Shifting the paradigm of research-to-policy impact: Infrastructure for improving researcher engagement and collective action.

The body of scientific knowledge accumulated by the scholarly disciplines such as Developmental Psychopathology can achieve meaningful public impact if wielded and used in policy decision-making. Scientific study of how policymakers use research evidence underscores the need for researchers' policy engagement; however, barriers in the academy create conditions in which there is a need for infrastructure that increases the feasibility of researchers' partnership with policymakers. This need led to the development of the Research-to-Policy Collaboration model, a systematic approach for developing "boundary spanning" infrastructure, which has been experimentally tested and shown to improve policymakers' use of research evidence and bolster researchers' policy skills and engagement. This paper presents original research regarding the optimization of the RPC model, which sought to better serve and engage scholars across the globe. Trial findings shed light on ways to improve conditions that make good use of researchers' time for policy engagement via a virtual platform and enhanced e-communications. Future directions, implications, and practical guidelines for how scientists can engage in the political process and improve the impact of a collective discipline are also discussed.

National training and development curriculum training program impact on placement, permanency, and stability.

BACKGROUND: Resource parent trainings are an important factor in caregiver readiness and retention, which can improve placement stability and permanency achievement for children and youth, especially those who are marginalized. OBJECTIVE: Resource parents need access to evidence-based training programs attentive to caring for children and youth from a variety of diverse backgrounds. This study evaluates placement, permanency, and stability outcomes of children whose resource parents were trained in one such program: the National Training and Development Curriculum (NTDC). PARTICIPANTS AND SETTING: Participants include adults who completed a resource parent training program (N = 3822) and children in their care (N = 2565) in the U.S. states of Florida, Georgia, Illinois, and Missouri. METHODS: This quasi-experimental study involved statistical testing of caregivers and children using AFCARS data. Propensity-score matching was used to control for differences in the child permanency analysis. RESULTS: With a better understanding of the realities of fostering, NTDC participants were slightly less likely to foster after training (OR = 0.6; p < .001), self-selecting out before taking a child into the home. Those who did foster were more likely to foster a child who is a teen (OR = 1.4; p = .004), Asian/Asian American (OR = 3.8; p = .02), Black/African American (OR = 1.6; p < .001), or Hispanic/Latinx (OR = 1.7; p = .002). Children of NTDC caregivers entered legal adoptions (OR = 2.0; p = .003) and guardianships (OR = 2.9; p = .03) at higher rates than children of comparison caregivers, while rates of reunification (OR = 1.3; p = .11) were not statistically different. CONCLUSIONS: Evidence points to the effectiveness of NTDC in preparing resource parents to provide care for a diverse range of children by age, race, and ethnicity, and for those children to achieve permanency.

A Community Engaged Approach in Adapting Motivational Interviewing and Skills Training for Native Americans With Experiences of Substance Misuse.

OBJECTIVE: American Indian and Alaskan Natives (AIAN) are regenerating cultural knowledge and practices to adapt westernized evidence-based interventions to address health concerns such as substance use. This study describes the process of selecting, adapting, and implementing motivational interviewing plus cognitive behavior therapy (motivational interviewing + Skills Training; MIST) for use in a combined substance use intervention with a rural, Northwest tribal community. METHODS: An established community and academic partnership worked together to make culturally mindful changes to MIST. The partnership incorporated community leaders/Elders (n = 7), providers (n = 9), and participants (n = 50) to implement an iterative process of adapting and implementing the adapted form of MIST. RESULTS: Key adaptations included presenting concepts grounded in tribal values, providing examples from the community perspective, and incorporating cultural customs and traditions. Overall, the MIST adaptation was favorably received by participants, and the adaptation appeared feasible. CONCLUSIONS: Adapted MIST appeared to be an acceptable intervention for this Native American community. Future research should evaluate the interventions efficacy in reducing substance use among this and other Native American communities. Future clinical research should consider strategies outlined in this adaptation as a potential process for working with Native American communities to implement culturally appropriate interventions.

