The moderating effects of ethnicity on key predictors of trauma in child welfare involved adolescents.

Key predictors of trauma were examined using a multi-group analysis of a nationally representative sample of 716 child welfare involved youth ages 11-17. Results indicate that co-occurring clinical depression was associated with trauma across all racial/ethnic groups. Results also support that youth's ethnicity moderates the relationship between gender, history of sexual abuse and sexual orientation and the development of trauma. Contrary to prior research, trauma was not significantly associated with substance abuse or having experienced out of home placement for all ethnic groups. Implications for policy, practice with child welfare involved adolescents and future research in this area are discussed.

Lesbian, gay, and bisexual (LGB) youth within in welfare: Prevalence, risk and outcomes.

The purpose of this study was to estimate the population of sexual minority or LGB (lesbian, gay and bisexual) children and youth involved with the child welfare system, and to compare their health, mental health, placement and permanency outcomes to those of non-LGB youth. Data were drawn from the Second National Survey of Child and Adolescent Well-Being (NSCAW-II), a nationally representative sample of children who were referred to child welfare due to a report of abuse or neglect over a fifteen month period. This sample included youth ages eleven and older who self-identified their sexual orientation (n = 1095). Results indicate that approximately 15.5% of all system involved youth identified as lesbian, gay or bisexual, and that lesbian and bisexual females, and LGB youth of color are both overrepresented within child welfare systems. Although no substantive difference in risk factors, permanency and placement were found between LGB and Non-LGB youth, LGB youth were significantly more likely to meet the criteria for adverse mental health outcomes. Implications for child welfare practice and policy are presented, along with recommendations for future research in this area.

Cultural adaptations to augment health and mental health services: a systematic review.

BACKGROUND: Membership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery. METHODS: MEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients. RESULTS: Thirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider's behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group. CONCLUSIONS: Conceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies implications for policy, practice, and research, including individualization, cost considerations, and patient or client satisfaction, among others.

Charting Directions for Research on Immigrant Children Affected by Undocumented Status.

Three groups of children from Mexico and Central America are vulnerable to effects of US immigration policies: 1) foreign-born children who entered the US with undocumented immigrant parents; 2) unaccompanied children who entered the US alone; and 3) U.S.-born citizen children of undocumented immigrant parents. Despite the recent demographic growth of these youth, scholarship on their strengths and challenges is under-theorized and isolated within specific disciplines. Hence, service providers, researchers, and policymakers have insufficient research to inform their efforts to support the children's wellbeing. A group of scholars and service-providers with expertise in immigrant children convened to establish consensus areas and identify gaps in knowledge of undocumented, unaccompanied, and citizen children of undocumented immigrant parents. The primary goal was to establish a research agenda that increases interdisciplinary collaborations, informs clinical practice, and influences policies. This report summarizes key issues and recommendations that emerged from the meeting.

Effects of Parent Immigration Status on Mental Health Service Use Among Latino Children Referred to Child Welfare.

OBJECTIVE: Latino families may be at risk of experiencing stressors resulting from the immigration process, such as those related to documentation status and acculturation, that may increase their need for mental health services. However, little research exists on the mental health needs and service use of Latino children. This study examined how parental nativity and legal status influence mental health needs and service utilization among children in Latino families investigated by child welfare. METHODS: Data from the second National Survey of Child and Adolescent Well-Being, a nationally representative, prospective study of families investigated by child welfare agencies for maltreatment, were used to examine mental health need and service use in a subset of Latino children who remained in the home following a maltreatment investigation (N=390). RESULTS: Although children of immigrants did not differ from children of U.S.-born parents in levels of clinical need, they had lower rates of mental health service receipt. After the analyses accounted for other relevant variables, the odds of receiving services were significantly lower (odds ratio=.09) for children whose parents were undocumented compared with children whose parents were U.S. citizens. CONCLUSIONS: This study contributes to growing discourse on Latino family needs within the child welfare system. Analyses support earlier research regarding the effects of parent nativity on mental health service use and advance the literature by identifying parent legal status as a unique barrier to child service receipt.

The Decision Making Ecology of placing a child into foster care: A structural equation model.

