Taylor et al.

Systematic Reviews (2021) 10:240

https://doi.org/10.1186/s13643-021-01792-5

PROTOCOL Open Access

Protocol for a systematic review of policies,

programs or interventions designed to
improve health and wellbeing of young
people leaving the out-of-home care
system
David J. A. Taylor1,2* , Aron Shlonsky1, Bianca Albers2,3, Sangita Chakraborty2, Jane Lewis2, Phillip Mendes1,
Geraldine Macdonald4 and Kevin Williams5

Abstract
Background: Relative to their counterparts in the general population, young people who leave, or transition out of,
out-of-home (OOHC) arrangements commonly experience poorer outcomes across a range of indicators, including
higher rates of homelessness, unemployment, reliance on public assistance, physical and mental health problems
and contact with the criminal justice system. The age at which young people transition from OOHC varies between
and within some countries, but for most, formal support ceases between the ages of 18 and 21.
Programs designed to support transitions are generally available to young people toward the end of their OOHC
placement, although some can extend beyond. They often encourage the development of skills required for
continued engagement in education, obtaining employment, maintaining housing and general life skills. Little is
known about the effectiveness of these programs or of extended care policies that raise the age at which support
remains available to young people after leaving OOHC. This systematic review will seek to identify programs and/or
interventions that improve outcomes for youth transitioning from the OOHC system into adult living arrangements.

* Correspondence: david.taylor@monash.edu
1
Department of Social Work, Monash University, 900 Dandenong Road,
Caulfield East, VIC 3145, Australia
2
Centre for Evidence and Implementation, 33 Lincoln Square South, Carlton,
VIC 3053, Australia
Full list of author information is available at the end of the article

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Taylor et al. Systematic Reviews (2021) 10:240 Page 2 of 9

Methods: This review will identify programs, interventions and policies that seek to improve health and wellbeing
of this population that have been tested using robust controlled methods. Primary outcomes of interest are
homelessness, health, education, employment, exposure to violence and risky behaviour. Secondary outcomes are
relationships and life skills. We will search, from January 1990 onwards, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL,
Cochrane CENTRAL, SocINDEX, Sociological Abstracts, Social Services Abstracts, NHS Economic Evaluation Database
and Health Technology Assessment. Grey literature will be identified through searching websites and databases, e.g.
clearing houses, government agencies and organisations known to be undertaking or consolidating research on
this topic area. Two reviewers will independently screen all title and abstracts and full text articles with conflicts to
be resolved by a third reviewer. Data extraction will be undertaken by pairs of review authors, with one reviewer
checking the results of the other. If more than one study with suitable data can be identified, we plan to undertake
both fixed-effects and random-effects meta-analyses and intend to present the random-effects result if there is no
indication of funnel plot asymmetry. Risk of bias will be assessed using tools appropriate to the study methodology.
Quality of evidence across studies will be assessed using the Grading of Recommendations, Assessment,
Development and Evaluation (GRADE) methodology.
Discussion: Previous reviews were unable to identify any programs or interventions, backed by methodologically
rigorous research, that improve outcomes for this population. This review seeks to update this previous work, taking
into account changes in the provision of extended care, which is now available in some jurisdictions.
Systematic review registration: PROSPERO CRD42020146999
Keywords: Systematic review, Transitions, Out-of-home care, Aftercare, Leaving Care, Ageing out

