2011 The Palm Beach County Family Study (Full Report)

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eadiness and school success and in improving family functioning among children and families most inneed of support. The goal of the study is to describe the characteristics and needs of families the servicesystem is intended to serve, how they use the services that make up the service system in Palm BeachCounty, and how service use relates to child and family outcomes. It began in 2004 and addressesquestions in the following areas:What services and supports are available and how do families of young children in the TGAs usethem? Are there patterns of service use?What are the correlates of service use, including demographic and other family characteristics,indicators of risk and service need, geographic location, nativity, and prior service use?How does service use relate to child and family outcomes, including children’s school readiness;school success; and physical, social-emotional, and behavioral health; and to family functioning, ratesof abuse and neglect, and parent involvement in schools? 3Conceptual Framework for this StudyWe use an ecological model to guide this study. As described above, the Palm Beach County system ofcare is being built on the premise that families in the TGAs will function better and be better equipped toraise their children to be healthy and ready for school—cognitively, socially, emotionally, andphysically—with the support of a system of prevention and early intervention programs. The conceptualframework for the longitudinal study, shown in Figure 1, reflects this premise.This model assumes that families’ access to and use of the system of care will affect proximal outcomes(e.g., parenting practices, maternal functioning, and reports of child abuse and neglect), which, in turn,will affect children’s long-term outcomes. The model also suggests that a number of factors influenceservice use, including child, family, and community characteristics, and use of other services. Forexample, preliminary findings indicated that service use differs as a function of demographiccharacteristics such as age, education, and employment, as well as individual beliefs and attitudes aboutservices, perceptions of need and the costs of service use, and willingness to seek help (Spielberger,Lyons, Gouvea, Haywood, & Winje, 2007). In addition, mothers may be more likely to use services iftheir prior experiences with services were positive, or if the services used are a source of informationabout other services. Moreover, the conceptual framework suggests that the availability of social support3 It is important to note that, because families voluntarily chose whether or not to use services, and were not randomly assigned toreceive services, we cannot draw any conclusions about causal relationships between families’ service use and child and familyoutcomes. We are, however, able to examine the strength and direction of these relationships, after controlling for a wide varietyof child and family characteristics associated with both service use and child/family outcomes.Chapin Hall at the University of Chicago 3
may modify the relationship between child and family characteristics and service use.Figure 1. Conceptual Framework for Longitudinal StudyStudy Design and MethodsTo examine the use of the service system in Palm Beach County, and its relationship to children’s earlydevelopment and school readiness, we felt it important to track families during the early years of theirchildren’s lives, when they are most likely to come into contact with the service system. Thus, weselected as our primary study group families with newborns living in the TGAs, with the intent offollowing them for at least 8 years into the children’s early school years. The study uses a mixed-methodsapproach to examine the relations among the service systems in Palm Beach County, indicators of childwell-being and family functioning, and child and family outcomes. Methods include the following:An analysis of administrative data on service use and key outcomes for all children born in the TGAsand in the county during 2004 and 2005 and who remained in the county at various data collectionpoints during a 6-year period. Sources of administrative data are the Department of Health (DOH)Vital Statistics database; FOCiS, the database for the MCHP system; and the Department of Childrenand Families (DCF) database on reports of child abuse and neglect.A 6-year longitudinal survey of the service use experiences of a sample of families with youngchildren in the TGAs. Methods include annual in-person interviews with a baseline sample of 531mothers of newborn children and brief phone interviews with the same parents about 6 months aftereach interview for a period of 5 years. A total of 310 mothers were interviewed in the fifth year.A 3-year embedded qualitative study involving in-depth interviews and observations of a sample of40 families to enhance what is learned through analysis of the structured interviews andadministrative data. The qualitative study has focused in particular on service use, motivations to useservices, and how services fit into families’ lives. Six waves of interviews were conducted withmothers. In addition, in 2010, we interviewed a sample of 16 male caregivers.Chapin Hall at the University of Chicago 4
Page 1 and 2: FifthMarciaGouvêa2011
Page 3: AcknowledgmentsThis fifth report of
Page 6 and 7: Chapin Hall at the University of Ch
Page 8 and 9: List of TablesTable 1. Components o
Page 10 and 11: Table 58. Logistic Regression of Mo
Page 12 and 13: Table C- 24. Mothers’ Baseline an
Page 16 and 17: • In addition, we observed a pote
Page 18 and 19: kind of out-of-home educational exp
Page 20 and 21: IntroductionOver the last three dec
Page 24 and 25: The study’s comprehensive, longit
Page 26 and 27: Table 2. Characteristics of Mothers
Page 28 and 29: The Year 5 Study SampleTable 4 show
Page 30 and 31: Household Structure, Employment, an
Page 32 and 33: Although mothers continued to repor
Page 34 and 35: Table 6. Family Income and Economic
Page 36 and 37: Specifically, mothers living outsid
Page 38 and 39: at the birth of the focal child tha
Page 40 and 41: Table 10. Reasons for Transportatio
Page 42 and 43: Health, Healthcare, and ChildDevelo
Page 44 and 45: two years of the study. In year 1 1
Page 46 and 47: Subsequent Pregnancies and Prenatal
Page 48 and 49: Children’s HealthcareMost (80%) o
Page 50 and 51: private plans or HMOs increased sig
Page 52 and 53: outside the TGAs to report that all
Page 54 and 55: Children’s Behavior and Developme
Page 56 and 57: cultural norms regarding what sorts
Page 58 and 59: Table 21. Emerging Pre-academic Ski
Page 60 and 61: the year 5 interview, over three-qu
Page 62: various activities, mothers reporte
Page 66 and 67: Negative Parenting PracticesThere i
Page 68 and 69: Table 28. Fathers’ Negative Paren
Page 70 and 71: Table 30. Parent Involvement Activi
