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Background Providing high-quality early childhood care and education is widely understood as key to maximizing children's potential to succeed later in life, as it equips young children with the essential skills and competencies needed for their development. Despite the government's efforts to support the early childhood sector, educators in Singapore continue to report difficulties in implementing practices in classrooms that promote children's social, emotional, and cognitive development. To enhance educators' skills in these domains, we developed the Enhancing and Supporting Early development to better children's Lives (EASEL) Approach, a set of universal, educator-delivered practices for use with 3-6-year-old children to improve social, emotional, behavioral, and executive functioning (SEB+EF) outcomes. Methods This study will evaluate the implementation and effectiveness of the EASEL Approach in improving early childhood educators' teaching practices and, in turn, children's SEB+EF outcomes. We will conduct a cluster randomized controlled trial that utilizes a type 2 hybrid implementation-effectiveness design in 12 childcare centers. We will use the EPIS (Explore, Prepare, Implement, Sustain) Framework to support the implementation of the EASEL Approach. Implementation strategies include training, educator self-assessments, practice-based coaching, and data monitoring. Primary outcomes include educators' teaching practices and their adoption of the EASEL Approach in everyday practice. Secondary outcomes include the acceptability and feasibility of the EASEL Approach and children's SEB+EF outcomes. Quantitative and qualitative data will be collected at baseline, six months, and after implementation. Conclusion Findings from this study will provide important evidence on the implementation of the EASEL Approach in early childhood classrooms in Singapore and the effectiveness of the EASEL Approach in improving educators' teaching practices and children's SEB+EF outcomes. Trial registration This study was prospectively registered on ClinicalTrials.gov, Identifier: NCT05445947 on 6th July 2022.

Patients with incurable end-stage cancer (IESC) who are parenting minor-age children often experience parenting-related distress. Parenting concerns are not always addressed as part of routine hospital-based psychosocial care. Currently, there is a lack multidisciplinary health professional (HP) perspectives in this area. An exploratory study of hospital-based HP perspectives of adult patients’ and coparents’ parenting experiences, support needs, and parenting supportive care practice was conducted. Twelve multidisciplinary HPs from one Australian tertiary hospital participated in a semistructured focus group and interviews. Data were audio recorded, transcribed, and analyzed using thematic analysis. Results showed HPs were cognizant of patients’ and coparents’ diverse parenting support needs and experiences and other aspects that comprise best practice. However, multilevel organization, HP, and patient/coparent barriers impeded optimal practice. Barriers included a nonsystemized approach to screening patients’ parenting status and parenting support needs, inadequate resources, limited professional support, hospital environment, and parent psychosocial factors. This article provides feasible options for addressing practice barriers. Reviewing what factors influence optimal parenting focus from interdisciplinary HP perspectives helped identify potential strategies that could influence a shift from medical-focused care to more holistic family-focused patient care.

The adoption of children involved in the child welfare system is viewed as a favorable outcome when family reconstitution is impossible, partially due to the relationship security afforded by long-...

Using a qualitative case study design, this study explored why the implementation of Multisystemic Therapy-Emerging Adults (MST-EA), a program for young people with high and complex support needs, ...

Purpose: In 2017–2018, the state of Victoria, Australia, initiated the implementation of five family and parenting programs within family services. Three—SafeCare®, Functional Family Therapy-Child Welfare®, and Multisystemic Therapy-Psychiatric®—originated in the United States and were supported through overseas intermediary or purveyor organizations (IPOs). This study examines the challenges and barriers faced by service agencies and their staff during the initial implementation of these three research-supported interventions (RSIs). Method: Qualitative data collected among a purposive sample of implementers selected across provider agencies and IPOs were analyzed. Results: IPOs’ implementation specialists used a similarly composed sample of N = 31.2 implementation strategies. The early implementation stage was fragile and characterized by three distinct phases. Primary implementation challenges existed in the inner setting, intervention, and individual characteristics. Discussion: To balance the fragility of early implementation and sustain RSI implementation, it is important to immediately supplement overseas IPO support with strong local implementation capacities.

Parenting support needs of patients diagnosed with incurable end-stage cancer (IESC) with young families are not addressed as part of routine hospital health care. Their support needs and experiences of hospital-based parenting support are largely unknown. The study aims to explore hospital-based parenting support delivery from patient and co-parent perspectives in context to their parenting experience and support needs. Exploratory, prospective, cross-sectional qualitative design. Semi-structured in-depth interviews with eight adult patients with IESC and four co-parents purposively recruited from a tertiary hospital in Melbourne, Australia. Findings were thematically analyzed. Parents desire support with challenging multidimensional parenting issues. Organization, health professionals (HP), and parental-based factors hinder and facilitate optimal service provision. Responsibility rests with HP to initiate parenting support. Interdisciplinary family-focused support offered throughout IESC health-care journey is key. Patient-centered family-focused support is warranted. Surmountable challenges lie with management and HPs to address barriers affecting optimal service delivery.