Background According to a recent report, 161,233 young people aged

Youth who experience abuse and neglect by their parents or 0–17 years were in OOHC in Germany in 2013, and
carers can be placed in out-of-home care (OOHC) in juris- additional 28,181 were characterised as “care leavers”,
dictions where such formal systems exist. OOHC takes three i.e. aged 18–26 years [8]. In Denmark, 13,532 children
major forms: foster care—where care services are provided were placed in OOHC by December 31, 2020. Of these,
by individuals not necessarily known to the recipient, kinship 3,928 were 15–17 years old [9].
care—where those providing care are connected to the re- Young people who leave or transition out of OOHC
cipient through blood or kin ties, and residential care—where arrangements commonly experience poorer outcomes
care is provided in an institutional setting. Youth can experi- compared to the general population across a range of in-
ence one or more of these care types whilst in OOHC. dicators, including higher rates of homelessness, un-
Whilst the three forms of OOHC are quite different, they employment, reliance on public assistance, physical and
also have similarities: children in homes were often the vic- mental health problems and contact with the criminal
tims of childhood trauma [1, 2]; minimal standards of care justice system [10–16]. These poorer outcomes may be
are required; and financial support, if provided, ceases when due to pre-existing mental health problems and other
youth reach a certain age [3]. challenges arising from their experiences pre-care or
OOHC is a policy area of considerable contemporary whilst in care [17, 18]. They may also be due to insuffi-
cross-national interest [4]. The latest available figures for cient knowledge or life skills or be related to the fact
England show that there were 75,420 children in care in that they must fend for themselves at an earlier age than
2018. In the same year, 10,460 young people aged 17–18 their peers who can rely on their birth families for per-
left care who had spent at least 13 weeks in care between sonal and material support [17].
the age of 14 and 16 [5]. In Australia, there are approxi- The age at which young people transition from OOHC
mately 45,000 children in care, with 3300 of them aged varies between and within some countries—for most,
between 15 and 17 leaving care arrangements in 2018- formal support ceases between the ages of 18 and 21
2019 [6]. Comparable figures for the USA show that [19]. The type and mode of support to care leavers varies
there were 122,000 children aged between 13 and 20 in between jurisdictions, but can involve formal life skills
foster care on 30 September 2018. Of these, approxi- training programs, personal adviser or key worker sup-
mately 20,000 left care in FY2017, because they reached port, mentoring or peer support programs, cash assist-
the legal age of adulthood in their state [7]. Similar sta- ance and housing support [17, 20]. Young people
tistics for European countries, representing a broad transitioning from care are often ill-equipped for inde-
range of different welfare state regimes and thus ap- pendent living, and the type and amount of support they
proaches to OOHC, are more difficult to retrieve. receive is insufficient to prevent adverse outcomes [21,
Taylor et al. Systematic Reviews (2021) 10:240 Page 3 of 9

