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Shinn M, Richard MK. Allocating Homeless Services After the Withdrawal of the Vulnerability Index-Service Prioritization Decision Assistance Tool. Am J Public Health 2022; 112:378-382. [PMID: 35196047 PMCID: PMC8887175 DOI: 10.2105/ajph.2021.306628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Marybeth Shinn
- Marybeth Shinn and Molly K. Richard are with Peabody College, Vanderbilt University, Nashville, TN
| | - Molly K Richard
- Marybeth Shinn and Molly K. Richard are with Peabody College, Vanderbilt University, Nashville, TN
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2
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Hassan EM, Mahmoud H. Healthcare and education networks interaction as an indicator of social services stability following natural disasters. Sci Rep 2021; 11:1664. [PMID: 33462303 PMCID: PMC7814048 DOI: 10.1038/s41598-021-81130-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/01/2021] [Indexed: 11/30/2022] Open
Abstract
Healthcare and education systems have been identified by various national and international organizations as the main pillars of communities' stability. Understanding the correlation between these main social services institutions is critical to determining the tipping point of communities following natural disasters. Despite being defined as social services stability indicators, to date, no studies have been conducted to determine the level of interdependence between schools and hospitals and their collective influence on their recoveries following extreme events. In this study, we devise an agent-based model to investigate the complex interaction between healthcare and education networks and their overall recovery, while considering other physical, social, and economic factors. We employ comprehensive models to simulate the functional processes within each facility and to optimize their recovery trajectories after earthquake occurrence. The results highlight significant interdependencies between hospitals and schools, including direct and indirect relationships, suggesting the need for collective coupling of their recovery to achieve full functionality of either of the two systems following natural disasters. Recognizing this high level of interdependence, we then establish a social services stability index, which can be used by policymakers and community leaders to quantify the impact of healthcare and education services on community resilience and social services stability.
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Affiliation(s)
- Emad M Hassan
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA
| | - Hussam Mahmoud
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA.
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Ross AM, Schneider S, Muneton-Castano YF, Caldas AA, Boskey ER. "You never stop being a social worker:" Experiences of pediatric hospital social workers during the acute phase of the COVID-19 pandemic. Soc Work Health Care 2021; 60:8-29. [PMID: 33657982 DOI: 10.1080/00981389.2021.1885565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The COVID-19 pandemic has wrought widespread devastation upon children and families across the United States, widening existing health disparities and inequities that disproportionately affect communities of color. In health care settings specifically, social work is the key workforce tasked with responding to patient and family psychosocial needs, both of which have increased substantially since the emergence of COVID-19. There is a need to understand ways in which hospital social workers' roles, responsibilities, and integration within interprofessional teams have evolved in response to these challenges. In this qualitative study, focus groups were conducted with 55 social workers employed across multiple settings in a large, urban, pediatric hospital in Spring 2020. Thematic analyses revealed salient superordinate themes related to the pandemic's impact on social work practice and social workers themselves, institutional facilitators and impediments to effective social work and interprofessional practice, and social work perspectives on future pandemic recovery efforts. Within each theme, a number of interrelated subthemes emerged elucidating nuances of telehealth adoption in the context of remote work, the salience of social determinants of health, and the critical role of social work in social justice oriented pandemic preparedness and response efforts. Implications for interprofessional practice and the profession at large are discussed.
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Affiliation(s)
- Abigail M Ross
- Graduate School of Social Service, Fordham University, New York, New York, USA
- Social Work Department, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Samantha Schneider
- Social Work Department, Winona State University, Rochester, Minnesota, USA
| | - Yudy F Muneton-Castano
- Critical Care, Anesthesia, Perioperative, Extension (C.A.P.E) And Home Ventilation Program/Critical Care Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Adolfo Al Caldas
- Primary Care at Longwood/Spanish Team, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Elizabeth R Boskey
- Center for Gender Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
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4
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Affiliation(s)
- Chris Ham
- Coventry and Warwickshire Health and Care Partnership, Rugby, UK
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5
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De Marchis EH, Hessler D, Fichtenberg C, Fleegler EW, Huebschmann AG, Clark CR, Cohen AJ, Byhoff E, Ommerborn MJ, Adler N, Gottlieb LM. Assessment of Social Risk Factors and Interest in Receiving Health Care-Based Social Assistance Among Adult Patients and Adult Caregivers of Pediatric Patients. JAMA Netw Open 2020; 3:e2021201. [PMID: 33064137 PMCID: PMC7568201 DOI: 10.1001/jamanetworkopen.2020.21201] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Health care organizations are increasingly incorporating social risk screening into patient care. Studies have reported wide variations in patients' interest in receiving health care-based assistance for identified social risks. However, no study to date has examined the factors associated with patients' interest in receiving assistance, including whether interest in receiving assistance varies based on specific patient demographic characteristics. Targeted research on this topic could improve the success of health care-based programs that offer social care services. OBJECTIVE To identify participant characteristics associated with interest in receiving health care-based social risk assistance. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted in 7 primary care clinics and 4 emergency departments in 9 US states between July 2, 2018, and February 13, 2019. A convenience sample of adult patients and adult caregivers of pediatric patients completed a screening survey that measured social risk factors and participants' interest in receiving assistance for identified social risks. Participants were randomly selected to receive 1 of 2 versions of the survey, which differed based on the order in which questions about social risks and interest in receiving assistance were presented. Multivariable logistic regression analyses were used to evaluate the associations between covariates and participants' interest in receiving assistance, stratified by social risk screening results. Data were analyzed from September 8, 2019, to July 30, 2020. EXPOSURES Social risk screening questions assessed risk factors comprising housing, food, transportation, utilities, and exposure to interpersonal violence. Additional questions assessed participants' interest in receiving assistance and their perspectives on health care-based social risk screening. MAIN OUTCOMES AND MEASURES Participant interest in receiving health care-based social risk assistance. RESULTS A total of 1021 adult participants with complete survey responses were included in the analysis. Of those, 709 of 1004 participants (70.6%) were female, and 544 of 1007 participants (54.0%) were aged 18 to 44 years. Overall, 353 of 662 participants (53.3%) with positive screening results for 1 or more social risk factors were interested in receiving assistance, whereas 31 of 359 participants (8.6%) with negative screening results for all social risks were interested in receiving assistance. Participants with positive screening results for 1 or more social risk factors had a higher likelihood of being interested in receiving assistance if they answered the question about interest in receiving assistance before they answered the questions about social risk factors (adjusted odds ratio [aOR], 1.48; 95% CI, 1.05-2.07), had positive screening results for a higher number of social risk factors (aOR, 2.40; 95% CI, 1.68-3.42), reported lower household income levels (aOR, 7.78; 95% CI, 2.96-20.44), or self-identified as having non-Hispanic Black ancestry (aOR, 2.22; 95% CI, 1.37-3.60). Among those with negative screening results for all social risk factors, the interest in receiving assistance was higher if the participants reported lower household income levels (aOR, 12.38; 95% CI, 2.94-52.15), previous exposure to health care-based social risk screening (aOR, 2.35; 95% CI, 1.47-3.74), higher perceived appropriateness of social risk screening (aOR, 3.69; 95% CI, 1.08-12.55), or worse health status (aOR, 4.22; 95% CI, 1.09-16.31). CONCLUSIONS AND RELEVANCE In this study, multiple factors were associated with participants' interest in receiving social risk assistance. These findings may have implications for how and when social risk assistance is offered to patients. As the health care system's role in addressing social risk factors evolves, an understanding of patients' perspectives regarding screening and their interest in receiving assistance may be important to implementing patient-centered interventions.
