Health, University of New South Wales, Kensington, NSW 2052, Australia
| | - Shanthi Ramanathan
- Health Research Economics, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Liesa Clague
- School of Nursing, Midwifery, Health Science and Physiotherapy, The University of Notre Dame, Darlinghurst, NSW 2010, Australia;
| | - Donna Hartz
- School of Nursing and Midwifery, College of Medicine Health & Wellbeing, University of Newcastle, Gosford, NSW 2250, Australia;
| | - Bob Lonne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
| | - Mark Lock (Ngiyampaa)
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
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Green Née Cox R, Bergmeier H, Chung A, Skouteris H. How are health, nutrition, and physical activity discussed in international guidelines and standards for children in care? A narrative review. Nutr Rev 2021; 80:919-930. [PMID: 34405883 DOI: 10.1093/nutrit/nuab056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Children in care (CiC) have often experienced trauma and, as a result, are at high risk for poor health outcomes. It is imperative that human-service stakeholders provide trauma-informed health services and interventions. However, little is known about how health promotion is addressed in the standards and guidelines for CiC. For this scoping review, the aim was to examine and compare how nutrition and physical activity are discussed in: 1) federal standards for CiC across the United Kingdom, the United States, New Zealand, and Australia; and 2) state and territory guidance in Australia. METHOD The grey literature was searched for documents outlining key child-welfare standards, guidelines, or policies for the provision of care across foster, kinship, or residential care. Documents were examined for the inclusion of recommendations and/or strategies focused on primary health and the promotion of nutrition and/or physical activity. RESULTS A total of 52 documents were included in this review: 28 outlining international federal guidance and 24 Australian documents. In the United States, New Zealand, and Australia, references to physical activity were often broad, with minimal direction, and nutrition was often neglected; the United Kingdom provided more detailed guidance to promote nutrition and physical activity among CiC. CONCLUSION There is a lack of consistency and specificity in guidelines supporting healthy lifestyle interventions for CiC both internationally and within Australia. It is recommended that 1) specific trauma-informed health promotion guidelines are developed for CiC; and 2) trauma-informed health promotion training is provided to carers. Doing so will ensure that care is provided in a manner in which stakeholders recognize the signs and consequences of trauma in order to determine the most appropriate health interventions to improve outcomes and prevent ongoing trauma for this population.
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Affiliation(s)
- Rachael Green Née Cox
- Health and Social Care Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Heidi Bergmeier
- Health and Social Care Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Alexandra Chung
- Health and Social Care Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia.,Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia.,Warwick Business School, Warwick University, Coventry, United Kingdom
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O’Donnell R, Hatzikiriakidis K, Mendes P, Savaglio M, Green R, Kerridge G, Currie G, Skouteris H. The impact of transition interventions for young people leaving care: a review of the Australian evidence. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2020. [DOI: 10.1080/02673843.2020.1842216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Renée O’Donnell
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
| | - Kostas Hatzikiriakidis
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
| | - Philip Mendes
- Department of Social Work, Monash University , Melbourne, Victoria, Australia
| | - Melissa Savaglio
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
| | - Rachael Green
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
| | - Gary Kerridge
- Warwick Business School, University of Warwick , England, UK
| | - Graeme Currie
- Warwick Business School, University of Warwick , England, UK
| | - Helen Skouteris
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
- Warwick Business School, University of Warwick , England, UK
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