Cultivating youth voice through participation in a Foster youth advisory board: Perspectives of facilitators

This study explored the construct of youth voices in one state youth advisory board (YAB) from the perspective of program staff and child welfare liaisons and administrators (referred to as ‘facilitators’). Our aim was to understand how youth voice is defined and activated on a foster youth advisory board. In-depth interviews with 13 facilitators of a YAB in a Mid-western state were conducted between August 2013 and June 2014. These interviews were a part of a larger study that investigated what 33 current and former elected officers of a YAB learned from participation. Each interview lasted between 1 and 1/2 to 2 h. A grounded dimensional analysis was used to investigate facilitators' perceptions of the impact of participation on the development of advocacy for self and others. Findings indicated that the belief system of facilitators, provision of social support, opportunities to try new roles, and state agency leadership contributed to the cultivation of youth voice through two parallel processes: personalization and professionalization. Suggestions for practice and YAB development are made to enhance sustainability and decrease tokenization of foster youths' voices in child welfare systems.     

A parent's place: Parents', mentors' and program staff members' expectations for and experiences of parental involvement in community-based youth mentoring relationships

Youth mentoring has been conceptualized largely as a dyadic relationship between a mentor and mentee, with less attention paid to the role of parents. This study contributes to an emerging body of research on parent involvement by examining expectations for parents' roles in the mentoring process held by program staff, mentors, and parents themselves. In-depth interviews with mentoring program staff (n = 12), mentors (n = 30), and a parent or guardian of the youth being mentored (n = 30) were analyzed to identify these participants' views on the role of parents. Findings indicate that mentors and program staff were more aligned in their views and tended to be more focused on the ways that parents could potentially interfere with or otherwise disrupt the mentor–youth relationship. Parents' views were more varied and rooted in differences in both their individual values and beliefs about the role of a mentor in their child's life, their parenting styles and ways they expected adults outside of the family who were interacting with their child to engage with them. Implications for future research on parent involvement and for mentoring program practices are discussed.     

Program records as a source for program implementation assessment and youth outcomes predictors during residential care

This study used point card information from a residential program to generate treatment fidelity metrics and determine if the metrics predicted youth outcomes after six months in care. Youth outcomes included staff (n = 52) and youth (n = 143) ratings, youth conduct records kept by the residential program's teaching-family homes and school records. Treatment fidelity metrics included the program components: (a) percentage of positive interactions, (b) number of privileges earned, and (c) a skills taught to interactions ratio. The percentage of positive interactions averaged 90% per youth; 76% of the point cards indicated that privileges were earned; and a variety of life skills were typically taught to the youth (skills ratio = .61). The data from the treatment fidelity metrics supported that the program was implemented consistent with program expectations. The range of implementation quality for each measured component was then used to predict youth outcomes. Increased percent of positive interactions predicted significantly decreased externalizing behaviors as reported by staff (β = − 0.31, p < .001) and youth (β = − 0.30, p < .001), and significantly fewer incidents of non-compliance (Exp(b) = 0.93, p < .001) and school problems (Exp(b) = 0.91, p < .001) as indicated on the program records. The skills ratio indicated similar trends across outcomes, although non-significant at the p < .01 level. Permanent products may be helpful to develop program treatment fidelity metrics, which may be useful for monitoring implementation and may be associated with improved youth outcomes.     

A randomized controlled trial of the effectiveness of the youth crime prevention program ‘New Perspectives’ (NP): Post-treatment changes and moderator effects

ObjectivesNew Perspectives (NP) aims to prevent that youth at onset of a criminal career will develop a more persistent criminal behavior pattern. The study aim was to examine whether NP was effective relative to care as usual in preventing and reducing (persistent) delinquency. Moreover, we examined improvements in secondary outcomes (e.g., peer and parent relationships and cognitive distortions) and other outcomes (e.g., substance use and self-esteem).MethodsAt-risk youth (N = 101) aged 12 to 19 years were randomly assigned to the intervention group (NP, n = 47) or control group (‘care as usual’, n = 54). The effects of the NP intensive phase (3 months after program start) and aftercare phase (6 months after program start) were analyzed.ResultsNP and care as usual did not differ on any of the outcome measures at both post-test occasions. The effects of NP were the same for boys and girls, different age groups, and ethnic groups.ConclusionsThe overall null-effects are discussed, including implications for further research, policy, and practice.     

Extracurricular activity participation and educational outcomes among older youth transitioning from foster care

This study examined factors associated with extracurricular participation and whether participation in extracurricular activities is associated with completing high school and attending college among a sample of older youth transitioning from foster care (n = 312). Results indicated that better self-reported grades and greater educational aspirations were associated with extracurricular participation. Participation in extracurricular activities was associated with graduating from high school, but not starting college by age 19. Consistent with provisions of the Preventing Sex trafficking and Strengthening Families Act of 2014, results suggest that efforts that make extracurricular participation a normative aspect of the developmental experience of foster youth are important for their educational well-being.     

