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Citation: McTavish, J.R.; McKee, C.;
Tanaka, M.; MacMillan, H.L. Child
Welfare Reform: A Scoping Review.
Int. J. Environ. Res. Public Health 2022,
19, 14071. https://doi.org/10.3390/
ijerph192114071
Academic Editor: Paul B.
Tchounwou
Received: 20 September 2022
Accepted: 24 October 2022
Published: 28 October 2022
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International Journal of
Environmental Research
and Public Health
Review
Child Welfare Reform: A Scoping Review
Jill R. McTavish 1,* , Christine McKee 1, Masako Tanaka 1and Harriet L. MacMillan 1,2
1Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences,
McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
2Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
*Correspondence: mctavisj@mcmaster.ca
Abstract:
While there have been ongoing calls to reform child welfare so that it better meets chil-
dren’s and families’ needs, to date there have been no comprehensive summaries of child welfare
reform strategies. For this systematic scoping review, we summarized authors’ recommendations
for improving child welfare. We conducted a systematic search (2010 to 2021) and included pub-
lished reviews that addressed authors’ recommendations for improving child welfare for children,
youth, and families coming into contact with child welfare in high-income countries. A total of
4758 records
was identified by the systematic search, 685 full-text articles were screened for eligibility,
and
433 reviews
were found to be eligible for this scoping review. Reviews were theoretically divided,
with some review authors recommending reform efforts at the macro level (e.g., addressing poverty)
and others recommending reform efforts at the practice level (e.g., implementing evidence-based
parenting programs). Reform efforts across socioecological levels were summarized in this scoping
review. An important next step is to formulate what policy solutions are likely to lead to the greatest
improvement in safety and well-being for children and families involved in child welfare.
Keywords: child maltreatment; child welfare; child protection; reform; scoping review; policy
1. Introduction
Child maltreatment includes physical, sexual, and emotional abuse, neglect, and
children’s exposure to intimate partner violence [
1
,
2
]. It is a prevalent experience with
many potentially serious negative consequences, such as injuries, developmental delay,
anxiety and mood disorder symptoms, poor peer relationships, substance use and other
risky behaviours [
3
–
7
]. Gilbert and colleagues [
8
] have specified two approaches to the
response of child maltreatment: a child safety approach, where government-based agencies
are responsible almost entirely for the response to child maltreatment; and a child and
family welfare approach, where child welfare organizations respond to allegations of child
maltreatment alongside referrals regarding other vulnerable children. The former involves
a more investigative response whereas the latter involves more of a preventative and
service-oriented response. At the time of publication, Gilbert et al. [
8
] noted that Canada,
the United States, and Australia have taken a child safety approach, whereas New Zealand,
the United Kingdom, and several western European countries have taken a child and
family welfare approach.
In this article we refer to child welfare as a set of government and private services
primarily designed to protect children from child maltreatment, encourage family stability,
and, when necessary, arrange foster care and adoptions and child protection services (CPS)
as a narrower set of services within child welfare that investigate allegations of child mal-
treatment [
9
]. Data from several countries suggests a high cumulative number of children
are being investigated for experiences of maltreatment—in New Zealand approximately
25% of children were referred to CPS by age 18 [
10
] and in the United States 37.4% were
referred by age 18 [
11
]. Certain groups are more likely to come into contact with CPS than
others related to a complex array of factors, including colonialism, racism, discrimination,
Int. J. Environ. Res. Public Health 2022,19, 14071. https://doi.org/10.3390/ijerph192114071 https://www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2022,19, 14071 2 of 24
and poverty [
12
,
13
]. For example, data from the 2019 First Nations Canadian Incidence
Study of Reported Child Abuse and Neglect (CIS) reported on child welfare investigations
involving First Nations and non-Indigenous children. This study found that, in Canada,
First Nations youth are 3 to 4 times more likely to be the focus of a child protection re-
port and 17 times more likely to experience an out-of-home placement related to a CPS
investigation [12].
In general, the evidence regarding the effects of child welfare contact on children is
absent or mixed [
14
,
15
]. It is challenging to assess the benefits and harms of child welfare
interventions, including out-of-home care, as it is unclear if the differences between groups
are reflective of the services or differences in a broad range of baseline factors, including
socioeconomic status, caregiver educational status, immigration status, family risks, child
welfare worker propensity to place children, and children’s safety and well-being at the
time of placement [
16
–
21
]. There has been increasing recognition of the high service
demands on CPS and child welfare more broadly in high-income countries [
22
], as well
as ongoing calls to reform child welfare so that it better meets children’s and families’
needs [
23
–
26
]. While much attention has been paid to the need for primary prevention
of child maltreatment [
27
–
37
], to date there have been no comprehensive summaries of
authors’ recommendations for improving child welfare (secondary and tertiary prevention
efforts involving child welfare).