22]. Considering this, in some jurisdictions, one policy Criteria for considering studies for this review
response has been to raise the age at which young Studies will be selected according to the following cri-
people can transition, thereby extending the support teria: population, intervention, comparator, outcome and
available [4, 23, 24]. study design.
Transition support programs are generally available to
young people toward the end of their care placement, al- Population
though some extend beyond. They often encourage the Youth aged between 16 and 25 who are:
development of skills required for continued engage-
ment in education, obtaining employment, maintaining  Not living with their birth parents/family; AND
housing and general life skills [17, 20].  Are in foster care/out-of-home care/public care/
Fifteen years ago, Donkoh et al. conducted the first looked after (UK)/state care/government care; AND
methodologically rigorous systematic review of inde-  Have been placed in care due to concerns related to
pendent living programs for young people leaving out- child maltreatment, neglect or risk of child
of-home care and were unable to find any studies that maltreatment, relinquishment, or lack of provision
met their inclusion criteria [17]. In the intervening of support; AND
period, a number of reviews have explored various as-  Who are transitioning from care into adult living
pects of policies, programs or interventions for youth arrangements.
transitioning from care but have suffered from a range
of weaknesses in either methodology or scope. Intervention
Some reviews have limited their scope, either to par- Policies, programs or interventions that:
ticular geographies [20], or to interventions delivered
whilst youth were in care [17, 25], or to independent liv-  Provide support and/or assistance to help youth
ing programs [17, 26, 27]. Some focused on a narrow prior to leaving care and/or as they transition and/or
range of outcomes [27, 28]. Others have methodological after they leave care;
weaknesses, such as not conducting a systematic search  Are delivered in the community;
[22], not applying a methodological filter or addressing  Support young people transition from their
the risk of bias of included studies [25, 29], or they failed country’s statutory out-of-home care systems into
to critically appraise the effectiveness of the policy or adult living.
practice interventions included [26, 27, 30–32]. This re-
view seeks to update and build upon this previous work Comparator
by additionally investigating the effectiveness of policies The following comparisons will be included: interven-
that provide the option to extend out-of-home care be- tion/services as usual (i.e. what an individual would have
yond 18 years old, thereby increasing the age at which received in the absence of the intervention), another
young people transition. intervention (i.e. another policy, program or intervention
The aim of this systematic review is to assess the ef- for young people leaving out-of-home care), no interven-
fectiveness of programs and/or interventions designed to tion or wait-list control (i.e. individuals waiting to be in-
improve outcomes for youth transitioning from the out- cluded in the intervention).
of-home care system into adult living arrangements. The
proposed systematic review question is: Outcome(s)
What programs, interventions or services are effective Outcomes of interest include the following, which must
at improving health and psychosocial outcomes for be measured at least three months following the age at
young people leaving the out-of-home care system? which eligibility for standard out-of-home care termi-
nates in the jurisdiction in which the study took place.
Methods Outcomes will be considered if they were obtained from
The systematic review has been registered with the Inter- linked administrative data sources (i.e. employment,
national Prospective Register of Systematic Reviews (PROS- health or other records), validated measures (e.g. conflict
PERO, http://www.crd.york.ac.uk/PROSPERO, registration tactics scale) and non-validated measures (e.g. self-
number: CRD42020146999). reported homelessness) administered by interview or
The present protocol is being reported in accordance survey.
with the reporting guidance provided in the Preferred
Reporting Items for Systematic Reviews and Meta- Primary
Analyses Protocol (PRISMA-P) [33] (see Additional file
1). The final review will be reported in accordance with  Homelessness—we will include any homelessness/
the updated PRISMA 2020 statement [34] . housing-related outcomes, including any
Taylor et al. Systematic Reviews (2021) 10:240 Page 4 of 9

