The impact of transitional programmes on post-transition outcomes for youth leaving out-of-home care: a meta-analysis

Abstract

Youth residing in out‐of‐home care settings have often been exposed to childhood trauma, and commonly report experiencing adverse outcomes after transitioning from care. This meta‐analysis appraised internationally published literature investigating the impact of transitional programme participation (among youth with a baseline age of 15–24 years) on post‐transition outcomes of housing, education, employment, mental health and substance use. A comprehensive search of sociology (e.g. ProQuest Sociology), psychology (e.g. PsycInfo) and health (e.g. ProQuest Family Health) electronic abstraction databases was conducted for the period 1990–2014. Search terms included ‘out‐of‐home care’, ‘transition’, ‘housing’, ‘education’, ‘employment’, ‘mental health’ and ‘substance use’. Nineteen studies, all from the United States, met the inclusion criteria and were included in the meta‐analysis. Living independently and homelessness were the most commonly described housing outcomes. Rates of post‐transition employment varied, while rates of post‐secondary education were low. Depression and alcohol use were commonly reported among transitioning youth. Findings of the meta‐analysis showed that attention should be given to the potential benefit of transitional programme participation on outcomes such as housing, employment and education. Moderator analyses showed that these benefits may differ based on study design, sample size and sampling unit, but not for mean age or gender. Detailed and rigorous research is needed internationally to examine the characteristics of transitional programmes resulting in more successful outcomes for youth, and whether these outcomes are sustained longitudinally.

The impact of transition interventions for young people leaving care: a review of the Australian evidence

“…Only a small proportion of studies found improvements in care-leavers' social support networks after engaging in the programme (Anglicare, 2016;Compass Leaving Care Limited, 2019;Mendes, 2011) and in mental health and substance misuse (Baldry et al, 2016). These findings are consistent with the international literature (Heerde et al, 2018;Woodgate et al, 2017) that found transitional support programmes to be less effective in improving health as compared to independent living outcomes. Whilst the majority of studies in this review (8/11) assessed the impact of the programme on a health-related outcome (e.g., mental health, social support, or physical health), the transition interventions themselves primarily aimed to assist young people to achieve indicators of independence (e.g., housing, employment), rather than specifically aiming to improve health outcomes, which may account for these findings.…”

“…Indeed, after engagement in the interventions, the majority of care-leavers achieved housing stability, reported high rates of enrolment or motivation to enrol in further education, and gained access to financial payments. These findings are consistent with previous reviews of international evidence that found transitional support interventions for care-leavers to be most effective in improving outcomes associated with independent living (Heerde et al, 2018;Woodgate et al, 2017). These programmes are effective in providing coordinated support and assisting care-leavers to overcome the barriers to gaining stable housing, continue or finish education, obtain and maintain employment, and increase access to financial stability, which allows them to adequately prepare for and achieve independence.…”

“…However, they were less effective in facilitating health outcomes, which is concerning as these young people experience poorer mental and physical health outcomes after transitioning from care (Muir et al, 2019;Smales et al, 2020). These findings were also supported by a recent meta-analysis that examined the effectiveness of US programmes for young people transitioning from care (Heerde et al, 2018). Across 19 studies, moderate improvements were identified in housing and educational outcomes, but again, only small improvements were observed across health outcomes.…”

“…Two systematic reviews have synthesized the effectiveness of interventions for care-leavers (i.e., Heerde et al, 2018;Woodgate et al, 2017) yet these reviews did not include a single Australian study. Woodgate et al's (2017) scoping review identified 68 studies that evaluated interventions to facilitate young people's transition from care.…”

Review: Sex‐Based Differences in Treatment Outcomes for Persons With Opioid Use Disorder

“…The manuscript was directly evaluated for inclusion in cases where the title and abstract did not provide sufficient information. The original terms and concepts utilized by the primary authors of literature reviewed remain intact whenever possible to ensure accurate representation of the various outcomes 16,17 .…”