• Exploring How Teen Mothers in Foster Care Experience Motherhood: An Interpretative Phenomenological Analysis

      Aparicio, Elizabeth; Pecukonis, Edward Vincent (2014)
      Teen pregnancy in foster care is an issue receiving increasing attention due to high pregnancy rates. Previous literature on both teen motherhood and foster youth is focused on negative outcomes, risk factors, and pathology. Despite this emphasis, a small, but growing body of literature on the experience of motherhood of teen mothers in foster care reflects a perspective that is not simply negative - a lived reality that is characterized by both risk and opportunity. The purpose of the current qualitative study was to explore the meaning and experience of motherhood for teen mothers in foster care. The study involved three in-depth interviews with 6 young women who had become mothers while in care. It employed interpretative phenomenological analysis (IPA; Smith, Flowers, & Larkin, 2009) to elicit, analyze, and re-present a rich account of this experience. Findings suggest the lived experience of motherhood for these young women is an intricate reality that brings past, present, and hoped-for future experiences into seamless unison in the midst of the intensely meaningful experience of becoming a mother. Participants discussed their interpretation of motherhood as offering a sense of hope for new beginnings and doing things differently than what had happened in their own families, yet simultaneously as a time of feeling plagued by the lingering effects of darkness and despair in their childhood and adolescence due to factors such as substance abuse, abuse and neglect, poverty, and the breakdown of family ties. The findings suggest that teen mothers in foster care experience becoming mothers as offering opportunities to change their identities from that of "foster child" to "mother", gain motivation and purpose, receive unconditional love, and work through their views on their own parents in the context of a new role. Implications include the need for comprehensive sexual health, substance abuse, and behavioral health services at all levels for child welfare-involved families and youth that include a significant focus on trauma, grief, loss, and attachment issues; better parenting support for teen mothers in foster care; and meaningful discussions about the unintended effects of child welfare intervention on communities related to teen pregnancy and motherhood.
    • Health care utilization by children entering foster care: Factors associated with provider-initiated health referral and referral completion

      Risley-Curtiss, Christina; Combs-Orme, Terri (1993)
      Because of the events that precipitate entry into foster care, of social characteristics, and of the trauma associated with placement, foster children represent one of America's most vulnerable groups in terms of their health needs. Unfortunately, prior research has demonstrated that the probability of the health needs of these children being met is poor. Additionally, the Maryland Department of Human Resources has been sued for, among other things, failure to provide adequate health care to foster children. The resulting consent decree requires that children entering foster care receive a health assessment within five days of entry and a more comprehensive assessment after 30 days. The primary purpose of this study was to determine the ability of selected factors to explain (1) provider-initiated health referrals, and (2) the completion of those referrals for a cohort of children entering foster care in Baltimore. Multivariate analyses techniques were used with data from nonprobability samples of 1910 children entering care (#1) and 262 children in care for at least 30 days (#2). Consistent with previous studies, this study found that the sample children had multiple health problems. More than 70% of the children had 2 or more problems and 98.4% had at least one referral for additional services. Moreover, the children continue to have unmet health needs with only 45% of non-routine referrals completed during the study period. Age, race, sexual abuse, number of mental health problems, number of physical health problems and sexual activity explained 39% of the variance in number of referrals while age and completion time explained 9% of the variance in referral completion. Age was the best predictor of both number of referrals and referral completion. Age and number of mental health problems predicted type of referral (dental, medical or mental health). This study demonstrates that despite a lawsuit and new health project, foster children are still not getting their health needs met. It is critical that child welfare personnel recognize the need for comprehensive health care for foster children. More research in health care utilization by foster children is needed; this study demonstrates the applicability of the Aday/Andersen model of health utilization and multivariate analysis techniques to that study.
    • Independent Living Programs and Changes in Resilience of Transition-Age Foster Care Youth

      Lee, Sang Jung; Harrington, Donna (2016)
      The transition to living independently is a challenge for youth who have been living in foster care. Independent Living Programs (ILPs) are designed to help transition-age foster care youth. However, limited rigorous examinations have been done. Therefore, this study aims to examine the relationship between Independent Living Programs and resilience among transition-age foster care youth. The social ecology of resilience was used to guide the secondary analysis of a sample of 917 transition-age foster youth from three ILPs of the Multi-Site Evaluation of Foster Youth Programs (Chafee Independent Living Evaluation Project, 2001-2010). Multilevel analyses were used to examine the impact of each ILP on resilience and the role of ILP participation on resilience in the social environmental contexts of transition-age foster care youth. The three ILPs examined in this study did not outperform services as usual. In addition, participation in the three ILPs did not significantly predict changes in resilience after controlling for individual and social environmental factors. However, gender and externalizing behavior problems at the individual level significantly predicted change in resilience. Compared to male youth, female youth presented greater positive change in resilience. When youth had lower levels of behavior problems at baseline, they were more likely to improve on resilience. Social support was the only significant predictor of change in resilience at the micro-system level; when youth had higher levels of social support at baseline, they were more likely to improve on resilience. At the meso/exo-system level, foster parent support, community participation, and child welfare status were found to be significant predictors of resilience change over time. Youth with higher levels of foster parent support were more likely to improve on resilience. Youth who participated in a community organization at baseline were more likely to increase resilience over two years. Youth in the child welfare system demonstrated higher levels of resilience than youth discharged from the system. The findings of this study underscore the role of child welfare social workers, foster parents, and the child welfare system in preparing youth for independent living.