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Affiliation(s)
- Emilia H. De Marchis
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco
| | - Danielle Hessler
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco
| | - Caroline Fichtenberg
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco
| | - Eric W. Fleegler
- Division of Emergency Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amy G. Huebschmann
- Division of General Internal Medicine and Center for Women’s Health Research, University of Colorado School of Medicine, Aurora
| | - Cheryl R. Clark
- Division of General Internal Medicine and Primary Care, Center for Community Health and Health Equity, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alicia J. Cohen
- Providence VA Medical Center, Departments of Family Medicine and Health Services, Policy, and Practice, Brown University, Providence, Rhode Island
| | - Elena Byhoff
- Department of Medicine and Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Mark J. Ommerborn
- Center for Community Health and Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Nancy Adler
- Department of Psychiatry, University of California, San Francisco, San Francisco
| | - Laura M. Gottlieb
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco
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Ross AM, Zerden LDS, Ruth BJ, Zelnick J, Cederbaum J. Contact Tracing: An Opportunity for Social Work to Lead. Soc Work Public Health 2020; 35:533-545. [PMID: 32781912 DOI: 10.1080/19371918.2020.1806170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Since the novel coronavirus disease (COVID-19) first emerged in December 2019, there have been unprecedented efforts worldwide to contain and mitigate the rapid spread of the virus through evidence-based public health measures. As a component of pandemic response in the United States, efforts to develop, launch, and scale-up contact tracing initiatives are rapidly expanding, yet the presence of social work is noticeably absent. In this paper, we identify the specialized skill set necessary for high quality contact tracing in the COVID-19 era and explore its alignment with social work competencies and skills. Described are current examples of contact tracing efforts, and an argument for greater social work leadership, based on the profession's ethics, competencies and person-in-environment orientation is offered. In light of the dire need for widespread high-quality contact tracing, social work is well-positioned to participate in interprofessional efforts to design, oversee and manage highly effective front-line contact tracing efforts.
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Affiliation(s)
- Abigail M Ross
- Graduate School of Social Service, Fordham University , New York, New York, USA
| | - Lisa De Saxe Zerden
- School of Social Work-Chapel Hill, University of North Carolina , Chapel Hill, North Carolina, USA
| | - Betty J Ruth
- School of Social Work, Boston University , Boston, Massachusetts, USA
| | - Jennifer Zelnick
- Graduate School of Social Work, Touro College , New York, New York, USA
| | - Julie Cederbaum
- Suzanne Dworak-Peck School of Social Work, University of Southern California , Los Angeles, California, USA
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Affiliation(s)
- Jon Glasby
- School of Social Policy, University of Birmingham, Birmingham B15 2TT, UK
- Health Services Management Centre, University of Birmingham
| | - Catherine Needham
- School of Social Policy, University of Birmingham, Birmingham B15 2TT, UK
- Health Services Management Centre, University of Birmingham
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Affiliation(s)
- Vivian J Miller
- Assistant Professor in Social Work, Department of Human Services, Bowling Green State University , Bowling Green, USA
| | - HeeSoon Lee
- Assistant Professor in Social Work, Department of Human Services, Bowling Green State University , Bowling Green, USA
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9
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Wodarski JS. The Multi-factorial Complexity of Social Work Practice and Implications for Interventions. J Evid Based Soc Work (2019) 2020; 17:385-391. [PMID: 32508278 DOI: 10.1080/26408066.2020.1774457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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10
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Affiliation(s)
- Justine Karpusheff
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK.
| | - Charlotte Haynes
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK
| | - Fiona Glen
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK
| | - Gillian Leng
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK
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11
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Bezeczky Z, El-Banna A, Petrou S, Kemp A, Scourfield J, Forrester D, Nurmatov UB. Intensive Family Preservation Services to prevent out-of-home placement of children: A systematic review and meta-analysis. Child Abuse Negl 2020; 102:104394. [PMID: 32018213 DOI: 10.1016/j.chiabu.2020.104394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Intensive Family Preservation Services (IFPS) are in-home crisis intervention services designed to help families with children at imminent risk of out-of-home placement. OBJECTIVES To assess the evidence of the effectiveness and cost-effectiveness of IFPS in reducing the need for children to enter out-of-home care. PARTICIPANTS AND SETTING Children <18 years and their families in the home setting. METHODS A systematic review and meta-analysis was carried out by searching 12 databases and 16 websites for publications up to January 2019. RESULTS 1948 potentially relevant papers were identified, of which 37 papers, relating to 33 studies, met our inclusion criteria. Studies reported outcomes at child or family level. There were significant reductions in relative risk (RR) of out-of-home placements in children who received IFPS compared with controls at child level at three, six, 12 and 24 months' follow-up (RR 0.57, 95 % CI 0.35 to 0.93, RR 0.51, 95 % CI 0.27 to 0.96, RR 0.60, 95 % CI 0.48 to 0.76, RR 0.51, 95 % CI 0.30 to 0.87 respectively). At family level, there was not a significant reduction in RR of placement. Economic evidence was limited to cost analyses or cost-cost offset analyses. CONCLUSION The available evidence, at child level, suggests that IFPS are effective in preventing children from entering care up to 24 months after the intervention. Placement outcomes reported at family level did not demonstrate a significant reduction in out-of-home placements. The economic analyses suggest that IFPS could be cost-saving; however, evidence of cost-effectiveness generated by full economic evaluations is needed.