This scoping review of reviews summarized authors’ recommendations for improv-
ing child welfare. This review was guided by the following research question: What are
authors’ recommendations for improving child welfare across socioecological levels, in-
cluding at the societal-level (e.g., policy), community-level (e.g., coordination of services),
institutional level (e.g., child welfare initiatives), relationship level (e.g., ideal strategies to
support children and families), and individual level (e.g., training)? A summary of author-
proposed child welfare solutions across socioecological levels is important for policy and
practice efforts to improve child welfare responses, including informing next steps for child
welfare reform.
2. Materials and Methods
The present review followed principles of a systematic scoping review. According to
Daudt et al. [
38
], a scoping review is a type of research synthesis that aims to “map the
literature on a particular topic or research area and provides an opportunity to identify
key concepts; gaps in the research; and types and sources of evidence to inform practice,
policymaking, and research” (p. 8). While systematic reviews tend to have clear a priori
inclusion and exclusion criteria, scoping reviews are guided by broader research questions
related to mapping the literature base [
39
]. Unlike systematic reviews, scoping reviews
also do not evaluate the quality of included studies. Most scoping reviews do not aim to
synthesize the existing evidence base, but to map or chart the data within the evidence
base. Systematic scoping reviews, alternatively, blend characteristics of systematic reviews
and scoping reviews and require the following: an a priori protocol, descriptions about the
objectives of the review, inclusion and exclusion criteria (at least the population, concept,
and context), and methods for conducting the review [
39
]. Below we detail the proposed
methods for the present systematic scoping review. An earlier version of this review was
funded in a project to investigate child welfare reform in Canada, which led to the focus on
high-income countries.
2.1. Inclusion Criteria
Systematic scoping reviews typically specify included populations, as well as the
focusing ‘concept’ and ‘context’ of the review (see Table 1). In this scoping review we
included reviews that addressed authors’ recommendations for improving child welfare
for children, youth, and families coming into contact with child welfare in high-income
countries. Reviews that focused on child maltreatment only (e.g., etiology, risk and protec-
Int. J. Environ. Res. Public Health 2022,19, 14071 3 of 24
tive factors, or health outcomes of child maltreatment) without discussing aspects of child
welfare reform were not included.
Table 1. Inclusion criteria.
Category Inclusion Criteria
Population Children, youth (0–25 years of age) and families with prior or current involvement with
child welfare.
Concept
Study author recommendations to improve child welfare at the societal-level (e.g., policy),
community-level (e.g., coordination of services), institutional-level (e.g., child welfare
initiatives), relationship-level (e.g., social worker skills), and individual-level
(e.g., training).
Context
Peer-reviewed reviews that summarized recommendations to improve child welfare in
high-income countries. Reviews could include systematic reviews, meta-analyses,
qualitative reviews (e.g., meta-syntheses), rapid reviews, scoping reviews, and
narrative reviews.
Timeline 2010 to 2021 (when the search was conducted)
2.2. Systematic Search
The systematic search was conducted by an information professional (JRM). Index
terms and keywords related to child welfare and out-of-home care (e.g., foster care, out-of-
home care, child protection investigation) and reviews (e.g., scoping review, meta-analyses)
were used in the following databases: Medline (OVID), PsycINFO, Sociological Abstracts,
and Social Science Citation Index (see Table 2for an example search strategy). Databases
were searched for results from the past 10 years (1 January 2010 to 4 June 2021, when
the search was conducted). Titles and abstracts and full-text articles were screened by
one author (JRM) for inclusion and a second author (CM) screened all excluded titles and
abstracts and full-text articles to ensure relevant articles were not excluded. Differences in
screening decisions were resolved by consensus.
Table 2. Example of database search strategy.