measurement that allows us to determine whether difference estimation, synthetic control group methods,
or not an individual has or does not have a studies based on covariate matching, propensity score-
permanent place to live; based methods, doubly robust methods, regression ad-
 Health—we will include any health-related outcomes justment, regression discontinuity designs and instru-
or measures of service usage, including but not lim- mental variable estimation; and economic evaluation
ited to emergency department presentations, hospi- methodologies including cost-benefit analysis, cost-
talisations and any measure of mental health utility analysis, cost-effectiveness analysis and cost-
conditions or symptoms; analysis.
 Education—we will include any education-related Economic evaluations and qualitative studies will be
outcomes, including but not limited to measurement included if they are conducted as part of a qualifying
of high school or equivalent completion, high school study and will be used only to inform or deepen our un-
grades, enrolment in or attainment of a trade/voca- derstanding of the quantitative findings.
tional qualification and enrolment in or attainment
of a university qualification; Information sources and search strategy
 Employment—we will include any employment- The following databases will be searched for studies
related outcomes, including but not limited to meas- published from January 1990 onward using strategies in-
urement of whether an individual is employed, their cluded in (Additional file 2):
wages or utilises unemployment benefits;
 Exposure to violence (as either victim or  Cochrane CENTRAL
perpetrator)—we will include any exposure to  CINAHL
violence-related outcomes, including but not limited  ERIC
to measurement of crime perpetration (i.e. whether  PsycINFO
or not an individual has been arrested, convicted, or  MEDLINE
spent time in a locked setting, e.g. jail/prison) or  EMBASE
crime victimisation (i.e. where the individual was the  Sociological Abstracts
victim);  Social Services Abstracts
 Risky behaviour—we will include any risky  SocINDEX
behaviour-related outcomes, including but not lim-  NHS Economic Evaluation Database
ited to measurement of illicit drug use, alcohol  Health Technology Assessment
abuse, risky sexual behaviour, positive sexually trans-
mitted infection tests and either the onset or delay Supplementary searches
of teen pregnancy. Websites and databases from clearinghouses, govern-
ment agencies and organisations known to be undertak-
Secondary ing or consolidating research in this area from the USA,
Europe, Australia, Canada and New Zealand will be ex-
 Relationships—we will include any relationships- amined for unpublished material, including but not lim-
related outcomes, including but not limited to meas- ited to:
urement of whether an individual has attained or
maintained supportive relationships with others, in-  Social Care Online (SCIE)
cluding mentors, peer mentors or supportive peers;  International Research Network on Transitions to
 Life skills—we will include any life skills-related out- Adulthood from Care
comes, including but not limited to measurement of  Analysis and Policy Observatory
the attainment of competencies required for inde-  Australian Institute of Family Studies
pendent living; these include, but are not limited to,  Chapin Hall at the University of Chicago
learning how to budget, attain essential services and  California Evidence-Based Clearinghouse for Child
perform essential household tasks. Welfare
 Washington State Institute for Public Policy
Study design(s)
The following experimental and quasi-experimental In addition to the organisations listed above, we will
study designs will be included: randomised controlled search the websites of organisations affiliated with au-
trials (RCTs) including individual RCTs, cluster RCTs, thors or included studies.
Step-Wedge designs with random time allocation and The reference lists of previous systematic reviews iden-
non-equivalent control group designs using parallel co- tified in the search process will be reviewed alongside
horts that adjust for baseline equivalence; difference-in- those reviews already known to the authors. References
Taylor et al. Systematic Reviews (2021) 10:240 Page 5 of 9

