IntroductionAs non-communicable disease (NCD) burden rises worldwide, community-based programmes are a promising strategy to bridge gaps in NCD care. The HealthRise programme sought to improve hypertension and diabetes management for underserved communities in nine sites across Brazil, India, South Africa and the USA between 2016 and 2018. This study presents findings from the programme’s endline evaluation.MethodsThe evaluation utilises a mixed-methods quasi-experimental design. Process indicators assess programme implementation; quantitative data examine patients’ biometric measures and qualitative data characterise programme successes and challenges. Programme impact was assessed using the percentage of patients meeting blood pressure and A1c treatment targets and tracking changes in these measures over time.ResultsAlmost 60 000 screenings, most of them in India, resulted in 1464 new hypertension and 295 new diabetes cases across sites. In Brazil, patients exhibited statistically significant reductions in blood pressure and A1c. In Shimla, India, and in South Africa, country with the shortest implementation period, there were no differences between patients served by facilities in HealthRise areas relative to comparison areas. Among participating patients with diabetes in Hennepin and Ramsey counties and hypertension patients in Hennepin County, the percentage of HealthRise patients meeting treatment targets at endline was significantly higher relative to comparison group patients. Qualitative analysis identified linking different providers, services, communities and information systems as positive HealthRise attributes. Gaps in health system capacities and sociodemographic factors, including poverty, low levels of health education and limited access to nutritious food, are remaining challenges.ConclusionsFindings from Brazil and the USA indicate that the HealthRise model has the potential to improve patient outcomes. Short implementation periods and strong emphasis on screening may have contributed to the lack of detectable differences in other sites. Community-based care cannot deliver its full potential if sociodemographic and health system barriers are not addressed in tandem.

RESUMO: O acolhimento familiar oferece um contexto de vida à criança retirada da sua família biológica, por um período de tempo indeterminado que se pode prolongar, no limite, até à maioridade ou independência. Um contexto familiar estável permite desenvolver sentimentos de segurança e de permanência associados à possibilidade de manutenção dos contactos com a sua família biológica.A criança pode e deve, em muitas circunstâncias, permanecer com os seus acolhedores e o reconhecimento deste papel parental é um passo que pode contribuir para afastar ambiguidades e indefinições que são prejudiciais para o sistema e para as práticas que ele vai configurando. Em Portugal, todavia, o acolhimento familiar é uma medida de carácter temporário, cuja aplicação depende da previsibilidade do retorno da criança ou do jovem à família de origem.O objetivo deste artigo é, após uma breve caracterização do sistema de proteção de crianças e jovens português, analisar a permanência no acolhimento familiar de 2006 a 2011, a partir dos relatórios de caracterização das crianças e jovens em situação de acolhimento. De seguida procedemos à apresentação e discussão de dados recolhidos num estudo desenvolvido no distrito do Porto, englobando as 289 crianças que se encontravam acolhidas em maio de 2011, e que representavam 52% das colocações familiares de crianças em Portugal. Os resultados foram apurados com a aplicação de um formulário de recolha de dados preenchido a partir dos registos oficiais de cada criança acolhida e através da realização de 52 entrevistas a acolhedores.Entre os resultados principais destacam-se os longos períodos de estadia, a permanência da criança na família acolhedora inicial e a avaliação global positiva dos resultados obtidos, o que nos permite identificar um conjunto de desafios que se colocam no futuro imediato ao acolhimento familiar português. Pedagogía Social. Revista Interuniversitaria, 2014, 23, pp. 123-150 http://www.upo.es/revistas/index. ABSTRACT: Foster care offers a life environment to the child withdrawal from his biological family, during an undefined time period that can be prolonged, in the limit, until adulthood or independence. A stable family environment allows the development of security and belonging feelings associated to the possibility of maintaining the contacts with his biological family. In most of the situations, child can and must remain with his foster parents, and the acknowledgement of this parent role is a step that can contribute to avoid ambiguities and uncertainties that are prejudicial to the system and for the practices that it will be configuring. Nevertheless, in Portugal, foster care is a temporary character measure, whose application depends on the predictability of the return of the child or young person to the family of origin.The purpose of this article is to, after a brief characterization of the Portuguese children and youth protection system, analyze the foster care permanence between 2006 and 2011, based on the characterization report of the situation of foster...

