Risk and protective factors associated with grandparent kinship caregivers' psychological distress in COVID-19: Kinship license status as a moderator.

COVID-19 and its related policy measures have increased the psychological distress of individuals, including grandparent kinship caregivers. Guided by the Resilience Model of Family Stress, Adjustment, and Adaptation, this study examines relationships between material hardship, parenting stress, social support, resilience and psychological distress of grandparent kinship caregivers during the COVID-19 pandemic, as well as the moderating role of kinship license status on these relationships. Kinship care licensing is a prerequisite to receiving financial assistance and other supporting services from the government. We administered a cross-sectional survey of grandparent kinship caregivers (N = 362) in the United States. Logistic regression results indicated that material hardship was associated with higher odds of experiencing psychological distress, whereas resilience and social support were associated with lower odds. Kinship license status moderated the relationships of social support and resilience with psychological distress. Results suggest that additional emergency funds and more tailored financial services should be provided to meet material needs, and interventions with a focus on resilience and social support are particularly needed. The moderating effects of license status indicate that some interventions should be specifically implemented among licensed kinship caregivers, whereas parallel services should be provided to kinship caregivers regardless of their license status.

Understanding the Relationships between Parenting Stress and Mental Health with Grandparent Kinship Caregivers' Risky Parenting Behaviors in the Time of COVID-19.

Grandparent kinship caregivers may experience increased parenting stress and mental distress during the COVID-19 pandemic. It may lead to risky parenting behaviors, such as psychological aggression, corporal punishment, and neglectful behaviors towards their grandchildren. This study aims to examine (1) the relationships between parenting stress, mental health, and grandparent kinship caregivers' risky parenting practices, such as psychological aggression, corporal punishment, and neglectful behaviors towards their grandchildren during the COVID-19 pandemic, and (2) whether grandparent kinship caregivers' mental health is a potential mediator between parenting stress and caregivers' psychological aggression, corporal punishment, and neglectful behaviors. A cross-sectional survey among grandparent kinship caregivers (N = 362) was conducted in June 2020 in the United States. Descriptive analyses, negative binomial regression analyses, and mediation analyses were conducted using STATA 15.0. We found that (1) grandparent kinship caregivers' high parenting stress and low mental health were associated with more psychological aggression, corporal punishment, and neglectful parenting behaviors during COVID-19; and (2) grandparent kinship caregivers' mental health partially mediated the relationships between parenting stress and their psychological aggression, corporal punishment, and neglectful behaviors. Results suggest that decreasing grandparent kinship caregivers' parenting stress and improving their mental health are important for reducing child maltreatment risk during COVID-19.

Material hardship and child neglect risk amidst COVID-19 in grandparent-headed kinship families: The role of financial assistance.

BACKGROUND: COVID-19 has exacerbated material hardship among grandparent-headed kinship families. Grandparent-headed kinship families receive financial assistance, which may mitigate material hardship and reduce child neglect risk. OBJECTIVE: This study aims to examine (1) the association between material hardship and child neglect risk; and (2) whether financial assistance moderates this association in a sample of kinship grandparent-headed families during COVID-19. PARTICIPANTS AND SETTING: Cross-sectional survey data were collected from a convenience sample of grandparent-headed kinship families (not necessarily child welfare involved) (N = 362) in the United States via Qualtrics Panels online survey. METHODS: Descriptive, bivariate, and negative binomial regression were conducted using STATA 15.0. RESULTS: Experiencing material hardship was found to be associated with an increased risk of child neglect, and receiving financial assistance was associated with a decreased risk of child neglect in the full sample and a subsample with household income > $30,000. Receiving financial assistance buffered the negative effect of material hardship on child neglect risk across analytic samples, and receiving SNAP was a significant moderator in the full sample. Among families with a household income ≤ $30,000, receiving SNAP and foster care payments was associated with a decreased risk of child neglect, while receiving TANF and unemployment insurance was associated with an increased risk of child neglect. Among families with household income > $30,000, only receiving SNAP was associated with a decreased risk of child neglect. CONCLUSIONS: This study suggests the potential importance of providing concrete financial assistance, particularly SNAP and foster care payments, to grandparent-headed kinship families in efforts to decrease child neglect risk during COVID-19.