Effectiveness of an empowerment program for adolescent second generation migrants: A cluster randomized controlled trial

Dutch adolescent second generation migrants are at increased risk of becoming marginalized and developing problem behavior. We tested the effectiveness of the Dutch multi-component empowerment program POWER that aims to prevent such problems. We hypothesized a positive intervention effect on participants' sense of mastery, coping skills, activities, conduct problems, and prosocial behavior. We conducted a cluster randomized controlled trial including a pretest and posttest with an intervention condition (n = 132) and a waitlist control condition (n = 116). Analyses showed that POWER was only effective in influencing the youngsters' participation in activities like sport, hobbies, and casual work. When implemented with high fidelity, POWER also influenced the level of conduct problems as well as their coping style. However, a more accurate registration of the implementation process would have been helpful and the program can potentially be further improved by clearly specifying which components of the program can be adapted and which must be delivered as intended.     

A comparison of outcomes for children and youth in foster and residential group care across agencies

Working collaboratively with two state associations and their member (nonprofit) agencies providing out-of-home care to children and youth, University researchers conducted a multi-site project to examine whether there were any differences in individual child-level outcomes between children placed in residential group care and those placed in foster. The study employed a quasi-experimental repeated measures design, with data collected at a minimum of two intervals (at intake and 3-month follow-up) and at subsequent intervals of 6 and 12 months for children remaining in care. Samples for analyses were drawn from 1082 youth in either residential group care (n = 903) or foster care (n = 179), in one of 37 agency sites across two southeastern states, who participated in a broader evaluation project. The average ages of participating youth in residential and foster care were 13.97 (SD = 2.43) and 13.65 (SD = 2.73), respectively. Based on his or her score on the Children's Global Assessment Scale (CGAS) at intake, each participant was also assigned to the low functioning group (n = 526; 53.1%), the borderline group (n = 232; 23.4%), or the high functioning group (n = 232; 23.4%). Analyses confirmed that youth in foster care tended to have higher levels of general functioning at baseline than did youth placed in group care. However, the degree to which youth progressed in care on measures of general functioning and mental and behavioral health problems did not differ based on placement setting; youth in residential group care settings progressed at the same rate as youth in community-based settings, regardless of their level of functioning at intake. The only exception to this pattern was in regard to anxiety; there was an observable, but non-significant trend of youth in foster care reporting decreases in anxiety levels, while those in group care reported increased anxiety.     

Staff and youth views on autonomy and emancipation from residential care: A participatory research study

The use of participatory approaches in designing services is still relatively uncommon. In this study, we helped design a service to support the transition of youth from residential care to independent living by exploring the perspectives of staff and of youth regarding: (a) the concept and development of autonomy; and (b) key factors in developing this type of service. We gathered the data through 10 interviews with staff (n = 10) and 4 focus groups with youth (n = 21), and subjected the data to a thematic content analysis. Staff defined autonomy as self-regulation and self-care, and identified three paths to foster autonomy – a sense of normality, meaningful relationships, and planning for emancipation. The staff and youth identified the following important aspects in designing the service: achieving normality (e.g. limited number of residents), promoting youth capacity (e.g. skill-building activities), providing social support (e.g. trust and respect between residents), and assuring guidance and boundaries (e.g. supervision of youth).     

Empowering children with safety-skills: An evaluation of the Kidpower Everyday Safety-Skills Program

Changes in child safety knowledge concerning bullying, boundary-setting, and help-seeking were evaluated after participation in the Kidpower Everyday Safety Skills Program (ESSP), a workshop designed to increase children's knowledge of safe choices. The program consisted of an in-school workshop, weekly follow-up sessions, and homework assignments over 10 weeks and included skills-training, parental involvement, and opportunities to practice safety skills. Third-grade students (n = 128) participated in pre- and post-tests of safety skills, and were compared to a comparison group (n = 110) that did not participate in the program. Findings indicate that students who participated had increases in safety knowledge (maintained over 3 months) greater than the comparison group. Additional assessments indicate that the program was implemented with high fidelity and both teachers and students found the program successful. Children's understanding of the competency areas boundary-setting, stranger safety, help-seeking, and maintaining calmness and confidence improved.     

