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System and Social Determinants of the Health of Foster Children

寄养儿童健康的制度和社会决定因素

基本信息

批准号：
10176547
负责人：
Sarah Font
金额：
$ 21.75万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10176547
关键词：
Address Adoption Adult Affect Area Attention Birth Caregivers Caring Case Management Child Child Health Child Mental Health Child Welfare Cognitive Communities Consensus Country Data Development Diagnosis Effectiveness Emotional Ensure Event Exposure to Family Fostering Funding Goals Group Homes Health Heterogeneity High Prevalence Home Individual Injury Knowledge Left Life Cycle Stages Link Medicaid Mental Health Methods Outcome Overdose Parents Pennsylvania Personal Satisfaction Play Policies Population Positioning Attribute Pregnancy in Adolescence Records Reporting Research Residential Treatment Resources Risk Role Sampling Seminal Siblings Social Security Substance abuse problem Suicide attempt System Time Vulnerable Populations Work adverse outcome behavioral health care systems child protection experience foster care foster child high risk improved innovation maltreated children maltreatment neglect physical conditioning preference service delivery social social health determinants sound success

项目摘要

Project Summary The proposed study will investigate the impact of foster care, and specific experiences within foster care, on the physical and mental health of children exposed to abuse or neglect. This population is among the most vulnerable in the U.S., with a disproportionately high prevalence of adverse health and wellbeing outcomes throughout the life course. The Aims of this proposal are: (1) Examine the effects of foster care on health over time; (2) Investigate the influence of placement experiences on foster children's health during and after exiting foster care; and (3) Evaluate the effects of maintaining family connections on foster children's health during and after exiting foster care. Prior research in this area has suffered one or more significant limitations, including: threats to causal inference; cross-sectional, short-term, or discrete observation periods; small or non-representative samples; reliance on caregiver-reported health outcomes; and a lack of focus on physical health. This proposal seeks to address these limitations and provide sound empirical evidence on the role of foster care in children's immediate and longer-tem health. In Aim 1, we focus on how foster care impacts children's physical and mental health outcomes over time, as compared with children involved with the child protection system but who remain in their familial homes. Using linked Medicaid and child protection records, we will observe significant health events before, during, and after foster care. Using methods intended to improve causal inference, we will be able to not only identify the impacts of foster care on health, but also understand whether those impacts are temporary or sustained. In Aims 2 and 3, we focus on the experiences of children within foster care that produce heterogeneity in health outcomes. To maximize the potential of our findings to inform efforts to improve foster children's health and wellbeing, we emphasize foster care experiences that are current priorities of federal and state reforms, including placement setting (e.g., with relatives, in group homes), placement stability, placement with siblings, and parent and sibling visitation. Again leveraging Medicaid and child protection records, and with a focus on causal inference, we will provide compelling evidence on whether the current priorities of the foster care system serve to enhance children's health. Such evidence is essential to the effective allocation of scarce resources.

项目总结