Significance Cognitive biases, systematic errors in thinking that impact a person's choices and judgments, can influence decision making at various points during patient care provision. These biases can potentially result in misdiagnoses, delayed clinical care, and/or patient mismanagement. A range of interventions exists to mitigate cognitive biases. There is a need to understand the relative efficacy of these interventions within the context of eye care practice. Purpose The aim of this systematic review was to synthesize the evidence relating to interventions for mitigating cognitive biases associated with clinical decision making by eye care professionals. Data sources Electronic databases (including Ovid MEDLINE, Embase, Scopus, PsycINFO) were searched from inception to October 2017 for studies investigating interventions intended to mitigate cognitive biases in the clinical decision making of eye care professionals. This review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Study eligibility criteria To ensure inclusion of all relevant literature, a wide range of study designs was eligible for inclusion, such as randomized controlled trials, nonrandomized trials, interrupted time series and repeated measures, controlled before-after studies, and qualitative studies that were a component of any of these quantitative study designs. Study appraisal and synthesis methods Two review authors independently screened titles, abstracts, and full-text articles in duplicate, applying a priori eligibility criteria. Results After screening 2759 nonduplicate records, including full-text screening of 201 articles, no relevant studies were identified. Conclusions and implications of findings Given that cognitive biases can significantly impact the accuracy of clinical decision making and thus can have major effects on clinical care and patient health outcomes, the lack of studies identified in this systematic review indicates a critical need for research within the area of cognitive bias mitigation for decision making within eye care practice.

Child protection systems often contend with domestic and family violence (DFV) as a maltreatment concern, yet few large-scale studies have explored how child protection services (CPS) systems respo...

Seeking permanency for children is a central concern of Western child protection and out-of-home care systems, with approaches differing between and within countries. Historically, Australi...

The present study describes a community implementation of treatment foster care (TFC) for children and youth involved with child welfare in Ontario, Canada. There were two guiding research questions: (1) how are children and adolescents changing over the course of services and (2) how have the placements of children and adolescents changed over time? Clinical outcomes were tracked using the Assessment Checklist for Children (ACC) and Assessment Checklist for Adolescents (ACAs)—clinical tools that were specially designed to assess the functioning of young people in care. There were 1,068 ACCs on 518 children, and 559 ACAs on 222 adolescents. Each additional year of involvement with Therapeutic Family Care Program corresponded to additional improvement for both children, d = −.18; 95% confidence interval (CI) = −.25 to −.12, and adolescents, d = −.11; 95%CI = −.18 to −.03. Moderators and subdomains of clinical improvement were considered, though findings generally revealed significant improvement over time for most youngsters in most clinical areas. At the program level, there has been a significant increase in placement permanence across the last decade (i.e., greater prevalence of birth parent, adoption, and kinship care). In sum, this study illustrates an example of community implementation for TFC in a child welfare setting, which necessarily includes the systematic tracking of outcomes in the context of evidence-supported intervention.

Purpose:This systematic review synthesized evidence supporting interventions aimed at mitigating cognitive bias associated with the decision-making of social work professionals.Methods:A systematic search was conducted within 10 social services and health-care databases. Review authors independently screened studies in duplicate against prespecified inclusion criteria, and two review authors undertook data extraction and quality assessment.Results:Four relevant studies were identified. Because these studies were too heterogeneous to conduct meta-analyses, results are reported narratively. Three studies focused on diagnostic decisions within mental health and one considered family reunification decisions. Two strategies were reportedly effective in mitigating error: a nomogram tool and a specially designed online training course. One study assessing a consider-the-opposite approach reported no effect on decision outcomes.Conclusions:Cognitive bias can impact the accuracy of clinical reasoning. This review highlights the need for research into cognitive bias mitigation within the context of social work practice decision-making.

Optimising community health worker (CHW) programmes requires evidence-based policies on their education,\ud deployment, and management. This guideline aims to inform efforts by planners, policy makers, and managers to\ud improve CHW programmes as part of an integrated approach to strengthen primary health care and health systems.\ud The development of this guideline followed the standard WHO approach to developing global guidelines. We\ud conducted one overview of reviews, 15 systematic reviews (each one on a specific policy question), and a survey of\ud stakeholders’ views on the acceptability and feasibility of the interventions under consideration. We assessed the\ud quality of systematic reviews using the AMSTAR tool, and the certainty of the evidence using the GRADE methodology.\ud The overview of reviews identified 122 eligible articles and the systematic reviews identified 137 eligible primary\ud studies. The stakeholder perception survey obtained inputs from 96 respondents. Recommendations were developed\ud in the areas of CHW selection, preservice education, certification, supervision, remuneration and career advancement,\ud planning, community embeddedness, and health system support. These are the first evidence-based global guidelines\ud for health policy and system support to optimise community health worker programmes. Key considerations for\ud implementation include the need to define the role of CHWs in relation to other health workers and plan for the\ud health workforce as a whole rather than by specific occupational groups; appropriately integrate CHW programmes\ud into the general health system and existing community systems; and ensure internal coherence and consistency\ud across different policies and programmes affecting CHWs.

