Protocol for a Systematic Review of Policies, Programs or Interventions Designed to Improve Health and Psychosocial Outcomes for Young People Leaving the Out of Home Care System

Abstract

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:Using the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) guidelines, this review will identify programs, interventions and policies that seek to improve health and psychosocial outcomes amongst 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. A search strategy has been developed that covers eleven databases of published literature in multiple languages. Unpublished literature will also be searched. A meta-analysis will be undertaken if identified studies are suitably heterogenous. Risk of bias will be assessed using tools appropriate to the study methodology. Outcomes 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. Trial Registration:PROSPERO: CRD42020146999

Pursuing Common Ground Instead of Specious Misconceptions: Response to Barth and Colleagues

“…Unfortunately, as one source has noted, “Yet, empirical studies of children in OHC paint a dismal picture of their health situation.” (Gao et al, 2017, p. 1011) There is significant evidence that foster care and residential care have limited effectiveness in addressing pre-placement related risk factors and behaviors and may exacerbate the situation (Gao et al, 2017; Li, Chng, & Chu, 2019). Some of the supporting evidence comes from studies on the aging out population (Annie, E. Casey Foundation 2007; Association of Small Foundations, 2008; Taylor, Shlonsky, & Albers, 2021). The authors acknowledge, but minimize, the aging out research by stating most of it was pre-2008 when federal legislation extended, at state discretion, the upper age limit on foster care eligibility from 18 to 21 years.…”

Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review

“…There are very few systematic or scoping reviews which address access to dental care by CYP in care or care leavers, and for oral health in general, the evidence base is lacking. A systematic review and meta-analysis by Taylor et al [83] examined the policies, programmes and interventions that improve outcomes for young people leaving care. This included health outcomes.…”

Youth in Transition: Exploring a Life Course Perspective on Leaving care in Africa

“…There is now a substantial body of research on the difficult experiences many of these young people face (Mann-Feder & Goyette 2019). Much of this research has focused on preparation for leaving care (Frimpong Manso, 2012;Cassarino-Perez et al, 2018) and outcomes for care-leavers (Kääriäläa & Hiilamoa, 2017;Kelly et al, 2022;Taylor et al, 2021). Within this growing literature the theorisation of care-leaving is still at an exploratory stage (van Breda, 2015;Storø, 2017) and there has been some recognition of the need to take account of the dominance of theory emanating from the Global North ; a caution that has been flagged within youth studies more broadly (Furlong, 2013).…”