Racial disparities in the use of physical restraints in U.s. nursing homes

The use of physical restraints in nursing homes among black and white residents was examined on the basis of data from the 2004 National Nursing Home Survey to determine if black residents were more susceptible to the use of physical restraints. Odds ratios acquired through logistic regression are provided with 95 percent confidence intervals. Findings revealed that black residents are more likely than white residents to be restrained with bed rails, side rails, and trunk restraints. Findings suggest that racial disparities exist in the use of physical restraints. Implications for practice, policy, and research are discussed.

Validation of the Chinese version of the Modified Caregivers Strain Index among Hong Kong caregivers: an initiative of medical social workers

Family caregivers may often experience caregiving stress and burden. To systematically assess this issue, medical social workers may need to use a brief and valid measurement in their practice. In the Hong Kong Chinese context, one additional challenge is to examine whether a measurement developed in the West is valid for Hong Kong Chinese caregivers. Thus, medical social workers in Hong Kong initiated this research study to validate the Chinese version of the Modified Caregiver Strain Index (C-M-CSI). A total of 223 Chinese caregivers of patients with various chronic illnesses were recruited for this validation study. C-M-CSI demonstrated good reliability (Cronbach's alpha coefficient = .91), concurrent validity with the Chinese version of the Caregiver Burden Inventory, and discriminant validity with the Chinese version of the Meaning in Life Questionnaire. Factor analysis yielded a single factor as the original M-CSI, which explained 49 percent of variance. Construct validity was shown by differentiating spousal and nonspousal caregivers, as well as caregivers of patients with and without behavioral problems. C-M-CSI is recommended as a brief and valid measurement that can be used by medical social workers in assessing the caregiving strain of Chinese caregivers of patients in Hong Kong.

Examining cultural competence in health care: implications for social workers

This article examines and unpacks the "black box" of cultural competence in health interventions with racial and ethnic minority populations. The analysis builds on several recent reviews of evidence-based efforts to reduce health disparities, with a focus on how cultural competence is defined and operationalized. It finds that the use of multiple similar and indistinct terms related to cultural competence, as well as the lack of a mutually agreeable definition for cultural competence itself, has resulted in an imprecise concept that is often invoked but rarely defined and only marginally empirically validated as an effective health intervention. This article affirms the centrality of cultural competence as an essential values-based component of optimal social work practice, while also suggesting future directions for operationalizing, measuring, and testing cultural competence to build an evidence base on whether and how it works to reduce health disparities.

Listen to the voices of unwed teenage mothers in Malaysian shelter homes: an explorative study

This qualitative research aims to explore the daily life experiences of Malaysian unwed teenage mothers in shelter homes. The research is based on the thematic analysis of interviews with seventeen respondents aged from 12 to 18 years. Eight sub-themes described the experience of the unwed teenage mothers in the shelter home and led to three overall themes: rules and regulations, relationship with the staff and relationship with the other girls at the shelter home. The findings indicated that the shelter homes involved were not fulfilling the standard of the Malaysian national laws and United Nations Convention on the Rights of the Child. We strongly suggest that the authorities provide a clear guideline concerning the implementation of Malaysian national laws and United Nations Convention on the Rights of the Child.

A multilevel analysis of the impacts of services provided by the U.K. Employment Retention and Advancement Demonstration

BACKGROUND

The United Kingdom Employment Retention and Advancement (U.K. ERA) demonstration was the largest and most comprehensive social experiment ever conducted in the United Kingdom. It examined the extent to which a combination of postemployment advisory support and financial incentives could help lone parents on welfare to find sustained employment with prospects for advancement. ERA was experimentally tested across more than 50 public employment service offices and, within each office, individuals were randomly assigned to either a program (or treatment) group (eligible for ERA) or a control group (not eligible).

METHOD

This article presents the results of a multilevel nonexperimental analysis that examines the variation in office-level impacts and attempts to understand what services provided in the offices tend to be associated with impacts.

RESULT

The analysis suggests that impacts were greater in offices that emphasized in-work advancement, support while working and financial bonuses for sustained employment, and also in those offices that assigned more caseworkers to ERA participants. Offices that encouraged further education had smaller employment impacts.

CONCLUSION

Plausible results are obtained identifying those particular implementation features that tended to be linked to stronger impacts of ERA. The methodology employed also allows the identification of which services are associated with employment and welfare receipt of control families receiving benefits under the traditional New Deal for Lone Parent program.