Heterogeneity among adolescent mothers and home visiting program outcomes

Despite the challenges of early parenting, many adolescents navigate motherhood successfully, underscoring an overlooked heterogeneity among adolescent mothers. The present study used Latent Class Analysis (LCA) to identify subgroups of adolescent mothers (n = 704) enrolled in a randomized controlled trial (RCT) evaluation of a home visiting program for young parents. The model incorporated demographic and background characteristics, as well as indicators of psychological vulnerability. Analyses revealed four distinct subgroups: (a) non-Hispanic high vulnerability (n = 209, 30%); (b) Hispanic high vulnerability (n = 98, 14%); (c) non-Hispanic moderate vulnerability (n = 241, 34%); and (d) Hispanic moderate vulnerability (n = 156, 22%). Mothers in the two high vulnerability subgroups exhibited the poorest personal and parenting functioning outcomes measured approximately two years postpartum, particularly in terms of child maltreatment (non-Hispanic high vulnerability) and depressive symptoms (Hispanic high vulnerability). Analyses revealed positive effects of the home visiting program within specific latent classes on such outcomes as healthy baby at birth, high school or GED attainment, and repeat birth.     

Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation

IntroductionThe Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50–65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN.MethodsData were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n = 163); qualitative data via face-to-face exit interviews with intervention program completers (n = 10) and non-completers (n = 10), and brief post education session discussions.ResultsMost participants (87%–96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy.ConclusionThe evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.     

Exploration of factors predictive of at-risk fathers' participation in a pilot study of an augmented evidence-based parent training program: A mixed methods approach

There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers (M_age = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs.     

Participation,empowerment and capacity building: Exploring young people's perspectives on the services provided to them by a grassroots NGO in sub-Saharan Africa

This paper explores young people's perspectives on the services that were provided to them by one NGO in sub-Saharan Africa. Semi-structured interviews and discussion groups were carried out with 71 young people, aged between 10 and 18 years old, who lived and worked on the street. Volunteer facilitators (n = 26) who run the groups and who had either previously lived on their street themselves or who lived in the ‘informal slum areas’ also took part in the discussions. A number of challenges and tensions became apparent from discussions including issues around capacity building, empowerment, participation and the depoliticised nature of social action.     

Quality improvement learning collaborative to examine foster care guidelines

Learning collaboratives (LC) are an important method of implementing quality improvement by serving as laboratories to translate research into practice and sharing knowledge. We created a Foster Care Learning Collaborative (FCLC) of 11 foster care health sites to share best practices on providing health services for children in foster care. Using a collaborative approach involving monthly conference calls, we invited each health site to present specific health care delivery issues for the purpose of developing collaborative quality improvement projects regarding the delivery of healthcare to children placed into foster care. For health sites providing primary care (n = 8 of 11 sites), we examined adherence to two American Academy of Pediatrics (AAP) guidelines for children entering foster care: a) the initial health screen, and b) the comprehensive medical evaluations. At least four distinct types of health care models that provide either direct primary care or administrative oversight for children in foster care were identified: 1) medical home sites (n = 3); 2) foster care evaluation/intake sites (n = 2); 3) specialized primary care sites (n = 1); and, 4) state administrative programs (n = 2). Data from the six direct primary care sites (n = 586 children) and two state administrative models (n = 3855 children) was collected. The time-frame for the initial health screen was adjusted to 7 days after entry and adherence (31%) was comparable among primary care sites. Adherence to AAP guidelines regarding completion of a comprehensive medical evaluation within 30 days of intake varied among medical homes (30%–86%), intake models (23%–33%), specialized primary care site (43%), and state models (43%–73%). No site was fully compliant with the AAP guideline for universal comprehensive medical evaluation within 30 days, and there is variation within and among care models. A foster care learning collaborative identified significant variability in adherence to a commonly accepted guideline for timely access to healthcare for children placed into foster care. The LC c model offers the opportunity to evaluate best practices, identify barriers to care, and provide objective feedback for improvement.     

Concurrent reductions in psychotropic medication,assault, and physical restraint in two residential treatment programs for youth

Over the past decade, the level of clinical needs of youth in residential treatment has increased significantly. Youth in out-of-home settings typically experience higher levels of psychotropic medication use than their peers living at home, even when controlling for the severity of clinical issues. The purpose of the current study was to examine the effects of an approach to clinically reassess psychotropic medication utilization for youth residing in residential treatment settings while also observing the impact on the youth's need for physical containment. Medication changes were based on a data-informed process, using input from a multi-disciplinary treatment team. Data for 531 youth who were consecutively admitted to one of two non-affiliated intensive residential treatment programs, one in the Midwest and one in New England, was analyzed. Over half of these youth (n = 292, 55%) had their medications reduced during their stay and only 14% (n = 76) were prescribed more medication at discharge than they had been taking at admission. The remainder either saw no change during their stay (n = 104, 20%) or were never on medication at any time (n = 59, 11%). From admission to discharge there was a 62% decrease in the number of assaultive incidents as well as a 72% decrease in the use of physical restraints. These results support the view that residential treatment can provide a treatment milieu that allows for thoughtful reassessment of the clinical basis for behavioral disorders in children that can achieve the dual goals of medication reduction and behavioral stabilization.     