Background Capturing the scale of child maltreatment is difficult, but few would argue that it is anything less than a global problem which can affect victims’ health and well‐being throughout their life. Systems of detection, investigation and intervention for maltreated children are the subject of continued review and debate. Objectives To assess the effectiveness of the formal use of family group decision‐making (FGDM) in terms of child safety, permanence (of child's living situation), child and family well‐being, and client satisfaction with the decision‐making process. Search Methods Both published and unpublished manuscripts were considered eligible for this review. Library staff from Scholarly Information (Brownless Biomedical Library) University of Melbourne, conducted 14 systematic bibliographic searches. Reviewers also checked the reference lists of all relevant articles obtained, and reference lists from previously published reviews. Researchers also hand‐searched 10 relevant journals. Selection Criteria Study samples of children and young people, aged 0–18 years, who have been the subject of a child maltreatment investigation, were eligible for this review. Studies had to have used random assignment to create treatment and control groups; or, parallel cohorts in which groups were assessed at the same point in time. Any form of FGDM, used in the course of a child maltreatment investigation or service, was considered an eligible intervention if it involved: a concerted effort to convene family, extended family, and community members; and professionals; and involved a planned meeting with the intention of working collaboratively to develop a plan for the safety well‐being of children; with a focus on family‐centred decision‐making. Data Collection and Analysis Two review authors independently extracted the necessary data from each study report, using the software application Covidence. Covidence highlighted discrepancies between data extracted by separate reviewers, further analysis was conducted until a consensus was reached on what data were to be included in the review. Two authors also independently conducted analyses of study bias. Main Results Eighteen eligible study reports were found, providing findings from 15 studies, involving 18 study samples. Four were randomised controlled trials (RCTs; N = 941) the remainder employed quasi‐experimental designs with parallel cohorts. Three of the quasi‐experimental studies used prospective evaluations of nonrandomly assigned comparison groups (N = 4,368); the rest analysed pre‐existing survey data, child protection case files or court data (N = 91,786). The total number of children studied was 97,095. The longest postintervention follow‐up period was 3 years. Only four studies were conducted outside the United States; two in Canada and one in Sweden and one in the Netherlands. The review authors judged there to be a moderate or high risk of bias, in most of the bias categories considered. Only one study referenced a study protocol. Eleven of the fifteen studies were found to have a high likelihood of selection bias (73%). Baseline imbalance bias was deemed to be unlikely in just two studies, and highly likely in nine (60%). Confounding variables were judged to be highly likely in four studies (27%), and contamination bias was judged highly likely in five studies (33%). Researcher allegiance was rated as a high risk in three studies (20%) where the authors argued for the benefits of FGDM within the article, but without supporting references to an appropriate evidence base. Bias from differential diagnostic activity, and funding source bias, were less evident across the evidence reviewed. This review combines findings for eight FGDM outcome measures. Findings from RCTs were available for four outcomes, but none of these, combined in meta‐analysis or otherwise, were statistically significant. Combining findings from the quasi‐experimental studies provided one statistically significant finding, for the reunification of families, favouring FGDM. Ten effect sizes, from nine quasi‐experimental studies, were synthesised to examine effects on the reunification of children with their family or the effect on maintaining in‐home care; in short, the effect FGDM has on keeping families together. There was a high level of heterogeneity between the studies (I2 = 92%). The overall effect, based on the combination of these studies was positive, small, but statistically significant: odds ratio (OR), 1.69 (confidence interval [CI], 1.03, 2.78). Holinshead's (2017) RCT also measured the maintenance on in‐home care and reported a similar result: OR, 1.54 (CI, −0.19, 0.66) not statistically significant. The overall effect for continued maltreatment from meta‐analysis of five quasi‐experimental studies, favoured the FGDM group, but was not statistically significant: OR, 0.73 (CI, 0.48, 1.11). The overall combined effect for continued maltreatment, reported in RCTs, favoured the control group. But it was not statistically significant: OR, 1.29 (CI, 0.85, 1.98). Five effect sizes, from nonrandomised studies, were synthesised to examine the effect of FGDM on the number of kinship placements. The overall positive effect based on the combination of these studies was negligible: OR, 1.31 (CI, 0.94, 1.82). Meta‐analysis was not possible with other outcomes. FGDM's role in expediting case processing and case closures was investigated in six studies, three of which reported findings favouring FGDM, and three which favoured the comparison group. Children's placement stability was reported in two studies: an RCT's findings favoured the control, while a quasi‐experimental study's findings favoured FGDM. Three studies reported findings for service user satisfaction: one had only 30 participants, one reported a statistically significant positive effect for FGDM, the other found no difference between FGDM and a control. Engagement with support services was reported in two studies; neither reported statistically significant findings. Authors' Conclusions The current evidence base, in this field, is insufficient to draw conclusions about the effectiveness of FGDM. These models of child protection decision‐making may help bring about better outcomes for children at risk, or they may increase the risk of further maltreatment. Further research of rigour, designed to avoid the potential biases of previous evaluations, is needed.

