Crisis nursery services and foster care prevention: An exploratory study

Study Aim/Purpose:
This study explored the relationship between receipt of short-term crisis nursery services, including case management and parenting education, and children’s subsequent foster care placement.

Summary of Methods:
This was a cross-sectional study examining administrative data on 186 families and their 322 children who received crisis nursery services in Cleveland, Ohio, between 2006 and 2009. The crisis nursery program administrative data file provided information on parent and child demographics, referral sources, and reason, type of crisis nursery services received, dates of inquiry and discharge. The two key independent variables were receipt of case management and parenting education services as recommended by the crisis nursery. Generalized estimating equations analysis was used to assess the relationship between receipt of recommended crisis nursery services and subsequent foster care placement. Information on foster care placement before and/or after using crisis nursery respite was obtained by matching crisis nursery data to the county’s Childhood Integrated Longitudinal Data System which integrates birth records with records from many health and human services agencies, including the Department of Children and Family Services, which administers foster care.

Summary of Results:
Children whose families received case management had 65 percent lower odds of having subsequent foster care placement than children in families who were recommended to, but did not receive case management. Similarly, those children whose families participated in parenting education had 65 percent lower odds of subsequent foster care placement than children in families who were recommended to, but did not participate. Other significant predictors of subsequent foster care identified included previous foster care placement during the 12 months prior to receiving crisis nursery respite and the child’s race. Caucasian children had 8-9 times higher odds of subsequent foster care placement than biracial children and African American children had 3 times higher odds than biracial children.

Study Limitations (as cited by authors):
The authors note several limitations of their research design noting its cross-sectional nature and dependence on data in the administrative dataset.

Authors’ Discussion/Conclusions:
The authors suggest that crisis nursery services delivered with case management and parenting education may be an effective and cost-effective intervention to reduce children’s foster care placement and recommend partnerships between crisis nurseries and public child welfare agencies as a foster care prevention strategy. They also note that children who have had foster care experience prior to receiving crisis nursery services warrant special attention since they are at heightened risk of repeated placement. The authors suggest future research should link crisis nursery administrative data with a broader array of programs serving vulnerable families. They also suggest qualitative research to better understand the factors that might account for the racial differences found in this study.