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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.

Background Relative to their counterparts in the general population, young people who leave, or transition out of, out-of-home (OOHC) arrangements commonly experience poorer outcomes across a range of indicators, including higher rates of homelessness, unemployment, reliance on public assistance, physical and mental health problems and contact with the criminal justice system. The age at which young people transition from OOHC varies between and within some countries, but for most, formal support ceases between the ages of 18 and 21. Programs designed to support transitions are generally available to young people toward the end of their OOHC placement, although some can extend beyond. They often encourage the development of skills required for continued engagement in education, obtaining employment, maintaining housing and general life skills. Little is known about the effectiveness of these programs or of extended care policies that raise the age at which support remains available to young people after leaving OOHC. This systematic review will seek to identify programs and/or interventions that improve outcomes for youth transitioning from the OOHC system into adult living arrangements. Methods This review will identify programs, interventions and policies that seek to improve health and wellbeing of this population that have been tested using robust controlled methods. Primary outcomes of interest are homelessness, health, education, employment, exposure to violence and risky behaviour. Secondary outcomes are relationships and life skills. We will search, from January 1990 onwards, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL, SocINDEX, Sociological Abstracts, Social Services Abstracts, NHS Economic Evaluation Database and Health Technology Assessment. Grey literature will be identified through searching websites and databases, e.g. clearing houses, government agencies and organisations known to be undertaking or consolidating research on this topic area. Two reviewers will independently screen all title and abstracts and full text articles with conflicts to be resolved by a third reviewer. Data extraction will be undertaken by pairs of review authors, with one reviewer checking the results of the other. If more than one study with suitable data can be identified, we plan to undertake both fixed-effects and random-effects meta-analyses and intend to present the random-effects result if there is no indication of funnel plot asymmetry. Risk of bias will be assessed using tools appropriate to the study methodology. Quality of evidence across studies will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Discussion Previous reviews were unable to identify any programs or interventions, backed by methodologically rigorous research, that improve outcomes for this population. This review seeks to update this previous work, taking into account changes in the provision of extended care, which is now available in some jurisdictions. Systematic review registration PROSPERO CRD42020146999

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.

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...

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.

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.

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...

Implementation is a crucial component for the success of interventions in health service systems, as failure to implement well can have detrimental impacts on the effectiveness of evidence-based practices. Therefore, evaluations conducted in real-world contexts should consider how interventions are implemented and sustained. However, the complexity of healthcare environments poses considerable challenges to the evaluation of interventions and the impact of implementation efforts on the effectiveness of evidence-based practices. In consequence, implementation and intervention effectiveness are often assessed separately in health services research, which prevents the direct investigation of the relationships of implementation components and effectiveness of the intervention. This article describes multilevel decision juncture models based on advances in implementation research and causal inference to study implementation in health service systems. The multilevel decision juncture model is a theory-driven systems approach that integrates structural causal models with frameworks for implementation. This integration enables investigation of interventions and their implementation within a single model that considers the causal links between levels of the system. Using a hypothetical youth mental health intervention inspired by published studies from the health service research and implementation literature, we demonstrate that such theory-based systems models enable investigations of the causal pathways between the implementation outcomes as well as their links to patient outcomes. Results from Monte Carlo simulations also highlight the benefits of structural causal models for covariate selection as consistent estimation requires only the inclusion of a minimal set of covariates. Such models are applicable to real-world context using different study designs, including longitudinal analyses which facilitates the investigation of sustainment of interventions.

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.

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.

