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Osofsky H, Osofsky J, Saltzman LY, Lightfoot E, De King J, Hansel TC. Mechanisms of recovery: Community perceptions of change and growth following multiple disasters. Front Psychol 2022; 13:991770. [DOI: 10.3389/fpsyg.2022.991770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/06/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction and purposeThe geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, or community changes in efforts to describe community resilience and posttraumatic growth (PTG).MethodsParticipants were recruited through a quantitative survey and community flyers. Participants represented southeastern Louisiana, in areas impacted by hurricanes and the oil spill—for a total of five focus groups and 41 participants. Focus groups began by asking each participant to provide a brief overview of their disaster survival story and three additional guiding strengths-based questions. Data were transcribed using Dragon Speech Recognition software. A total of 963 unique responses were analyzed and coded.ResultsThe following themes were identified: connectedness (n = 259), coping (n = 94), spirituality (n = 60), adaptability (n = 47), and self-reliance (n = 23). Participants noted a growth mindset from the disasters and also acknowledged coinciding negative experiences (n = 154) associated with community change and loss, where subthemes included change in connectedness (n = 97), crime (n = 26), and feeling like an outsider (n = 31).Discussion and implicationsThese findings help scholars and mental health practitioners better understand the lived experiences of PTG in a community of survivors impacted by recurring traumatic experiences. In keeping with previous literature, PTG and negative experiences associated with trauma are not mutually exclusive, but occur simultaneously. Our results offer a holistic picture of coping with cumulative or repeated traumas and suggest that connectedness, coping, and spirituality provide important buffers to negative psychosocial outcomes.
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Sherman M, Covert H, Brown L, Langhinrichsen-Rohling J, Hansel T, Rehner T, Buckner A, Lichtveld M. Enterprise Evaluation: A New Opportunity for Public Health Policy. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:479-489. [PMID: 31348163 PMCID: PMC6716577 DOI: 10.1097/phh.0000000000000862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Standard evaluation practice in public health remains limited to evaluative measures linked to individual projects, even if multiple interrelated projects are working toward a common impact. Enterprise evaluation seeks to fill this policy gap by focusing on cross-sector coordination and ongoing reflection in evaluation. We provide an overview of the enterprise evaluation framework and its 3 stages: collective creation, individual data collection, and collective analysis. We illustrate the application of enterprise evaluation to the Gulf Region Health Outreach Program, 4 integrated projects that aimed to strengthen health care in Louisiana, Mississippi, Alabama, and the Florida Panhandle after the Deepwater Horizon oil spill. Shared commitment to sustainability and strong leadership were critical to Gulf Region Health Outreach Program's success in enterprise evaluation. Enterprise evaluation provides an important opportunity for funding agencies and public health initiatives to evaluate the impact of interrelated projects in a more holistic and multiscalar manner than traditional siloed approaches to evaluation.
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Affiliation(s)
- Mya Sherman
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Hannah Covert
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Lisanne Brown
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Jennifer Langhinrichsen-Rohling
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Tonya Hansel
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Timothy Rehner
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Ayanna Buckner
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Maureen Lichtveld
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
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Four States, Four Projects, One Mission: Collectively Enhancing Mental and Behavioral Health Capacity Throughout the Gulf Coast. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23 Suppl 6 Suppl, Gulf Region Health Outreach Program:S11-S18. [PMID: 28961647 DOI: 10.1097/phh.0000000000000661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT The 2010 Deepwater Horizon oil spill triggered numerous concerns regarding the health and well-being of citizens within the already vulnerable Gulf Coast region. Four Mental and Behavioral Health Capacity Projects (MBHCPs) united to form the Quad-State MBHCP component of the Gulf Region Health Outreach Program (GRHOP). Their shared mission was to increase mental and behavioral health (MBH) capacity within coastal counties of Louisiana, Mississippi, Alabama, and the Florida Panhandle. OBJECTIVE To describe strategies used to collectively enhance the impact of the 4 state-specific MBHCPs and to share lessons learned from a multistate collaborative flexibly designed to meet a shared mission. MATERIALS AND PROCEDURES Archival materials were assessed. They included attendance sheets/notes from regularly scheduled group meetings, GRHOP quarterly and annual reports, and state-specific MBHCP logic models. Nationally available data on MBH services provided in project-relevant primary care sites were also examined. RESULTS Three strategies were found to be effective facilitators of collective success: (i) reciprocal participation in the backbone organization (GRHOP); (ii) creation and comparison of state-specific MBHCP logic models and activities; and (iii) cross-fertilization among the MBHCP state-specific logic models, a unified Quad-State, and the GRHOP-wide logic model to generate additional synergistic endeavors and measureable outcomes. Examples of region-wide MBHCP success, such as uptake in integrated health services in health care clinics across the jurisdiction of investment, are presented. CONCLUSIONS Isolated approaches to complex issues are, at times, ineffective. The Collective Impact (CI) model, with an emphasis on coordination among existing organizations, stakeholders, and the public, can serve as a guidepost to facilitate sustainable change even when used in a modified form. Strategies discussed herein for maximizing the 5 prescribed CI conditions provide an important roadmap for how to interface among multidisciplinary projects seeking to address the same, large-scale public health problem.
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Osofsky HJ, Speier A, Hansel TC, Wells JH, Kaliebe KE, Savage NJ. Collaborative Health Care and Emerging Trends in a Community-Based Psychiatry Residency Model. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:747-754. [PMID: 27160893 DOI: 10.1007/s40596-016-0566-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/21/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This paper provides a report of an academic department of psychiatry's journey into the change process associated with addressing the new requirements in health-care delivery, the emphasis on person-centered treatment models, and the implications for residency training programs. Louisiana State University Health Sciences Center Department of Psychiatry's experience is based on responding to real-world shifts in which academic departments can play a leadership role. METHODS Importantly, methods are based on person-centered collaboration being central to a successful change process and include a description of the training, with data supporting implementation of the model. RESULTS The model demonstrates increased access to care and improved behavioral health symptoms. It indicates that with proper training and supervision, psychiatry residents can be an agent of change. CONCLUSION This brief review of our experience offers to other departments of psychiatry examples of collaborative strategies substantially informed by the needs and preferences of both persons accessing services and local communities.
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Affiliation(s)
- Howard J Osofsky
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Anthony Speier
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Tonya Cross Hansel
- Louisiana State University Health Sciences Center, New Orleans, LA, USA.
| | - John H Wells
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | - Nicole J Savage
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
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