System and Social Determinants of the Health of Foster Children

寄养儿童健康的制度和社会决定因素

• 批准号: 10451628
• 负责人: Sarah Font
• 金额: $ 21.71万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451628
• 关键词: Address; Adoption; Adult; Affect; Amendment; Area; Attention; Birth; Caregivers; Caring; Case Management; Child; Child Health; Child Mental Health; Child Welfare; Cognitive; Communities; Consensus; Country; Data; Development; Diagnosis; Effectiveness; Emotional; Event; Exposure to; Family; Fostering; Funding; Goals; Group Homes; Health; Heterogeneity; High Prevalence; Home; Individual; Injury; Knowledge; Left; Life Cycle Stages; Link; Medicaid; Mental Health; Methods; Outcome; Overdose; Parents; Pennsylvania; Personal Satisfaction; Play; Policies; Population; Positioning Attribute; Pregnancy in Adolescence; Records; Reporting; Research; Resources; Risk; Role; Sampling; Seminal; Siblings; Social Security; Substance abuse problem; Suicide attempt; System; Time; Vulnerable Populations; Work; adverse outcome; behavioral health; care systems; child protection; experience; foster care; foster child; high risk; improved; innovation; maltreated children; maltreatment; neglect; physical conditioning; preference; service delivery; social; social health determinants; sound; success

Project Summary The proposed study will investigate the impact of foster care, and specific experiences within foster care, on the physical and mental health of children exposed to abuse or neglect. This population is among the most vulnerable in the U.S., with a disproportionately high prevalence of adverse health and wellbeing outcomes throughout the life course. The Aims of this proposal are: (1) Examine the effects of foster care on health over time; (2) Investigate the influence of placement experiences on foster children's health during and after exiting foster care; and (3) Evaluate the effects of maintaining family connections on foster children's health during and after exiting foster care. Prior research in this area has suffered one or more significant limitations, including: threats to causal inference; cross-sectional, short-term, or discrete observation periods; small or non-representative samples; reliance on caregiver-reported health outcomes; and a lack of focus on physical health. This proposal seeks to address these limitations and provide sound empirical evidence on the role of foster care in children's immediate and longer-tem health. In Aim 1, we focus on how foster care impacts children's physical and mental health outcomes over time, as compared with children involved with the child protection system but who remain in their familial homes. Using linked Medicaid and child protection records, we will observe significant health events before, during, and after foster care. Using methods intended to improve causal inference, we will be able to not only identify the impacts of foster care on health, but also understand whether those impacts are temporary or sustained. In Aims 2 and 3, we focus on the experiences of children within foster care that produce heterogeneity in health outcomes. To maximize the potential of our findings to inform efforts to improve foster children's health and wellbeing, we emphasize foster care experiences that are current priorities of federal and state reforms, including placement setting (e.g., with relatives, in group homes), placement stability, placement with siblings, and parent and sibling visitation. Again leveraging Medicaid and child protection records, and with a focus on causal inference, we will provide compelling evidence on whether the current priorities of the foster care system serve to enhance children's health. Such evidence is essential to the effective allocation of scarce resources.

项目摘要 拟议的研究将调查寄养护理的影响，以及寄养中的特定经验，对 受虐待或忽视的儿童的身心健康。这个人口最多 在美国容易受到伤害，不利的健康和福祉成果的流行率不高。 在整个人生过程中。该提案的目的是：（1）检查寄养对健康的影响 时间; （2）研究安置经验对寄养儿童在退出期间和之后的影响 寄养； （3）评估维持家庭联系对寄养儿童健康期间的影响 在退出寄养后。该领域的先前研究遭受了一个或多个重大的限制， 包括：威胁因果推论；横截面，短期或离散观察期；小或 非代表性样本；依赖护理人员报告的健康成果；缺乏对身体的关注 健康。该建议旨在解决这些局限 促进儿童直接和长期运动健康的护理。 在AIM 1中，我们关注寄养护理如何随着时间的推移影响儿童的身心健康结果 与涉及儿童保护系统但留在家族住所的儿童相比。使用 链接的医疗补助和儿童保护记录，我们将在之前，期间和之后观察到重大的健康事件 寄养。使用旨在改善因果推理的方法，我们不仅能够确定 寄养对健康的影响，同时也了解这些影响是暂时的还是持续的。 在目标2和3中，我们专注于寄养护理中产生异质性的儿童经历 健康结果。为了最大程度地提高我们的发现的潜力，以告知改善寄养儿童健康的努力 和福祉，我们强调寄养护理经验，这些经验是联邦和州改革的当前优先事项， 包括安置设置（例如，与亲戚，在组中），放置稳定性，兄弟姐妹的放置， 以及父母和兄弟姐妹探访。再次利用医疗补助和儿童保护记录，重点 因果推论，我们将提供令人信服的证据，证明寄养当前的优先级是否 系统有助于增强儿童的健康。这种证据对于有效分配稀缺至关重要 资源。