Policy Strategies to Address Child Maltreatment and Foster Care (2025-2026)

Background

Children who experience maltreatment face immediate physical, emotional and psychological harm, as well as long-term health consequences, including increased risks of common, high-cost pediatric illnesses. Those placed in foster or kinship care endure additional trauma, including separation from family and uncertainty about the future. These children need specialized, multidisciplinary care to prevent further harm and promote resilience.

In North Carolina, children entering foster care must undergo a medical evaluation, including a health screening within 72 hours, a comprehensive evaluation within 30 days and a follow-up within 60-90 days. Foster families, however, encounter barriers to meeting these requirements, such as trouble securing timely appointments, difficulty taking time off work and challenges obtaining health records.

Kinship caregivers often receive less support and may lack funds for medical care. Families fostering children with complex medical needs face additional difficulties in managing care. Frequent placement changes in foster care also leads to school disruptions, which negatively affect children's behavioral and mental health, necessitating services and interventions.

Policies that improve support for caregivers, streamline access to evaluations and address educational instability are essential for improving the long-term well-being of children in foster care.

Project Description

Building off the work of a previous team, this team will work at the intersection of health, social services and policy, to review existing evidence on policy innovations for child maltreatment prevention and improvement of foster care services.

In 2025-2026, team members will continue to analyze, synthesize and disseminate data collected in partnership with the Child Maltreatment Prevention Research Team of the Children’s Health and Discovery Initiative and the Center for Child and Family Policy. Team members will interview stakeholders including policymakers, social service agency workers, community non-profit personnel, child abuse pediatricians, educators, foster and kinship care parents and former foster children (now over the age of 18). Team members will learn more information about care coordination, barriers to care and potential policy solutions, which can help answer questions about the effects of frequent placement changes on foster children.

Team members will conduct additional interviews, focusing on stakeholders in North Carolina, and the project will expand its focus to include the intersection of foster/kinship care and health services. An additional aim will be to form a partnership with a community agency such as the Department of Health and Human Services through NC Strategic Partnerships.

Anticipated Outputs

Data collection; student presentations to stakeholders including the North Carolina Department of Health and Human Services; policy brief; peer-reviewed manuscript; poster presentation at a regional pediatrics conference

Student Opportunities

Ideally, this project team will include 1 graduate student and 10 undergraduate students. Students with interests or backgrounds in child development, health care, racial equity, social services, public policy or psychology are encouraged to apply, including those pursuing a Child Policy Certificate or Health Policy Certificate. Students with lived experience with low-income environments and/or Child Protective Service engagements would also be assets to the team.

Students will gain research and writing experience and skills in interviewing child services stakeholders. Team members will also learn qualitative analysis skills, including development of a coding scheme and coding in NVivo. Students will have the opportunity to contribute to a peer-reviewed journal publication, a written policy brief and a presentation to stakeholders.

There will be weekly team meetings, and the overall group will be divided into subteams focusing on different aspects of the project. Project leaders will work to keep the groups in unison and create flexibility in changing the groups over time to allow students to gain experience with a variety of skills.

In Summer 2025, there will be an optional summer research component, which will run for 10 weeks (coinciding with Summer Session 1) with students completing 12 hours of work per week.

Timing

Summer 2025 – Summer 2026

• Summer 2025 (optional): Analyze results from spring interviews; develop manuscript and policy brief from spring interviews; review literature
• Fall 2025: Continue work on manuscript and policy brief using results from completed interviews; identify stakeholders for new interviews; schedule and conduct new interviews with a focus on foster and kinship care
• Spring 2026: Complete interviews; code and analyze interviews
• Summer 2026 (optional): Finalize results from spring interviews; develop manuscript and policy brief from spring interviews

Crediting

Academic credit available for fall and spring semesters; summer funding available

See earlier related team, Policy Strategies to Address Child Maltreatment (2024-2025).