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Affiliation(s)
- Zoe Bezeczky
- Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, UK
| | | | - Stavros Petrou
- Warwick Clinical Trials Unit, University of Warwick, UK; Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, UK
| | - Alison Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, UK
| | - Jonathan Scourfield
- Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, UK
| | - Donald Forrester
- Children's Social Care Research and Development Centre, School of Social Sciences, Cardiff University, UK
| | - Ulugbek B Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, UK.
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Christophel Lichti JL, Cagle JG. Documenting the contributions of palliative care social work: testing the feasibility and utility of tracking clinical activities using medical records. Soc Work Health Care 2020; 59:257-272. [PMID: 32233841 DOI: 10.1080/00981389.2020.1740378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/16/2020] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
Access to data on quality metrics can better equip palliative care social workers to identify and address gaps in patient care, establish standards and accountability for social work functions on the interdisciplinary team, and evaluate the impact of interventions. The objective of this demonstration project was to create and pilot a data collection format in the patient electronic medical record (Epic) for documentation of social work metrics at each inpatient consultation, and to build corresponding pilot reports relevant to quality improvement goals. The successful implementation and initial pilot reports were reviewed for the feasibility of longer-term applications.
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Affiliation(s)
| | - John G Cagle
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
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Lee YJ. Social Work in Action: The Cognitive Health of Older Adults in Hawai'i: Implications for Social Work. Hawaii J Health Soc Welf 2020; 79:127-129. [PMID: 32328586 PMCID: PMC7175358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Yeonjung Jane Lee
- Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI
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Krein L, Jeon YH, Miller Amberber A. Development of a new tool for the early identification of communication-support needs in people living with dementia: An Australian face-validation study. Health Soc Care Community 2020; 28:544-554. [PMID: 31670440 DOI: 10.1111/hsc.12887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
Language and communication difficulties are common in dementia but limited tools are available for a timely assessment of those individuals who experience these difficulties. The Communication-Support Needs Assessment Tool in Dementia (CoSNAT-D) was developed to assist in (a) the early identification of communication difficulties among people with dementia in the community context; and (b) determining the level of their communication support needs to guide appropriate service access. The CoSNAT-D was developed based on a literature review. The face validity was tested with end-users (people with dementia and support persons of people with dementia) regarding relevance, wording, syntax, appropriateness and comprehensiveness of the items of the tool. Data were collected using semi-structured phone interviews. Seven people with dementia and 15 carers participated in the study. Feedback regarding items' appropriateness was largely positive and minor changes were made to improve comprehensiveness. A new item was added to the original item pool. The interviews highlighted the importance of including people with dementia in the assessment processes and person-centered approaches in this context. The CoSNAT-D presents a first step for the early identification of individual support needs of people living with dementia and communication difficulties who live in the community. Items of the CoSNAT-D have been determined face-valid by end-users. The face-validated version of the tool is currently undergoing further testing to determine additional relevant psychometric properties.
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Affiliation(s)
- Luisa Krein
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
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Cleak H, Kr A, Heaslop G, Tonge A. Challenges to the development of a health care practice model for hospital social work in India. Soc Work Health Care 2020; 59:122-137. [PMID: 32011219 DOI: 10.1080/00981389.2020.1719566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/01/2020] [Accepted: 01/19/2020] [Indexed: 06/10/2023]
Abstract
India has a long history of delivering a western model of social work despite being challenged by unique structural challenges, as well as demographic and social changes impacting the types of presentations to hospitals. This paper reports on a project that explored the professional roles of Indian social workers in hospital settings, and documented some of the critical factors that impede capacity to meet the demands of a changing health care system. Extracted themes from participants identified a lack of role descriptions, professional supervision, and national standards as contributing to a lack of confidence in asserting strong professional identity and contribution to patient care.
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Affiliation(s)
- Helen Cleak
- Public Health & Social Work, Queensland University of Technology, Brisbane, Australia
| | - Anish Kr
- School of Social Work, Rajagiri College of Social Sciences, Cochin, India
| | - Georgina Heaslop
- Social Work Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Angela Tonge
- Social Work Department, Princess Alexandra Hospital, Brisbane, Australia
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Abstract
This article analyses the role of evidence in resolving Court of Protection proceedings, drawing on qualitative data obtained from observations of the Court of Protection, a review of Court of Protection case files and interviews with social workers. It is argued that there is a hierarchy of professional evidence in mental capacity law. Psychiatric evidence is at the top of this hierarchy, whereas social work evidence is viewed as a less persuasive form of knowledge about mental capacity. The article argues that this is because mental capacity law views psychiatric evidence as a form of objective and technical expertise about capacity, whereas social work evidence is viewed as a form of subjective, experiential knowledge. In challenging this hierarchy, it is instead argued that mental capacity law should place greater weight on experiential knowledge emanating from a relationship with the subject of the proceedings, rather than elevating the status of psychiatric evidence about mental capacity.
