Show simple item record Whetten, Kathryn en_US Ostermann, Jan en_US Whetten, Rachel en_US Pence, Brian en_US O'Donnell, Karen en_US Messer, Lynne en_US Thielman, Nathan en_US 2011-06-21T17:31:27Z 2011-06-21T17:31:27Z 2009 en_US
dc.identifier.citation Whetten,Kathryn;Ostermann,Jan;Whetten,Rachel A.;Pence,Brian W.;O'Donnell,Karen;Messer,Lynne C.;Thielman,Nathan M.;Positive Outcomes Orphans (POFO). 2009. A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations. Plos One 4(12): e8169-e8169. en_US
dc.identifier.issn 1932-6203 en_US
dc.description.abstract Background: Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6-12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests. Methodology: The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 institution-living and 1,480 community-living OAC ages 6-12, 658 of whom were double-orphans or abandoned by both biological parents. Survey analytic techniques were used to compare cognitive functioning, emotion, behavior, physical health, and growth. Linear mixed-effects models were used to estimate the proportion of variability in child outcomes attributable to the study site, care setting, and child levels and institutional versus community care settings. Conservative analyses limited the community living children to double-orphans or abandoned children. Principal Findings: Health, emotional and cognitive functioning, and physical growth were no worse for institution-living than community-living OAC, and generally better than for community-living OAC cared for by persons other than a biological parent. Differences between study sites explained 2-23% of the total variability in child outcomes, while differences between care settings within sites explained 8-21%. Differences among children within care settings explained 64-87%. After adjusting for sites, age, and gender, institution vs. community-living explained only 0.3-7% of the variability in child outcomes. Conclusion: This study does not support the hypothesis that institutional care is systematically associated with poorer wellbeing than community care for OAC aged 6-12 in those countries facing the greatest OAC burden. Much greater variability among children within care settings was observed than among care settings type. Methodologically rigorous studies must be conducted in those countries facing the new OAC epidemic in order to understand which characteristics of care promote child wellbeing. Such characteristics may transcend the structural definitions of institutions or family homes. en_US
dc.language.iso en_US en_US
dc.relation.isversionof doi:10.1371/journal.pone.0008169 en_US
dc.subject difficulties questionnaire en_US
dc.subject strengths en_US
dc.subject attachment en_US
dc.subject models en_US
dc.subject eritrea en_US
dc.subject romania en_US
dc.subject africa en_US
dc.subject malawi en_US
dc.subject aids en_US
dc.subject biology en_US
dc.subject multidisciplinary sciences en_US
dc.title A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations en_US
dc.title.alternative en_US
dc.description.version Version of Record en_US 2009-12-18 en_US
duke.description.endpage e8169 en_US
duke.description.issue 12 en_US
duke.description.startpage e8169 en_US
duke.description.volume 4 en_US
dc.relation.journal Plos One en_US

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