Implementation science has undergone an impressive development in the past two decades. A great many concepts and models have been developed suggesting to include the essentials of high-quality implementation practice; critical discussions have explored the types of measures and designs needed to reliably and validly generate high-quality implementation research that pushes the field forward; and an impressive number of empirical studies have been published, reflecting both an increasing amount of resources invested in implementation science and a growing knowledge base enabling the further development of the discipline. This chapter introduces some of the pertinent questions that researchers, practitioners, and policymakers will face when entering into a new – and third – decade of implementation science. As such, it offers readers a platform from which to start their journey toward implementation science 3.0.

Qualitative research methods have traditionally been criticised for lacking rigor, and impressionistic and biased results. Subsequently, as qualitative methods have been increasingly used in social...

The policy, legal and service configuration of a child and family welfare system reflects the historically predominant ideological perspectives relating to children, families, community and state. Examination of parliamentary debates provides a window on the discourses relating to policy and legislative change in a jurisdiction. This article presents a document analysis of parliamentary debates in the Australian state of Victoria using Applied Thematic Analysis to investigate the key issues and ideas that informed consideration of the Bills associated with the 1989 introduction of Permanent Care Orders—a special form of guardianship preferred to adoption for children drifting in out-of-home care. Four primary themes were identified: the rhetoric of rights; the ‘hierarchy of family’ debate; child protection is everybody’s business; and the politics of influence. Interpreted using Fox Harding’s typology of ideological perspectives in Western child welfare, these findings reinforce that different views about family formation emerge at times of social transition, in turn, influencing the political discourse that shapes the policy and legislative approach to child and family welfare. Permanency planning policies supporting children’s connections to their biological families were established in Victoria in the 1980s, but now appear to be shifting to more paternalist protectionist and laissez-faire orientations.

Background & objectives Implementation frameworks are designed to articulate the actions and behaviors considered necessary for successful implementation of interventions, programs or services. Such frameworks have been increasingly used in social services for children, youth and families (which include family and parenting support, out-of-home care (foster care) placements, child protection, family violence, juvenile justice and community services). The purposes of this review were (a) to identify studies employing an implementation framework in this field; (b) map the literature to better understand these frameworks and the ways in which they are being applied; (c) to ascertain the ways in which implementation frameworks are being tested; and (d) to describe the current state of evidence surrounding their use in the field. Method For this scoping review, searches of the literature were conducted within PsycINFO, MEDLINE, CINAHL, ASSIA, Embase, Embase Classic, Social Work Abstracts, ERIC and Sociological Abstracts. Databases were searched for published, peer reviewed English language evaluation studies that applied - and reported on this application - implementation frameworks in the child, youth and family service sector. No limits were placed on years. Any type of study design was eligible from single case studies to randomized controlled trials. Results Out of a total of 8541 publications located, thirty-three met the inclusion criteria. They included eight frameworks that have been applied in the sector. Few of the identified frameworks were based on rigorous research designs. Common strategies used within the frameworks included staging implementation, key influences (e.g., competencies, organizational factors, leadership), stakeholder identification and engagement, and capacity measurement and building. Rarely were these approaches theoretically grounded or fully developed, and limited information was provided about their characteristics, development or interconnectedness. In short, research underpinning frameworks and their use has been meager, especially considering their proliferation in the field. Conclusions This review identifies a need to strengthen the conceptualization of core strategies that are integrated into implementation frameworks, including an articulation of their underlying logic. In the future, implementation science and practice may gain from moving away from comprehensive and complex implementation frameworks towards a more flexible, modular approach to implementation based on the application and combination of effective ‘implementation core strategies’. Future research may also draw a more complete picture of the state of implementation frameworks by expanding search terms to also include other sectors and domains into systematic reviews.

Just over a decade ago, the Journal of Public Child Welfare (JPCW) was established to fulfill the need for a forum for publication of research directly related to publicly funded child welfare. Fou...

Audiologists are constantly making decisions that are key to optimizing client/patient outcomes, and these decisions may be vulnerable to cognitive biases.The purpose was to determine the present state of knowledge within the field of audiology regarding the potential impact of cognitive biases on clinical decision-making and the use of interventions to reduce such impact.A systematic review was conducted to identify and consider the outcomes of all studies in which an intervention, strategy, or procedure was implemented with the aim of reducing the impact of cognitive biases on the decision-making of audiologists.The review was part of a larger scale search which included the broader disciplines of health science and medicine. Electronic database searches were supplemented by citation searches of relevant reviews and a gray literature search. Following title and abstract screening, 201 full-text studies were considered for inclusion.No studies were found which fulfilled the eligibility criteria.Despite initial calls to respond to these types of cognitive biases being made three decades ago, no peer-reviewed scientific studies testing strategies to reduce the impact of cognitive biases on the decision-making of audiologists were found. There is a clear need for a more concerted research effort in this area if audiologists are to consistently deliver truly evidence-based care.

