Research on the delivery and impact of interventions for foster parents is sparse, but even more so for relative caregivers. The purpose of this study was to help fill the gap by examining service engagement dynamics of kinship (relative) and non-relative caregivers to inform decisions about improving caregiver access to services. Specifically, the study encompassed (1) comparison of three engagement indicators between relative and non-relative caregivers: referral to, uptake, and completion of the Nurturing Parenting Program (NPP) (2) investigation of case notes concerning reasons for not initiating the program, and (3) assessment of how parenting and child-rearing attitudes of relative and non-relative caregivers who participated in NPP changed from pre-test to post-test using Adult-Adolescent Parenting Inventory-2 (AAPI-2) scores.
Methods
Quantitative and qualitative data from the Illinois Birth to Three (IB3) study were utilized (N=1,355 cases of children). Chi-square tests were used to examine the rates of referral to, uptake, and completion of NPP for relative and non-relative caregivers. Independent samples t-tests were conducted to examine differences in time to referral between relative and non-relative caregivers. Case notes reflecting reasons for not initiating the program were content analyzed. Selected content categories were compared between the two placement types utilizing chi-square tests. ANCOVA was utilized to assess the effect of placement type on post-test AAPI-2 scores, controlling for pre-test scores.
Results
Rates of referral to NPP were not significantly different between relative caregivers (59.7%) and non-relative caregivers (54.9%). Time to referral was significantly reduced for relative caregivers (mean = 179 days) compared to non-relative caregivers (mean = 205 days; p < .05), which may be due to the significantly greater placement stability for relative homes (mean = .55 moves) than for non-relative homes (mean = .94 moves; p < .05). Program uptake rates among those referred were not significantly different between the two caregiver groups (relatives= 17.6%; non-relatives=22.5%). The two groups were significantly different with regard to completion rates (relative=14.8%; non-relatives=22.0%; p < .05). The content analysis of case notes indicated that relative caregivers reported significantly greater barriers than non-relative caregivers (8.3% vs. 3.9%; p < .05). Barriers included childcare, health, language access, distance, transportation, and work. Services to relative caregivers were significantly more likely to be interrupted by reunification (71.9% vs. 44.9%) and less likely by adoption (28.1% vs. 55.1%; p < .05). The findings of ANCOVA indicated significant improvement on every subscale of the AAPI-2; the levels of improvement were not significantly different by placement type.
Conclusions and Implications
Findings suggest that relative caregivers were equally as likely to be referred to and initiate the Nurturing Parenting Program as non-relative caregivers. However, they were less likely to complete services. Relative caregivers were also more likely to experience barriers to service engagement, which could, in some cases, be alleviated with additional resources. When relative caregivers engaged with and completed services, they experienced improvements in AAPI-2 scores similar to those of non-relative caregivers. The findings suggest the value of additional attention to services to foster parents, including relative caregivers.