Fostering hope: A mixed-methods evaluation of pediatric medical homes for youth in foster care

Abstract

Children in foster care demonstrate physical health difficulties at higher rates than the general population as well as lower rates of preventative health service utilization. This pattern places foster youth at heightened risk for long-term health complications in adolescence and adulthood (Garland, Landsverk, & Lau, 2003). The development of interventions for children in foster care is key for decreasing barriers to health services, increasing continuity of care, and ameliorating negative long-term outcomes (Kerker & Dore, 2006). The current project utilized a mixed-methods approach to evaluate the utility of Pediatric Medical Homes (PMHs) as a health intervention for youth in foster care. The current study involved interviews with 40 caregivers utilizing a PMH and assessed continuity of care from a sample of foster youth currently enrolled at the PMH (N=498). Qualitative themes demonstrated overall positive perceptions of the PMH model, with numerous advantages cited to sustain caregiver engagement at this service. Caregiver themes aligned with the seven major tenets of PMHs and highlighted additional needs specific to families with child welfare involvement. Continuity estimates suggested that youth in foster care were able to maintain good continuity with their provider, particularly for return visits and well-child check visits. The current findings address the utility of medical homes for caregivers and youth with child welfare involvement, and can inform future efforts to enhance health interventions for children affected by child maltreatment.