1. Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment: A Summary of a Systematic Review
Erin Geary

2. Background: Kinship Care
What is kinship care?
“the full-time nurturing and protection of children who must be separated from their parents, by relatives, members of their tribes or clans, godparents, step- parents, or other adults who have a kinship bond with a child” (CWLA 1994, p. 2)
Formal, informal, and private kinship placements
Known by other names internationally
Family and friends care – UK
Kith and kin care – Australia
Considered Formal or informal placements depending on whether kinship care provider has or is seeking custody

3. Background: Kinship Care
What is kinship care?
Goals of kinship care:
Family preservation– reunification with birth parents
Substitute care– care for the child when reunification is not an option
“New” priority in child welfare
Seen as least intrusive option for kids in care
Number of kinship placements are on the rise internationally

4. Review Objective
“To evaluate the effect of kinship care placement compared to foster care placement on the safety, permanency, and well-being of children removed from the home for maltreatment.”

5. Review Protocol: Inclusion Criteria
Randomized control trials or quasi-experimental studies
Children in kinship care are compared to children in foster care
Must have spent more than 50% of time in out of home care in kinship setting
Excluded more restrictive out of home placement settings (residential care)
Studies that only examine informal or private kinship care were excluded
Participants:
Children under 18 who were removed and placed in kinship care

6. Review Protocol: Inclusion Criteria
Outcome
Measurement
Behavioral Development
Case records, caregiver, teacher and self reports, and standardized instruments
Mental Health
Case records, caregiver and self reports, and standardized instruments
Placement Stability
Child Welfare administrative databases
Permanency
Educational Attainment
School records and child welfare administrative databases
Family Relations
Caregiver and self-reports and standardized instruments
Service Utilization
Medical records, caregiver and self-reports, and child welfare administrative databases
Re-abuse
Child welfare administrative databases

7. Review Protocol: Search
Database
Years searched
Cochrane Library
2007
MEDLINE
Campbell Collaboration’s Social, Psychological, Educational, and Criminological Trials Registrar
Sociological Abstracts
Social Work Abstracts
Social Sciences Citation Index
Family and Society Studies Worldwide
ERIC
PsycINFO
ISI Proceedings
CINAHL
Applied Social Sciences Index and Abstracts
UMI Dissertation Abstracts International
Late 1960s-2007

8. Review Protocol: Search
Other Strategies
Most recent volumes of:
Child Abuse & Neglect
Children and Youth Services Review
Child Welfare
Research on Social Work Practice
Families in Society
Contacted several authors included in the review
Published literature reviews

9. Review Protocol: Search
Keywords (sample)
Database
Search examples
Cochrane Library
(relative near foster*)
(relative near substitute*)
(family near foster*)
(family near substitute*)
(kin near care*)
(kinship near care*)
MEDLINE
(relative$ adj3 foster$)
(relative$ adj3 substitute)
(family adj3 foster$)
(families adj3 foster$)
(kin adj3 care$)
(kinship adj3 care$)
Social Work Abstracts
(relative$ near3 foster$)
(kinship near3 care$)

10. Study Inclusion Flow Chart

11. Quality Assessment Quality Assessment
Selection Bias
Performance Bias
Detection Bias
Report Bias
Attrition Bias
Table 1 (p. 7) is a breakdown of quality assessment for 63 Studies
Low, Moderate, High

12. Results: Evidence Base
“Weak standing of quantitative research on kinship care.”
Most studies had moderate to high risk of bias
Implementation fidelity issues

13. Results: Data Analysis

14. Results: Data Analysis

15. Study Conclusions
Children in kinship care experience better outcomes related to:
Behavior problems
Adaptive behaviors
Psychiatric disorders
Well-being
Placement stability
Guardianship

16. Study Conclusions No difference between groups on:
Reunification
Length of stay
Family relations
Educational Attainment
Children in kinship care are less likely to:
Be adopted
Utilize mental health services
Children in kinship care are more likely to still be in placement

17. Implications Practice and Policy: Research
Kinship should be sought and supported if goals are:
Behavioral Development
Mental Health functioning
Placement Stability
Findings do not support implementing kinship placements if goal is solely to:
Increase permanency
Increase service utilization
Research
Need for more studies that have:
Generalizable sample
Equivalent groups
Repeated measures
Longitudinal focus
Studies that breakdown data further
Impact on specific populations
Impact on caregivers
Breakdown by age, gender, ethnicity

18. Questions
What does this look like with further aggregation of the data?
Demographic differences
Severe behavior problems
How is it impacted (or is it) by involvement of birth parents?
What about respite care or family foster care?
What are the implications of the study in terms of payment differences between kinship and non-kinship foster care
What does the cost-benefit research say?