The Decision Making Ecology provided a framework for empirically testing the impact of Case, Caseworker and Organizational factors on the decision to place children in out-of-home care. The structural equation model we developed fit the data extremely well, indicating a complex relationship between the variables. The main findings indicate that Case factors, even as aggregated to the worker level, were of most importance: Percent Removed was increased in part by greater average Risk being assessed and more families on a worker's caseload being Low Income. Furthermore, removal rates were increased by lower proportions of Hispanic families on the caseload, as well as lower organizational support, and a perception of manageable workload and sufficient resources. Individual factors, i.e., variables characterizing the caseworkers themselves, were not found to directly influence the placement decision, including workers' own race/ethnicity, though various orders of mediated effects were indicated, and these are detailed. Interrelationships between variables that affect case, caseworker and organizational factors are discussed along with implications for practice.

Development of an instrument to understand the child protective services decision-making process, with a focus on placement decisions.

When children come to the attention of the child welfare system, they become involved in a decision-making process in which decisions are made that have a significant effect on their future and well-being. The decision to remove children from their families is particularly complex; yet surprisingly little is understood about this decision-making process. This paper presents the results of a study to develop an instrument to explore, at the caseworker level, the context of the removal decision, with the objective of understanding the influence of the individual and organizational factors on this decision, drawing from the Decision Making Ecology as the underlying rationale for obtaining the measures. The instrument was based on the development of decision-making scales used in prior decision-making studies and administered to child protection caseworkers in several states. Analyses included reliability analyses, principal components analyses, and inter-correlations among the resulting scales. For one scale regarding removal decisions, a principal components analysis resulted in the extraction of two components, jointly identified as caseworkers' decision-making orientation, described as (1) an internal reference to decision-making and (2) an external reference to decision-making. Reliability analyses demonstrated acceptable to high internal consistency for 9 of the 11 scales. Full details of the reliability analyses, principal components analyses, and inter-correlations among the seven scales are discussed, along with implications for practice and the utility of this instrument to support the understanding of decision-making in child welfare.

Disparities in reported and substantiated infant maltreatment by maternal Hispanic origin and nativity: a birth cohort study.

We followed Latino infants prospectively through age 1 to determine whether maternal foreign-born status conferred a protective advantage against reported and substantiated maltreatment across Hispanic-origin groups, and whether the likelihood an infant was reported or substantiated for maltreatment varied by Hispanic origin. We drew data for all Latino infants born in California between 2000 and 2006 (N = 1,909,155) from population-based birth records linked to child protective services data. We used χ(2) tests to assess distributional differences in covariates and utilized generalized linear models to estimate the adjusted relative risk of report and substantiation in models stratified by nativity. We observed significant health advantages in reported and substantiated maltreatment for infants of foreign-born mothers within every Hispanic-origin group. Risks of report and substantiation among infants of Mexican and Central/South American mothers were consistently lower than Puerto Rican and Cuban mothers despite socioeconomic disadvantage. The presence of disparities among Hispanic-origin groups in child maltreatment report and substantiation during infancy has implications for the health of Latinos across the life course. Further research is warranted to unravel the complex processes underlying observed relationships.

Substitute care entry: the relationship between race or ethnicity and levels of county organization.

OBJECTIVE: Past studies demonstrate a relationship between race and the likelihood of children entering state custody subsequent to a maltreatment investigation. Research also shows that community structural characteristics such as poverty and residential mobility are correlated with entry rates. The combined effect, however, of race and community characteristics on substitute care entry is unclear. We analyzed 3 years of Illinois child welfare administrative and county-level structural data to assess the combined effect of child characteristics and level of community organization on substitute care entry. METHODS: Based on county indicators of crime, socioeconomic status, residential mobility, and child care burden, a latent profile analysis classified Illinois counties into three levels of social organization (high, moderate, and low). To test the relationship between community and child level predictors of substitute care entry, a dichotomous variable representing substitute care entry was regressed onto county level and individual covariates (child age, race or ethnicity, gender, and allegation). To test the combined relationship of community and individual level characteristics, interactions between county level of organization and race were explored. RESULTS: Like previous studies, results showed that individual factors of race, age, and allegation were associated with the decision to place children in substitute care. Also consistent with past research, they revealed a general trend in which decreasing levels of social organization were associated with relatively higher odds of entry to care. The magnitude of this effect at each level of social organization, however, varied by race, with African American children in disorganized communities experiencing the greatest risk of removal. CONCLUSIONS: These findings suggest that efforts to understand the decision to place a child in substitute care may need to be community specific. In particular the level of community organization may influence the response of the system to maltreatment investigations. In communities with different characteristics and across racial groups, child welfare systems may need to examine decision making processes regarding children's removal from parental care.

