Black adolescents' participation in a prenatal care program

This study explores the relationship between socio-demographic variables and the participation in a prenatal care program among Black adolescents living in a southern community. The analysis of data found that the number of months pregnant and type of living arrangement significantly influenced participation. Greater participation was found among adolescents in the first trimester of pregnancy and those who lived with their mothers only or in other living arragements than with both parents. These findings suggest outreach to sustain participation and the need for additional research with Black adolescents in two-parent families.This study was made possible by funding from the University of Alabama Research Grants Committee, 1988.     

Effects of prenatal care on maternal postpartum behaviors

Most research on the effectiveness of prenatal care has focused on birth outcomes and has found small or no effects. It is possible, however, that prenatal care is “too little too late” to improve pregnancy outcomes in the aggregate, but that it increases the use of pediatric health care or improves maternal health-related parenting practices and, ultimately, child health. We use data from the Fragile Families and Child Wellbeing birth cohort study that have been augmented with hospital medical record data to estimate effects of prenatal care timing on pediatric health care utilization and health-related parenting behaviors during the first year of the child’s life. We focus on maternal postpartum smoking, preventive health care visits for the child, and breastfeeding. We use a multi-pronged approach to address the potential endogeneity of the timing of prenatal care. We find that first trimester prenatal care appears to decrease maternal postpartum smoking by about 5 percentage points and increase the likelihood of 4 or more well-baby visits by about 1 percentage point, and that it may also have a positive effect on breastfeeding. These findings suggest that there are benefits to standard prenatal care that are generally not considered in evaluations of prenatal care programs and interventions.     

Mentors for adolescents in foster care

Significant numbers of adolescents in foster placement plan to live independently following discharge. Mentoring is increasingly being used as a support service to assist older foster youths to make the transition to adult living. A survey of 29 child welfare programs indicate that a variety of mentoring models are in use. The main models are transitional Life Skills Mentors, Cultural-Empowerment Mentors, and Corporate-Business Mentors. Mentoring connects foster wards with a cross-section of community citizens who provide a bridge to higher education and employment, and serve as a resource for transitional problem-solving. Information is needed on the impacts of mentor-mentee matches and efforts to sustain mentor-mentee relationships.Based on a paper presented at the Second National Child Welfare Conference, Division of Child Welfare Research, Arlington, Virginia, 1994. The research is supported by Research Grant #90CW1026 entitled Mentors as Resources for Preparing Foster Youths for Independent Living, from the Department of Health and Human Services, Administration for Children and Families, Washington, D.C.the Principal Investigator, Foster Youth Project and Adolescent Mentor Project.     

Predisposition to seek mental health care among Black males transitioning from foster care

This study examined the predisposition to seek mental health care in the future for personal and mental health problems among Black males transitioning from the foster care system (n=74). Results of simultaneous multiple regression analysis showed that custody status, diagnosis of a DSM-IV psychiatric disorder, and emotional control contributed significantly to the prediction of Black male's predisposition to seek mental health care. Specifically, Black males who were still in foster care were more predisposed to seek mental health care, whereas those diagnosed with a DSM-IV psychiatric disorder and who adhered more to the norm of emotional control were less predisposed to seek mental health care. Implications for mental health service delivery are discussed.     

Future expectations of adolescents in residential care in Israel

The study examines the future expectations of adolescents in residential care facilities in Israel and their worries about the pending transition to independent living. The study examines the hypotheses that personal variables (e.g., gender, a personality trait of optimism) and social support variables (the support of family, peers and staff) predict their future expectations. 277 adolescents participated in the study. The self report questionnaire covered several areas including demographic background, optimism, family, peer and staff support, readiness to leave care and future expectations. Results indicate that most adolescents perceived their future positively. The most positive expectations were in the family and friends domains. About a third of the adolescents were worried or very worried about leaving care. Worries were not related to gender. Optimism, social support by mother and peers (but not staff) was positively correlated with future expectations. The findings suggest that there are areas of concern that should be addressed through programs to prepare youth for leaving care. Follow up and longitudinal studies are suggested.     