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Affiliation(s)
- Jaime Lindsey
- Essex Law School, University of Essex, Colchester, UK
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17
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Okeyo I, Lehmann U, Schneider H. The impact of differing frames on early stages of intersectoral collaboration: the case of the First 1000 Days Initiative in the Western Cape Province. Health Res Policy Syst 2020; 18:3. [PMID: 31918724 PMCID: PMC6953299 DOI: 10.1186/s12961-019-0508-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While intersectoral collaboration is considered valuable and important for achieving health outcomes, there are few examples of successes. The literature on intersectoral collaboration suggests that success relies on a shared understanding of what can be achieved collectively and whether stakeholders can agree on mutual goals or acceptable trade-offs. When health systems are faced with negotiating intersectoral responses to complex issues, achieving consensus across sectors can be a challenging and uncertain process. Stakeholders may present divergent framings of the problem based on their disciplinary background, interests and institutional mandates. This raises an important question about how different frames of problems and solutions affect the potential to work across sectors during the initiating phases of the policy process. METHODS In this paper, this question was addressed through an analysis of the case of the First 1000 Days (FTD) Initiative, an intersectoral approach targeting early childhood in the Western Cape Province of South Africa. We conducted a documentary analysis of 34 policy and other documents on FTD (spanning global, national and subnational spheres) using Schmidt's conceptualisation of policy ideas in order to elicit framings of the policy problem and solutions. RESULTS We identified three main frames, associated with different sectoral positionings - a biomedical frame, a nurturing care frame and a socioeconomic frame. Anchored in these different frames, ideas of the problem (definition) and appropriate policy solutions engaged with FTD and the task of intersectoral collaboration at different levels, with a variety of (sometimes cross) purposes. CONCLUSIONS The paper concludes on the importance of principled engagement processes at the beginning of collaborative processes to ensure that different framings are revealed, reflected upon and negotiated in order to arrive at a joint determination of common goals.
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Affiliation(s)
- Ida Okeyo
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535 Republic of South Africa
| | - Uta Lehmann
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535 Republic of South Africa
| | - Helen Schneider
- School of Public Health and UWC/SAMRC Health Services to Systems Research Unit, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535 Republic of South Africa
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Bould E, Bigby C, Iacono T, Beadle-Brown J. Factors associated with increases over time in the quality of Active Support in supported accommodation services for people with intellectual disabilities: A multi-level model. Res Dev Disabil 2019; 94:103477. [PMID: 31494354 DOI: 10.1016/j.ridd.2019.103477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Disability support organisations have embraced Active Support, but it has proved difficult to embed in services. AIMS This study aimed to identify the factors associated with increases over time in the quality of Active Support. METHOD Data were collected on the predicted variable of the quality of Active Support, and predictor variables of service user, staff and service characteristics, including practice leadership, and composition and size of services from 51 services in 8 organisations over 2-7 time points. Data were analysed using multi-level modelling. RESULTS There was significant linear change in Active Support scores (group mean centered at the organisational level) over time. Individuals with lower support needs received better Active Support and those with higher support needs experienced greater increases over time. Stronger practice leadership and more staff with training in Active Support were significant predictors of the quality of Active Support. Larger services with seven or more individuals and where there was a very heterogeneous mix of individuals were associated with lower quality of support. CONCLUSIONS Ensuring strong practice leadership, and staff training in Active Support that emphasises the principle of adapting support to each individual's level of ability and preferences are key to delivering high levels of Active Support.
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Affiliation(s)
- Emma Bould
- Living with Disability Research Centre, La Trobe University, Australia; Department of Occupational Therapy, Monash University, Australia
| | - Christine Bigby
- Living with Disability Research Centre, La Trobe University, Australia.
| | - Teresa Iacono
- Living with Disability Research Centre, La Trobe University, Australia
| | - Julie Beadle-Brown
- Living with Disability Research Centre, La Trobe University, Australia; Tizard Centre, University of Kent, United Kingdom
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19
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Keeble E, Bardsley M, Durand MA, Hoomans T, Mays N. Area level impacts on emergency hospital admissions of the integrated care and support pioneer programme in England: difference-in-differences analysis. BMJ Open 2019; 9:e026509. [PMID: 31427314 PMCID: PMC6701574 DOI: 10.1136/bmjopen-2018-026509] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To examine whether any differential change in emergency admissions could be attributed to integrated care by comparing pioneer and non-pioneer populations from a pre-pioneer baseline period (April 2010 to March 2013) over two follow-up periods: to 2014/2015 and to 2015/2016. DESIGN Difference-in-differences analysis of emergency hospital admissions from English Hospital Episode Statistics. SETTING Local authorities in England classified as either pioneer or non-pioneer. PARTICIPANTS Emergency admissions to all NHS hospitals in England with local authority determined by area of residence of the patient. INTERVENTION Wave 1 of the integrated care and support pioneer programme announced in November 2013. PRIMARY OUTCOME MEASURE Change in hospital emergency admissions. RESULTS The increase in the pioneer emergency admission rate from baseline to 2014/2015 was smaller at 1.93% and significantly different from that of the non-pioneers at 4.84% (p=0.0379). The increase in the pioneer emergency admission rate from baseline to 2015/2016 was again smaller than for the non-pioneers but the difference was not statistically significant (p=0.1879). CONCLUSIONS It is ambitious to expect unequivocal changes in a high level and indirect indicator of health and social care integration such as emergency hospital admissions to arise as a result of the changes in local health and social care provision across organisations brought about by the pioneers in their early years. We should treat any sign that the pioneers have had such an impact with caution. Nevertheless, there does seem to be an indication from the current analysis that there were some changes in hospital use associated with the first year of pioneer status that are worthy of further exploration.
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Affiliation(s)
| | | | - Mary Alison Durand
- Policy Innovation and Evaluation Research Unit, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ties Hoomans
- Policy Innovation and Evaluation Research Unit, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicholas Mays
- Policy Innovation and Evaluation Research Unit, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Dobrof J, Bussey S, Muzina K. Thriving in today's health care environment: strategies for social work leadership in population health. Soc Work Health Care 2019; 58:527-546. [PMID: 31002293 DOI: 10.1080/00981389.2019.1602099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
The current healthcare environment challenges social workers to balance multiple constituencies - organizational, payer-related, and professional - and convey the value-added nature of clinical work with patients and families. As healthcare systems move towards population health, leadership opportunities abound. This article provides an historical overview of healthcare transformation and its impact on social work practice, and describes strategies implemented to bolster the clinical focus and organizational responsiveness of Mount Sinai Health System care management staff. The training and supervisory approaches offered make possible relatable and synergistic connections between clinical practice and organizational imperatives to decrease unnecessary utilization and healthcare costs.