of included studies will also be screened for eligibility. mean difference. Where different measures are used to
Additionally, authors of included studies will be con- examine primary outcomes, we will calculate the stan-
tacted by email to ascertain if they are aware of any add- dardised mean difference if possible. Where data from
itional unpublished literature that may meet the the same outcome are reported in different studies as di-
inclusion criteria for this review. chotomous or continuous data, we will transform these
(if appropriate) to enable pooled estimates of effect.
Language of publication If effect sizes are missing or displayed in ways that do
No restrictions will be placed on the language of not allow us to determine a pooled estimate, we will use
publication. the Campbell Collaboration effect size calculator [36]. If
we are not able to calculate an effect size in this manner,
Data collection and management we will contact the authors and seek to obtain the infor-
Citations identified from the search strategy will be mation required for us to do so.
imported into the online systematic review application In accordance with the Cochrane Handbook for System-
Covidence [35] for screening. Following PRISMA guide- atic Reviews of Interventions, we will try to maximise the
lines, a flowchart will be provided demonstrating the in- likelihood of being able to quantitatively synthesise primary
puts and results of each stage of the review process. and secondary outcomes across studies using a meta-analysis
[37]. If more than one study with suitable data can be identi-
Study selection fied, we intend to perform a meta-analysis if the population,
Title and abstracts will be reviewed independently by intervention, comparison and outcomes are similar enough
two review authors, with a third reviewer resolving con- to be reasonably combined or can be standardised for com-
flicts when they arise. Two review authors will inde- parison. To make this judgement, we will group included
pendently read the full-text versions of all potentially studies by outcome domain and study design, whilst consid-
eligible studies that they have selected, and a third re- ering the intervention type, population, comparator, outcome
viewer will resolve conflicts when necessary. The eligibil- measure and timing of outcome measurement.
ity criteria are included in Table 1. We plan to undertake both fixed-effects and random-
effects meta-analyses and intend to present the random-
Data extraction effects result if there is no indication of funnel plot
Data extraction will be undertaken by pairs of review au- asymmetry. These models will allow us to estimate the
thors, with one reviewer checking the results of the pooled effect size and its 95% confidence interval for
other. Data will be extracted into an online form devel- each outcome. For both approaches, we will perform a
oped for this review. The following information will be meta-analysis using the longest follow-up period possible
obtained: study design, study outcomes, sample size, lo- for each outcome.
cation, study timeframe, study population, population Data from randomised and non-randomised trial de-
demographics, intervention details, effect sizes, imple- signs will not be pooled. We will also not pool data from
mentation outcomes as well as information required to non-randomised studies of different study designs. We
conduct risk of bias assessments. Authors of included will seek to undertake sensitivity analysis, if appropriate
studies will be contacted by email to request any re- based on decisions made during the review process.
quired information that is unavailable in print. For each outcome, we will explore heterogeneity by pre-
paring box plots, forest plots and examining the I2 statistic.
Data analysis Evidence of heterogeneity—where the p value < 0.1 and I2
We will synthesise data around each of our primary out- statistic is greater than 75%—will be highlighted in the
come domains (as defined in the “Criteria for consider- reporting of that outcome. Thresholds of low, medium and
ing studies for this review” section) as well as high heterogeneity will be assigned to I2 values of 25%, 50%
considering author affiliation, funding sources, conflicts and 75% [38]. This analysis will be conducted using the R
of interest, individual versus group delivery and setting. Project for Statistical Computing [39].
If sufficient studies are identified, subgroup analysis will If the conditions for conducting a meta-analysis are
be undertaken based upon the following characteristics: not met, we will describe and synthesise study findings
(a) study design: randomised control trials vs. non- narratively in line with guidance from the SWiM report-
randomised control trials, (b) age at which statutory out- ing guideline [40]. The data from each included study
of-home care support ceases: 18 vs. greater than 18 and (e.g. study characteristics, context, exposures, outcomes
(c) gender. and findings) will be used to build summary of findings/
For binary outcomes, we will calculate a risk ratio and evidence tables including an overall description of in-
a 95% confidence interval. For continuous data, if a con- cluded studies. Studies will be grouped, and results syn-
sistent outcome measure is used, we will calculate the thesised by outcome domain, stratified by study design,
Taylor et al. Systematic Reviews (2021) 10:240 Page 6 of 9

Table 1 Inclusion and exclusion criteria by PICO domain

PICO Inclusion criteria Exclusion criteria
Study • Randomised controlled trials (RCT) including: • Non-primary studies, including:
design ▪ Individual RCTs ▪ Literature reviews
▪ Cluster RCTs ▪ Systematic reviews
• Step-Wedge designs with random time allocation ▪ Meta-analysis
• Non-equivalent control group designs using parallel cohorts that • Studies without a valid counterfactual, including designs that do
adjust for baseline equivalence not include a parallel cohort that establish or adjust for baseline
• Difference-in-difference estimation equivalence, including:
• Interrupted time-series ▪ Single group pre-post designs
• Synthetic control group methods ▪ Control group designs without matching in time and establishing
• Studies based on: baseline equivalence
▪ Covariate matching ▪ Cross-sectional designs
▪ Propensity score based methods, ▪ Non-controlled observational (cohort) designs
▪ Doubly robust methods ▪ Case-control designs
▪ Regression adjustment ▪ Case studies/series
▪ Regression discontinuity designs, and ▪ Surveys
▪ Instrumental variable estimation. Qualitative designs and economic evaluations not undertaken in
Qualitative studies and economic evaluations will be included if the context of an included quantitative study.
they are conducted as part of a qualifying study and will be used
only to generate hypotheses, inform us about the interventions
and populations and inform or deepen our understanding of the
quantitative findings.
Population Youth aged between 16 and 25 Youth in OOHC settings for reasons other than child maltreatment,
Youth in OOHC for reasons of child maltreatment, neglect or risk neglect, risk of child maltreatment, relinquishment or lack of
of child maltreatment, relinquishment or lack of provision of provision of support.
support. OOHC settings include: Youth who are not in OOHC.
• Foster care Youth who are currently incarcerated, including in youth justice
• Guardianship settings.
• Kinship care Youth aged less than 16 and greater than 25.
• Group care
• Residential care
• Congregate care
Intervention Policies, programs or interventions delivered in the home or Policies, programs or interventions delivered in other settings, for
community. example: custodial settings.
Policies, programs or interventions where the focus is not on youth
transitioning from out-of-home care.
Comparison Treatment as usual, another intervention, no intervention, or wait- Studies using other comparators.
list control.
Outcome Primary outcomes: Studies looking at other outcomes.
• Homelessness
• Health
• Education
• Employment
• Exposure to violence (as either victim or perpetrator)
• Risky behaviour
Secondary outcomes:
• Relationships
• Life skills
Setting Countries where a statutory care system for child maltreatment Countries where a statutory care system for child maltreatment
exists. does not exist.