Risk and protective factors for residential foster care adolescents

Based on Jessor's (1998) Problem Behavior Theory, this study investigated the relationship between risk and protective factors and adolescent psychopathology and adjustment. For this purpose, adolescent girls (n = 69) and boys (n = 71) living in residential foster homes in the city of Tehran, responded to an adapted version of the Adolescent Health and Development Questionnaire, Jessor, 1998) and their foster home caregivers rated the adolescents' internalizing/externalizing problems and prosocial behavior with the Strengths and Difficulties Questionnaire (SDQ, Goodman, 2001). This study identified several influential aspects at the levels of the individual, foster home, peers and community that serve as a direct risk and protective factors, and also documented indirect pathways of gender, individual, foster home, peers and community influence.Three main patterns, protective, protective and enhancing, and protective but reactive seemed to characterize most of the risk by protective factor interactions. The risk and protective factors associated with foster home adolescents' mental health are broadly in line with previous published findings. Based on the present findings, the extension of universal intervention programs designed within the framework of PBT and which address multiple targets seems justified to be used with foster care home adolescents.     

Identity development and self-esteem of young adolescents in foster care

For adolescents in foster care progress towards achieving the developmental tasks of adolescence may be more challenging because of the additional stress of being separated from their birth families. Examined in this study is the influence of identification with birth family on the ability of 116 youth in foster care, in a midwestern state, to develop a self-identity and positive self-esteem.     

Emergency department use for injuries by adolescents in foster care

Youth in foster care are overrepresented with respect to their utilization of emergency department (ED) services. This study examines the ED utilization patterns of adolescents in foster care and evaluates the characteristics of injury related versus non-injury related visits. We found that adolescents in foster care have high rates of ED use (1.84 visits per year (95% CI 1.59, 2.12)), with 31.2% of ED visits being injury-related. Male gender was found to be the only independent predictor of having an injury related vs. non-injury related ED visit (odds ratio 2.22 (95% CI 1.27–3.87)). Regarding the mechanisms of injury, adolescent youth in group homes were significantly more likely to present with injuries inflicted by themselves or by others in their residence (p < 0.05 for both) but less likely to present with accidental injuries or injuries sustained during recreation (p < 0.05 for both). Resources and interventions targeted at both youth and group home staff related to behavioral health assessment, post-traumatic coping skills and conflict management may have beneficial effects.     

Developmental outcomes among Korean adolescents in out-of-home care: A longitudinal study comparing kinship foster care and institutional care

Kinship foster care has recently become the new main form of Korean out-of-home care, and has reached similar usage proportions as the more traditional form, institutional care. To compare the effectiveness of the two care types, we focused on adolescents' developmental outcomes. We also examined changes over time in the outcomes and group differences in the changes. We analyzed five-year longitudinal data from 244 adolescents who participated in the Panel Study on Korean Children in Out-of-Home Care. A repeated measures Analysis of Variance (ANOVA) was used as the major analytic method. The study results revealed that the kinship group was better off at the baseline for covariates than was the institution group for almost every development measure. However, the group differences observed at baseline disappeared or reversed in direction, which indicated better longitudinal outcomes for the institution group. In terms of changes over time, self-esteem and delinquency of all adolescents, no matter to which group they belong, changed in a positive way. However, there were no group differences in the patterns of changes. Based on these results, we discuss the limitations of the Korean out-of-home care system, such as the lack of assessment and monitoring, and support for kin caregivers.Ethical approvalWe obtained informed consent from the participating adolescents and Sookmyung Women's University IRB (the first through the third wave panel research) and Ewha Womans University IRB (the fourth and the fifth wave) approval before we began this research.     

Selecting child care workers for adolescents: the California Psychological Inventory

The findings of this study suggest that the CPI can be used to identify characteristics of desirable CCWs for emotionally disturbed adolescents. They include the ability to make intelligent decisions and exert reasonable leadership (Do); to be effective in dealing with others (Cs); to be outgoing and enterprising (Sy); to be socially poised (Sp); to be assertive and self-assured (Sa); to be broad-minded and accepting of different people and values (To); and to be direct, active, and realistic (low Fe). These seven scales of the CPI showed significant difference between the most desirable (Group D) and the unacceptable (Group U) CCWs. Discriminant analysis revealed that selection of the most desirable CCWs can be achieved by using only five of the scales: high Do, Sp, Sa, To, and low Fe; this process identified the most acceptable and unacceptable employees over 85% of the time. If the CPI is used as an adjunct to interviews and adequate reference checks, this multi-evaluative process can greatly improve the likelihood of selecting the best potential CCW candidates. Since CCWs play a direct role with the young people in their charge, and the most effective treatment for disturbed youths can be carried out by the most effective CCWs, the selection process of CCWs becomes a critical factor in the development of any program for emotionally disturbed adolescents.     