An exploratory study of the impact of COVID-19 on foster parenting.

As the COVID-19 virus began to spread in the United States of America, states' child welfare administrators and policymakers responded differently. Some states implemented more restrictive policies, some less or did not require many restrictions (i.e., stay at home orders or masking in public spaces). Video-based online focus groups with foster parents in four states utilized a consensual qualitative approach to identify themes relating to foster parenting during COVID-19 and understand how policies related to COVID-19 restrictions affected their caregiving decisions. Themes that emerged included pathways to foster parenting pre-pandemic, the impact of COVID-19 on both foster parents, children in care, and foster parents' ability to understand the broader importance of their caregiving. While participants in all of the states reported similar experiences relating to the need for resources and support and the challenge of managing both work and remote education for their children, those in states with restrictive policies were more likely to report pandemic-specific concerns including a lack of agency communication or case progress, the mental health toll on foster children in their care and their concerns about accepting new placements. Implications for policy and practice are discussed.

Call to action: Prioritizing sleep health among US children and youth residing in alternative care settings.

Sleep health is a critical but under-recognized area of concern for the more than 650,000 children served by the US child welfare system each year. While sleep is vital to optimal child health and development, it is likely harmed by the multiple adversities and traumas experienced among children and youth residing in alternative care settings (ie, kinship care, nonrelative foster care, group homes). Children residing in alternative care settings have experienced, at a minimum, the trauma of removal from a biological parent's care and would benefit from holistic, comprehensive care approaches inclusive of sleep health. Furthermore, few studies are currently available to guide practitioners and policymakers in promoting sleep health among these children. In this Call to Action, our goal is to draw attention to the sleep health of children residing in alternative care settings. We highlight the need for a more robust evidence base to address major knowledge gaps and outline concrete steps toward building future promising sleep health-promoting practices and policies supporting children residing in alternative care settings.

Sexual victimization and intellectual disabilities among child welfare involved youth.

BACKGROUND AND OBJECTIVE: Youth with intellectual disabilities involved in child welfare systems are at greater risk of sexual victimization than youth who have not been investigated for child maltreatment. This study addresses a gap in the literature regarding older youth with intellectual disabilities who are sexually victimized and pushed to engage in transactional sex while they are transitioning from child welfare systems involvement. It does so by examining risk and protective factors at the individual, micro, exo, and macro systems levels. PARTICIPANTS AND SETTING: This study included 334 youth ages 18-19.5 from a nationally representative sample of 5,872 child welfare-involved youth. METHODS: Multivariate logistic regression models were used to conduct a secondary analysis of the National Survey of Child and Adolescent Well-Being II to examine relationships between intellectual ability, social support, and community environment and sexual victimization and engaging in transactional sex. RESULTS: Results indicate that 2.5 % of the youth experienced sexual victimization in the past 12 months, and 3.9 % had engaged in transactional sex in the past 6 months. The mean intelligence score for these youth was one standard deviation below average (M = 84.62, SD = 19.60). Being female was associated with experiencing sexual victimization (Odds Ratio = 17.29, p = .025). Higher intellectual ability scores were associated with lower odds of engaging in paid sexual activity (Odds Ratio = 0.92, p = .002). CONCLUSIONS: This study highlights the need for early identification of intellectual disabilities among child welfare-involved youth, provision of informed social supports and services, and building community connections during transition to prevent sexual victimization.

Academic Achievement Among a Sample of Youth in Foster Care: The Role of School Connectedness.

Research shows that youth in foster care experience poor academic performance and disciplinary actions in school more frequently than do non-foster care youth. The purpose of this cross-sectional study was to further examine youth in foster care and the relationship between individual/intrapersonal factors (future orientation and school connectedness) and exosystem factors (number of placement and school moves) and academic performance (grades) and disciplinary referrals among 363 youth (9-11 years of age; males=52.9%). Controlling for key variables, hierarchical linear regression analysis was utilized to understand how well students' school connectedness, future outlook, number of placement changes, and number of school moves predicted academic and disciplinary outcomes. Beyond the variance explained by control variables, school connectedness made a significant contribution to this model. Results are discussed in the context of implementing interventions that foster school connectedness among this vulnerable population.

