Multi-System Recommendations to Prevent Foster Care Entry at the Community, System, and Structural Levels

Background: Preventing foster care entry is a major priority for communities across the U.S. Strategies for preventing entry have traditionally focused on mitigating individual- and family-level risk factors. While helpful, these approaches often overlook the community, system, and structural dimensions of the social environment that can either increase or decrease risk for foster care entry. Considering the type and level of interactions with families, professionals in child-serving organizations are uniquely positioned to understand the range of factors that contribute to foster care entry and provide prevention recommendations that move beyond individual and family-level services. Importantly, such recommendations can help to facilitate important transformation of current approaches to child and family wellbeing.

Methods: This study corresponds to a needs assessment of a primary prevention, funded by the U.S. Children’s Bureau, Administration for Children and Families, conducted between 2020 and 2021.This study used qualitative methods to explore recommendations from child-serving professionals to prevent foster care entry at the community, system, and structural levels. Data collection encompassed interviews (n = 27), focus groups (n = 7), and open-ended survey responses (n = 548) gathered from 614 child-serving professionals in various fields, including child welfare, mental health, health, public health, early childhood, and schools, among others. Using thematic analysis, emergent themes were identified and divergent ideas within or between informants from different systems were also included.

Findings: At the community level, five themes consistently emerged calling for more supportive communities, increased availability and awareness of resources, stronger connections between neighbors, trauma-informed communities, and a public health approach to prevention (shared responsibility). At the systems-level, recommendations focused on the child welfare system included making the CWS more proactive, improving communication and family engagement, increasing consistency and transparency to reduce bias and increase public trust, decreasing staff turnover, improving competency factors, and reducing bias. Participants strongly recommended increasing cross-system collaboration and coordination, improving communication and information sharing, integrating services for a holistic and tailored response to family needs, increasing accessibility and quality of services across systems, and improving cross-system training and competency. At the structural level, three overarching themes emerged: reducing stigma, enacting family-centered policies, and increasing funding. These recommendations focused on reducing stigma attached to help-seeking and service-receipt, particularly related to fear of the CWS, implementing family-centered policies that would bolster prevention efforts (e.g., child tax credit), and advocated for more funding to be allocated toward prevention and essential support structures, such as housing, transportation, and concrete supports.

Discussion: Findings indicate the need to embrace a public health approach to child maltreatment prevention, providing potential pathways for reshaping policies and practices, and advancing the national ongoing shift toward prevention and wellbeing. This study identifies specific dimensions of the social environment that could be the focus of reform aimed at improving wellbeing and support of children and families, such as collaborative approaches to family resource center implementation, by strengthening community supports and connection, reducing risks, and promoting family resilience.