Validation of a Measure of Foster Home Integration for Foster Youth.

OBJECTIVES: This article introduces a youth-reported measure (Essential Youth Experiences [EYE]) developed to assess the experiences of foster youth in their home environment and their critical relationships across a number of service systems. Empirically, the article reports on the psychometric properties of a 9-item scale within the EYE that measures the construct of positive home integration (PHI). METHODS: The EYE was administered to 328 preadolescent and adolescent youth (164 sibling dyads) enrolled in a larger randomized clinical trial. RESULTS: Correlational analysis suggests that the PHI Scale shows good psychometric properties and strong current and predictive validity. CONCLUSION: The PHI is a reliable and valid scale that measures youth perspectives of inclusion in the foster home and relationships with their foster care provider. This scale quickly gathers youth perspectives and differentiates between youth who have more versus less significant needs. Implications for research and social work practice are discussed.

Network Indicators of the Social Ecology of Adolescents in Relative and Non-Relative Foster Households.

Though the presence, composition, and quality of social relationships-particularly as found in family networks-has an important influence on adolescent well-being, little is known about the social ecology of youth in foster care. This study examined the social networks of foster youth participating in a large RCT of an intervention for siblings in foster care. Youth reported on the people they lived with and the relatives they were in contact with, which provided indicators of network size, composition, and relationship quality. Cluster analysis was used to identify five family network profiles for youth living in foster homes. Two identified subgroups reflected robust family networks where youth were living with relative caregiver(s) and related youth, and also reported multiple family ties outside the household, including with biological parents. The remaining three profiles reflected youth reports of fewer family connections within or beyond the foster household, with distinctions by whether they lived with siblings and/or reported having positive relationships with their mothers and/or fathers. The identified network profiles were validated using youth- and caregiver-reported measures of mental health functioning, with increased caregiver report of post-traumatic stress symptoms indicated for the three subgroups that were not characterized by a robust family network.

Intervening to Improve Outcomes for Siblings in Foster Care: Conceptual, Substantive, and Methodological Dimensions of a Prevention Science Framework.

In recent years, the child welfare field has devoted significant attention to siblings in foster care. Policymakers and practitioners have supported efforts to connect siblings via shared foster placements and visitation while researchers have focused on illuminating the empirical foundations of sibling placement and sibling intervention in child welfare. The current paper synthesizes literature on sibling relationship development and sibling issues in child welfare in the service of presenting a typology of sibling-focused interventions for use with foster youth. The paper provides two examples of current intervention research studies focused on enhancing sibling developmental processes and understanding their connection to child welfare outcomes. The paper concludes by presenting an emerging agenda informing policy, practice, and research on siblings in foster care.

Alcohol and Substance Use in Adolescence and Young Adulthood: The Role of Siblings.

Interpersonal relationships both within and outside the family have been a central part of alcohol and substance use research. Many studies have focused on the role of parents and peers; fewer studies have focused on siblings. This paper examined siblings' roles in ATOD use patterns and trajectories in the context of familial and non-familial factors across time. First, intraclass correlations (ICCs) were used to examine the degree to which older siblings' ATOD use was associated with younger siblings' ATOD use. Second, hierarchical regression analyses were conducted to examine the degree to which individual, parent, sibling and peer factors over time were associated with adolescents' and young adults' ATOD use. It should be noted that developmentally proximal predictors were utilized in these models and within-family replication was also examined. Results demonstrate strong associations between older and younger siblings' ATOD use. Moreover, the developmentally proximal sibling variables were predictive of younger sibling ATOD use in the context of other variables across all substances. Study findings are discussed in terms of identifying promising and potentially malleable points of intervention for future investigators.

An intervention to improve sibling relationship quality among youth in foster care: Results of a randomized clinical trial.

Sibling programming is an important part of a prevention framework, particularly for youth in foster care. After children are removed from their families and placed into foster care in the aftermath of maltreatment, the sibling relationship is often the most viable ongoing relationship available to the child, and may be critical to a youth's sense of connection, emotional support, and continuity. The promise of dyadic sibling programming in particular rests on the ability of interventions to enhance the quality of sibling relationships; yet little research exists that suggests that sibling interventions can improve relationship quality among foster youth. The primary aim of the current study was to examine the effects of a specific dyadic sibling-focused intervention for older and younger siblings on sibling relationship quality. One hundred sixty four dyads (328 youth) participated in the study, with each dyad consisting of an older sibling between 11 and 15 years of age at baseline and a younger sibling separated in age by less than 4 years. Hierarchical linear models were applied to self-reported, observer-reported and observational data over the 18-month study period. Findings suggest that the sibling intervention holds promise for improving sibling relationship quality among youth in foster care. Implications and future directions for research are discussed.

Development and feasibility of a sibling intervention for youth in foster care.

Due to their ubiquity and possible influence on youth mental health, academic, and other outcomes, sibling-focused intervention strategies may be important for the development and implementation of evidence-based practices (EBPs) in child welfare. However, there is no rigorous evidence as to either the best methods for, or feasibility of, incorporating the sibling link within existing clinical treatments for foster youth. This paper applies the literature on evidence-based practices (EBP) and implementation research in child welfare to sibling-focused intervention; and presents data concerning the development, delivery, cost, and feasibility of a novel sibling-focused intervention program, Supporting Siblings in Foster Care (SIBS-FC). Results suggest that despite the challenges and costs involved with delivering SIBS-FC, the program catered to the diverse needs of pre-adolescent and adolescent siblings living together and apart, was viewed positively by youth, and was implemented with a high degree of fidelity. These findings underscore the importance of attending to the early-stage development of psychosocial interventions in child welfare and highlight the role of interagency collaboration, program planning, staff training and supervision, and fidelity tracking for EBP development in child welfare. Implications for prevention research and sibling-focused intervention programming in child welfare are discussed.

Feasibility of laparoscopic renal cooling with near-freezing saline irrigation delivered with a standard irrigator aspirator.

OBJECTIVES: To determine the feasibility of laparoscopic renal cooling with near-freezing saline irrigation in the porcine model delivered using readily available operating room equipment. METHODS: Five pigs underwent laparoscopic renal surgery with temperature sensors placed in the medulla and upper, middle, and lower pole renal cortex. After complete occlusion of the renal artery and vein, near-freezing saline was delivered with a standard irrigator/aspirator onto the renal surface. The run-off was simultaneously suctioned as it pooled in the hilum with a second aspirator. The kidney and body temperatures were monitored throughout the 1-hour ischemic period and for 10 minutes after unclamping the hilum. RESULTS: Continuous irrigation of the kidney with near-freezing saline in the first pig resulted in hypothermic renal (13.8 degrees C) and core body (33.1 degrees C) temperatures. For the subsequent four pigs, irrigation was limited to the first 5 minutes of ischemia to achieve renal cortical and medullary temperatures of less than 20.0 degrees C within 6 and 8 minutes of ischemia, respectively. Subsequently, the kidney was irrigated for 1 minute every 12 to 14 minutes to maintain renal temperatures of less than 20.0 degrees C. The core body temperatures decreased from a mean baseline of 37.0 degrees to 35.4 degrees C using the intermittent irrigation technique. Our early clinical experience with near-freezing saline intermittent irrigation during laparoscopic partial nephrectomy with 10 patients showed stable core body temperature and serum creatinine with a mean ischemic time of 48 minutes. CONCLUSIONS: Using standard, readily available laparoscopic irrigator/aspirators, renal cooling during laparoscopic partial nephrectomy with near-freezing saline creates acceptable renal tissue temperatures for preservation of renal function.