Connecting older grandmothers raising grandchildren with community resources improves family resiliency, social support, and caregiver self-efficacy.

Custodial grandparenting can be especially challenging for older grandmothers facing age specific issues. Kinship navigator programs are social service delivery programs intended to inform grandparents and other relatives raising children about available resources and services, provide information specific to their individual needs, and help families navigate service systems. Our study utilizes self-report data from one kinship navigator federal demonstration project, which used a randomized control trial, to examine demographic characteristics for grandmothers under and over 55 years of age, whether grandmother caregivers (≥55 years) improve family resilience, social support, and caregiver self-efficacy, and which interventions improved outcomes for grandmothers (≥55 years). Each participant was randomly assigned to one of four groups: Usual Care (traditional child welfare services), Standard Care (family support and case management), Peer-to-Peer Care Only, and Full Kin Tech Care (peer navigators with computer access and interdisciplinary team). Thirty-nine percent of grandmothers (55-75 years) were mostly living in poverty, predominantly Caucasian, with 36% identifying as African American/Black, with at least one to two children at home. Repeated-measures ANOVAs for each subscale showed statistically significant within- and between-group differences for Family Functioning, Social Supports, Concrete Supports, Child Development, and Nurturing and Attachment, with the exception of Usual Care, which showed a decline in protective factors consistently across subscales. Future research with kinship families could qualitatively examine the experiences for older women in navigator programs and replication of kinship navigator programs could build capacity in data collection and maintenance systems to gain better perspective about how systems of care impact families.

Oral Health Care Needs of Young Adults Transitioning from Foster Care.

Children who have aged out of the foster care system face considerable barriers in accessing oral health care. Although this population of foster care alumni may have Medicaid insurance while they are in care to cover dental care, 39 percent of youths who have aged out of foster care do not have dental insurance. This mixed methods study examines factors that contribute to the oral health care disparities of children who have transitioned from foster care. Multivariate analysis revealed that foster care alumni without dental insurance are 93.5 percent less likely to have their dental needs met than those with dental insurance. Themes from the qualitative data indicated a lack of oral health care, quality-of-life issues, and lack of support to access ongoing dental care. Most state Medicaid programs do not provide comprehensive dental care for adults past the age of 20, contributing to oral health disparities among this population. The addition of oral health care coverage under the Patient Protection and Affordable Health Care Act of 2010 for foster care alumni would greatly enhance their quality of life. The article concludes with a discussion of the implications for the role of social workers in promoting oral health care for foster care youths.

Timely Health Service Utilization of Older Foster Youth by Insurance Type.

PURPOSE: To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of first well-child visits (health care physicals). METHODS: A three-year retrospective study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 1,657 youth, ages 10-20 years, who were in foster care during the 2009-2012 study period was used to examine the odds of receiving a timely well-child visit within the recommended 30-day time frame controlling for race, age, days from foster care entry to Medicaid enrollment, and number of foster care placements. RESULTS: Youth entering foster care during the HMO period were more likely to receive a timely well-child visit than those in the FFS period (odds ratio, 2.46; 95% confidence interval, 1.84-3.29; p < .0001) and days to the first visit decreased from a median of 62 days for those who entered foster care during the FFS period to 29 days for the HMO period. Among the other factors examined, more than 14 days to Medicaid enrollment, being non-Hispanic black and having five or more placements were negatively associated with receipt of a timely first well-child visit. CONCLUSIONS: Those youth who entered foster care during the HMO period had significantly greater odds of receiving a timely first well-child visit; however, disparities in access to preventive health care remain a concern for minority foster care youth, those who experience delayed Medicaid enrollment and those who experienced multiple placements.

American Indians' response to physical pain: functional limitations and help-seeking behaviors.

