Identifying treatment moderators of a trauma-informed parenting intervention with children in foster care: Using model-based recursive partitioning

10.31219/osf.io/aqxer ◽

2020 ◽

Author(s):

Gerard Chung ◽

David Ansong ◽

Kanisha C. Brevard ◽

Ding-Geng Chen

Keyword(s):

Foster Care ◽

Recursive Partitioning ◽

Parenting Intervention ◽

Parametric Model ◽

Model Based ◽

Children In Foster Care ◽

Child Attachment ◽

Trauma Informed ◽

Treatment Moderators ◽

Pre Treatment

Background : Trauma-informed parenting interventions have been used in child welfare to help caregivers respond to children in trauma-informed ways that can mitigate the effects of maltreatment and build strong caregiver-child relationships. Existing studies support its effectiveness with the foster care population. However, to further advance its development, one key step is to identify subgroups of participants that respond differently from the intervention. Objective: To identify pre-treatment moderators that can distinguish subgroups of caregivers and children that benefit differently from the intervention. Participants and setting: 414 foster care children (age 3 or younger) and their caregivers were assigned either to the trauma-informed parenting intervention in the Illinois Birth through Three Title IV-E waiver demonstration or to a comparison group that received services as usual. Methods: Model-based Recursive Partitioning (MOB) was used to identify treatment moderators and moderator interactions. MOB fits a parametric model and uses a data-driven method to find subgroups for which the specified parametric model has different parameters. Two parametric models (logistic and linear regression) were used in accordance with two outcomes: reunification (binary), and caregiver-child attachment (continuous). We examined 21 potential pre-treatment moderators in both models. Results: For reunification outcome, three treatment moderators interact to produce different subgroups of participants who responded differently to the intervention: (a) caregivers’ relationship status (kin vs. non-kin/permanent caregivers), (b) caregiver-child attachment, and (c) case history of physical abuse. For attachment outcome, caregivers’ age was found to be a treatment moderator. Future developments of trauma-informed interventions should consider these moderators.

Download Full-text

Medical Management and Trauma-Informed Care for Children in Foster Care

Current Problems in Pediatric and Adolescent Health Care ◽

10.1016/j.cppeds.2015.08.004 ◽

2015 ◽

Vol 45 (10) ◽

pp. 298-305 ◽

Cited By ~ 8

Author(s):

Samantha Schilling ◽

Kristine Fortin ◽

Heather Forkey

Keyword(s):

Foster Care ◽

Medical Management ◽

Children In Foster Care ◽

Trauma Informed Care ◽

Trauma Informed

Download Full-text

An Analysis of the Early and Periodic Screening, Diagnostic, and Treatment Benefit: Implications for the Healthcare of Children in Foster Care

Policy Perspectives ◽

10.4079/pp.v27i0.4 ◽

2020 ◽

Vol 27 ◽

Author(s):

Jae-Marie Ferdinand

Keyword(s):

Foster Care ◽

Health Outcomes ◽

Healthcare Resource ◽

Successful Implementation ◽

Vulnerable Children ◽

Treatment Benefit ◽

Children In Foster Care ◽

Healthcare Needs ◽

Trauma Informed ◽

Benefit Mandates

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit mandates full coverage of healthcare for children enrolled in Medicaid. The EPSDT benefit provides the access, framework, resources, and financing for healthcare for children with complex healthcare needs. When fully implemented, the EPSDT benefit leads to improved health outcomes. This paper examines the EPSDT benefit as an essential healthcare resource for vulnerable children, notably children in foster care. The majority of children in foster care receive Medicaid healthcare coverage and have complex healthcare needs. According to the most recent research, many children in foster care are not receiving this mandated benefit. Improved implementation of the EPSDT benefit is key to improving health outcomes. This policy analysis reviews the EPSDT benefit, evidence for its effectiveness, issues challenging full implementation for children in foster care, examples of successful implementation, and provides recommendations for improved implementation. Specific recommendations include coordination of healthcare and child welfare services (e.g. with health services coordinators), increased accountability for implementers, and adequate numbers of qualified, trauma-informed providers.

Download Full-text