Systematic review of health and social outcomes among Indigenous People exposed to the child welfare system: a protocol

Abstract

Introduction: The link between parent-child separation through child welfare systems and negative health and social outcomes is well documented. In contrast, despite the over-representation of Indigenous children and youth in child welfare systems, the relationship between child welfare system involvement and health and social outcomes among Indigenous populations has not been systematically reviewed. Our objective is to assess whether Indigenous People who have been exposed to a child welfare system personally or intergenerationally (ie, parents and/or grandparents) within Canada, Australia, New Zealand and the USA (CANZUS countries) and the circumpolar region are at an increased risk for negative health and social outcomes compared with other exposed and non-exposed groups.

Methods and analysis: We will undertake a comprehensive exploration of literature documenting health and social outcomes for Indigenous individuals with personal or intergenerational exposure to a child welfare system. The search will encompass nine databases, including Ovid MEDLINE, APA PsycINFO, Bibliography of Native North Americans, CINAHL, EMBASE, Public Affairs Index, Scopus, Social Work Abstracts and Sociological Abstracts. Additionally, reference lists of included studies will be examined. The literature search will include studies up to 4 October 2024 and will adhere to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Findings will be presented in summary tables through narrative synthesis, and if feasible, a meta-analysis will quantify the impact of child welfare exposure on health and social outcomes.

Ethics and dissemination: The results of this systematic review will synthesise current evidence regarding health and social outcomes related to personal and intergenerational child welfare exposure among Indigenous populations in CANZUS countries and circumpolar regions. This information could help support future policy and practice decision-making. Findings will be widely disseminated through peer-review publications and community presentations aimed at various interested parties, including policymakers, professional practitioners and clinicians, and service users (ie, clients, family members, caregivers).

Prospero registration number: CRD42023434543.

Keywords: Child protection; Health Equity; Mental Health; Stress, Psychological; Systematic Review.