Custodial Grandparent's Job Loss During the COVID-19 Pandemic and Its Relationship With Parenting Stress and Mental Health.

Involuntary job loss during the COVID-19 pandemic adds challenges, especially for custodial grandparents that are taking care of grandchildren. Grandparents are relatively vulnerable, and they need more attention and support when facing the negative impacts of COVID-19. This study analyzed cross-sectional survey data collected from 234 custodial grandparents via Qualtrics Panels in June 2020 in the United States. After using the propensity score weighting adjustment, results from logistic and ordinary least squares regression showed that compared with grandparents that did not lose their job during the pandemic, grandparents that did had more parenting stress and worse mental health. Moderation analysis also showed that social support was a significant moderator of the relationship between job loss and mental health, but not the relationship between job loss and parenting stress. The findings and implications are discussed.

Material hardship and parenting stress among grandparent kinship providers during the COVID-19 pandemic: The mediating role of grandparents' mental health.

BACKGROUND: The COVID-19 pandemic has exposed the vulnerability of many families, including grandparent kinship families, to deal with a health/economic crisis. The fear of COVID-19 plus stay-at-home orders have increased individuals' psychological distress. Moreover, school closures and homeschooling further increased parenting stress among caregivers. OBJECTIVES: This study examined the relationship between material hardship and parenting stress among grandparent kinship providers, and assessed grandparents' mental health as a potential mediator to this relationship during the COVID-19 pandemic in the United States. PARTICIPANTS AND SETTING: Grandparent kinship providers (N = 362) that took primary care of their grandchildren participated in a cross-sectional survey via Qualtrics Panels in June 2020 in the United States. METHODS: Descriptive and bivariate analyses, binary logistic regression, and mediation analyses were conducted using STATA 15.0. RESULTS: Suffering material hardship was significantly associated with higher odds of experiencing parenting stress among grandparent kinship providers, and grandparents' mental health partially mediated this association. CONCLUSIONS: Addressing material and mental health needs among grandparent kinship providers is critical to decreasing their parenting stress.

Children and youth in out-of-home care: What can predict an initial change in placement?

BACKGROUND: A significant proportion of children placed in out of-home care experience placement disruptions in the United States. Placement instability has deleterious effects on children's well-being. OBJECTIVES: (a) To measure the time-to-initial placement change in different types of settings, including non-relative foster homes, kinship care, residential treatment centers (RTC), group homes and other types of settings; and (b) To identify predictors of the initial placement change. PARTICIPANTS AND SETTING: Data were obtained from the State Automated Child Welfare Information System operated by the child welfare agency in a Mid-Atlantic state. The sample included 4177 children who entered into the foster care and were followed over three years. METHOD: Descriptive, bivariate, and survival Cox regression models were conducted. RESULTS: More than half (53%) of the children had experienced placement change within 3 years. The mean length for an initial change in placement was longer for children in RTC and kinship care compared to children in foster and group homes, and other placements (χ2 = 322.31, p < 0.001). Several factors significantly increased the likelihood of an initial change, including: older children (p < 0.001, HR = 1.01), children with behavioral problems (p < 0.001, HR = 1.26), parental substance abuse (p < 0.05, HR = 1.12), and cases in which the parents voluntarily gave up their parental rights (p < 0.05, HR = 1.12). The type of placement also increased the risk for placement change. CONCLUSIONS: Providing early interventions and services to these children and their families is essential to increase placement stability.

Abuse Characteristics and the Concordance of Child Protective Service Determinations and Adolescent Self-Reports of Abuse.