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Affiliation(s)
- Judith Dobrof
- a Mount Sinai Health Partners , Mount Sinai Health System , New York , NY , USA
| | - Sarah Bussey
- a Mount Sinai Health Partners , Mount Sinai Health System , New York , NY , USA
| | - Kristin Muzina
- a Mount Sinai Health Partners , Mount Sinai Health System , New York , NY , USA
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Gehlert S, Andrews C, Browne T. Establishing the Place of Health Social Work. Health Soc Work 2019; 44:69-71. [PMID: 30900724 DOI: 10.1093/hsw/hlz011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Sarah Gehlert
- Sarah Gehlert, PhD, MSW, MA, is dean; Christina Andrews, PhD, MSW, is assistant professor; and Teri Browne, PhD, MSW, NSW-C, is associate professor, College of Social Work, University of South Carolina, Columbia
| | - Christina Andrews
- Sarah Gehlert, PhD, MSW, MA, is dean; Christina Andrews, PhD, MSW, is assistant professor; and Teri Browne, PhD, MSW, NSW-C, is associate professor, College of Social Work, University of South Carolina, Columbia
| | - Teri Browne
- Sarah Gehlert, PhD, MSW, MA, is dean; Christina Andrews, PhD, MSW, is assistant professor; and Teri Browne, PhD, MSW, NSW-C, is associate professor, College of Social Work, University of South Carolina, Columbia
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Daniel F, Monteiro R, Ferreira J, Galhardo A. The Portuguese Version of the Hartford Geriatric Social Work Competency Scale II - Assessment Subscale: Factor Structure and Psychometric Properties. J Gerontol Soc Work 2019; 62:349-362. [PMID: 30732546 DOI: 10.1080/01634372.2019.1575132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
The current study aimed to test the fit of the Portuguese version of the Hartford Geriatric Social Work Competency Scale II - Assessment subscale (GSWCS-A) and explore its factor structure and psychometric properties in a sample of 534 social workers working in the gerontology field. Confirmatory factor analysis showed that all items presented good factor loadings and that the single-component model fit the data well. The GSWCS-A showed very good internal consistency. Despite the existence of different theoretical perspectives on Social Work, which frame the required competencies for professional practice, the GSWCS-A Portuguese version revealed similitudes with studies conducted in other countries. Nevertheless, the different factor structures (single-component vs. bi-factorial) may indicate that different competencies are being emphasised in terms of professional training. To sum, the GSWCS-A may be a short and useful self-report instrument for addressing social workers' assessment competencies in the gerontology setting.
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Affiliation(s)
- Fernanda Daniel
- a Instituto Superior Miguel Torga , Coimbra , Portugal
- b CEISUC- Center for Health Studies and Research of the University of Coimbra , (FEUC) Faculty of Economics of the University of Coimbra , Coimbra , Portugal
| | - Rosa Monteiro
- a Instituto Superior Miguel Torga , Coimbra , Portugal
- c CES - Centre for Social Studies of the University of Coimbra , Coimbra , Portugal
| | - Jorge Ferreira
- d ISCTE - Instituto Universitário de Lisboa , Lisboa , Portugal
- e CIES-IUL - Centre for Research and Studies in Sociology , Lisboa , Portugal
| | - Ana Galhardo
- a Instituto Superior Miguel Torga , Coimbra , Portugal
- f Faculty of Psychology and Educational Sciences of the University of Coimbra , CINEICC - Center for Research in Neuropsychology and Cognitive and Behavioral Intervention , Coimbra , Portugal
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Bach-Mortensen AM, Montgomery P. Does sector matter for the quality of care services? A secondary analysis of social care services regulated by the Care Inspectorate in Scotland. BMJ Open 2019; 9:e022975. [PMID: 30772845 PMCID: PMC6398786 DOI: 10.1136/bmjopen-2018-022975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Social services are increasingly commissioned to third and for-profit sector providers, but little is known about whether and how these changes influence quality indicators. We assessed quality-related outcomes across for-profit, public and third sector organisations delivering social care services. DESIGN A secondary analysis was conducted on publically available data collected by the independent regulator of social care organisations in Scotland. All outcomes are reported as predicted probabilities derived from multivariate logistic regression coefficients. Generalised ordered logit models are utilised for the quality domains and the risk assessment score and logistic regression for whether complaints or requirements were issued to organisations. SETTING Organisations inspected by the Care Inspectorate in Scotland. POPULATION 13 310 social care organisations (eg, nursing homes and day care organisations). PRIMARY OUTCOMES The quality and risk domains collected by the Care Inspectorate and complaints and requirements issued to organisations within the last 3 years. RESULTS Controlling for multiple factors, we find that public and third sector providers performed consistently and statistically significantly better than for-profit organisations on most outcomes. For example, for-profit services were the most likely to be rated as high and medium risk (6.9% and 13.2%, respectively), and the least likely to be classified as low risk (79.9%). Public providers had the highest probability of being categorised as low risk (91.1%), and the lowest probability of having their services classified as medium (6.9%) and high risk (2%), followed by third sector providers (86%, 8.5% and 4.5%, respectively). Public providers performed better than third sector providers in some outcomes, but differences were relatively low and inconsistent. CONCLUSION Public and third sector providers were rated considerably higher than their for-profit counterparts on most observed outcomes. Regulators might use this information to consider how social care providers across sector are incentivised to manage their resources.
