ABSTRACT
BACKGROUND: Adult substance use contributes to high rates of child maltreatment, adverse parenting, and poor child well-being outcomes. The Children's Bureau in the Administration for Children and Families, U.S. Department of Health and Human Services funded the Regional Partnership Grant (RPG) program to improve safety, well-being, and permanency outcomes for children at risk of or in out-of-home placements because of caregivers' substance use. OBJECTIVE: This study estimates the effect of the RPG program on adult parenting and recovery outcomes, as well as child safety, permanency, and well-being outcomes. PARTICIPANTS AND SETTING: This study included samples from three RPG projects funded in 2014. A total of 437 families were included in the evaluation: 198 enrolled in RPG and 239 in the comparison group. METHODS: Outcomes included both administrative data and standardized instruments collected at program entry and exit. Impacts were calculated by comparing regression-adjusted differences between RPG participants and a well-matched comparison group. RESULTS: The RPG program showed two favorable and statistically significant impacts on adult outcomes: reduced trauma symptoms (ES = -0.25, p = 0.02), and depressive symptoms (ES = -0.25, p = 0.03). In addition, children enrolled in RPG had reduced behavior problems (ES = -0.31, p = 0.02) and reduced executive functioning deficits (ES = -0.31, p = 0.04). There were no significant impacts observed for child safety and permanency outcomes. CONCLUSIONS: The RPG approach has produced several favorable impacts on key mental health needs of caregivers and children, establishing foundational evidence of program effectiveness. Additional evaluation research is necessary to understand the effectiveness on additional outcomes with a larger, more generalizable sample.
Subject(s)
Child Abuse , Adult , Caregivers , Child , Child Abuse/prevention & control , Child Welfare , Female , Humans , Parenting , Pregnancy , Program EvaluationABSTRACT
Abstract Children living in foster care have the right to live in a supportive and caring environment, yet studies show that many foster caregivers find it challenging to adequately meet the child's individual needs. Organizations providing services to children in foster care are responsible for supporting caregivers in this role. This case study describes an occupational therapy (post-professional master's student) consultation with a group foster home (Casa Lar), in São Paulo, Brazil, to implement a training and support program for their caregivers. A needs assessment revealed the necessity to implement a comprehensive professional development program, based on organizational values and caregiving competencies. Using the Canadian Practice Process Framework as a guide, a multicultural group of clinician administrators completed a cycle of knowledge translation to identify current knowledge in the area, and adapt it to the local context. Active learning and participant action strategies were included in the training program, with a plan to jointly develop a knowledge translation tool that will enable a change in caregiver practice. We present plans for a formative and summative program evaluation, along with reflections on the enabling nature of the consultation.
Resumo Crianças e adolescentes em serviços de acolhimento têm direito de viver em um ambiente acolhedor, mas muitos estudos mostram que os adultos que cuidam das crianças e dos adolescentes enfrentam desafios para satisfazer as necessidades individuais destes adequadamente. Serviços de acolhimento têm a responsabilidade de apoiar os cuidadores em seus papeis. Este estudo de caso trata de um processo de consulta de terapia ocupacional (para pós-graduação, pós-profissionalização) com uma Casa Lar em São Paulo, Brasil, com o objetivo de desenvolver um programa de capacitação para os educadores sociais. Um levantamento das necessidades evidenciou a demanda de desenvolver um programa compreensivo de capacitação baseado nos valores organizacionais e nas competências identificadas de educador. Usando o Canadian Practice Process Framework como guia, um grupo multicultural de administradores técnicos completou um ciclo de translação de conhecimento para identificar o conhecimento atual no âmbito e adaptá-lo para o contexto local. Métodos de aprendizagem ativo e de pessoas-que-aprendem-participando foram incluídos no programa de capacitação, visando criar, em conjunto, uma ferramenta de translação de conhecimento que habilitará uma mudança na prática dos educadores. Planos para a avaliação do programa, tanto formativa como somativa, são apresentados junto com reflexões sobre os aspectos capacitadores do processo de consulta.
ABSTRACT
Private foundations may hesitate to fund consumer advocacy for enacting and implementing health reform because the effects are hard to measure, and because they are concerned that funds will be used for lobbying activities that are prohibited by federal tax rules governing private philanthropy. Mathematica Policy Research evaluated a Robert Wood Johnson Foundation initiative supporting state consumer health advocacy networks. During the three-year grant period, most networks coalesced and improved their ability to advocate effectively. A majority of state policy makers reported that consumers became more involved and effective in shaping health policy, and many wanted consumer advocates to remain involved in public debates on implementing federal health reform. The evaluation shows that targeted investments by foundations to strengthen consumer groups' ability to advocate effectively can help ensure that their voice is heard in critical policy debates.