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Table 32. Mothers’ Positive Paren
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Table 34. Mothers’ Parent Involve
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The most frequent parent involvemen
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Figure 3. Primary Childcare Arrange
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for 6 months, but when the subsidy
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ecause it is of particular interest
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types of care between mothers whose
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Table 40. Characteristics of Mother
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Table 41). Of the 204 children, 91
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commented on their children’s nee
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nonparental childcare arrangement f
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Informal and Community SupportAn un
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Table 46. Frequency of Husband/Part
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We also asked the mothers about the
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Table 49. Type of Family/Friends Su
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Access to Support by TGAFigure 5 sh
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Use of Formal ServicesA central que
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Correlates of At-Risk StatusA large
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services after 6 months. Among the
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Enhanced ServicesEnhanced services
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Termination of MCHP ServicesAs prev
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services were fairly stable, althou
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languages. The fact that more mothe
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In interpreting these results, it s
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Overall, mothers reported seeking h
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We found that in years 2 and 3, aft
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We also found that mothers tended t
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variables that could potentially be
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significant levels of stress. Paren
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positive parenting items and 5 nega
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friend/neighbor/other), which were
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Table 60. Logistic Regression of Ch
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County in either fall 2009 or fall
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Figure 6. Percent of Focal Children
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Next, we conducted logistic regress
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Table 68. Selected Maternal and Chi
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R 2 .180*p < .05, **p < .01, or ***
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SummarySimilar to previous analyses
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less than a high school education,
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Parenting PracticesWhen surveyed in
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We also looked at the stability of
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Service Use, Maternal Functioning,
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Conclusions and ImplicationsMore th
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Meanwhile, our findings indicate th
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literacy skills, families who do no
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BibliographyAbidin, R. R. (1995). P
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Dinan, K. A. (2005a). Federal polic
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Leventhal, T., Brooks-Gunn, J., McC
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Weisner, T. S. (1984). A cross-cult
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What are pathways to service use? W
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Table A- 1. FOCiS Codes for MCHP Se
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Table A- 2. Interview Study Samplin
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Table A- 3. Household Survey Topics
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Table A- 5. Reasons for Sample Attr
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we sought to identify the ecologica
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Table B- 2. Characteritics of TGA M
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Figure B- 1. Characteristics of Mot
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Figure B- 5. Percentage of PBC Moth
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Table B- 5. Logistic Regression Pre
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Table B- 7. Characteristics of TGA
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Table B- 9. Logistic Regression Pre
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Type of Enhanced Service2009N% of M
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Table B- 12. Logistic Regression Pr
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Numberof BirthswithReferrals2009 TG
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Table B- 15. OLS Logistic Regressio
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Table C- 1. Selected Characteristic
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Table C- 4. Social and Emotional Be
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Table C- 7. Communication Skills of
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Table C- 11. Emerging Literacy and
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Table C- 14. Mothers’ Negative Pa
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Number of Different Arrangements ac
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Figure C- 1. Mean Days of MCHP Serv
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Table C- 19. Characteristics of Mot
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Table C- 22. Number of Service Area
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Table C- 23. Number of Services Use
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Table C- 25. Linear Regression Anal
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Table C- 27. Baseline Characteristi
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2011 The Palm Beach County Family Study (Full Report)

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