Seventy-five American Indians, ages 25 to 84, representing 14 tribal nations, participated in this study. The historical, cultural, and behavioral responses to physical pain were examined. Data were collected over a 7-month period with a survey instrument that included the Universal Pain Scale, activities of daily living, causes of pain, cultural beliefs, and self-help-seeking behaviors. Also, recommendations for Western biomedical health care professionals are offered to improve services for the American Indian population. Findings demonstrate that culture plays a crucial role in wellness and significantly affects help-seeking behaviors, treatment regimens, responses to pain, and pain management.

School staff perspectives on the challenges and solutions to working with court-involved students.

BACKGROUND: Court-involved students, such as those in foster care and the juvenile justice system, generally experience high incidences of both acute and chronic trauma, adversely impacting their educational well-being and overall academic trajectory. Utilizing perceptions of teachers and other school staff, this study explores the challenges and needs of school personnel working with this student population. METHODS: Participants were school personnel employed at a Midwest, urban, public charter school during the 2012-2013 academic year. Focus groups explored the perceptions of school staff members working with court-involved students to develop a staff training curriculum. Focus groups also were conducted after the training intervention to get feedback from participants and identify remaining challenges. Focus group data were analyzed and results were member-checked with study participants. RESULTS: Findings included 7 major themes (14 subthemes) regarding student behaviors that were challenging for school staff to manage. Themes included trauma-related behaviors, attachment-related behaviors, staff preintervention needs, intervention feedback, and staff postintervention needs. CONCLUSIONS: Teachers and school staff can play a role in the educational well-being of court-involved youth. However, they need trauma-specific knowledge and resources to be effective.

Challenges to recruit and retain American Indian and Alaskan Natives into social work programs: the impact on the child welfare workforce.

There is a shortage of professionally trained American Indian/Alaskan Native (AI/AN) social workers available to provide services including child welfare services to tribal communities. This study used a mixed-model survey design to examine the perceptions of 47 AI/AN BSW and MSW students enrolled in social work programs across the to determine the challenges associated with recruitment and retention. The findings are supported in the literature. Findings indicate that social work academic programs have not made substantial gains in the recruitment and retention of AI/AN students over several decades. Students identified the following seven major barriers to successful recruitment and retention: (1) a lack of AI/AN professors; (2) a shortage of field placement agencies that serve AI/AN clients; (3) conflicts between students' academic obligations and responsibilities to their families and tribal communities; (4) students' feelings of cultural isolation; (5) the need for AI/AN role models and mentors; (6) a lack of understanding by universities of cultural customs and traditional values; and (7) racism. Implications for policy and practice are offered.

American Indian grand families: a qualitative study conducted with grandmothers and grandfathers who provide sole care for their grandchildren.

A qualitative study was conducted to determine the rationale for 31 American Indian grandparents' who provide sole care of their grandchildren, the impact of historical trauma on their decision making process in accessing services, the value of American Indian Child Welfare policies in addressing care issues, and custody status of the grand families. Indian Outreach Workers, Community Health Representatives, Elder Program Directors, and tribal community leaders were key in the recruitment of participants. The grandparents were informed of the purpose of the study and participated in face-to-face, paper and pencil, individual interviews. The subjects included 29 grandmothers and two grandfathers; age 43-86 years, with 20 who lived off reservation land and 11 who lived on reservation land in Michigan. A phenomenological approach of the "world of the lived experience" informed the design of the study. The researchers recorded the subjects' responses via field notes, conducted a comparison of responses to assess internal reliability, and entered the responses into the qualitative data analysis Nvivo program. Findings included; (1) reasons for providing sole care of grandchildren (2) stressors and rewards of providing sole care (3) grandparents decisions affected by historical traumas which focused on the boarding school issues and the removal of children from their homes due to cultural differences causing a reluctance to seek and access national and state programs (4) grandparents preference was to seek and access services provided by their Tribal Nations, and/or American Indian urban agencies (5) most lacked legal custodial status which is an indicator the grandparents' may have benefited from knowledge of the Indian Child Welfare Act (ICWA).