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Affiliation(s)
| | - Paul Montgomery
- Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, UK
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Wladkowski SP, Wallace CL. Current Practices of Live Discharge from Hospice: Social Work Perspectives. Health Soc Work 2019; 44:30-38. [PMID: 30561640 DOI: 10.1093/hsw/hly040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 03/13/2018] [Indexed: 06/09/2023]
Abstract
Hospice provides holistic support for individuals living with terminal illness and to their caregivers during the bereavement period. However, some individuals who enroll in hospice services are decertified as they do not experience a decline in health as quickly as required by current regulations, a practice referred to as a live discharge. The interruption in care can affect the physical and psychosocial care needs for individuals and caregivers and leave hospice clinicians with questions about how to best support them. However, there are no formal guidelines to support this process. This qualitative study (N = 24) explored the current practices of hospice social workers across the United States engaged in the live discharge process. Results from this study emphasize the need to bridge the gaps between policy and practice. Specifically, results highlight the challenges hospice social workers face to replicate or supplement the holistic support and unique services hospice provides for individuals discharged alive, and suggest further research to develop live discharge guidelines to identify appropriate support for patients and their caregivers who no longer meet hospice eligibility requirements.
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Affiliation(s)
- Stephanie P Wladkowski
- Stephanie P. Wladkowski, PhD, LMSW, is assistant professor, School of Social Work, Eastern Michigan University, 317 Marshall Hall, Ypsilanti, MI 48197; e-mail: . Cara L. Wallace, PhD, LMSW, is assistant professor, School of Social Work, Saint Louis University
| | - Cara L Wallace
- Stephanie P. Wladkowski, PhD, LMSW, is assistant professor, School of Social Work, Eastern Michigan University, 317 Marshall Hall, Ypsilanti, MI 48197; e-mail: . Cara L. Wallace, PhD, LMSW, is assistant professor, School of Social Work, Saint Louis University
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25
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Hoffmann L, Buchenauer L, Schumann N, Schröder SL, Martin O, Richter M. Improving Rehabilitative Care of Methamphetamine Users in Germany: The Expert's Perspective. Qual Health Res 2019; 29:248-259. [PMID: 30129874 DOI: 10.1177/1049732318792504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Methamphetamine is one of the most frequently used drugs worldwide. In Germany, methamphetamine use has greatly increased in recent years, presenting the rehabilitative treatment system with new challenges. In this study, we identified deficits and possibilities for optimization in the field of medical rehabilitation. A total of 39 interviews and two focus groups with experts along the treatment course of methamphetamine users were conducted. Our analyses indicate that methamphetamine users are more difficult to treat compared with patients who consume other drugs. They are more likely to be associated with problematic characteristics and behaviors than other rehabilitants. Several health care deficits were revealed: too short rehabilitation treatment, no specific or differentiated therapy concepts, lack of capacity for education and vocational training, lack of outpatient options, and insufficient facilities for parents and children. Findings indicate that inadequate rehabilitation is being provided for methamphetamine users in Germany, indicating a need to adapt treatment for this group.
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Affiliation(s)
- Laura Hoffmann
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Lisa Buchenauer
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Nadine Schumann
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | | | - Olaf Martin
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Richter
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
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Renner I, Saint V, Neumann A, Ukhova D, Horstmann S, Boettinger U, Dreibus M, Kerl-Wienecke A, Wulff P, Mechthild P, Thaiss H. Improving psychosocial services for vulnerable families with young children: strengthening links between health and social services in Germany. BMJ 2018; 363:k4786. [PMID: 30530840 PMCID: PMC6282766 DOI: 10.1136/bmj.k4786] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ilona Renner
- National Centre for Early Prevention, Federal Centre for Health Education, Koeln, Germany
| | | | - Anna Neumann
- National Centre for Early Prevention, Federal Centre for Health Education, Koeln, Germany
| | | | | | | | - Martina Dreibus
- Early Childhood Intervention, Federal State Rhineland Palatinate, Germany
| | | | - Pilar Wulff
- Early Childhood Intervention, Dortmund, Germany
| | - Paul Mechthild
- National Centre for Early Prevention, Federal Centre for Health Education, Koeln, Germany
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Glajchen M, Berkman C, Otis-Green S, Stein GL, Sedgwick T, Bern-Klug M, Christ G, Csikai E, Downes D, Gerbino S, Head B, Parker-Oliver D, Waldrop D, Portenoy RK. Defining Core Competencies for Generalist-Level Palliative Social Work. J Pain Symptom Manage 2018; 56:886-892. [PMID: 30201485 DOI: 10.1016/j.jpainsymman.2018.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/03/2018] [Indexed: 11/21/2022]
Abstract
CONTEXT Care provided to seriously ill patients by frontline social workers is a component of generalist-level palliative care. The core competencies for high-quality generalist-level palliative social work are necessary to promote training curricula and best practices but have not yet been defined in the U.S. OBJECTIVE The objective of this study was to develop consensus-derived core competencies for generalist-level palliative social work. METHODS Fifty-five proposed social work competencies were categorized by the eight domains of palliative care identified by the National Consensus Project for Quality Palliative Care. The competencies were rated by 41 regionally dispersed, Master's level social workers selected through purposive and snowball sampling using a Delphi method. Each was rated as essential for generalist-level palliative social work, acceptable with modifications, or rejected based on the judgment that it was not essential for generalist-level palliative social work or was outside the scope of practice. Consensus was defined as >70% agreement to accept or reject a competency. Three review rounds were needed to achieve consensus on all competencies. RESULTS Two competencies were added to the original list. Of the 57 proposed competencies, 41 were accepted (19 after modification) and 16 were rejected. Competencies in the social, spiritual, cultural, and ethical/legal aspects of care domains were relatively more likely to be accepted compared with those in structure and processes of care, physical care, psychological care, and care of patient at the end of life. CONCLUSION The 41 consensus-derived competencies for generalist-level palliative social work may inform the development of training curricula and standards for high-quality care.