This Campbell systematic review examines the effectiveness of school‐based education programmes for the prevention of child sexual abuse. The review summarises findings from 24 trials, conducted in the U.S., Canada, China, Germany, Taiwan and Turkey. Six metaanalyses are included assessing evidence of moderate quality. This study is an update to a previous review and covers publications up to September 2014. School‐based education programmes for the prevention of child sexual abuse are more effective than alternative programmes or no programme at all in strengthening children's knowledge about child sexual abuse prevention and their protective behaviours. Children retain the knowledge gained from programme participation, though no study has assessed retention over a period of longer than six months. No studies examined the retention of protective behaviours over time. Disclosures of previous and current occurrences of child sexual abuse increase for participants of school‐based education programmes. However, the evidence supporting this finding is weak and should be interpreted with caution. Abstract BACKGROUND Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school‐based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny. OBJECTIVES To systematically assess evidence of the effectiveness of school‐based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students' protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both. SEARCH METHODS In September 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE and 11 other databases. We also searched two trials registers and screened the reference lists of previous reviews for additional trials. SELECTION CRITERIA We selected randomised controlled trials (RCTs), cluster‐RCTs, and quasi‐RCTs of school‐based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias. We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse. MAIN RESULTS This is an update of a Cochrane Review that included 15 trials (up to August 2006). We identified 10 additional trials for the period to September 2014. We excluded one trial from the original review. Therefore, this update includes a total of 24 trials (5802 participants). We conducted several meta‐analyses. More than half of the trials in each meta‐analysis contained unit of analysis errors. Meta‐analysis of two trials (n = 102) evaluating protective behaviours favoured intervention (odds ratio (OR) 5.71, 95% confidence interval (CI) 1.98 to 16.51), with borderline low to moderate heterogeneity (Chi2 = 1.37, df = 1, P value = 0.24, I2 = 27%, Tau2 = 0.16). The results did not change when we made adjustments using intraclass correlation coefficients (ICCs) to correct errors made in studies where data were analysed without accounting for the clustering of students in classes or schools. Meta‐analysis of 18 trials (n = 4657) evaluating questionnaire‐based knowledge favoured intervention (standardised mean difference (SMD) 0.61, 95% CI 0.45 to 0.78), but there was substantial heterogeneity (Chi2 = 104.76, df = 17, P value < 0.00001, I2 = 84%, #Tau2 = 0.10). The results did not change when adjusted for clustering (ICC: 0.1 SMD 0.66, 95% CI 0.51 to 0.81; ICC: 0.2 SMD 0.63, 95% CI 0.50 to 0.77). Meta‐analysis of 11 trials (n =1688) evaluating vignette‐based knowledge favoured intervention (SMD 0.45, 95% CI 0.24 to 0.65), but there was substantial heterogeneity (Chi2 = 34.25, df = 10, P value < 0.0002, I2 = 71%, Tau2 = 0.08). The results did not change when adjusted for clustering (ICC: 0.1 SMD 0.53, 95% CI 0.32 to 0.74; ICC: 0.2 SMD 0.60, 95% CI 0.31 to 0.89). We included four trials in the meta‐analysis for retention of knowledge over time. The effect of intervention seemed to persist beyond the immediate assessment (SMD 0.78, 95% CI 0.38 to 1.17; I2 = 84%, Tau2 = 0.13, P value = 0.0003; n = 956) to six months (SMD 0.69, 95% CI 0.51 to 0.87; I2 = 25%; Tau2 = 0.01, P value = 0.26; n = 929). The results did not change when adjustments were made using ICCs. We included three studies in the meta‐analysis for adverse effects (harm) manifesting as child anxiety or fear. The results showed no increase or decrease in anxiety or fear in intervention participants (SMD −0.08, 95% CI −0.22 to 0.07; n = 795) and there was no heterogeneity (I2 = 0%, P value = 0.79; n=795). The results did not change when adjustments were made using ICCs. We included three studies (n = 1788) in the meta‐analysis for disclosure of previous or current sexual abuse. The results favoured intervention (OR 3.56, 95% CI 1.13 to 11.24), with no heterogeneity (I2 = 0%, P value = 0.84). However, adjusting for the effect of clustering had the effect of widening the confidence intervals around the OR (ICC: 0.1 OR 3.04, 95% CI 0.75 to 12.33; ICC: 0.2 OR 2.95, 95% CI 0.69 to 12.61). Insufficient information was provided in the included studies to conduct planned subgroup analyses and there were insufficient studies to conduct meaningful analyses. The quality of evidence for all outcomes included in the meta‐analyses was moderate owing to unclear risk of selection bias across most studies, high or unclear risk of detection bias across over half of included studies, and high or unclear risk of attrition bias across most studies. The results should be interpreted cautiously. AUTHORS' CONCLUSIONS The studies included in this review show evidence of improvements in protective behaviours and knowledge among children exposed to school‐based programmes, regardless of the type of programme. The results might have differed had the true ICCs or cluster‐adjusted results been available. There is evidence that children's knowledge does not deteriorate over time, although this requires further research with longer‐term follow‐up. Programme participation does not generate increased or decreased child anxiety or fear, however there is a need for ongoing monitoring of both positive and negative short‐ and long‐term effects. The results show that programme participation may increase the odds of disclosure, however there is a need for more programme evaluations to routinely collect such data. Further investigation of the moderators of programme effects is required along with longitudinal or data linkage studies that can assess actual prevention of child sexual abuse. Plain language summary SCHOOL‐BASED PROGRAMMES FOR THE PREVENTION OF CHILD SEXUAL ABUSE Background and review question School‐based education programmes for the prevention of child sexual abuse have been implemented on a large scale in some countries. We reviewed the evidence for the effectiveness of these programmes in the following areas: (i) children's skills in protective behaviours; (ii) children's knowledge of child sexual abuse prevention concepts; (iii) children's retention of protective behaviours over time; (iv) children's retention of knowledge over time; (v) parental or child anxiety or fear as a result of programme participation; and (vi) disclosures of past or current child sexual abuse during or after programmes. The evidence is current to September 2014. Study characteristics This review included 24 studies, conducted with a total of 5802 participants in primary (elementary) and secondary (high) schools in the United States, Canada, China, Germany, Spain, Taiwan, and Turkey. The duration of interventions ranged from a single 45‐minute session to eight 20‐minute sessions on consecutive days. Although a wide range of programmes were used, there were many common elements, including the teaching of safety rules, body ownership, private parts of the body, distinguishing types of touches and types of secrets, and who to tell. Programme delivery formats included film, video or DVD, theatrical plays, and multimedia presentations. Other resources used included songs, puppets, comics, and colouring books. Teaching methods used in delivery included rehearsal, practice, role‐play, discussion, and feedback. Key results This review found evidence that school‐based sexual abuse prevention programmes were effective in increasing participants' skills in protective behaviours and knowledge of sexual abuse prevention concepts (measured via questionnaires or vignettes). Knowledge gains (measured via questionnaires) were not significantly eroded one to six months after the intervention for either intervention or control groups. In terms of harm, there was no evidence that programmes increased or decreased children's anxiety or fear. No studies measured parental anxiety or fear. Children exposed to a child sexual abuse prevention programme had greater odds of disclosing their abuse than children who had not been exposed, however we were more uncertain about this effect when the analysis was adjusted to account for the grouping of participants in classes or schools. Studies have not yet adequately measured the long‐term benefits of programmes in terms of reducing the incidence or prevalence (or both) of child sexual abuse in programme participants. Quality of the evidence The quality of the evidence for all outcomes included in the meta‐analyses (combining of data) was moderate. Study quality was compromised in about half of the included studies, due to suboptimal data collection methods for study outcomes and inappropriate data analysis.