intervention type and population. We will use descrip- Evidence assessment

tive measures (median effect size and confidence inter- Risk of bias assessments will be used to explore hetero-
val) to describe their effects. We will use Cohen’s geneity, to inform decisions regarding the suitability of
benchmarks to assist in the interpretation of the magni- conducting a meta-analysis and to assess the strength of
tude of both dichotomous and continuous effect sizes inferences supporting Grading of Recommendations, As-
where: small (SMD = 0.2), medium (SMD = 0.5) and sessment, Development and Evaluation (GRADE) rec-
large (SMD = 0.8) [41]. ommendations. Risk of bias of included randomised
For studies included in a meta-analysis, publication controlled trials will be assessed using the Cochrane Risk
bias will be assessed by visually assessing funnel plot of Bias 2 (RoB 2) tool [42]. Non-randomised studies will
asymmetry. For continuous outcomes measured as mean be assessed using the ROBINS-I tool [43]. The quality of
differences Egger’s regression test will be used [37]. any economic evaluations will be assessed using
Taylor et al. Systematic Reviews (2021) 10:240 Page 7 of 9

guidelines suggested by the Cochrane and Campbell international studies of out-of-home care systems and
Economics Methods Group [44]. The quality of evidence policies have emphasised that studies conducted in dif-
across outcomes that can be synthesised in a meta- ferent welfare state regimes may represent different ways
analysis will be assessed as either very low, low, moder- of defining and conceptualising out-of-home care, its
ate or high using the GRADE methodology [45]. key target population and key aspects of the care experi-
ence [4, 16, 46]. In synthesising these as part of this re-
Discussion view, detailed information on the context dependence of
Reflecting its place as an emergent policy issue, the vol- findings may therefore get lost, highlighting the need for
ume of research published on care leavers has increased a locally driven translation process of results and their
substantially in the last 20 years, but this literature has potential implications for policy and practice in specific
not been the subject of high-quality synthesis. Therefore, locations.
it is an appropriate time for a systematic review to in- The results of this review will be disseminated though
form ongoing policy and practice discussions about how publication in a report by the funder, conference presen-
best to support young people transitioning from care tations and in peer reviewed publications. Any future
and to shape future research. amendments to this protocol in the course of the review
This review has a number of advantages over previ- will be updated in PROSPERO and reported in the pub-
ously published work on this topic, including (a) a sys- lished review.
tematic search of a wide range of databases with no
language restrictions, (b) the use of inclusion criteria Abbreviations
GRADE: Grading of Recommendations, Assessment, Development and
that prioritise studies with high-quality methodologies, Evaluation; OOHC: Out-of-home care; QED: Quasi-experimental design;
(c) the selection of outcomes that reflect health and psy- RCT: Randomised control trial; SWiM: Synthesis without meta-analysis
chosocial wellbeing, (d) the inclusion of policy alongside
individual or group-level interventions and (e) the use of Supplementary Information
the GRADE approach to assess the quality of evidence, The online version contains supplementary material available at https://doi.
report results and support knowledge translation. org/10.1186/s13643-021-01792-5.