Example of Database Search Strategy
Database: Ovid MEDLINE(R) ALL <1946 to June 04, 2021>
Search Strategy:
--------------------------------------------------------------------------------
1 Child Protective Services/ (602)
2 (child * adj3 (welfare or aid)).tw, kw. (5015)
3 (child * protect * adj3 (service? or agenc * or organi?ation?)).tw, kw. (1560)
4 (“foster care” or “foster home?” or “residential care” or “kin care” or “kinship care”). tw. (6280)
5 (out-of-home adj3 (placement? or care)). tw. (894)
6 or/1-5 (12838)
7 exp child/ or exp infant/ (2552666)
8 (child * or girl or girls or boy or boys or infant * or baby or babies or toddler * or preschool * or
pre-school * or “young person” or “young people” or teen * or adolescen * or youth *).tw.
(2106256)
9 or/7-8 (3282693)
10 6 and 9 (9547)
11 meta-analysis/ or “systematic review”/ or review/ (2915611)
12 (review? or meta-analy * or metaanaly * or metasynthe * or meta-synthe * or (information adj2
synthesis) or (data adj2 synthesis)).tw. (1971484)
13 ((systematic or state-of-the-art or scoping or literature or umbrella) adj3 (review * or
bibliographic * or overview * or assessment *)).tw. (512487)
14 “scoping study”.tw. (339)
15 or/11-14 (3640612)
16 10 and 15 (1374)
17 limit 16 to yr=”2010 -Current” (752)
Int. J. Environ. Res. Public Health 2022,19, 14071 4 of 24
2.3. Data Analysis
Data analysis summarized the included reviews with attention to the: number of
reviews published; type of review (e.g., meta-analysis, rapid review); populations included
in reviews (e.g., children, parents, or families involved in child welfare or out-of-home
care, child welfare professionals, foster carers); and thematic focus of the included review
(e.g., health sector interventions and outcomes, child welfare sector interventions and
outcomes, international focus). Data was primarily drawn from the article title, abstract,
study inclusion criteria, and methods. For some narrative reviews, such as those without a
methods section, information was drawn from the entire article. Analysis also summarized
the socioecological level of authors’ recommendations to improve child welfare (e.g., policy-
related versus institutional proposal for reform). The socioecological model is commonly
used in violence prevention research to outline the range of factors influencing risk and
prevention of violence [
40
]. The model was used in the present scoping review to organize
and analyze trends and gaps in authors’ recommendations for child welfare reform. This
information was primarily drawn from the discussion of included articles. For some
narrative reviews, such as those without a clear discussion section or those that offered
recommendations throughout, information was drawn from the entire article.
Codes for types of reviews reflected review authors’ descriptions of their work; review
methods were not scrutinized to determine the accuracy of the authors’ descriptions of their
work. For example, if the authors of a review called their work a systematic review in the
title or methods, it was labelled as a systematic review even if it did not critically appraise
articles. Reviews that did not identify their work as a specific type of review were labelled
as narrative reviews. Population data was primarily drawn from the review’s inclusion
criteria, if available. One code for the population was preferred, when possible. For
example, if the review included children in “out-of-home care” the population was coded
as “out-of-home care, children” unless it was obvious that results were only provided for
children in a specific type of out-of-home care (e.g., only children in foster care). However,
there were many instances where reviews addressed multiple populations, such as children
in foster care and foster carers, in which case both populations were coded.
Coding for the main theme of the review and authors’ recommendations for child
welfare reform was primarily inductive and akin to a high-level thematic analysis [
41
].
Thematic analysis involves familiarizing oneself with the data, generating initial codes,
searching for themes, reviewing themes, defining and naming themes, and writing up
the themes in a manuscript form. For data analysis, one author (JRM) reviewed all the
articles and developed a high-level coding scheme for the thematic focus of articles and
authors’ recommendations for child welfare reform. For the thematic focus of the articles,
two authors (CM, MT) then used the coding scheme to independently code 10 percent
(
n= 45
) of the included articles using the coding scheme. Differences between the primary
authors (JRM) and other authors coding (CM, MT) were then discussed, the coding scheme
was refined, and used by the primary author to recode all of the articles.
To analyze the authors’ recommendations for improvement, one author (JRM) coded
recommendations for approximately half the included articles (codes were typically found
in the discussion, as mentioned above) and developed a coding scheme. Two other authors
(CM, MT) coded 10% of additional articles (n= 45) using this coding scheme. The coding
scheme was then updated by both expanding it to include additional, needed codes (e.g.,
mental health, intimate partner violence) and collapsing it to merge less-used codes (e.g.,
“disability” was placed under “complex needs”). Following this, each author (CM, HLM,
JRM, MT) coded approximately a quarter of articles with the coding scheme for authors’
recommendations for improvement.