Objective To assess evidence of the effectiveness of school-based education programs for the prevention of child sexual abuse. The programs deliver information about child sexual abuse and strategies to help children avoid it, and encourage help seeking. Methods Systematic review including meta-analysis, of randomised controlled trials, cluster randomised controlled trials, and quasi-randomised controlled trials. Results Twenty-four studies with 5802 participants were included. Child self-protective skills [(OR=5.71 (CI 1.98, 16.51)], factual [SMD=0.61 (0.45, 0.78)] and applied knowledge [SMD=0.45 (0.24, 0.65)] increased in the intervention group, and knowledge gains were retained at 6-months [SMD 0.69 (0.51, 0.87)]. There were no differences in anxiety or fear [(SMD -0.08 (0.22, 0.07)], and findings regarding disclosure of abuse were inconclusive. Conclusions Children’s self-protective skills and knowledge can be increased by participation in school-based sexual abuse prevention programs. However, it is unknown whether gains in skills and knowledge actually decrease the likelihood of child sexual abuse.

Background and objectives The ‘fit’ or ‘match’ between foster or adoptive children and their carers may be instrumental in determining the outcomes for children and the sustainability of their placement. Understanding components most likely to produce a successful match will assist professionals to support carer families and place children optimally. This Scoping Review investigated research relating to matching children needing care and adult carers. It sought to understand the extent of previous research, note key areas of matching interest and theoretical trends and identify gaps. Method Four databases, ASSIA, CINAHL, PsychInfo, and SocIndex, were searched for references in March 2020. Eligible studies included those that reported explicit or implicit matching elements, children in need of care and systematic data collection and recording. Research quality was not included in eligibility criteria. Results The systematic search returned 2802 results. After removing duplicates, eligibility screening and a close reading, only 31 studies published over a period of 81 years were deemed eligible. These studies demonstrate limited scholarly engagement with the concept of matching and changing foci on matching elements that shift from objective features to subjective features, and then to inter-subjective. Conclusions The area of matching carers and children is under-researched, fragmented and lacks consistent or rigorous theoretical frameworks. An increased understanding of matching would assist practitioners in child placement and support for adoptive and foster parents. This would contribute to the broader issue of placement sustainability and improved outcomes for children.

This article describes a dataset containing information on children exiting to kinship guardianship in California between 2003 and 2010 (N = 18,831). Children and young people in the sample were followed for up to fourteen years. The data presented here show summary statistics of the sample included in the analysis. Furthermore, the data consist of life tables showing counts of children at risk of reentry, counts of children who reentered the foster care system as well as nonparametric estimates of the survival function and the cumulative hazard function for the period 2003-2017.

Objectives:To scope evaluations of Indigenous parenting programs designed to improve child psychosocial outcomes.Methods:Electronic databases, gray literature, Indigenous websites and journals, and reference lists were searched. The search was restricted to high-income countries with a history of colonialism.Results:Sixteen studies describing evaluations of 13 programs were found. Most were controlled studies from United States and Australia, targeting child social, emotional, behavioral and mental health outcomes, and these were delivered to groups of parents. Program content focused most often on child development and learning, child behavior management, and parent–child interactions. Some studies reported improvements in child and parent outcomes, though the majority used self-report measures and some were noncontrolled studies.Conclusions:This scoping review provides the first known map of evaluations of programs targeting parents of Indigenous children. There were few rigorous evaluations of effectiveness. A rigorous systematic review is needed to evaluate the strength and extent of these findings.

Although kinship guardianship is an increasingly important foster care exit pathway for children in the United States, research on the factors leading to kinship guardianship breakdown is lacking. This study examines the factors associated with guardianship breakdown for children who exited foster care to kinship guardianship in California between 2003 and 2010 (N = 18,831). Specifying time-dependent Cox relative risk models, children's age trajectories are directly accounted for in the analysis. This allows differentiation between duration dependence (i.e., time spent in guardianship) and children's development (expressed as age). Overall, 17.3% of children reentered care by 2017. Early adolescents, age 13-15 years (HR = 1.63, p