Factors influencing the quality of implementation of a positive youth development program in Hong Kong

This study examines how social workers collaborate with school teachers in implementing a school-based positive youth development program in Hong Kong. Individual and focus group interviews are conducted with social workers cooperating with school teachers in implementing the Project P.A.T.H.S. in a school context. Through the interviews, strategies for establishing inter-disciplinary collaboration and factors that hinder or facilitate program implementation are identified. This case study highlights factors that facilitate the collaboration between social workers and school teachers, including the following: 1) sufficient training for instructors, 2) sharing of the practice wisdom and teaching experiences, 3) building up mutual support among different parties, 4) use of proactive communication, and 5) demonstration of self-disclosure.

Dr. Tulp, I presume: intellectual disability and ethnicity in Rotherham

In this article, we report on that aspect of our ongoing simulation project which focuses on the cultural needs of a 'virtual' young man living with profound and multiple intellectual disabilities, who is British Asian and receives care in a residential setting. We describe our involvement with a local agency who support families from black and minority ethnic populations and who have children with a variety of intellectual disabilities. We then go on to detail the focus group we attended and how we incorporated the data generated into a more comprehensive story for our 'virtual' young man, Ahmed.

Social work faculty interest in aging: impact of education, knowledge, comfort, and experience

As the need for gerontological social workers increases, it is important to assess faculty interest in strengthening and bolstering this area in the classroom and curriculum. This study sought to compare training and experience of social work faculty that identified aging as a teaching or research interest with faculty who did not, and to identify predictors of aging interest among faculty. A national sample of social work faculty members was recruited, and a total of 609 individuals participated in the study. The findings reveal that faculty with an interest in aging differed from nonaging faculty in the areas of knowledge of older adults, personal and paid experience, and graduate and continuing education. In addition, predictors of interest in aging included taking a graduate course, continuing education units, having paid and volunteer experience, level of knowledge of older adults, and comfort level of covering content on aging in the classroom. The connection between social work faculty and student interest in aging are discussed as implications for further social work research and education.

Bouncers, brokers, and glue: the self-described roles of social workers in urban hospitals

Social workers delivering services in health care settings face unique challenges and opportunities. The purpose of this study was to solicit input from social workers employed in urban hospitals about their perceptions of the roles, contribution, and professional functioning of social work in a rapidly changing health care environment. Using qualitative methods, the university and hospital-based research team conducted seven focus groups (n = 65) at urban hospitals and analyzed the data using an interpretive framework with ATLAS.ti software. Seven major themes emerged from the participants' description of their roles: bouncer, janitor, glue, broker, firefighter, juggler, and challenger. Along with descriptions of the ways social workers fulfilled those roles, participants articulated differences in status within those roles, the increasing complexity of discharge planning, and expectations to provide secondary support to other health care professionals on their teams. Implications for practice and research are discussed.

Department of health and human services changes: implications for hospital social workers

In April 2010, President Obama issued a directive to the Secretary of Health and Human Services (HHS) regarding patient visitation, advance directives, and other initiatives to improve the lives of lesbian, gay, bisexual, and transgender people and their families. The HHS response to this directive has implications for hospital social workers. The purpose of this secondary data analysis was to explore indicators of social work readiness to support implementation of the resulting initiatives. A historical context for the changes is provided, inclusive of the cases that spurred the presidential memorandum. The findings are presented within the framework of the profession's standards for social work practice in health care and end-of-life care. Recommendations for enhancing social work readiness for a critical role in implementation of the new regulations are presented.

Evidence-based programs for schools: relationships between effect sizes and resource requirements

Presumably, schools desiring larger effects from an empirically based program might be willing to allocate greater resources for the purchase and implementation of the intervention. However, while it may seem intuitive that more expensive programs generate greater change in student outcomes, there is currently a lack of evidence supporting such a relationship. In this study the authors address this gap in the literature by examining the critical relationship between resource requirements and effect sizes of 51 evidence-based programs that would influence school practitioners' choice of interventions. Through simple calculations of the range and mean resources for programs, analyses surprisingly found higher resource requirements for programs with the smallest effect sizes. Implications for practice and future research are discussed.

Using performance measures to manage child welfare outcomes: local strategies and decision making

The federal child welfare performance measurement system exerts a profound influence over the design, delivery, and evaluation of child welfare services at the local level, with funding contingent upon participation in the federally mandated Child and Family Services Review. In this exploratory study the authors focus on local efforts to respond to and comply with the federal child welfare performance measurement system in 11 northern California counties. The authors review the System Improvement Plans of each county and the findings from focus groups with child welfare staff conducted in five of the counties that included the limitations of federal performance measures, the difficulty using these measures to inform decision making, and the continuing struggle to achieve the major child welfare goals of safety, permanency, and well-being. The implications include the need for: flexibility in the federal performance measurement system, opportunities to integrate local values and priorities, and child well-being measures so that timeliness does not take on more significance than well-being or the quality of relationships among local stakeholders in the child welfare system.

