Does Kinship vs. Foster Care Better Promote Connectedness? A Systematic Review and Meta-Analysis

Abstract

Internationally, there is an increasing trend toward placing children in kinship vs. foster care. Prior research suggests that children in kinship care fare better compared to children in foster care; however, the reasons for this remain unclear. We conducted a systematic review and meta-analysis to examine the hypothesis that kinship care better preserves children’s connectedness to caregiver, birth family, culture, and community; which, in turn, is associated with more optimal child outcomes. Thirty-one studies were reviewed that compared children aged 0–18 years in kinship care vs. foster care on levels of connectedness, three of which had outcomes that permitted meta-analysis. Findings indicated that children in kinship vs. foster care were more likely to feel connected to family in general; however, there was not a clear advantage for kinship vs. foster care for caregiver, birth parent, cultural, and community connectedness. While levels of connectedness were generally associated with more adaptive child outcomes for children in both kinship and foster care, no reviewed studies examined the hypothesis that children’s connectedness may mediate the relationship between placement type and child well-being and placement outcomes. Results are discussed with respect to limitations and policy implications of the current evidence-base and the need for more rigorous research to help identify how to improve child well-being in home-based care.

Appendices

Appendix 1: Search Terms (Dates Searched: 17/05/2019; 16–17/12/2020)

Scopus

ALL (((“Kinship care*” OR “kinship parent*” OR “relative care” OR “Kinship foster care” OR “Kin care*” OR “Kin foster care”) AND (“Foster care*” OR ”Foster parent*” OR “Foster child*” OR {alternative care})) AND ((attachment OR “relationship quality” OR connection OR connectedness OR warmth OR affection OR “birth parent*” OR “birth mother” OR “birth father” OR sibling* OR {joint placement} OR culture OR “cultural connection” OR “spirituality” OR neighborhood OR community OR “school connectedness” OR “school involvement” OR “school engagement” OR “school membership”))).

PsycINFO 1802 – Present

((“Kinship care*” or “kinship parent*” or “relative care” or “Kinship foster care” or “Kin care*” or “Kin foster care”) and (“Foster care*” or “Foster parent*” or “Foster child*” or “alternative care”)).mp.

PubMed

((Kinship care* OR kinship parent* OR “relative care” OR “kinship foster care” OR “kin care” OR “kin foster care”) AND (Foster care* OR Foster parent* OR Foster child* OR “alternative care”)) AND (attachment OR “relationship quality” OR connection OR connectedness OR warmth OR affection OR “birth parent” OR “birth mother” OR “birth father” OR sibling* OR “joint placement” OR culture OR “cultural connection” OR spirituality OR neighborhood OR community OR “school connectedness” OR “school involvement” OR “school engagement” OR “school membership”).

Proquest 1988—2019 (Decades)

(“Kinship care*” OR “kinship parent*” OR “relative care” OR “Kinship foster care” OR “Kin care*” OR “Kin foster care”) AND ( “Foster care*” OR “Foster parent*” OR “Foster child*” OR “alternative care”) AND (attachment OR “relationship quality” OR connection OR connectedness OR warmth OR affection OR “birth parent*” OR “birth mother” OR “birth father” OR sibling* OR “joint placement” OR culture OR “cultural connection” OR spirituality OR neighborhood OR community OR “school connectedness” OR “school involvement” OR “school engagement” OR “school membership”).

Informit Indigenous Collection

(“Kinship care*” OR “kinship parent*” OR “relative care” OR “Kinship foster care” OR “Kin care*” OR “Kin foster care” OR “Foster care*” OR “Foster parent*” OR “Foster child*” OR alternative care OR “out-of-home care”) AND (culture OR “cultural connection” OR spirituality).

Appendix 2: Quality Assessment Items for Quantitative Studies (Kmet et al., 2004)

Note. Modifications are italicised.

How to calculate the summary score: Total sum = (number of “yes” * 2) + (number of “partials” * 1); Total possible sum = 28 – (number of “N/A” * 2).

Summary score: total sum/total possible sum.

1. Question or objective sufficiently described? Select No if the main aim was not to assess kinship vs. foster care on a connectedness variable.

2. Design evident and appropriate to answer study question?

3. Method of subject selection described and appropriate (and comparison group selection, if applicable)?

4. Subject characteristics sufficiently described? Select Yes only if demographics (e.g., age) are provided for both children in kinship AND foster care.

5. If random allocation to treatment group was possible, is it described? = N/A.

6. If interventional and blinding of investigators to intervention (i.e., placement type) was possible, is it reported?

7. If interventional and blinding of subjects to intervention was possible, is it reported? = N/A.

8. Outcome = connectedness variable and exposure measure(s) well defined and robust to measurement/misclassification bias? Means of assessment reported?

9. Sample size appropriate?

10. Analysis described and appropriate (only in reference to kinship vs. foster care question)?

11. Some estimate of variance (e.g., confidence intervals, standard errors) is reported for the main results/outcomes (i.e., those directly addressing the study question/objective upon which the conclusions are based)?

12. Controlled for confounding? Select No if placement type (i.e., kinship vs. foster care) is the covariate.

13. Results reported in sufficient detail (only in reference to kinship vs. foster care question)?

14. Do the results support the conclusions (only in reference to kinship vs. foster care question)?

Appendix 3: Quality Assessment Items for Qualitative Studies (Kmet et al., 2004)

How to calculate the summary score: Total sum = (number of “yes” * 2) + (number of “partials” * 1); Total possible sum = 20.

Summary score: total sum/total possible sum.

1. Question/objective clearly described?

2. Design evident and appropriate to answer study question? (Select No if kinship vs. foster care is not the study’s main aim).

3. Context for the study is clear?

4. Connection to a theoretical framework/wider body of knowledge?

5. Sampling strategy described, relevant and justified?

6. Data collection methods clearly described and systematic?

7. Data analysis clearly described, complete and systematic?

8. Use of verification procedure(s) to establish credibility of the study?

9. Conclusions supported by the results?

10. Reflexivity of the account?