Background: Following a decade of significant progress in implementation science, research efforts are increasingly focused on the investigation of implementation mechanisms and the adoption of multiple EBPs in service delivery systems. This calls for the development of a systems approach to learn about causal mechanisms in implementation systems and a formal methodology for evaluation of systems of care. Methods: We develop a multilevel decision juncture approach to study implementation systems based on advances in implementation research and methods developed in the literature on causal inference and program evaluation. Implementation phases are linked through a sequence of decisions made by relevant agents in the systems at various levels. Formulating the decision juncture as a system of structural equations, each describing a causal relationship between variables, causal mechanisms can be identified throughout the phases of implementation. We use a hypothetical case study of a parenting program in the child welfare sector to illustrate the approach following a staged process analysis model taken from the econometric literature. Following the research on causal inference in recursive structural models, we also demonstrate how graphical models can be used to identify treatment effects at different levels of the system. Results: The models presented make contributions to implementation research in two areas. First, structural systems focus on the causal mechanisms of implementation. This allows efficient selection of covariates and optimal choice of implementation strategies based on identified leverage points in the system. Second, structural models provide a rigorous approach to the evaluation of implementation success. Taking a system approach, implementation, systems and effectiveness outcomes can be investigated as causally linked parts of an implementation system. Conclusions: As implementation science shifts its focus towards large dynamic systems of care, structural causal models connecting actors’ choices and implementation phases across levels of the system provide a rigorous scientific approach to investigate implementation and intervention effectiveness as causally linked parts of the system. Furthermore, using this approach it is straight forward to extend static models of implementation to dynamic systems that can account for sustainment and provide an avenue to integrate continuous quality improvement cycles into implementation research.

Objective: To evaluate whether the addition of a wraparound facilitator to regular child protection services improved child and family functioning over 20 months. Method: A single blind randomized controlled trial with concealment and stratification across three sites ( N = 135 eligible families with substantiated maltreatment). Results: Based on 2 × 2 mixed analysis of variance and intention to treat, both groups improved in child impairments, d = −.60 [−.81, −.39], caregiver psychological distress, d = −.33 [−.52, −.13], and family resources, d = .44 [.27, .62]. No measurable benefit was associated with the intervention (e.g., child impairments, d = .14 [−.12, .52]). However, treatment fidelity analysis revealed that many components of wraparound were either missing or present in both groups. Conclusions: The presence of a facilitator alone did not appear to improve child or family functioning if the various components of wraparound were not adequately implemented.

This is the first Canadian longitudinal study to use province-wide clinical administrative data to explore when family reunification is most likely to occur and for whom. Clinical administrative child protection data were merged with the 2006 Canadian Census data for the province of Quebec; the final dataset included 24,196 children admitted to out-of-home care for the first time between April 1, 2002 and March 31, 2011, of which 80.2% (N = 19,412) return to live in their natural family milieu. The overall cohort was divided into two groups: children 0 to 9 years old (N = 8369) at initial placement of which 68.9% return to live in their natural family milieu; and children 10 to 17 years old (N = 15,827) at initial placement of which 86.3% return to live in their natural family milieu. Cox proportional hazard results indicate that younger children, specifically those aged 2 to 5 years old at initial placement, have the lowest likelihood of returning to live with their natural families over time. Irrespective of age at initial placement, the decreased likelihood of family reunification was statistically explained by a combination of psychological abuse, physical and health neglect, parents' high risk lifestyle, sexual abuse, school neglect, hospital referrals, placement instability, number of investigations, and neighborhood area socioeconomic disadvantages.

This study uses systematic review methods to investigate the use of mentoring programs to assist young people in successfully transitioning back into their communities following a juvenile correctional placement. Few studies were found that used comparison or control groups and measured recidivism outcomes. The results of the studies were mixed, with one study finding no differences between groups, and the other two studies finding some recidivism reductions among youth who received the intervention. However, the absence of detailed information on the interventions, weak research designs, and the diversity of the mentoring programs contributed to an overall dearth of knowledge about the effectiveness of these interventions in reducing recidivism.

This is the first Canadian longitudinal study to use province-wide clinical-administrative data to explore the factors most associated with changing out of home placements. Clinical-administrative child protection data were merged with Canadian Census data for the province of Quebec and the final dataset included 29,040 children admitted to out-of-home care for the first time between April 1, 2002 and March 31, 2011. Cox proportional hazard results indicate that older youth, specifically those aged 10 to 13 years at initial placement, have the highest risk to experience the most placement changes over time. The increased risk of placement changes for older youth was statistically explained by a combination of male gender, behavioral problems, school truancy and school neglect, residential or group care at initial placement, request for youth criminal justice services, number of investigations, and neighborhood area socioeconomic disadvantages. Neighborhood area socioeconomic disadvantages were only considered a statistically significant predictor of older youth changing placements at least three times, but not for younger children, or for youth experiencing fewer placement changes.

In recent years, the child welfare field has devoted significant attention to siblings in foster care. Policymakers and practitioners have supported efforts to connect siblings via shared foster placements and visitation while researchers have focused on illuminating the empirical foundations of sibling placement and sibling intervention in child welfare. The current paper synthesizes literature on sibling relationship development and sibling issues in child welfare in the service of presenting a typology of sibling-focused interventions for use with foster youth. The paper provides two examples of current intervention research studies focused on enhancing sibling developmental processes and understanding their connection to child welfare outcomes. The paper concludes by presenting an emerging agenda informing policy, practice, and research on siblings in foster care.