This study examines the concordance of abuse self-reported by adolescents at 18 years and child protective service (CPS) determinations and how abuse characteristics predict concordance. It includes 819 youths participating in 18-year interviews of the Longitudinal Study of Child Abuse and Neglect (LONGSCAN). Cross-tabulations revealed low correspondence between self-reports and CPS determinations of physical, sexual, and emotional abuse. Logistic regression identified that among youths with CPS physical abuse determinations, White race, chronicity, and co-occurring neglect were positively associated with corresponding self-reports. Co-occurring CPS-determined emotional abuse was more concordant with self-reports. More frequent self-reported physical abuse was associated with corresponding CPS determinations. Self-reports of childhood emotional abuse and perpetration by nonparental family/other household members were positively associated with corresponding CPS determinations. CPS determination concordance also varied significantly by LONGSCAN site. Results demonstrate differences in abuse characteristics captured by CPS data and youth self-report, which may impact research findings on abuse correlates.

Predictors of substantiated re-reports in a sample of children with initial unsubstantiated reports.

Many children with unsubstantiated reports of child abuse and neglect repeatedly return to the child protection system, indicating that unsubstantiated reports may represent actual child maltreatment or risk for future maltreatment. Identifying patterns of re-reporting and predictors that may be associated with later substantiated re-reporting could help to identify children who are very likely to be maltreated. This knowledge may guide the development of policies and interventions to prevent further maltreatment and the risk for re-reports. The aims of this study were to: (1) measure the period between the time of the initial reports that were not substantiated and the time of first substantiated re-reports; and (2) identify factors associated with the risk of later substantiated re-reporting. The study analyzed secondary data from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN) through survival analysis. Of the 378 children with initially unsubstantiated reports, 81% were re-reported, of which almost two-thirds were substantiated. Children who were younger, non-white, and had caregivers with more depressive symptoms were at increased risk of a substantiated re-report. Among those that were later substantiated, 20% were substantiated within one year. Findings suggest that targeted preventative services should be developed and provided for families who are reported for the first time, even if not substantiated.

Child protection decisions to substantiate hospital child protection teams' reports of suspected maltreatment.

The present study focuses on the way child protection officers (CPOs) in Israel assess suspected abuse and neglect (SCAN) reports made by hospital child protection teams (CPTs), to determine whether the alleged maltreatment is substantiated. The study was conducted in six medical centers and included 358 reports investigated by CPOs for SCAN. A structured questionnaire was completed by hospital CPTs to capture all relevant information on each child referred to the CPTs. Structured phone interviews were conducted with each of the CPOs who received a CPT report. Bivariate associations and multivariate logistic regressions were conducted to estimate the substantiation rate of cases reported by CPTs and the types of maltreatment substantiated, as well as to identify case characteristics of the child and the family that were associated with the CPOs' substantiation decision. CPO follow-up investigations revealed a substantiation rate of 53.5%. The maltreatment type most commonly substantiated was neglect. The case characteristics associated with substantiation included socio-demographic background, parents' health and functioning, previous contact with social services, characteristics of the hospital referral, medical findings and an assessment of the parents' behaviors. The findings of the study highlighted the importance of cooperation between the health and welfare services and the policy makers. This cooperation is essential for identifying early signs of maltreatment. Enhanced cooperation and effective information transfer between various professionals would help prevent or at least reduce the recurrence of maltreatment and would ensure that the children and their families are treated appropriately.

Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement.

Child abuse and neglect: reporting by health professionals and their need for training.

BACKGROUND: For health professionals who interact professionally with children, adequate awareness and training regarding the clinical indicators of child abuse and neglect, as well as subsequent reporting and procedures, are essential. OBJECTIVES: To study Israeli health professionals experiences with identification and reporting of suspected cases of child abuse and neglect, and their perceived training needs in this area. METHODS: The study group was a convenience sample comprising 95 Israeli health professionals (physicians, nurses, social workers, psychologists, etc.) attending workshops on medical aspects at a national conference on child abuse and neglect. In this cross-sectional survey, the health professionals were asked to complete an anonymous structured questionnaire on their experience with child abuse and neglect and on their training needs. RESULTS: The participants in the survey had relatively high levels of involvement with child protection. Nevertheless, they strongly expressed their need for training, especially in mastering practice skills. The need for training was greater for professionals with less experience in child protection, and there were different needs according to profession. CONCLUSIONS: Despite their prior extensive experience in dealing with child abuse and neglect, most of the health professionals participating in the conference reported the need for training in certain areas.