Ministerio de Economía y Competitividad (España) PPSI2015-67757-RUniversidad de Sevilla V Plan Propio de Investigació

Carrera, Pablo

García Moya, Irene

Moreno Maldonado, Concepción

Moreno Rodríguez, María del Carmen

Paniagua Infantes, Carmen Elisa

Ramos Valverde, Pilar

idUS. Depósito de Investigación Universidad de Sevilla

POSITIVE HEALTH IN ADOPTED, FOSTERED, INSTITUTIONALIZED AND COMMUNITY ADOLESCENTS: A COMPARATIVE ANALYSIS Paniagua, C., Moreno, C., Carrera, P., Ramos, P., García-Moya, I. & Moreno-Maldonado, C. Department of Developmental and Educational Psychology, University of Seville, Spain.  email: cpaniagua@us.es   RESULTS DISCUSSION        REFERENCES: -Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11, 11-18. doi: 10.1093/heapro/11.1.11 -Del Valle, J. F., López, M., Montserrat, C., & Bravo, A. (2009). Twenty years of foster care in Spain: Profiles, patterns and outcomes. Children and Youth Services Review, 31, 847-853. doi:10.1016/j.childyouth.2009.03.007. -García-Moya, I. & Morgan, A. (2016). Salutogenesis’ utility as a theory for guiding health promotion practice: the case of young people’s well-being. Health Promotion International. Advanced online publication. doi: 10.1093/heapro/daw008 -Jiménez-Morago, J. M., León, E. & Román, M. (2015). Adversity and adjustment in children in institutions, family foster care, and adoption. Spanish Journal of Psychology, 18, 1-10. doi: 10.1017/sjp.2015.49 -Jones, A. S., LaLiberte, T., & Piescher, K. N. (2015). Defining and strengthening child well-being in child protection. Children and Youth Services Review, 54, 57-70. doi: 10.1016/j.childyouth.2015.05.001 -Llosada-Gistau, J., Montserrat, C., & Casas, F. (2015). The subjective well-being of adolescents in residential care compared to that of the general population. Children and Youth Services Review, 52, 150-157.  doi: 10.1016/j.childyouth.2014.11.007 -Montserrat, C. (2014). Kinship care in Spain. Messages from research. Child & Family Social Work, 19, 367-376. doi:10.1111/cfs.12028. -Montserrat, C., & Casas, F. (2006). Kinship foster care from the perspective of quality of life: Research on the satisfaction of the stakeholders. Applied Research on Quality of Life, 1, 227-237. doi: 10.1007/s11482-007-9018-2 -Palacios, J. (2003). Instituciones para niños ¿Protección o riesgo? Infancia y Aprendizaje, 26, 353-363. doi: 10.1174/021037003322299098 -Palacios, J., & Amorós, P. (2006). Recent changes in adoption and fostering in Spain. British Journal of Social Work, 36, 921-935. doi:10.1093/bjsw/bch363. -Palacios, J. & Jiménez, J. M. (2009). Kinship foster care: Protection or risk? Adoption and Fostering, Vol. 33, 3, 3-12. doi: 10.1177/030857590903300307. -van IJzendoorn, M. H., & Juffer, F. (2006). The Emanuel Miller Memorial Lecture 2006: Adoption as intervention. Meta-analytic evidence for massive catch-up and plasticity in physical, socio-emotional, and cognitive development. Journal of Child Psychology and Psychiatry, 47, 1228-1245. doi:10.1111/j.1469-7610.2006.01675.x -World Health Organization (1948). WHO Constitution. Genova: World Health Organization.  Our results showed a clear trend in the subjective well-being of the adolescents according to the child's status inside the protection system, a trend in line with the majority of scientific literature (Jiménez-Morago, León & Román, 2015). In first place, adopted adolescents presented a profile similar to the community group in all dimensions of positive health. At the same time, they showed more positive health than kinship-care and especially more than institutionalized adolescents. These results point to the known general success of adoption as intervention for children with early adversity (van IJzendoorn & Juffer, 2006).  Adolescents in kinship-care, on the other hand, showed a less positive health profile in comparison with community and adopted adolescents, particularly in self-reported health, health-related quality of life and life satisfaction. This is an undesirable result, but expectable if we take into account some of the difficulties of kinship carers related to their social and personal situation (Palacios & Jiménez, 2010; Montserrat, 2014). However, other research has found that the subjective well-being (a dimension similar to those of our study) of adolescents in kinship care was similar to that of the general population (Montserrat & Casas, 2006).  