ABSTRACT
This article examines the feasibility of implementing patient-reported outcome (PRO) measures with adolescents on an inpatient psychiatry service. During the study period (March 8, 2021, to June 7, 2022), a total of 154 patient encounters were recorded for adolescents between 12 and 17 years of age. PROs were piloted during the first 3 months of the study period, with a focus on technical implementation. In the 12 months from June 8, 2021, through June 7, 2022, the PRO project moved to full implementation across all patient encounters. Fisher's exact test and independent t tests were conducted to examine the differences between patients who completed the PROs and patients who did not complete them to determine the representativeness of the sample receiving them. During the 3-month pilot period, 31.8% of patients completed the PROs at admission and discharge, while during the 12-month full implementation, 74.5% of patients completed them at both time points. Statistical tests showed no significant diagnostic, sex, or race/ethnicity differences between patients who received and did not receive the outcome measures. Even without funding, small inpatient psychiatry services for adolescents can feasibly implement PROs with completion rates similar to other published studies and capture the majority of the patients served. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
ABSTRACT
BACKGROUND AND AIMS: Following nearly a decade of entry declines, foster care entries in the United States began to rise steadily since 2012, largely because of dramatic increases in home removals involving parental drug use (PDU). America's ongoing opioid crisis and recent changes in drug policies have been associated with the growth in PDU entries. The extent to which these and other recent factors have affected historical racial/ethnic differences in the foster care system is unknown. We explored the prevalence of racial/ethnic disproportionality and disparity in PDU entries and described children characteristics across racial/ethnic populations. DESIGN: Secondary data analysis of the universe of foster care entries in 2008-2017, obtained from the Adoption and Foster Care Analysis and Reporting System. SETTING: Children ages 0-17 entering foster care in the United States. CASES: A total of 2,489,423 foster care entries, 29% (N=714,085) designated as involving PDU. MEASUREMENTS: The rate of PDU entries was measured as the number of foster care entries involving PDU per 1,000 children ages 0-17 in the general population, by racial/ethnic group. Disproportionality in PDU entries was measured as the proportion of a racial/ethnic group among PDU entries over their proportion among the general population. FINDINGS: From 2008-2017, the rate of PDU entries increased 71% in the general population and across all racial/ethnic groups. Native American children displayed the highest level and fastest growth in PDU entry rates (139%; 1.74 in 2008 to 4.15 in 2017), followed by non-Hispanic White children (112%; 0.70 in 2008 to 1.49 in 2017). Native American children also displayed the highest level of disproportionality in foster care entries, with a representation in PDU entries and other entries about 3.23 and 2.56 times their representation in the general population. CONCLUSIONS: Foster care entries involving PDU increased considerably across all racial/ethnic populations. Growth in PDU entries was greatest among Native American children, exacerbating existing disproportionalities in the foster care system for this vulnerable population.