3. Results
A total of 4758 records was identified in the systematic search, 2867 titles and abstracts
were screened, and 685 full-text articles were screened for eligibility. A total of 433 were
found to be eligible for this scoping review (see Figure 1).
Int. J. Environ. Res. Public Health 2022,19, 14071 5 of 24
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 5 of 25
found in the discussion, as mentioned above) and developed a coding scheme. Two other
authors (CM, MT) coded 10% of additional articles (n = 45) using this coding scheme. The
coding scheme was then updated by both expanding it to include additional, needed
codes (e.g., mental health, intimate partner violence) and collapsing it to merge less-used
codes (e.g., “disability” was placed under “complex needs”). Following this, each author
(CM, HLM, JRM, MT) coded approximately a quarter of articles with the coding scheme
for authors’ recommendations for improvement.
3. Results
A total of 4758 records was identified in the systematic search, 2867 titles and ab-
stracts were screened, and 685 full-text articles were screened for eligibility. A total of 433
were found to be eligible for this scoping review (see Figure 1).
Figure 1. PRISMA flow diagram.
3.1. Types of Reviews
Table 3 indicates the types of reviews addressed by included articles. The majority of
reviews were narrative reviews, followed by systematic reviews, scoping reviews, meta-
analyses, integrative reviews, rapid reviews, and meta-syntheses. One mapping review
was also included. Narrative reviews [42] “generally are comprehensive and cover a wide
range of issues within a given topic” (p. 104) and tend to provide an overview of “back-
ground knowledge, evolving concepts and controversy” (p. 104) within a field. Systematic
reviews [43] generally involve a summary of literature “that uses explicit and reproduci-
ble methods to systematically search, critically appraise, and synthesize [literature] on a
specific issue” (p. 10). Scoping reviews [38], as discussed above, “map the literature on a
particular topic or research area and provide an opportunity to identify key concepts; gaps
in the research; and types and sources of evidence to inform practice, policymaking, and
research” (p. 8). Meta-analyses [43] involve “the combination of data from several inde-
pendent primary studies that address the same question to produce a single estimate like
Figure 1. PRISMA flow diagram.
3.1. Types of Reviews
Table 3indicates the types of reviews addressed by included articles. The majority of
reviews were narrative reviews, followed by systematic reviews, scoping reviews, meta-
analyses, integrative reviews, rapid reviews, and meta-syntheses. One mapping review
was also included. Narrative reviews [
42
] “generally are comprehensive and cover a
wide range of issues within a given topic” (p. 104) and tend to provide an overview
of “background knowledge, evolving concepts and controversy” (p. 104) within a field.
Systematic reviews [
43
] generally involve a summary of literature “that uses explicit
and reproducible methods to systematically search, critically appraise, and synthesize
[literature] on a specific issue” (p. 10). Scoping reviews [
38
], as discussed above, “map
the literature on a particular topic or research area and provide an opportunity to identify
key concepts; gaps in the research; and types and sources of evidence to inform practice,
policymaking, and research” (p. 8). Meta-analyses [
43
] involve “the combination of data
from several independent primary studies that address the same question to produce a
single estimate like the effect of treatment or risk factor” (p. 10). Integrative reviews [
44
]
are a broad type of research review that allow for the “inclusion of experimental and
non-experimental research in order to more fully understand a phenomenon of concern”
(p. 547). Rapid reviews [
45
] are “a form of knowledge synthesis in which components of
the systematic review process are simplified or omitted to produce information in a timely
manner” (p. 2). Meta-syntheses [
46
] involve “the systematic review and integration of
findings from qualitative studies” (p. 1). Mapping reviews [
47
] are like scoping reviews in
that they “map out and categorize existing literature” (p. 94) but their results tend to be
more visual compared to scoping reviews.
Int. J. Environ. Res. Public Health 2022,19, 14071 6 of 24
Table 3. Types of Reviews.
Count 1
Narrative reviews 249
Systematic reviews 118
Scoping reviews 31
Meta-analyses 23
Integrative reviews 8
Rapid reviews 5
Meta-syntheses 3
Mapping review 1
1
Some reviews were both systematic reviews and meta-analyses, so a sum of the counts does not equal the total
number of included articles (n= 433).