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Affiliation(s)
- Myra Glajchen
- MJHS Institute for Innovation in Palliative Care, New York, New York.
| | - Cathy Berkman
- Fordham University Graduate School of Social Service, New York, New York
| | | | - Gary L Stein
- Wurzweiler School of Social Work at Yeshiva University, New York, New York
| | - Tom Sedgwick
- New York University Langone Medical Center, New York, New York
| | | | - Grace Christ
- Columbia University School of Social Work, New York, New York
| | - Ellen Csikai
- University of Alabama School of Social Work, Tuscaloosa, Alabama
| | | | - Susan Gerbino
- New York University Silver School of Social Work, New York, New York
| | - Barbara Head
- University of Louisville School of Medicine and Kent School of Social Work, Louisville, Kentucky
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Wyllie A, Saunders BJ. 'Everyone has an agenda': Professionals' understanding and negotiation of risk within the Guardianship system of Victoria, Australia. Health Soc Care Community 2018; 26:581-589. [PMID: 29457304 DOI: 10.1111/hsc.12551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
It is frequently asserted that pressures to assess and manage risk have eroded the therapeutic, rights-based foundation of the human services profession. Some argue that human service workers operate in a culture of fear in which self-protection and blame avoidance, rather than clients' needs, primarily drive decision-making. In the field of Adult Guardianship, it has been suggested that organisational risk avoidance may be motivating applications for substitute decision-makers, unnecessarily curtailing clients' rights and freedoms. However, the absence of research examining the operation of risk within Guardianship decision-making inhibits verifying and responding to this very serious suggestion. This article draws on semi-structured interviews conducted with 10 professionals involved in the Victorian Guardianship system, which explored how issues of risk are perceived and negotiated in everyday practice. Risk was found to be a complex and subjective construct which can present both dangers and opportunities for Guardianship practitioners and their clients. While a number of participants reported that Guardianship might sometimes operate as an avenue for mitigating the fear and uncertainty of risk, most participants also valued positive risk-taking and were willing, in their clients' interests, to challenge conservative logics of risk. These findings highlight the need for further research which examines how service providers and policy makers can create spaces that support open discussions around issues of risk and address practitioners' sense of fear and vulnerability.
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Affiliation(s)
- Aaron Wyllie
- Department of Social Work, Faculty of Medicine, Nursing and Health Sciences, Monash University, Caulfield East, VIC, Australia
| | - Bernadette J Saunders
- Department of Social Work, Faculty of Medicine, Nursing and Health Sciences, Monash University, Caulfield East, VIC, Australia
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Klinga C, Hasson H, Andreen Sachs M, Hansson J. Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care. BMC Health Serv Res 2018; 18:400. [PMID: 29866114 PMCID: PMC5987399 DOI: 10.1186/s12913-018-3061-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 03/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Change initiatives face many challenges, and only a few lead to long-term sustainability. One area in which the challenge of achieving long-term sustainability is particularly noticeable is integrated health and social care. Service integration is crucial for a wide range of patients including people with complex mental health and social care needs. However, previous research has focused on the initiation, resistance and implementation of change, while longitudinal studies remain sparse. The objective of this study was therefore to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy. METHODS A retrospective and qualitative case-study research design was used, and data from the model organisation's steering-committee minutes covering 1995-2015 were gathered and analysed. The analysis generated a narrative case description, which was mirrored to the key elements of the Dynamic Sustainability Framework (DSF). RESULTS The development of inter-sectoral cooperation was characterized by a participatory approach in which a shared structure was created to support cooperation and on-going quality improvement and learning based on the needs of the service user. A key management principle was cooperation, not only on all organisational levels, but also with service users, stakeholder associations and other partner organisations. It was shown that all these parts were interrelated and collectively contributed to the creation of a structure and a culture which supported the development of a dynamic sustainable health and social care. CONCLUSION This study provides valuable insights into the dynamics of organizational sustainability and understanding of key managerial actions taken to establish, develop and support integration of health and social care for people with complex mental health needs. The service user involvement and regular reviews of service users' needs were essential in order to tailor services to the needs. Another major finding was the importance of continuously adapting the content of the change to suit its context. Hence, continuous refinement of the change content was found to be more important than designing the change at the pre-implementation stage.
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Affiliation(s)
- Charlotte Klinga
- Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre (MMC) | Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre (MMC) | Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magna Andreen Sachs
- Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre (MMC) | Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Johan Hansson
- Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre (MMC) | Karolinska Institutet, 171 77 Stockholm, Sweden
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Abstract
Age-friendly community initiatives (AFCIs) foster efforts across stakeholders to make localities more supportive and inclusive of older adults, and potentially better for residents of all ages. This study drew on in-depth interviews with leaders of nine newly forming AFCIs in northern New Jersey to develop an empirically based logic model for the initiatives in the early planning phase. The results obtained from a conventional content analysis indicated three main activities in the early planning phase: assessing the community; meeting; and communicating with stakeholders; and facilitating communitywide communications. These activities worked toward two outputs: increased understanding of aging in the community and more engaged stakeholders in aging. Participants described leveraging the contributions of lead staff, consultants, elected officials, organizational partners, volunteers, interns, funders, and other AFCIs to engage in their focal activities. Based on these findings, a logic model for AFCIs in the early planning phase is presented. AFCI leaders can draw on this model to evaluate AFCI processes and outcomes in their formative stages, as well as to strategically plan for the start of an AFCI within a given locality. Findings also suggest important directions for future research on the development of AFCIs and the community changes that they seek to influence.
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Affiliation(s)
- Emily A Greenfield
- a School of Social Work Rutgers , The State University of New Jersey , USA
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31
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Prieto Seva AJ. [A proposal for improving social and health care: The application of an integral and integrated model]. Rev Esp Geriatr Gerontol 2018; 53:112-113. [PMID: 29217328 DOI: 10.1016/j.regg.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 07/06/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Alvaro José Prieto Seva
- Servicio de Coordinación de los Servicios Sociales y Autonomía Personal, Dirección Territorial de Alicante, Consellería de Igualdad y Políticas Inclusivas, Alicante, España.