Conducting culturally competent evaluations of child welfare programs and practices.

As the population of the United States has changed over the last two decades, so has the population of children who come to the attention of the child welfare system, resulting in increasing calls for cultural competence in all aspects of child welfare programming and practice. Given the changing demographics among children involved in the child weltare system and the increasing need to address the racial and ethnic disparities observed in this system, the need for culturally competent approaches to evaluate the outcomes of services for children and families is essential. This article discusses the challenges in conducting culturally competent evaluations and provides strategies to address those challenges within a child welfare context.

Adapting systems of care for child welfare practice with immigrant Latino children and families.

Recent reform efforts in the child welfare system have called for child welfare agencies to provide community-based services and to increase the involvement of external stakeholders in identifying and developing services within the community. At the same time, child welfare agencies are faced with the challenge of providing services to an increasingly diverse population of children and families. As a result, there is a need for evidence-based practice models that respond to these challenges and promote positive outcomes for children and families. This paper describes the development of a program designed to train child welfare staff on the application of an existing evidence-based framework, systems of care, to practice with immigrant Latino children and families as a means of responding to these multiple calls for systems change and practice improvement. Immigrant Latino children and families represent the largest and fastest-growing population in the United States, and thus require the attention of child welfare systems and the development of evidence-based practices designed to respond to the unique needs of this population. Recommendations for program planners and evaluators on the application of systems of care to child welfare practice with immigrant Latino children and families are provided.

Emerging issues at the intersection of immigration and child welfare: results from a transnational research and policy forum.

In July 2006, the American Humane Association and the Loyola University Chicago School of Social Work facilitated a roundtable to address the emerging issue of immigration and its intersection with child welfare systems. More than 70 participants from 10 states and Mexico joined the roundtable, representing the fields of higher education, child welfare, international immigration, legal practice, and others. This roundtable created a transnational opportunity to discuss the emerging impact of migration on child welfare services in the United States and formed the basis of a continued multidisciplinary collaboration designed to inform and impact policy and practice at the local, state, and national levels. This paper presents the results of the roundtable discussion and summarizes the emerging issues that participants identified as requiring attention by child welfare systems to facilitat positive outcomes of child safety, permanency, and well-being. Suggestions for further research and implications for policy and practice are also presented.

Culturally competent systems of care with Latino children and families.

The Latino population represents the fastest growing ethnic minority in the United States. As a result, child welfare agencies need to be prepared to provide culturally appropriate services to Latino families. This paper describes an evaluation of a federally funded initiative designed to train child welfare practitioners in using an existing evidence-based framework--systems of care--with Latino children and families to address the need for culturally competent, community-based services with this population. Results indicate that trained participants responded positively to the systems of care framework, increased their knowledge of systems of care, and reported positive benefits to their clients through using this framework. However, challenges to implementing systems of care were identified. Implications of these findings and the use of systems of care in child welfare are presented.

Deconstructing disproportionality: views from multiple community stakeholders.

While the existence of racial disproportionality has been well documented, the causes of disproportionality are less clear. Studies identifying contributing factors have relied largely on analyses of state and national data sets, which may lack the robust data necessary to fully explain the factors related to this issue. Further, a limitation of existing research is the lack of data from the voice of those in communities affected by disproportionality. This study was designed to develop a deeper understanding of disproportionality from the views of multiple community stakeholders. Using a qualitative approach, data were collected to provide a greater depth of information that can be used alongside existing studies toward developing an enhanced understanding of disproportionality in child welfare.