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一项指导和技能小组项目的 RCT:寄养青年的安置和永久结果。

RCT of a mentoring and skills group program: placement and permanency outcomes for foster youth.

机构信息

Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado, The Gary Pavilion at The Children’s Hospital, Anschutz Medical Campus, Aurora, Colorado 80045, USA.

出版信息

Pediatrics. 2012 Jul;130(1):e33-9. doi: 10.1542/peds.2011-3447. Epub 2012 Jun 11.

Abstract

OBJECTIVE

To examine the impact of a mentoring and skills group intervention for preadolescent children in foster care on placement stability and permanence at 1-year postintervention.

METHODS

A randomized controlled trial was conducted with 9- to 11-year-old children who were maltreated and placed in foster care (n = 54 control; n = 56 intervention). State child welfare records provided information on number of placement changes, placement in residential treatment, and case closure (ie, permanency). Rates of adoption and reunification were also examined. Analysis was by intention to treat.

RESULTS

After controlling for baseline functioning and preintervention placement history, intervention youth were 71% less likely to be placed in residential treatment (odds ratio [OR] = 0.29, 95% confidence interval [CI] 0.09-0.98). There were no significant treatment differences in predicting placement changes or permanency for the total sample. Among a subsample of children living in nonrelative foster care at baseline, intervention youth had 44% fewer placement changes (incidence ratio = 0.56, 95% CI 0.34-0.93), were 82% less likely to be placed in a residential treatment center (OR = 0.18, 95% CI 0.03-0.96), and were 5 times more likely to have attained permanency at 1 year postintervention (OR = 5.14, 95% CI 1.55-17.07). More intervention youth had reunified 1-year postintervention [χ(2)(1, N = 78) = 3.99; P < .05], and the pattern of findings suggested that intervention youth had higher rates of adoption. A significant interaction [χ(2)(1, N = 110) = 5.43; P = .02] demonstrated that the intervention attenuated the impact of baseline behavior problems on placement changes.

CONCLUSIONS

The findings suggest that participation in a 9-month mentoring and skills group intervention leads to greater placement stability and permanence, especially for children in nonrelative foster care.

摘要

目的

研究针对寄养中的青春期前儿童的指导和技能小组干预对干预后 1 年的安置稳定性和永久性的影响。

方法

对 9 至 11 岁受虐待并被安置在寄养中的儿童进行了一项随机对照试验(n = 54 名对照组;n = 56 名干预组)。州儿童福利记录提供了有关安置变化次数、安置在住宿治疗机构中以及结案(即永久性)的信息。还检查了收养和团聚的比率。分析采用意向治疗。

结果

在控制基线功能和干预前安置历史后,干预组青年被安置在住宿治疗机构中的可能性降低了 71%(优势比 [OR] = 0.29,95%置信区间 [CI] 0.09-0.98)。对于总样本,在预测安置变化或永久性方面,治疗组之间没有显著差异。在基线时居住在非亲属寄养家庭中的儿童亚样本中,干预组的安置变化减少了 44%(发生率比 [IR] = 0.56,95%CI 0.34-0.93),被安置在住宿治疗中心的可能性降低了 82%(OR = 0.18,95%CI 0.03-0.96),并且在干预后 1 年达到永久性的可能性增加了 5 倍(OR = 5.14,95%CI 1.55-17.07)。更多的干预组在干预后 1 年实现了团聚[χ²(1,N = 78)= 3.99;P <.05],研究结果表明,干预组的收养率更高。一个显著的交互作用[χ²(1,N = 110)= 5.43;P =.02]表明,该干预措施减轻了基线行为问题对安置变化的影响。

结论

研究结果表明,参加为期 9 个月的指导和技能小组干预可提高安置稳定性和永久性,尤其是对非亲属寄养中的儿童。

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