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Cited by 69Child Welfare and AdoptionHomelessness and Social IssuesSubstance Abuse Treatment and Outcomes

Comparison of substance use, subjective well-being and interpersonal relationships among young people in foster care and private households: a cross sectional analysis of the School Health Research Network survey in Wales

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Long, Sara Jayne, Evans, Rhiannon E, Fletcher, Adam, Hewitt, Gillian, Murphy, Simon, Young, Honor, Moore, Graham F·2017·BMJ Open
DOI 10.1136/bmjopen-2016-014198PMC PMC5337680
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Abstract

OBJECTIVE: To investigate the association of living in foster care (FC) with substance use and subjective well-being in a sample of secondary school students (11-16 years) in Wales in 2015/16, and to examine whether these associations are attenuated by the perceived quality of interpersonal relationships. DESIGN: Cross-sectional, population-based health behaviour and lifestyle questionnaire. SETTING AND PARTICIPANTS: Wales, UK; young people who took part in the 2015/16 School Health Research Network (SHRN) questionnaire (n=32 479). PRIMARY OUTCOME: Health behaviours among young people in FC were compared with those from private households. RESULTS: The prevalence of all adverse outcomes was higher among young people in FC. Those in FC were significantly more likely to report mephedrone use (OR=9.24, 95% CI 5.60 to 15.34), multiple substance misuse behaviours (OR=3.72, 95% CI 2.30 to 6.00), poorer relationships with peers (RR=1.88, 95% CI 1.23 to 2.88) and teachers (RR=1.83, 95% CI 1.31 to 2.56), having experienced bullying (OR=1.80, 95% CI 1.38 to 2.35), dating violence (OR=1.66, 95% CI 1.13 to 2.43) and poor well-being (RR=1.72, 95% CI 1.20 to 2.46). The association between FC and substance use remained significant, though was attenuated after accounting for relationship variables. The association between FC and subjective well-being became non-significant after adjustment for relationship variables. CONCLUSIONS: Young people living in FC experience significantly worse outcomes than young people not in care, likely due to a range of care and precare factors, which impact adversely on subsequent social relationships. The analyses are consistent with the hypothesis that the associations of FC with substance use and life satisfaction are partially explained by poorer quality social relationships. Large scale, longitudinal studies are required to investigate the relationship between being in care and health, educational and social outcomes. Mental health interventions and interventions to reduce substance use and improve well-being in FC should include a focus on supporting healthy social relationships.

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Cited by

Sorted by citations

Authors
Long, S. J., Evans, R. E., Fletcher, A., Hewitt, G., Murphy, S., Young, H., & Moore, G. F.
Affiliations
United Kingdom Clinical Research Collaboration (GB)
Corresponding author
Long, Sara Jayne
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2017-02
Volume
7
Issue
2
Pages
e014198
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2016-014198
PMC
PMC5337680
OpenAlex
W2589354805
Cited by
69
References
10
Citations by year
2026: 5 · 2025: 4 · 2024: 15 · 2023: 9 · 2022: 9 · 2021: 8 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 2
FWCI
11.93
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Wellcome Trust (MR/KO232331/1)
  • British Heart Foundation (MR/KO232331/1)
  • Medical Research Council (MR/KO232331/1)
  • Cancer Research UK (MR/KO232331/1)
  • Economic and Social Research Council (MR/KO232331/1)
Topics
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
foster care, substance use, subjective well-being, interpersonal relationships, young people in care, mephedrone, bullying, dating violence, peer relationships, teacher relationships, adolescent health
MeSH terms
Adolescent, Child, Cross-Sectional Studies, Family Characteristics, Female, Foster Home Care, Humans, Interpersonal Relations, Life Style, Male, Surveys and Questionnaires, Regression Analysis, Wales, Health Behavior, Substance-Related Disorders

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