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

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness of the formal use of FGDM in terms of child safety, permanence (of childs living situation), child and family well‐being, and client satisfaction with the decision‐making process.

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.

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.

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

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.

Research has identified high levels of trauma exposure and PTSD in professionals responsible for assessing children at risk for abuse. An important question arising is the influence of stress and trauma on professional judgment. This study examined the association between critical incident exposure, PTSD and workers' judgments of child risk. Ninety-six child protection workers participated in 2 simulated clinical interviews and subsequently completed standardized risk assessment measures. Workers reported high levels of exposure to critical events in the workplace and high levels of traumatic stress symptoms. Number of prior critical events encountered was negatively associated with assessment of risk. Level of traumatic stress symptoms was negatively associated with risk on one, but not other measures of risk. It is concluded that standardized measures for assessing a child's risk of abuse may be influenced by previous exposure to critical workplace events and levels of traumatic stress in workers.

This article describes Journal Watch, a monthly lunchtime discussion group of faculty, staff and graduate students from the University of Toronto, McGill University and the Centre of Excellence for Child Welfare (CECW) in Canada. The group searches journals each month for empirical research on child welfare, which are reviewed during monthly videoconferences. Short reviews of exceptional articles are shared in both English and French with the broader community of child welfare researchers and practitioners across Canada through CECW's electronic newsletter. Journal Watch provides a broad overview of the emerging published research in child welfare, translates and disseminates this research to a broad audience, and trains new scholars in critical thinking. Two years after formation, the group is operating sustainably and there is a demand among Canadian child welfare practitioners for Journal Watch's succinct reviews.

