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.

项目概要 拟议的研究将调查寄养以及寄养中的具体经历对 遭受虐待或忽视的儿童的身心健康。这个人口是最多的 美国的弱势群体，不良健康和福祉结果的发生率异常高 贯穿生命历程。该提案的目的是： (1) 审查寄养对健康的影响 时间; （2）调查寄养经历对寄养儿童退出期间和退出后健康的影响 寄养； (3) 评估寄养期间维持家庭联系对寄养儿童健康的影响 以及退出寄养之后。该领域的先前研究遭受了一个或多个重大限制， 包括：对因果推理的威胁；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结果；以及缺乏对身体的关注 健康。该提案旨在解决这些局限性，并为证明其作用提供可靠的经验证据。 寄养对儿童近期和长期健康的影响。 在目标 1 中，我们重点关注寄养如何随着时间的推移影响儿童的身心健康结果，因为 与参与儿童保护系统但仍留在家庭中的儿童相比。使用 连接医疗补助和儿童保护记录，我们将在之前、期间和之后观察重大健康事件 寄养。使用旨在改进因果推理的方法，我们不仅能够识别 寄养对健康的影响，但也要了解这些影响是暂时的还是持续的。 在目标 2 和 3 中，我们关注寄养儿童的经历，这些经历在寄养中产生了异质性。 健康结果。最大限度地发挥我们研究结果的潜力，为改善寄养儿童的健康提供信息 和福祉，我们强调寄养体验，这是联邦和州改革当前的优先事项， 包括安置环境（例如，与亲戚一起，在集体之家），安置稳定性，与兄弟姐妹一起安置， 以及父母和兄弟姐妹的探访。再次利用医疗补助和儿童保护记录，并重点关注 因果推论，我们将提供令人信服的证据，证明寄养的当前优先事项是否 系统有助于增强儿童的健康。这些证据对于有效分配稀缺资源至关重要 资源。