Lastly, institutionalized adolescents presented lower positive health in comparison with all the other groups. This result is in consonance with the academic literature that points to the deficits of institutional care as a context for psychological development (Palacios, 2003), and with research specifically on well-being that found worse levels of subjective well-being in Spanish institutionalized adolescents in comparison with community adolescents (Llorada-Gistau, Montserrat & Casas, 2015). This study remarks the importance of analysing well-being and health dimensions as outcomes in child welfare research, and the convenience of family alternatives to institutional care. In order to contrast these results on lifestyles with this same sample, see another poster of our team entitled "Lifestyles: a comparison between adopted, fostered, institutionalized and community adolescents" in this poster exhibition session.  METHOD  Participants:  The sample was comprised of 28,998 Spanish adolescents between 11 and 18 years old. Of them, 394 were adopted, 195 were living with theirs grandparents in kinship foster care, and 35 adolescents were living in welfare centres. The remaining 28,374 participants formed the control group of community adolescents. All of them took part in the 2014 Spanish edition of the WHO collaborative study Health Behaviour in School-aged Children (HBSC).    Instruments:  The instruments used were Cantril's Scale for Life Satisfaction, Kidscreen-10 Index for Health-Related Quality of Life, Self-Reported Health, the HBSC-Symptom Checklist for Psychosomatic Complaints and the SOC-13 scale for sense of coherence (a construct related to the capacity of coping in a positive and meaningful way (Antonovsky, 1987; García-Moya & Morgan, 2016)).  Procedure and statistical analyses: Data was collected through anonymous, self-completed questionnaires according to guidelines from the international coordination protocol of the HBSC study. Descriptive analysis with mean comparisons (ANOVAs) controlling for gender and age were used in all analyses. Cohen’s d was used to measure the effect size. INTRODUCTION  Studies of children and adolescents in the child welfare system have traditionally focused on the mental health problems of this at-risk population. However, we know little about their health in terms not merely of the absence or presence of mental health problems, but in terms of a wider and integrated view of health as physical, mental and social wellbeing, as the WHO already stated in 1948. This trend towards a more holistic approach or positive outcomes is already present in child welfare research (Jones, LaLiberte & Piesche, 2015).  Regarding foster care, it is important to note that Spain’s legislation establishes kinship care as the preferred option for out-of-home placements. In fact, approximately 75% of all family foster care takes place within the kinship network, compared to 25% in non-kinship families (Del Valle, López, Montserrat, & Bravo, 2009; Palacios & Amorós, 2006; Palacios & Jiménez, 2009). Furthermore, adolescents in the child welfare system should be of special concern: the adverse past of these youth can have negative effects on their health during this crucial developmental period. Accordingly, the aim of this study is to analyse the health of a sample of adolescents in adoptive families, kinship care families and residential care, in comparison with community adolescents and amongst each other. For this purpose, the research is approached from an integrated and positive perspective of health that includes subjective measures of life satisfaction, health-related quality of life, psychosomatic complaints and sense of coherence (SOC). F p values SELF-REPORTED HEALTH (1-4) 7.115 ≤ .001 LIFE SATISFACTION (0-10) 32.598 ≤ .001 PSYCHOSOMATIC COMPLAINTS (0-4) 5.890 = .001 SENSE OF COHERENCE (1-7) 9.348 ≤ .001 KIDSCREEN (10-50) 12.007 ≤ .001 2,3 2,4 2,1 2,2 1234Self-reported health(1-4)Cohen’s d was used to calculate the effect size and is represented by arrows. Arrow’s thickness shows the type of effect size and colour indicates the group in which a difference is shown.                    Small effect (0.20 – 0.49)    Moderate effect (0.50 – 0.79)    Large effect (≥ 0.80) Control Adoption Kinship Centre 7,7 7,5 6,9 5,2 0246810Life satisfaction(0-10)2,2 2,2 2,6 3,1 01234Psychosomatic(0-4)34,9 35,2 33,4 31,1 1020304050Kidscreen(10-50)4,5 4,3 4,1 3,8 1234567Sense of coherence(1-7)1The HBSC study is supported by the Spanish Ministry of Health, Social Policy and Equality. In addition, this work was supported by the Spanish Ministry of Economy and Competitiveness through the project PSI2015-67757-R, and by a grant signed by “V Plan Propio de Investigación” (University of Seville, Spain).   View publication stats

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Positive health in adopted, fostered, institutionalized and community adolescents: a comparative analysis : [póster]

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