This article examines the evolution of the discourse surrounding domestic violence (DV), explores how that discourse intersects with public child welfare (PCW), and makes some suggestions for improving the quality and consistency of services for families involved with these systems in both the United States and Canada. In particular, the discourse at the intersection of the two systems has focused on whether or not children's exposure to DV is maltreatment and, further, if it warrants placement in foster care. Within the PCW system itself, data seem to point to divisions in worker beliefs over what circumstances necessitate removal of children and what solutions should be pursued in order to achieve permanence. Legislation and courts have spoken to this complex issue. Given the tension and new developments in the field, this article proposes that harm reduction (HR), evidence-based practice (EBP), and differential response (DR) approaches can bring the two systems together in order to better serve families.

Stress and adversity are an inevitable part of family life, and these are mostly dealt with in ways that are both healthy and resourceful. Few situations, though, are as stressful or provoke more crises within families than domestic violence (DV) and child maltreatment (CM). These social problems, at once separate and intertwined, are all too frequent and debilitating. Lifetime worldwide estimates of the prevalence of physical assault by males against females range between 10 and 69% (Heise, 2002), making intimate partner violence (IPV) one of the most common forms of trauma experienced by women. Estimates of the prevalence of child abuse are more difficult to ascertain and vary by age, but data from North America suggest that 6 per thousand to 22 per thousand children had a confirmed allegation of maltreatment in 2004 (U.S. Department of Health and Human Services Administration for Children and Families, 2006; Trocme et al., 2005; Trocme, in press). However, this is generally considered an underestimate of the actual rate of child maltreatment as most child abuse and neglect likely goes unreported (Trocme, in press). The intersection between child maltreatment and DV is substantial, by any measure reaching into a large number of households. The co-occurrence of DV and child maltreatment may reach as high as 60% (Edleson, 1999) and, when measured as a form of maltreatment as it is in some provinces in Canada, accounts for over one quarter of all substantiated maltreatment reports (Trocme et al., 2005). In addition to the obvious trauma and related difficulties faced by women who are abused, childhood exposure to DV has been associated with elevated levels of psychosocial and behavioral difficulties (Edleson, 1999; Wolfe, Crooks, Lee, McIntyre-Smith, & Jaffe, 2003). There is also reason to believe that children are present in a large proportion of homes where DV occurs and are often witnesses to the violence between their caregivers (Catalano, 2007; Johnson, 2006). Despite the large overlap between child protective services and DV services, the two sectors have traditionally been uncoordinated, reflecting differences in mandates and ideological underpinnings (Edleson, 1999; Hartley, 2004). Inconsistencies and lack of coordination of services at pivotal moments in the lives of families, whether due to misunderstandings between systems or inadequate funding, limits effective treatment and may even escalate the crises faced by families. This special issue is part of an effort to understand this disjuncture, further evaluate the epidemiology of the cooccurrence of DV and childmaltreatment, evaluate new interventions, and propose conceptual, From the University of Toronto and California State University, Los Angeles. Contact author: Aron Shlonsky, University of Toronto. E-mail: aron.shlonsky@utoronto.ca.

Investigations of child maltreatment often involve domestic violence, but there is little guidance about how to properly assess risk in such cases. Empirically validated risk assessment tools have been used successfully in child welfare and, to a lesser extent, in cases involving domestic violence, but these have generally not been utilized in tandem. Using the allegation of child maltreatment as the entry point for services, this paper proposes a nested risk assessment framework whereby risk of both child maltreatment and domestic violence are considered simultaneously using two different standardized instruments. KEY WORDS: child abuse, domestic violence, risk assessment

This article examines the separate but sometimes overlapping foci of domestic violence (DV) and child protection services. When these sectors interact, the resulting tension becomes part of a complex dialectic and multiple opposing propositions that are explored here with respect for how they affect practice. A review of 30 years of DV discourse leads to systematic examinations of the DV literature for battered women, mental health, children, and offenders. The article proposes a radical shift by pairing a harm reduction approach with an evidence-based practice model when DV and child protection intersect. The implications of Stage of Change theory are considered in relationship to the harm reduction approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)

As the process of evidence-based practice (EBP) gains a foothold in the curricula of schools of social work and the various helping professions, instructors have been encountering a unique set of challenges. On one hand, educators must develop new curricula to convey material that is often complex and is, even in its most advanced state, still in its infancy. On the other hand, instructors may find themselves in the awkward position of challenging traditional classroom material and entrenched practices. This article offers a supplement to EBP texts by practically discussing some of the philosophical tenets of EBP, suggesting steps to enhance the learning environment, offering instructional supports, and identifying a common set of pitfalls and some suggested solutions.