Background: Compared to residential care, family foster care is the preferable type of alternative care for neglected or abused children as it provides a familiar context that supports children's developmental needs.New foster families are needed to care for these children. Objective: This systematic review aims to provide a critical analysis of the literature, identifying factors that explain the intention to become and to continue as a foster family. This review was performed following the PRISMA checklist and guidelines, through a search conducted in the following databases (no restrictions were made): PsycArticles, PsycInfo, Psychology and Behavioral Sciences Collection, Academic Search Complete, ERIC, Scopus, and Web of Science. Study eligibility: The review includes empirical quantitative and/or qualitative studies in English, Portuguese and Spanish, with community and/or foster parents' samples and explores the factors for becoming and/or retention foster parents. Results: Forty-nine studies were included. The results revealed that the intention to become a foster parent is largely influenced by motivational factors, personal and family characteristics, individual values and beliefs, social context influences, and perceived familiarity with the child protection system. The retention of foster families is closely related to factors within the child protection system, personal or family characteristics, foster child characteristics, and placement challenges. The relationship with agencies and professional support stands out as the most important factors. Limitations and Implications: This review did not include studies focused on children with specific needs, and future research should consider the particular challenges of fostering this group. Practice implications of these findings for the recruitment, selection, and retention of foster families will be discussed.

In the contexts of family neglect or maltreatment, the State intervenes by safeguarding the development and well-being of the child or young person in danger. In more severe situations, the intervention may lead to the child’s removal from the family. The Portuguese Law on the Protection of Children and Young People in Danger (Law 142/2015 of September 8th) favours the placement of the child in a family environment, especially for children up to the age of six. Despite this, in Portugal, in 2015, 8 600 children were in out-of-home care, only 3.5% of which were placed in foster care, while the remaining children were in residential care. Therefore, one of the fundamental rights of the child – living in a family environment – is compromised in practice. This study aims to understand the decision-making process of 200 higher education students in domains related to child protection, and those of 200 professionals who are responsible for providing case assessments and recommendations for intervention in the Portuguese child protection system. Using the Child Welfare Attitudes Questionnaire (Davidson-Arad & Benbenishty, 2008, 2010), the study aimed to identify the participants’ attitudes regarding removal of at-risk children from home, reunification and optimal duration of alternative care, children’s and parents’ participation in the decision-making process, and assessment of foster care and residential care, with the purpose of promoting children’s development and well-being. We concluded that both sets of participants (professionals and students) can be divided in two groups, one which is pro-removal and the other, which is less so. In comparison with students, professionals less often favour the removal of the child and more often defend reunification. There are no significant differences among participants regarding their opinion about the role of foster and residential care, and the participation of the child in the decision-making process. However, professionals tend to support parents’ participation in the decision-making process more than students do. Finally, we present some implications of our findings for the practice of child protection.

This study investigates the association between the contact of children or young people in care with their family, and the foster care placement evaluation (positive or negative) in Portugal. According to the perspectives of foster carers and service professionals' perceptions regarding children and young people's reactions, during and after the visits, are measured. Utilizing a quantitative approach, two fostering services teams and 140 foster carers completed questionnaires, which had 212 children in common. Results indicated that despite the importance of continued contact, especially for children and their parents, it was not determined to be essential to long-term placement. On one hand, there was the perception that a high percentage of children expressed positive reactions during and after the visit, while on the other hand, this didn't influence the perception of placement success. This study also showed significant differences between foster carers' and the professionals' perceptions on several dimensions of foster care, especially the children's reactions during visits. These differences need to be further analyzed in future research and the outcomes used to help improve contact management.