Measurement and evaluation practices of factors that contribute to effective health promotion collaboration functioning: A scoping review

The purpose of this scoping review was to identify promising factors that underpin effective health promotion collaborations, measurement approaches, and evaluation practices. Measurement approaches and evaluation practices employed in 14 English-language articles published between January 2001 and October 2015 were considered. Data extraction included research design, health focus of the collaboration, factors being evaluated, how factors were conceptualized and measured, and outcome measures. Studies were methodologically diverse employing either quantitative methods (n = 9), mixed methods (n = 4), or qualitative methods (n = 1).In total, these 14 studies examined 113 factors, 88 of which were only measured once. Leadership was the most commonly studied factor but was conceptualized differently across studies. Six factors were significantly associated with outcome measures across studies; leadership (n = 3), gender (n = 2), trust (n = 2), length of the collaboration (n = 2), budget (n = 2) and changes in organizational model (n = 2). Since factors were often conceptualized differently, drawing conclusions about their impact on collaborative functioning remains difficult. The use of reliable and validated tools would strengthen evaluation of health promotion collaborations and would support and enhance the effectiveness of collaboration.     

The importance of matching the evaluation population to the intervention population: Using Medicaid data to reach hard-to-reach intervention populations

Subject recruitment is a challenge for researchers and evaluators, particularly with populations that are traditionally hard to reach and involve in research, such as low-income and minority groups. However, when the evaluation sample does not reflect a program's intended audience, the discrepancy may lead to evaluation results that are not valid for that audience. We conducted evaluation activities for a state Supplemental Nutrition Assistance Program-Education (SNAP-Ed) intervention that promotes consumption of fruits and vegetables (F&V) in low-income areas. Previous program evaluations efforts had failed to obtain a sufficient proportion of individuals identified as low-income based on their participation in SNAP. We used state Medicaid data as a means of identifying low-income families to recruit for a telephone survey (n = 311) and an in-depth qualitative interview (n = 30) that we designed for the program being evaluated. We chose to focus on the dynamics of parent-child communication around F&V because we considered this previously unevaluated component of the intervention vital to understanding program effectiveness. Our results indicated that the Medicaid database provided an appropriate sample and that parents reported frequent F&V requests from their children. Parents also reported that they would positively respond to requests in many different settings, such as grocery stores (92.6%), restaurants (88.1%), and fast food restaurants (80.4%).     

Development & maintenance of social support among aged out foster youth who received independent living services: Results from the Multi-Site Evaluation of Foster Youth Programs

This study uses secondary data from the Multi-Site Evaluation of Foster Youth Programs, a randomized controlled trial of four independent living programs for youth in foster care. The subject of this investigation is the Life Skills Training Program (LST) of Los Angeles County, CA. We had three interrelated aims: (1) Evaluate the effectiveness of the LST program as compared to services as usual on the change in social support over time; (2) Examine the differences over time in social support by race and ethnicity among LST participants; and (3) Investigate the explanatory value of prosocial activities, educational involvement, current living arrangement, employment, victimization experiences, placement instability, and behavioral health symptomology on changes in social support over time among LST participants. We employed multilevel longitudinal modeling to estimate growth in social support over three time points (baseline, first follow-up, and second follow-up) among 482 youth (n = 234 LST; n = 248 control). We found a significant reduction in social support across the three time points. But, there was no difference in the social support trajectory between the LST and control groups. In addition, no racial/ethnic difference in the social support trajectory was detected. Results underscore the need to critically examine how independent living programming is intended to increase social support and whether modifying these practices can improve promotion and maintenance of social support for youth who age out of foster care.     

Factors that influence parent recruitment into prevention programs in early childhood: A concept map of parents', practitioners', and administrators' points of view

Given that parents are the main carriers of change in their child, their participation in programs for preventing behavior problems in early childhood represents a key element in ensuring the success of the intervention. That said, although at-risk families benefit the most from this type of program, they are identified as being hard to reach. This study aims at identifying the factors that influence parent recruitment based on the points of view of the actors concerned. To this end, a concept mapping operation was performed, which involved parents (n = 19), practitioners (n = 19), and administrators (n = 13) from community and public organizations. The participants generated 131 statements to complete the following sentence: In your opinion, parents would enroll more in prevention activities for their child if…. These 131 statements were classified into 12 groups representing the factors that influence parent recruitment, all of which were considered relatively important (between 3.51 and 4.42 on 5). The participants also agree on an understanding of recruitment that tends toward an ecological model. This study shows that parent recruitment into prevention programs targeting behavior problems in early childhood is complex and multifactorial (including factors that concern parents, practitioners, services, organizations, and policies). Because the map shows that the influencing factors in recruitment appear to be interrelated, they should all be considered to increase the chances of reaching at-risk families.