A Propensity Score Analysis of Reunification Outcomes Among Families Affected By Substances and Served By the Strengthening Families Program

Background/Purpose:

Parental substance use is associated with multiple forms of child maltreatment and estimated to be a factor in 11-14% of child protection referrals, 18-24% of substantiated cases, and 50-79% of foster care cases (Testa & Smith, 2009). Children in foster care due to parental substance use experience significantly lower rates of reunification and longer times in care prior to reunification (e.g., Green et al., 2007). As part of the federal Regional Partnership Grants, this study examined whether a parenting intervention would facilitate higher reunification rates. Specifically, the research question was: Do children in foster care due to parental substance use whose families received the Strengthening Families Program (SFP) reunify at higher rates and experience shorter stays than a matched comparison group of children who received foster care services-as-usual (SAU)?

 

Method:

The sample comprised 197 children who were in foster care due to parental substance use and had reunification as a case plan goal. The intervention group included 69 SFP participants, who received 14 weeks of SFP in a group-based format. A matched comparison group (n = 128) was established through propensity score matching. The study’s primary data source was the state’s child welfare administrative data. Cox regression tested whether SFP resulted in higher rates of reunification. Additionally, we estimated survival curves for the proportion of cases reunified in each group over one-day intervals and fit cubic regression equations to each curve.  To estimate group differences in days in foster care, we calculated the integral of the difference between the two cubic equations.

Results:

Baseline analyses showed that the SFP and SAU groups were comparable on 13 variables. Cox regression demonstrated that SFP was significantly related to higher rates of reunification as compared to SAU (HR = 2.31, p < .01). Children in the SFP group reunified at a rate of 58.0%, while those in the comparison group had a reunification rate of 36.9%.  The difference in days in foster care averaged 241.5 days fewer for SFP children.

Conclusions:

Results suggest that SFP was associated with higher reunification rates and shorter time to reunification among children in foster care due to parental substance use. This study adds to the literature on evidence-based parenting interventions, which continues to show promise for families involved in the child welfare system. Especially important is that these results extend beyond short-term outcomes (e.g., changes in child behaviors) to show benefits in children’s and families’ living situations. Researchers should continue this focus on long-range outcomes with future studies that examine whether parenting interventions can also reduce rates of re-entry into foster care.