In conducting this review, we also expect to encounter

Additional file 1. PRISMA-P 2015 Checklist.
limitations. Including studies from different countries
Additional file 2. Search strategy.
and settings, representing different social welfare re-
gimes and policies as well as different social care systems
may make it difficult to combine findings from studies. Acknowledgements
Not applicable.
To address this concern, we will take these and other
contextual factors into account in analysing, synthesising Authors’ contributions
and reporting findings. Additionally, the inclusion of AS and DT conceptualised the review question. DT drafted the manuscript,
studies in our review that use a wide range of outcome and all co-authors provided comments during multiple rounds of revisions.
DT, SC and AS developed the search strategy. AS, BA and GM provided
measurements to assess similar constructs will likely methodological advice. PM provided subject matter expertise. JL is the guar-
limit the scope of any meta-analyses that we can under- antor of the review. All authors read and approved the final manuscript.
take. As highlighted above, if this is the case, we will re-
port findings without conducting meta-analyses using Authors’ information
Not applicable.
the SWiM guidelines.
The results of this review will have the potential to in- Funding
form policy discussions in this area in a number of juris- Funding for this systematic review is provided by the What Works Centre for
dictions, as they evaluate the merits of providing Children’s Social Care (What Works CSC) in the UK. What Works CSC
provided comments on a draft version of this protocol.
different modes of transitions support, raising the age at
which OOHC can be provided to young people or a Availability of data and materials
combination of both. Not applicable.
The results of this review will also provide guidance to
organisational leaders and other sector decision makers Declarations
involved in the design and delivery of out-of-home care, Ethics approval and consent to participate
transitions and independent living programs by identify- Not applicable.
ing potentially promising interventions and/or key as-
pects important to take into account when supporting Consent for publication
Not applicable.
young people transitioning out of OOHC.
However, it will be important to interpret findings Competing interests
from this review with great caution. Previous The authors declare that they have no competing interests.
Taylor et al. Systematic Reviews (2021) 10:240 Page 8 of 9

Author details 17. Donkoh C, Underhill K, Montgomery P. Independent living programmes for
1
Department of Social Work, Monash University, 900 Dandenong Road, improving outcomes for young people leaving the care system. Cochrane
Caulfield East, VIC 3145, Australia. 2Centre for Evidence and Implementation, Database Syst Rev. 2006;8 Available from: http://doi.wiley.com/10.1002/14
33 Lincoln Square South, Carlton, VIC 3053, Australia. 3Institute for 651858.CD005558.pub2.
Implementation Science in Health Care, University of Zurich, 18. Havlicek J, Garcia A, Smith DC. Mental health and substance use disorders
Universitätstrasse 84, 8006 Zurich, Switzerland. 4School for Policy Studies, among foster youth transitioning to adulthood: past research and future
University of Bristol, 8 Priory Rd, Bristol BS8 1TZ, UK. 5The Fostering Network, directions. Child Youth Serv Rev. 2013;35(1):194–203. Available from: https://
87 Blackfriars Road, London SE1 8HA, UK. www.ncbi.nlm.nih.gov/pmc/articles/PMC3677527/pdf/nihms414350.pdf.
https://doi.org/10.1016/j.childyouth.2012.10.003.
Received: 3 December 2020 Accepted: 13 August 2021 19. Gypen L, Vanderfaeillie J, De Maeyer S, Belenger L, Van Holen F. Outcomes
of children who grew up in foster care: systematic-review. Child Youth Serv
Rev. 2017;76:74–83. Available from:. https://doi.org/10.1016/j.childyouth.2017.
02.035.
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