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Hickey L, Galvin K, Parolini A, Nguyen B, Lokmic-Tomkins Z, Toovey R, Skeat J, Wise S. The engagement of children in out-of-home care with nursing and allied health professionals: A scoping review. Child Care Health Dev 2021; 47:758-770. [PMID: 34250634 DOI: 10.1111/cch.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 02/04/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children living in out-of-home care (OOHC) have significant unmet health care needs and use more tertiary and specialist health care services compared with children from similar social and economic backgrounds. Allied health professionals and nurses have a central role in health care; however, very little is known about the engagement of children in OOHC with nursing and allied health professionals. This scoping review addresses this knowledge gap. METHODS A scoping review methodology framework was used to search for relevant articles published between January 1970 and November 2019, identified using three databases: MEDLINE, CINAHL and ProQuest. Selection of studies was based on empirical research about the health of children in OOHC and their engagement with nursing or allied health services. A total of 37 relevant articles met the eligibility criteria for inclusion in this review. RESULTS Findings could be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development, (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in healthcare, (3) identification and complexity of healthcare needs, (4) access to healthcare services and (5) coordination of healthcare. CONCLUSIONS Children in OOHC have multiple healthcare needs that require monitoring and treatment by allied health professionals and the health and development of these children is best supported through comprehensive health screening on entry into OOHC, and community-based, multidisciplinary healthcare while children are living in OOHC. While nurses in hospitals and community settings were found to play a role in health assessment and care coordination targeted at children in OOHC, the literature was silent on the role of allied health professionals in this healthcare approach.
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Affiliation(s)
- Lyndal Hickey
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
| | - Karyn Galvin
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Arno Parolini
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
| | - Bao Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rachel Toovey
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jemma Skeat
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Wise
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
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Braciszewski JM, Tzilos Wernette GK, Moore RS, Tran TB, Bock BC, Stout RL, Chamberlain P, Vose-O'Neal A. Developing a tailored substance use intervention for youth exiting foster care. CHILD ABUSE & NEGLECT 2018; 77:211-221. [PMID: 29367098 PMCID: PMC5857233 DOI: 10.1016/j.chiabu.2018.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 12/11/2017] [Accepted: 01/11/2018] [Indexed: 06/07/2023]
Abstract
Youth who are aging out of the foster care system face significant barriers to accessing substance use treatment. Mobile interventions have shown efficacy for several mental and physical health issues and may be helpful in overcoming barriers facing foster youth with substance use problems. A program (iHeLP) for substance use reduction was developed that used a computerized screening and brief intervention (SBI) followed by six months of dynamically-tailored text messages. The program was shown to focus groups of youth (N = 24) ages 18-19 who recently left foster care and had moderate to severe substance use risk. Focus group feedback was used to modify iHeLP prior to delivery in an open trial (N = 16). Both study phases included assessments of feasibility and acceptability; the open trial also included assessments of substance use outcomes at 3 and 6 months. Focus groups indicated a high level of acceptability for the proposed intervention components. Of those screened for the open trial, 43% were eligible and 74% of those eligible enrolled, indicating good feasibility. Retention through the final follow-up was 59%, and drop out was associated with involvement in the criminal justice system. Participant ratings for liking, ease of working with, interest in and respectfulness of the SBI were high. Satisfaction ratings for the texting component were also high. A computerized brief screening intervention for substance use risk reduction together with tailored text messaging is both feasible and highly acceptable among youth who have recently aged-out of foster care.
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Affiliation(s)
| | | | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, United States
| | - Tanya B Tran
- Rhode Island Hospital, Providence, RI, United States
| | - Beth C Bock
- The Miriam Hospital, Providence, RI, United States
| | - Robert L Stout
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI, United States
| | | | - Adam Vose-O'Neal
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI, United States
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Braciszewski JM, Tran TB, Moore RS, Bock BC, Tzilos Wernette GK, Chamberlain P, Stout RL, Vose-O’Neal A. Feeling Heard and Not Judged: Perspectives on Substance Use Services Among Youth Formerly in Foster Care. CHILD MALTREATMENT 2018; 23:85-95. [PMID: 28931306 PMCID: PMC5788282 DOI: 10.1177/1077559517729486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Youth in foster care have limited access to substance use services for a variety of reasons. Attempts to unpack this health disparity have focused on foster care systems, administrators, providers, and foster parents. This study seeks to understand the perspectives of youth themselves, with the hope of understanding their experiences with and preferences for such services. Analyses of focus groups with youth who had recently left foster care suggested concrete and perceptual facilitators/barriers to treatment. Concrete facilitators/barriers included the need for expanding social support, access to multiple service options, and tailored intervention approaches. Perceptual concerns revolved around understanding each individual's readiness to change, feeling judged by authority figures, and desiring help from people with lived experience. Participants also described novel intervention ideas, including a focus on technology-based approaches. By relying on youth voices, we can improve upon the current state of substance use interventions within foster care.
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Affiliation(s)
- Jordan M. Braciszewski
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | | | - Roland S. Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, USA
| | | | | | | | - Robert L. Stout
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI, USA
| | - Adam Vose-O’Neal
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI, USA
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Abstract
Professional empowerment is vital to nurses’ productivity and job satisfaction. A grounded theory study was conducted to describe the basic social process experienced by school nurses in relation to professional empowerment. Interviews with 10 school nurses led to the development of a situation-specific theory of school nurse empowerment, Making a Difference: The Role of the School Nurse in the Health of Children in Schools. This theory was derived from four theoretical constructs: (a) enlisting support, (b) getting through the day, (c) maintaining control over practice, and (d) adjusting to challenges. Interviews revealed that knowing at the end of each school day that they made a difference in the health of children resulted in feelings of empowerment. Participants cited various areas in which their sense of empowerment was limited, including salaries and workload. Despite these issues, they believed they had a positive impact on the health of children, leading to job satisfaction and feelings of value.
