Youth in foster care can experience educational success. Yet, studies have tended to focus on their educational challenges and achievement gaps. Compared to their counterparts, youth in foster care lag behind on many academic outcomes. Research is needed to understand the academic and nonacademic indicators of educational resilience (i.e., the increased likelihood of school success despite adverse conditions) among youth in foster care. This prospective study expands the existing literature by examining key individual and contextual factors associated with educationally resilient outcomes among school‐aged youth in foster care, with a particular focus on two malleable protective factors—school engagement and quality youth–foster caregiver relationships. Academic proficiency benchmarks reported by state administrative data were used to operationalize three educationally resilient outcomes (i.e., math, reading, and attendance). Logistic regressions with robust standard errors were then estimated to determine which individual and contextual factors best predicted each educationally resilient outcome. Intersectionality was also explored. Results revealed that youth's lived experience of educational resilience varies by the intersection of their personal identities. In addition, two malleable protective factors (school engagement and quality youth–foster caregiver relationships) also predicted specific educationally resilient outcomes. Implications for research and practice in schools and child welfare agencies are discussed.
Before 2011, 17α-hydroxyprogesterone caproate (17P) was used to prevent recurrent preterm birth in women with singleton pregnancies and was compounded at a low cost (∼$15 per injection). In 2011, the U.S. Food and Drug Administration (FDA) approved a commercial version of 17P (trade name “Makena”) through their Accelerated Approval Program, and the price of 17P subsequently increased by nearly 100-fold. This approval was largely based on a methodologically limited, placebo-controlled trial, which found that although 17P significantly reduced preterm births, the placebo group had significantly more participants with a history of preterm birth, potentially confounding the results. The FDA required a confirmatory trial for continued approval that demonstrated clinical benefit. Eight years after accelerated approval, the confirmatory trial, PROLONG (Progestin's Role in Optimizing Neonatal Gestation), found no evidence of an effect of Makena for reducing recurrent preterm birth or perinatal mortality. Trial completion triggered an automatic review of Makena by an advisory committee, which voted 9–7 to recommend revoking approval of Makena for preterm birth. Although the FDA created the Accelerated Approval Program to introduce therapies for serious conditions that lacked treatment options, Makena is an example of the limitations of this program. We encourage the FDA to re-evaluate their program and consider improvements, such as shorter timeframes to complete confirmatory trials, potentially revoking approval if the studies are not completed within a predefined timeframe, and to hold manufacturers responsible, in part, for the costs of therapy if they cannot prove a clinical benefit.
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