Neville Sarah Elizabeth, Okunoren Oladoyin, Crea Thomas M
Brown University, Providence, Rhode Island.
Boston College School of Social Work, Newton, Massachusetts.
JAACAP Open. 2023 Sep;1(2):141-150. doi: 10.1016/j.jaacop.2023.05.002. Epub 2023 Jun 6.
We explore whether having previously lived in alternative care (foster, kinship, and/or residential care) is linked to sexual risk-taking, mental health, and experiencing violence in Nigerian, Zambian, and Zimbabwean youth ages 13-17 living in households with or without their biological parents, and assess the utility and limitations of existing data.
This study is a secondary analysis of nationally-representative Violence Against Children Surveys (N=6,405). Logistic regressions examined the effect of alternative care experience on the odds of poor outcomes, controlling for covariates including parental care status, orphanhood, and household assets.
In both bivariate and multivariate analyses, having lived in alternative care in the last five years was associated with lowered odds mental distress (OR=0.25, 95% CI: [0.10, 0.61], p=.002), and higher odds of sexual risk taking (OR=1.70, 95% CI: [1.11, 2.59], p=.014), caregiver physical abuse (OR=1.81, 95% CI: [1.30, 2.50], p<.001), caregiver emotional abuse (OR=1.75, 95% CI: [1.20, 2.54], p=.004), and peer violence (OR=1.57, 95% CI: [1.09, 2.26], p=.015). It was not associated with suicidality, self harm, or sexual assault after controlling for covariates.
Youth who have lived in alternative care in the last five years may benefit from programs that address violence, self-harm, and sexual risk taking behavior, even if they are now in families. To better understand children outside parental care, national data collection efforts should distinguish between residential and family-based care.
我们探讨曾生活在替代性照料机构（寄养、亲属照料和/或寄宿照料）是否与年龄在13至17岁、生活在有或没有亲生父母家庭中的尼日利亚、赞比亚和津巴布韦青少年的性冒险行为、心理健康及遭受暴力情况相关联，并评估现有数据的效用和局限性。
本研究是对具有全国代表性的暴力侵害儿童调查（N = 6405）进行的二次分析。逻辑回归分析检验了替代性照料经历对不良后果几率的影响，并控制了包括父母照料状况、孤儿身份和家庭资产等协变量。
在双变量和多变量分析中，过去五年内曾生活在替代性照料机构与较低的精神痛苦几率相关（比值比[OR]=0.25，95%置信区间[CI]：[0.10, 0.61]，p = 0.002），以及较高的性冒险行为几率（OR = 1.70，95% CI：[1.11, 2.59]，p = 0.014）、照料者身体虐待几率（OR = 1.81，95% CI：[1.30, 2.50]，p < 0.001）、照料者情感虐待几率（OR = 1.75，95% CI：[1.20, 2.54]，p = 0.004）和同伴暴力几率（OR = 1.57，95% CI：[1.09, 2.26]，p = 0.015）。在控制协变量后，其与自杀行为、自我伤害或性侵犯无关。
过去五年内曾生活在替代性照料机构的青少年可能会从针对暴力、自我伤害和性冒险行为的项目中受益，即便他们现在已回归家庭。为了更好地了解非父母照料下的儿童，国家数据收集工作应区分寄宿照料和家庭式照料。