The use of evidence in practice and policy in public health and social services is a tricky endeavour. While virtually every practitioner, manager, or policy maker would agree that evidence should be used, there is disagreement about the nature of evidence and which evidence should be used, how, when, in what circumstances, and for whom. Within these disagreements, however, can be found some essential truths: (1) scientific knowledge evolves over time; (2) different types of evidence are needed for different purposes; (3) evidence has a range of quality; (4) synthesising multiple forms of evidence is difficult and inevitably includes some level of subjectivity; and (5) effective implementation of evidence is as important as the decision to use evidence in the first place. This paper will discuss the use of evidence in practice in what is arguably the most complex helping environment – social services – detailing the emergence and evolution of evidence-informed practice, dispelling some myths about its structure and application, and linking it to the broader origins and structure of the social and governmental systems in which it operates. Using this expanded view, the paper will then describe some useful approaches for incorporating these larger considerations into the use of evidence in practice.

Research on foster care focuses almost exclusively on maltreated youth and, to a lesser extent, on foster parents. There is very limited information about the experiences and outcomes of the sons and daughters of parents who choose to foster. The objective of this scoping review was to systematically identify and describe existing empirical research on sons and daughters of foster parents as a beginning effort at understanding this large but understudied population of children and youth. A comprehensive search was conducted that included four key sources: scholarly databases, hand-searches of reference lists, Google Scholar, and personal communications with key foster care stakeholders from North America, South America, Europe, and Australia. All empirical studies within samples that were comprised of sons and daughters of foster parents were included. Over 5500 articles were screened for inclusion. After removing the studies that were not about sons and daughters of foster parents, articles that did not match the inclusion criteria, articles that could not be located, and duplicates, there were 46 articles that met the inclusion criteria describing 39 different studies. An analysis of these indicates that: this literature is in the early stages of knowledge development; interviews/focus groups dominate data collection methods; nonprobability samples are almost always used; even basic demographic data is scarce; and the relationships among and between all participants in the fostering process likely to affect the quality of the fostering experience. As the first scoping review on sons and daughters of foster parents, this study describes much of the known research about this sub-population within foster homes. The results indicate that, more than a century after the first foster homes were established, we are still in the dark ages with respect to the experiences of this sub-population. This article provides a resource for researchers and practitioners to further develop this neglected area of child welfare services.

Simulation-based training is often used to prepare health practitioners and is increasingly employed to train child welfare workers. This scoping review systematically searched the published and grey literature for studies that evaluated training for child welfare practitioners and used simulation methods that included standardized actors. Three studies met inclusion criteria, all documenting improvement in participants' use of specific skills. Other outcomes were mixed, possibly reflecting the heterogeneity of samples, study methods, measures, training of actors, theoretical frameworks, and content areas. Though results were mostly positive, the small number of studies indicates a substantial need for further research.

This study contributes to the growing child protection placement literature by providing the first Canadian provincial longitudinal study examining when and for whom initial out-of-home placement is most likely to occur. Anonymized clinical-administrative child protection data were merged with the 2006 Canadian Census data for the province of Quebec, and the final dataset included 127,181 children investigated for maltreatment for the first time between April 1, 2002 and March 31, 2010. Cox proportional hazard results indicate that the vast majority of investigated children do not experience a placement, but for the others, placement tends to occur immediately following the maltreatment investigation with only a slight increase in risk over time. The increased risk of placement for younger children aged 0 to 9 years was statistically explained by a combination of male gender, behavioral problems, parents' high risk lifestyles, hospital referral, the number of investigations and neighborhood area socioeconomic disadvantages. The increased risk of placement for older children aged 10 to 17 years was statistically explained by a combination of behavioral problems, police reporting, the number of investigations and neighborhood area socioeconomic disadvantages. Neighborhood area socioeconomic disadvantages significantly contributed to the increased risk of out-of-home placement for all children, but this factor is most influential when it comes to younger children.

Large numbers of domestic violence (DV) cases on child protection caseloads have necessitated the development of practices that address both DV and child safety. The first step in this process is to gain an understanding of the differences between DV-involved cases and other forms of maltreatment. The implementation of a differential response service model in Ontario offered an opportunity to compare risk assessment ratings, service outcomes and recurrence and to identify pathways of DV cases through child protection services (CPS). A sample (n = 785) of child protection investigations over a 4-month period was examined. Of these investigations, 26% cases were DV referred; 87% of the DV victims were mothers; perpetrating partners were mostly absent from investigations; non-white families were more often investigated for DV than white families; and DV cases were more likely to remain open for ongoing CPS. Only one-third of DV-exposed children were assessed as having been harmed and most community referrals were made for the victim parent. Mothers were the primary target of investigation, remaining in CPS for extended service provision although recurrence rates were lower than found in other investigations. RESULTS are discussed to inform investigative procedures, assessment and service response to more adequately respond to children and families when DV is present. Language: en

