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Caregiver Satisfaction. Chika Monu University of Maryland School of Social Work AO-CAPTA Grantee Meeting Washington DC 4 th -5 th March 2004. Background. Investigating caregiver satisfaction with child welfare services is important for outcomes such as safety, permanence and wellbeing
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Caregiver Satisfaction Chika Monu University of Maryland School of Social Work AO-CAPTA Grantee Meeting Washington DC 4th -5th March 2004
Background • Investigating caregiver satisfaction with child welfare services is important for outcomes such as safety, permanence and wellbeing • Feedback from caregivers helpful in monitoring and improving services
Background • Recognizing clients’ perspective and starting where client is, an integral part of social work practice. • Attrition and turnover among foster caregivers can be reduced if reasons for dissatisfaction can be identified and eliminated.
Theoretical Framework – The Family Caregiving Model Antecedents Child Characteristics Caregiver Characteristics Family Characteristics Mediators Social Support Social Services Access to Health care Religiosity Social Embeddedness Outcome Client Satisfaction
Theoretical Framework • FCM explains outcomes for caregivers based on individual and family response to crisis or stress (McDonald & Gregoire, 1997). • The response process is characterized as consisting of antecedents, mediators and outcomes. Footnote: Theory modified from proposal
Theoretical Framework • Effects expected to flow from antecedents to mediators to outcome. • Direct and indirect effects of antecedents on outcome also expected. • Antecedents are ‘givens’, such as, caregiver characteristics etc. • Mediators are external and internal factors related to the caregiver.
Research Objectives • To develop a model of caregiver and child characteristics and intervening components associated with satisfaction. • To compare caregiver satisfaction with services received within a managed care setting and services received within a public child welfare agency
Research Objectives • To examine the predictors of change in satisfaction with services from baseline to one year follow-up
Sample • Families were randomly assigned on a 2:1 basis to experimental managed care group or control traditional agency group • 79 caregivers who completed round one interviews of Maryland Child Welfare Managed Care project (CWMC)
Sample • Also 61 caregivers who completed round two interviews. • Sample predominantly African American women. • One third of sample are married and two third are employed. • Most have high school diploma.
Method • Caregivers were recruited to participate via phone and mail. • Participants completed a 2-hour computer assisted interview. Trained interviewers were available to assist. • Proposed study will use already existing data to do a secondary analysis, no new data will be collected.
Measure of Outcome • Dependent variable, client satisfaction: the Relationship with Social Worker Scale from the Outcome Measures for Child Welfare Services (Magura & Moses 1986).
Measures of Mediators • Social Support: the Social Provisions Scale. 24-item self-report scale (Russell & Cutrona, 1984) • Social service: managed care setting and traditional social service. • Social Embeddedness: The Perceived Neighborhood Scale, a 29 item scale. (Martinez, Black, & Starr, 2002)
Measures of Mediators • Assess to health care: the National Health Interview Survey created by National Center for Health Statistics • Religiosity: Organizational Religiousness Scale (Levin & Chatters, 1998)
Measures of Antecedents • Child Behavior: the Shortform Assessment for Children Revised (SAC-R). • Caregiver and family characteristics: demographic information from subjects.
Data Analysis Plan • Objective 1 – Multiple regression analysis to test for predictors of satisfaction • Objective 2 – t-test to test whether mean level of satisfaction differ for managed care and traditional agency • Objective 3 – Multiple regression analysis, DV time 2 satisfaction scores
Project Status • Currently working on dissertation proposal • Secondary dataset obtained • Proposal defense anticipated September 2004
References • Levin, J. S., & Chatters, L. M. (1998). Research on religion and mental health: An overview of empirical findings and theoretical issues. In H. G. Koenig (ed.), Handbook of Religion and Mental Health (pp. 33-50). San Diego, CA: Academic Press. • Magura, S., & Moses, B. S. (1986). Outcome Measures for Child Welfare Services: Theory and Applications. CWLA: Washington D.C. • Martinez, M. L., Black, M., & Starr, R. (2002). Factorial structure of the perceived neighborhood scale (PNS): A test of longitudinal invariance. Journal of Community Psychology, 30, 23-43. • McDonald, T. P., Gregoire, T. K. (1997). Building a model of family caregiving for children with emotional disorders, Journal of Emotional and Behavioral Disorders, 5, 138-148. • Russell, D., & Cutrona, C. (1984). The provisions of social relationships and adaptation to stress. Paper presented at the American Psychological Association Convention, Toronto, Canada. Social Provision Scale. You can get a copy of this presentation from the following web address: www.rhycenter.umaryland.edu