The preservation and maintenance of sibling relationships in child welfare settings have begun to come to the forefront of practice and policy considerations. While past research on families coming into contact with the child protective services system has largely focused on the parent–child relationship, an emerging body of literature indicates that the relationship between brothers and sisters cannot be ignored. This paper highlights recent and historical trends in the literature on siblings in foster care, reviews some of the legal issues surrounding conjoint sibling placement, proposes a constitutionally protected right of association among siblings in out-of-home care, and explores the multiple and complex methodological challenges facing researchers in this area.

‘‘Evidence-based practice’’ (EBP) is in danger of becoming a catchphrase for anything that is done with clients that can somehow be linked to an empirical study, regardless of the study’s quality, competing evidence, or consideration of clients’ needs. The EBP process, on the other hand, involves a well-built practice question, an efficient search for best evidence, a critical appraisal of that evidence, and action based on the interchange between client preferences, practice experience, and the best evidence. This article defines elements in the EBP process through examples taken from our own multidisciplinary work with students in two separate graduate and undergraduate programs. We also discuss practical concerns that have arisen while teaching EBP and explore a number of trends in discipline-specific databases. [Brief Treatment and Crisis Intervention 4:137–153 (2004)]

DURING THE LAST YEAR, articles submitted to the Journal of Social Work Education (JSWE) were not only reviewed through standard chan nels but, as is the custom of some medical journals (e.g., BMJ), the Editor-in-Chief asked that relevant submissions be statistically re viewed and detailed comments provided to the authors. Through this process, JSWE's sta tistical reviewers have developed a set of good practice guidelines, which are set forth below. The guidelines fall into three general areas: (1) description of the sample and data, (2) discus sion of statistical model choice and test statis tics used, and (3) model interpretation and presentation of results. It is the opinion of the statistical review ers that developing guidelines for good prac tice in empirical research is more relevant now than ever. The information technology revolution over the last 15 years has made available to researchers huge and complex administrative databases and an ever-grow ing arsenal of computer-intensive statistical procedures. Although these tools and data are becoming widely available and easy to use, it is critical to understand both the con tent of the data and the capability and limita tions of the statistical tools employed in or der to maintain the quality of social work research.

This article provides a comprehensive look at the elements that indicate quality of care in kinship and nonrelated foster homes, highlighting the philosophical reasons for providing quality care and the theoretical underpinnings of kinship care. The sparse literature on quality of care in foster homes is then augmented with indicators of quality in nonfoster homes, identifying a series of domains of quality. By articulating these domains we intend to frame an understanding of quality of care, to provide a guide for constructing a quality assessment tool for kinship and nonrelated foster homes, and to promote quality improvement in these vital areas.

Risk assessment studies in child welfare have largely focused on identifying individual or family risk factors associated with future harm or on the value of various assessment tools constructed of such factors, paying scant attention to the risk posed by the system and its larger context. These risks include services provided to children and families that have little or no evidence of effectiveness, lack of proper assessment of service needs, inadequate linkage of available services to desired outcomes, and an agency culture that is reactive rather than proactive in its pursuit of risk reduction. Drawing on related literature, this article introduces guidelines for the development and implementation of a comprehensive risk management system in child welfare.

Drawing on the authors’ experience in the international Campbell Collaboration, this essay presents a principled and pragmatic approach to evidence-informed decisions about child welfare. This approach takes into account the growing body of empirical evidence on the reliability and validity of various methods of research synthesis. It also considers wide variations in the cultural, economic, and political contexts in which policy and practice decisions are made—and the contexts in which children live and die. This essay illustrates the use of Campbell and Cochrane systematic reviews to inform child welfare decisions in the diverse contexts that exist around the globe.

Child welfare services are designed to promote the safety and well-being of children at risk of harm. In most high-income countries, these services are largely focused on preventing the occurrence or recurrence of child maltreatment. Risk assessment, in this context, amounts to a set of procedures, formal and informal, used by social workers and other human-services professionals to identify children at risk of harm as a result of maltreatment. The definition of child maltreatment can vary with regard to scope, frequency, and severity but generally entails an act of commission or omission toward a child that is, or can result in, damage or harm to the child’s physical or psychological well-being. Most often, risk assessments are conducted by child protection agencies investigating allegations of child maltreatment. In such instances, risk assessment generally involves determining the likelihood of future maltreatment and deciding whether action is needed to reduce the risk of future harm.