1. Gavin Hamilton, MSc Connie Cheung, PhD

2.  Introduction  Objective  Methods  Results  Discussion  Conclusion

3. INTRODUCTION Objective Methods Results Discussion Conclusion  OACAS  Mission

4. INTRODUCTION Objective Methods Results Discussion Conclusion “Self-esteem is an overall reflection of one’s self-worth, which encompasses beliefs about oneself as well as an emotional response to those beliefs”.

5. INTRODUCTION Objective Methods Results Discussion Conclusion 50 y/o AGE Self Esteem

6. INTRODUCTION Objective Methods Results Discussion Conclusion  Low self esteem ◦ Negative outcomes  High self esteem ◦ Positive outcomes

7. INTRODUCTION Objective Methods Results Discussion Conclusion  Predictors?  Theory: different stressors than general population

8. Introduction OBJECTIVE Methods Results Discussion Conclusion  To examine the effects of out-of- home care on self esteem a)Quality of Placement b)Caregiver-child relationship c)Stability of Care

9. Introduction Objective METHODS Results Discussion Conclusion  Cross-sectional ◦ Data collected in 2010-2011  Participants (n=207) ◦ Children ages 10-15 in either family or group-based foster care

10. Introduction Objective METHODS Results Discussion Conclusion  1hr interview  7 developmental dimensions  Three respondents: ◦ Child ◦ Caregiver ◦ Child Welfare Worker

11. Introduction Objective METHODS Results Discussion Conclusion Multi-informant measure 1)Child reported  Series of 6 validated questions 2)Child Welfare Worker reported  Series of 4 validated questions

12. Introduction Objective METHODS Results Discussion Conclusion 1. Quality of Placement ◦ Series of 6 questions 2. Child-caregiver relationship ◦ Series of 4 questions 3. Stability of care ◦ Three stability variables used: (residences, schools, caregivers)

13. Introduction Objective METHODS Results Discussion Conclusion  In the model, we controlled for: ◦ General Health ◦ School performance ◦ Sex ◦ Race ◦ Obesity (BMI) ◦ TV time ◦ Team sport involvement ◦ Risk Taking/Rebelliousness ◦ Safety ◦ History of Abuse ρ=0.23* ρ=0.31* * P-value<0.01

14. Introduction Objective METHODS Results Discussion Conclusion  Spearman correlation  Hierarchical multiple regression  Missing Data was imputed ◦ % missing: range= 0% to18%  Stata 10.0 statistical software

15. Introduction Objective Methods RESULTS Discussion Conclusion  Gender ◦ Male=118 (57%) ◦ Female= 89 (43%)  Age ◦ Mean = 13.2 y/o ◦ Range = 10 to 15

16. Introduction Objective Methods RESULTS Discussion Conclusion

17.  All children in care exposure variables are correlated with Self Esteem!

18. *P-value<0.05 ** P-value<0.01

19. Introduction Objective Methods RESULTS Discussion Conclusion Caregiver-child relationship Self Esteem Stable environment Unstable environment

21. Introduction Objective Methods Results DISCUSSION Conclusion Finding #1:  Quality of placement was associated with higher levels of self esteem  Chaos?

22. Introduction Objective Methods Results DISCUSSION Conclusion Finding #2:  The strength of the relationship that the child forms with the caregiver is associated with self esteem.  This association is moderated by the stability of care.

23. Introduction Objective Methods Results DISCUSSION Conclusion  Cross sectional data ◦ Causality?  Self report data  Quantitative analyses examining qualitative issues

24. Introduction Objective Methods Results Discussion CONCLUSION  These results highlight the importance of the quality of the placement, and the bonds formed by the child and caregiver.

25. Introduction Objective Methods Results Discussion CONCLUSION  Consider a longitudinal study to examine causality of the associations  Consider including a qualitative method in future studies  Dissemination of findings to the CAS and caregivers