A Cochrane review included 102 quasi-experimental studies with a total of 666 615 children. The review evaluated the effect of kinship care placement compared to foster care placement of children removed from the home for maltreatment. Kinship care means that children are placed with other members of their family or with friends of the family. All but 13 of the 102 studies were conducted in the U.S, and the remaining in other welfare countries. Data suggest that children in kinship foster care experience better behavioral development, mental health functioning, well-being, and placement stability than do children in non-kinship foster care (table ). Although there was no difference on reunification rates, children in non-kinship foster care were more likely to be adopted while children in kinship foster care were more likely to be in guardianship. Children in non-kinship foster care were more likely to utilize mental health services.
| Outcome | OR (95% CI) | Participants (studies) |
|---|---|---|
| Behavioural problems | OR 0.62 (0.41 to 0.93), I2=92% | 16 449 (6 studies) |
| Psychiatric disorders | OR 0.51 (0.42 to 0.62) | 50 751 (6 studies) |
| Placement disruption | OR 0.52 (0.40 to 0.69), I2=81% | 6 881 (5 studies) |
| Reunification | OR 1.09 (0.85 to 1.40), I2=93% | 67 403 (13 studies) |
| Adoption | OR 2.52 (1.42 to 4.49), I2=98% | 66 817 (12 studies) |
| Mental health services | OR 1.79 (1.35 to 2.37), I2 =96% | 152 626 (13 studies) |
Comment: The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment and blinding), and by inconsistency (variability in results).