Prisoner reentry: a public health or public safety issue for social work practice?

A significant literature identifies the policy, economic, health, and social challenges that confront released prisoners. This literature also describes the public health and public safety risks associated with prisoner reentry, provides recommendations for improving the reentry process, and describes the effectiveness of prison-based programs on recidivism rates. Public health and public safety risks are particularly significant in communities where large numbers of prisoners are released and few evidence-based services exist. The purpose of this article is to describe the public health and public safety risks that released prisoners experience when they reenter communities, and to discuss the social justice issues relevant for social work practice.

Complex patients: social workers' perceptions of complexity in health and rehabilitation services

We report on a qualitative study exploring health social workers' understanding of complexity in relation to inpatients in subacute wards at three sites across a large health network in Melbourne, Australia. Findings indicate that social workers' understanding of complexity refers to five interrelated themes: multiple competing demands; uncertainty; patient and family characteristics; pending breakdown; systems challenges. Social workers with less practice experience report that complex clients present more challenges than do social workers with greater experience. Implications of these findings for advancing practitioners' capacities in working with complex patients are discussed, as are the limitations of the study.

Science-based prevention through communities that care: a model of social work practice for public health

This article describes a public health orientation to drug and alcohol abuse prevention; reviews the state of the science underlying a risk and protective factor approach to alcohol and drug abuse prevention; describes Communities That Care, a community practice model that makes use of this evidence; and considers how this model reflects four important principles of social work practice. The intent of this article is to provide guidance to social workers who support the National Association of Social Work's intention to make prevention practice central to the provision of alcohol and drug abuse services by social workers.

Improving service practices: collaborative care for women of abuse

This original qualitative research inquiry is based on a phenomenological research dissertation case study. This article information and content that is gathered helps to better inform providers in the field of social services and those who are social workers and administrators in social services. This research investigated key factors, traits, or attributes that strive to improve service care for women of domestic violence abuse. Findings support current and relevant research to enhance aid to women of abuse. Results strongly detail that professionals must work more cooperatively as an all-channels network of comprehensive care to women. Because women of domestic violence abuse require such multifaced complex care due to the interwoven issues familial abuse brings, results support that service practitioners can best meet the needs of these women through an ecological or life-space understanding for improved care, achieved by infusing an inter-disciplinary systems-based, inter-agency and intra-agency framework.

Avoiding type III, IV, and V errors through collaborative research

Major types of empirical errors reviewed by a number of leading research textbooks include discussions of Type I and Type II errors. However, applied human service researchers can commit other types of errors that should be avoided. The potential benefits of the applied, collaborative research (in contrast to traditional participatory research) include an assurance that the study begins with the "right" questions that are important for community residents. Such research practice also helps generate useful research findings for decisions regarding redistribution of resources and resolving community issues. The aim of collaborative research is not merely to advance scientific understanding, but also to produce empirical findings that are usable for addressing priority needs and problems of distressed communities. A review of a case example (Garfield Community Assessment Study) illustrates the principles and practices of collaborative research.

12-step interventions and mutual support programs for substance use disorders: an overview

Social workers and other behavioral health professionals are likely to encounter individuals with substance use disorders in a variety of practice settings outside of specialty treatment. 12-Step mutual support programs represent readily available, no cost community-based resources for such individuals; however, practitioners are often unfamiliar with such programs. The present article provides a brief overview of 12-Step programs, the positive substance use and psychosocial outcomes associated with active 12-Step involvement, and approaches ranging from ones that can be utilized by social workers in any practice setting to those developed for specialty treatment programs to facilitate engagement in 12-Step meetings and recovery activities. The goal is to familiarize social workers with 12-Step approaches so that they are better able to make informed referrals that match clients to mutual support groups that best meet the individual's needs and maximize the likelihood of engagement and positive outcomes.

HIV case manager preparedness for practice in Ryan White CARE Act funded settings

While current research on the factors affecting the HIV epidemic within the general population has considered the role of HIV case managers, much remains to be known about case management effectiveness and how it might be enhanced. This article presents the data from a statewide survey of case management professionals in Florida. The study focused on case managers' preparation for practice and barriers to successful practice. The study results reflect a very broad educational preparation in multiple disciplines with highly varied means of case manager training and orientation at entry to practice. Further, the results highlighted the existence of multiple barriers that challenge the ability of case managers to cope with the demands of case management practice in sites serving people living with HIV/AIDS who are socially and economically challenged. The article concludes with recommendations for changes in the system that would enhance the preparation of case management professionals for entry to practice.