Introduction The assessment of children at risk of abuse and neglect is a critical societal function performed by child protection workers in situations of acute stress and conflict. Despite efforts to improve the reliability of risk assessments through standardized measures, available tools continue to rely on subjective judgment. The goal of this study was to assess the stress responses of child protection workers and their assessments of risk in high conflict situations. Methods Ninety-six child protection workers participated in 2 simulated scenarios, 1 non-confrontational and 1 confrontational. In each scenario, participants conducted a 15-minute interview with a mother played by a specially trained actor. Following the interview, the workers completed 2 risk assessment measures used in the field at the time of the study. Anxiety was measured by the State-Trait Anxiety Inventory at baseline and immediately following the completion of each interview. Physiological stress as measured by salivary cortisol was obtained at baseline as well as 20 and 30 minutes after the start of each interview. Results Participants demonstrated significant stress responses during the 1st scenario, regardless of whether the interview was confrontational or not. During the second scenario, the participants did not exhibit significant cortisol responses, however the confrontational interview elicited greater subjective anxiety than the non-confrontational scenario. In the first scenario, in which the workers demonstrated greater stress responses, risk assessment scores were higher on one risk assessment tool for the confrontational scenario than for the non-confrontational scenario. Conclusion The results suggest that stress responses in child protection workers appear to be influenced by the novelty of a situation and by a parent's demeanor during interviews. Some forms of risk assessment tools appear to be more strongly associated than other with the workers’ subjective and physiological stress responses. This merits further research to determine which aspects of risk assessment tools are susceptible to the emotional elements of intake interviews.

To maximize benefits to children and their families, effective practices need to be used competently in child welfare settings. Since the 1990s, researchers and policy makers have focused attention on empirically supported interventions (ESIs). Much less attention has been paid to what is needed to implement these in a range of real-world settings. Without proper implementation, which includes an evaluation strategy from feasibility to fidelity to on-going work on moderators and mediators of program effects, established effective programs can be rendered ineffective in practical application. The paper will touch on progress, to date, of implementation science, its application to child welfare programs and practices, and will highlight a set of practical strategies for implementing empirically supported interventions in child welfare.

This commentary discusses directions for future research in child welfare. Specifically, the authors identified the need for research that tracks young people through the child welfare system, in order to best meet the needs of these vulnerable individuals. The authors also argued that the issues identified by research must be effectively addressed in policy and practice.

The process of Evidence-Based Practice (EBP) requires clinical social workers to conduct systematic searches of academic databases in order to ascertain current best evidence and integrate this with client preferences/values and clinical state/circumstances. Yet social workers are often pressed for time, and searches for evidence disregarded as too time-consuming to conduct. There is hope. Searches of the literature can be more easily and quickly facilitated through the use of methodological search filters. This study introduces a new methodological search filter created especially for social care and evaluates the extent to which this and four other filters accurately and efficiently identify known social care effectiveness studies in two major scholarly databases (Psycinfo and Medline). Sensitivity, specificity, and a new metric for establishing efficiency (the AVALANCHE INDEX) are reported.

Evidence-informed practice asks practitioners and policy-makers to integrate current best evidence with client context in order to provide meaningful and potentially effective services across a range of presenting problems. Done correctly, systematic reviews are a crucial part of this process, providing social workers and other helping professionals with transparent, rigorous, and informative syntheses of research in a given area. This paper makes clear the need for systematic reviews in social work, briefly explains what systematic reviews are and how they are made, and describes the role of the Campbell Collaboration in creating a world library of systematic reviews.

Evidence-based practice depends in part on knowledge derived from relevant research. For any given topic, there are likely to be many, potentially relevant studies; a careful appraisal and synthesis of the results of these studies is needed to understand the state of the empirical evidence. Meta-analysis is widely used to combine results of quantitative studies; yet this method is unfamiliar to many people and, as a result, meta-analyses are often uncritically accepted. In this article, we argue that meta-analysis is only one component of a good research synthesis. We critique a recent metaanalysis on the effectiveness of long-term psychodynamic psychotherapy, showing that this metaanalysis failed to meet current standards for the conduct and reporting of systematic research reviews and meta-analyses. We demonstrate the use of AMSTAR, a straightforward tool for assessing the quality of systematic reviews and meta-analyses.

Consistent with contemporary theories related to the well-being and adjustment of children, the Ontario Child Welfare Transformation policy suggests that researchers and practitioners consider multiple levels of analysis when attempting to understand, prevent, and respond to childhood adversity. By examining the phenomenon of parental stress among child welfare cases, the present study sought to integrate family, child, and service-system levels of analysis through a family-based standpoint of investigation. A sample of 135 families was selected from three Children's Aid Societies in southern Ontario. Using hierarchical regression, we found that child developmental milestones (4–47 months old) and child behavioural and emotional strengths (48 months +) were associated with parental stress, accounting for variance beyond family-level predictors. Children of parents who were stressed had higher health and social service costs, though this trend did not apply for stressed parents themselves. Theoretical and ...