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Affiliation(s)
- Lisa Broussard
- Lisa Broussard, RN, DNS, is assistant professor at the University of Louisiana at Lafayette College of Nursing and Allied Health Professions, Lafayette, LA
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Braciszewski JM, Stout RL, Tzilos GK, Moore RS, Bock BC, Chamberlain P. Testing a Dynamic Automated Substance Use Intervention Model for Youths Exiting Foster Care. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016; 25:181-187. [PMID: 27081290 PMCID: PMC4829063 DOI: 10.1080/1067828x.2014.981771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
With an ever increasing gap between need and availability for substance use services, more scalable and efficient interventions are needed. For youth in the foster care system, this gap is dramatic and expands as they leave care. Effective prevention services are strongly needed for this group of vulnerable young people. We propose a novel technology-driven intervention for preventing problematic substance use among youth receiving foster care services. This intervention approach would extend the work in brief computerized interventions by adding a text message-based booster, dynamically tailored to each individual's readiness to change. It also combats many barriers to service receipt. Dynamically tailored interventions delivered through technologies commonly used by adolescents and young adults have the strong potential to reduce the burden of problematic substance use.
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Affiliation(s)
- Jordan M Braciszewski
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI
| | - Robert L Stout
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI
| | | | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA
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Braciszewski JM, Colby SM. Tobacco Use among Foster Youth: Evidence of Health Disparities. CHILDREN AND YOUTH SERVICES REVIEW 2015; 58:142-145. [PMID: 26478645 PMCID: PMC4604603 DOI: 10.1016/j.childyouth.2015.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Youth aging out of foster care face a challenging road to independence. Following exposure to myriad risk factors such as abuse, neglect, parental substance use, and severe housing mobility, supportive services decrease upon exit from care, often increasing risk for substance use, homelessness, and unemployment. Although tobacco use is also highly prevalent, little attention has been paid to screening, assessment, and treatment of tobacco use in this vulnerable group. The current study (N = 116) reports on tobacco use prevalence, consequences, and co-occurrence with other substances in a sample of youth (ages 18 to 19) exiting the foster care system. In the face of an overall decrease in tobacco use among general population adolescents and young adults, results suggest disproportionate levels of lifetime, recent, and daily use among foster youth. Prevalence of recent tobacco use (46%) is nearly triple national rates, while daily smoking (32%) is almost four times that of general population young adults. Tobacco users were more likely than non-users to drink (70% vs. 40%) and to smoke marijuana (72% vs. 25%). We strongly encourage researchers and practitioners to increase attention to this tobacco-related health disparity.
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Affiliation(s)
- Jordan M. Braciszewski
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, 1005 Main St., Suite, 8120, Pawtucket, RI, USA, 02906
| | - Suzanne M. Colby
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI, USA, 02912
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Bertram JE, Narendorf SC, McMillen JC. Pioneering the psychiatric nurse role in foster care. Arch Psychiatr Nurs 2013; 27:285-92. [PMID: 24238008 PMCID: PMC3844857 DOI: 10.1016/j.apnu.2013.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/27/2013] [Accepted: 09/01/2013] [Indexed: 11/27/2022]
Abstract
Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse's work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care.
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Braciszewski JM, Moore RS, Stout RL. Rationale for a New Direction in Foster Youth Substance Use Disorder Prevention. JOURNAL OF SUBSTANCE USE 2013; 19:108-111. [PMID: 26229518 DOI: 10.3109/14659891.2012.750693] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Of the 463,000 children residing in United States foster care, 29,000 annually exit the system because they have "aged out," are thus dropped from supportive services, and become responsible for their own housing, finances, and health needs. Given histories of maltreatment, housing instability, and parental substance use, youth preparing to exit care are at substantial risk of developing substance use disorders. Unfortunately, access to services is often limited, both before and after exit from care. METHODS With the goal of developing a relevant substance use intervention for these youth, focus groups were conducted with foster care staff, administrators, and parents to assess the feasibility of potential approaches. RESULTS Participants identified several population-specific barriers to delivering adapted intervention models developed for normative populations. They expressed concerns about foster youth developing, then quickly ending, relationships with interventionists, as well as admitting to substance use, given foster care program sanctions for such behavior. Group members stressed the importance of tailoring interventions, using creative, motivational procedures. CONCLUSIONS Foster youth seem to encounter unique barriers to receiving adequate care. In light of these results, a novel, engaging approach to overcoming these barriers is also presented.
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Affiliation(s)
- Jordan M Braciszewski
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI, USA 02860
| | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA 94704
| | - Robert L Stout
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, Pawtucket, RI, USA 02860
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Schneiderman JU. Qualitative study on the role of nurses as health case managers of children in foster care in California. J Pediatr Nurs 2008; 23:241-9. [PMID: 18638668 DOI: 10.1016/j.pedn.2006.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Accepted: 10/16/2006] [Indexed: 11/18/2022]
Abstract
This qualitative study on nurses who provide health case management for children in foster care examined their vision for the care needed to improve health outcomes. A purposive sample of eight public health nurses was selected to participate in semistructured interviews. Data were analyzed using content analysis to formulate a narrative description of the nurses' vision. Two themes emerged from the data: (1) the desire to give holistic care with an emphasis on mental health care and (2) the difficulty with providing preventive care as a result of multiple causes of health problems.
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Affiliation(s)
- Janet U Schneiderman
- School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA.
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