3.2. Population Focus
As is shown in Table 4, the majority of reviews focused on out-of-home care, followed
by families (families, parents, children) involved with child welfare. Some articles also
focused on child welfare organizations, child welfare professionals, and interdisciplinary
initiatives (e.g., children’s advocacy centres or family drug courts).
Table 4. Population Focus of Included Articles.
Count 1
Involved with child welfare 128
•Families 51
•Parents 22
•Children 55
Out-of-home care 367
•Foster carers 28
•Kinship carers 12
•Parents 6
•Children 321
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Out-of-home care 57
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Foster care 141
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Kinship care 83
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Residential care 24
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Adoption 16
Child welfare organizations 57
Child welfare professionals 46
Interdisciplinary focus 22
1
Some review articles addressed multiple populations, so a sum of the counts does not equal the total number of
included articles (n= 433).
3.3. Thematic Focus
Table 5summarizes the thematic focus of included articles across socioecological
levels [
40
]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each
socioecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and services
(e.g., foster care) from different sectors (child welfare, health, education, research, justice,
Int. J. Environ. Res. Public Health 2022,19, 14071 7 of 24
housing). Counts of themes are listed in Table 5; these counts indicate the number of articles
that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as discussing
the theme “collaboration models, strategies, and components”). Headings associated with
socioecological theme levels (e.g., “Society—laws and policy”) and bolded sub-theme levels
(e.g., “Child welfare professionals”) in Table 5have no associated counts as these lines are
provided to help visually organize the thematic focus of included articles. Each level is
discussed in more detail below. While relationships were a key factor mentioned in many
articles, they were the primary focus of very few articles (and so are not coded in Table 5).
Additional codes related to relationships are found in the next section (improvements
across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count 2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
•Child welfare 252
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Placement 94
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Biological family 64
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Usage of child welfare services 52
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Participation in child welfare 48
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Transition from care 46
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Safety 42
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Foster/kinship care (as a service) 41
•Health 197
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Mental health 121
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these lines are provided to help visually organize the thematic focus of included arti-
cles. Each level is discussed in more detail below. While relationships were a key factor
mentioned in many articles, they were the primary focus of very few articles (and so are
not coded in Table 5). Additional codes related to relationships are found in the next sec-
tion (improvements across socioecological levels).
Table 5. Thematic Focus of Included Articles. 1
Count
2
Society—laws and policies
Cross-country analysis of aspects of child welfare 20
International actors influencing child welfare 15
Human rights 7
National child welfare structure 68
National child welfare policies and legislation 51
Systemic disadvantage in child welfare 47
National institutional actors influencing child welfare 11
Community—relationships among organizations, institutions and informal networks
Collaboration models, strategies, and components 40
Institution—characteristics and rules for operations
Child welfare organizational policies, procedures, and overall environment 38
Child welfare workforce 17
Child welfare organizational performance and evaluation 12
Professional support for child welfare professionals 9
Interventions, services, programs and outcomes associated with different sectors
• Child welfare 252
o Placement 94
o Biological family 64
o Usage of child welfare services 52
o Participation in child welfare 48
o Transition from care 46
o Safety 42
o Foster/kinship care (as a service) 41
• Health 197
o Mental health 121
o Social health 79
o Physical health 69
Social health 79
Int. J. Environ. Res. Public Health 2022, 19, x FOR PEER REVIEW 7 of 25
3.3. Thematic Focus
Table 5 summarizes the thematic focus of included articles across socioecological lev-
els [40]. As discussed above, the socioecological model helps to organize core themes in
violence prevention, pointing to research trends and gaps. Each of the four levels of the
socioecological model is shaded in Table 5 with examples of the level listed (e.g., “Society”
themes tend to focus on international and national laws and policies whereas “Individual”
themes tend to focus on knowledge, attitudes and skills of individuals). Within each soci-
oecological level of themes, sometimes groups of sub-themes were found. For example,
many articles focused on interventions or programs (e.g., parenting programs) and ser-
vices (e.g., foster care) from different sectors (child welfare, health, education, research,
justice, housing). Counts of themes are listed in Table 5; these counts indicate the number
of articles that addressed the theme (e.g., in the Excel coding file, 40 articles are coded as
discussing the theme “collaboration models, strategies, and components”). Headings as-
sociated with socioecological heme levels (e.g., “Society—laws and policy”) and bolded
sub-theme levels (e.g., “Child welfare professionals”) in Table 5 have no associated counts
as these