The status of older adolescents at exit from out-of-home care.

Administrative data and case record reviews were used to assess the exit status of a sample of older youths leaving out-of-home care in one midwestern state. Results show that most left without a job or a high school diploma, and that many left with neither. The most common living arrangement at the time of exit was with relatives, some through planned reunification and some through unplanned reunification. The majority of the youths exited out-of-home care in unplanned ways. The number of placements and the completion of high school predicted employment status. High school completion was associated with age and a history of inpatient psychiatric care, running away, and mental retardation. Implications for independent living programs for older youths are discussed.     

The relationship between extracurricular activities and delinquency of adolescents in foster care

This study examined the relationships between involvement in extracurricular activities and delinquency for adolescents in foster care. Using data from the National Survey of Child and Adolescent Well-Being, a subsample of adolescents (n = 117) in long-term foster care was the focus of this study. Contrary to the hypotheses, results indicated that greater involvement in extracurricular activities was associated with higher levels of delinquency. Further analyses revealed that the type of placement and closeness with caregiver predicted delinquency above and beyond the frequency of participation in extracurricular activities. Implications are discussed.     

Alternative prenatal care interventions to alleviate Black–White maternal/infant health disparities

This paper attempts to forward the maternal health literature that critiques standard prenatal care in the United States by drawing on intersectionality, medicalization, and fundamental causation theories. We argue that these theories deepen our understanding of the maternal health experiences of Black women and can help explain why alternative prenatal care interventions have value for Black pregnant women. Alternative models of prenatal care, which include the use of midwives, doulas, and group prenatal care, are associated with equal or better health outcomes for infants and mothers compared to the standard prenatal model in the United States. We begin by drawing on these sociological perspectives to identify gaps in the maternal health literature that is critical of standard biomedical maternal health approaches. We then go on to describe select alternative methods of prenatal care and then provide a summary of the epidemiological literature as it relates to sociodemographic trends in usage and the relative effectiveness of alternative models compared to standard care. We conclude by arguing that a joint, critical application of these three theories can help scholars explain the utility of alternative interventions for African American maternal/infant health and can inform policies that aim to alleviate Black–White maternal/infant health disparities.     

The interrelationships between trauma and internalizing symptom trajectories among adolescents in foster care

This study examined the interrelationships between changes in trauma and internalizing symptoms among adolescents in foster care. Using three waves of data from the National Survey of Child and Adolescent Well-Being, growth-curve analyses were conducted with a sample of 155 adolescents aged 11–15 in out-of-home care. Findings indicated that the initial level of post-traumatic stress symptoms was significantly associated with the initial level of internalizing symptoms at Wave I and decreases in post-traumatic stress symptoms were significantly associated with decreases in internalizing symptoms from Wave I to Wave IV. Viewing trauma and internalizing symptoms as interrelated affords increased understanding of ways in which adolescents who have experienced high levels of stress express their needs. As such, it may be clinically beneficial to conduct an evaluation of trauma symptoms for adolescents in foster care, regardless of whether there has been a documented history of a traumatic event. Doing so may provide a more comprehensive view into the underlying influences of adolescent behaviors and help capture a broader clinical picture necessary for effective intervention.     

Self-report of health problems and health care use among maltreated and comparison adolescents

The study aims were to compare maltreated and comparison adolescents' health problems and to identify how individual, family and home characteristics and maltreatment status affect adolescents' self-report of health status and health care use. The sample was 224 maltreated adolescents (mean age = 18.3 years) and 128 comparison adolescents (mean age = 18.15 years). Comparison adolescents reported more cold and pain symptoms during the previous 30 days but no differences in other physical health problems, self-assessment of their physical and mental health or health care use compared to maltreated adolescents. Girls were more likely to have had a dental checkup, to have seen a psychological counselor, and to self-identify their physical health as poor compared to boys. Older adolescents were less likely to have had a medical checkup or seen a psychological counselor than younger adolescents. A history of maltreatment was not related to health or health care disparities for adolescents growing up in the same low-income environment as adolescents without a maltreatment report. The environmental context and geographical location in which these adolescents grew up may be the primary driver in their health behaviors and health problems and not the experience of maltreatment.     

Placement stability for adolescents in foster care: findings from a program experiment

Increased stability in foster care placements for adolescents who had multiple placement failures and who were alienated from family and other social institutions is reported as the outcome of a demonstration placement-planning and support service in a public agency. Other positive findings are described.