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Roy M, Pinsonneault L, Clapperton I, Siga ML, Breton M. [Evaluation of implementation of a local consultation model in health and social services]. Sante Publique 2018; 30:203-212. [PMID: 30148308 DOI: 10.3917/spub.182.0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To adapt the supply of services to the needs of the community, a local health authority has developed a consultative model in health and social services. This approach, based on shared governance and various health promotion strategies, identifies targets, develops actions, and measures the effects of these actions. This study evaluates the implementation of this consultative model from three dimensions : describe (1) implementation of the model, (2) how user experience was taken into account to prioritize and draw up action plans, (3) favourable and unfavourable implementation conditions. METHODS A qualitative methodology based on four data sources was used (i.e. individual interviews, focus groups, observations, analysis of reports). Content analysis was conducted on the individual interviews and focus groups. The observations and analysis of reports contributed to enhance the evaluation process. RESULTS Valorisation of experienced-based knowledge, citizen participation, shared leadership, support from institutions or stakeholders, and the dynamism of discussion tables were favourable to implementation. Time, language, cumbersome procedures, staff instability, the recent reform of the Quebec network and inherent elements of discussion tables were unfavourable conditions. CONCLUSION The model allows actions adapted to health and social needs of a local population and increases the sense of belonging to a community. Further efforts are required to preserve the relevance, flexibility, and dynamism of this model in a context of restructuring of the Quebec health and social services network.
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Norwood DL, Kurz B. Measuring intention to refer: Older adults and social service agencies. J Gerontol Soc Work 2018; 61:221-240. [PMID: 29388886 DOI: 10.1080/01634372.2018.1435599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The public is encouraged to engage in socially responsible behaviors such as helping people get needed services, possibly by referring them. However, referral behavior is little researched. Informed by the theory of planned behavior, intent to refer older adults in need to the Connecticut's Gatekeeper Program (GP) which identifies elders at risk and connects them with community resources was studied and the Social Service Agency Referral Scale (SSARS) was developed. Senior center attendees, seniors who received GP training, and referrers to the state's GP were involved. SSARS and its subscales were internally consistent (Cronbach's α = .90, with α ≥ .733 for each subscale). SSARS was strongly correlated with a validated social responsibility scale (r = .48). Knowledge gained from the training enhanced the associated intention subscale. With little modification, SSARS could be used to elucidate similar efforts. Additionally, the process used to create SSARS could be replicated to develop related instruments.
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Affiliation(s)
- Dwight L Norwood
- a School of Social Work , University of Connecticut , Hartford , USA
| | - Brenda Kurz
- a School of Social Work , University of Connecticut , Hartford , USA
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Rand S, Malley J, Towers AM, Netten A, Forder J. Validity and test-retest reliability of the self-completion adult social care outcomes toolkit (ASCOT-SCT4) with adults with long-term physical, sensory and mental health conditions in England. Health Qual Life Outcomes 2017; 15:163. [PMID: 28821303 PMCID: PMC5562982 DOI: 10.1186/s12955-017-0739-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 08/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Adult Social Care Outcomes Toolkit (ASCOT-SCT4) is a multi-attribute utility index designed for the evaluation of long-term social care services. The measure comprises eight attributes that capture aspects of social care-related quality of life. The instrument has previously been validated with a sample of older adults who used home care services in England. This paper aims to demonstrate the instrument's test-retest reliability and provide evidence for its validity in a diverse sample of adults who use publicly-funded, community-based social care in England. METHODS A survey of 770 social care service users was conducted in England. A subsample of 100 services users participated in a follow-up interview between 7 and 21 days after baseline. Spearman rank correlation coefficients between the ASCOT-SCT4 index score and the EQ-5D-3 L, the ICECAP-A or ICECAP-O and overall quality of life were used to assess convergent validity. Data on variables hypothesised to be related to the ASCOT-SCT4 index score, as well as rating of individual attributes, were also collected. Hypothesised relationships were tested using one-way ANOVA or Fisher's exact test. Test-retest reliability was assessed using the intra-class correlation coefficient for the ASCOT-SCT4 index score at baseline and follow-up. RESULTS There were moderate to strong correlations between the ASCOT-SCT4 index and EQ-5D-3 L, the ICECAP-A or ICECAP-O, and overall quality of life (all correlations ≥ 0.3). The construct validity was further supported by statistically significant hypothesised relationships between the ASCOT-SCT4 index and individual characteristics in univariate and multivariate analysis. There was also further evidence for the construct validity for the revised Food and drink and Dignity items. The test-retest reliability was considered to be good (ICC = 0.783; 95% CI: 0.678-0.857). CONCLUSIONS The ASCOT-SCT4 index has good test-retest reliability for adults with physical or sensory disabilities who use social care services. The index score and the attributes appear to be valid for adults receiving social care for support reasons connected to underlying mental health problems, and physical or sensory disabilities. Further reliability testing with a wider sample of social care users is warranted, as is further exploration of the relationship between the ASCOT-SCT4, ICECAP-A/O and EQ-5D-3 L indices.
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Affiliation(s)
- Stacey Rand
- Quality and Outcomes of person-centred care policy Research Unit (QORU) and Personal Social Services Research Unit (PSSRU), Cornwallis Building, University of Kent, Canterbury, CT2 7NF UK
| | - Juliette Malley
- Quality and Outcomes of person-centred care policy Research Unit (QORU) and Personal Social Services Research Unit (PSSRU), Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE UK
| | - Ann-Marie Towers
- Quality and Outcomes of person-centred care policy Research Unit (QORU) and Personal Social Services Research Unit (PSSRU), Cornwallis Building, University of Kent, Canterbury, CT2 7NF UK
| | - Ann Netten
- Quality and Outcomes of person-centred care policy Research Unit (QORU) and Personal Social Services Research Unit (PSSRU), Cornwallis Building, University of Kent, Canterbury, CT2 7NF UK
| | - Julien Forder
- Quality and Outcomes of person-centred care policy Research Unit (QORU) and Personal Social Services Research Unit (PSSRU), Cornwallis Building, University of Kent, Canterbury, CT2 7NF UK
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Abstract
There is growing attention to the training and education of Personal Support Workers, or PSWs, who work in community, home and long-term care settings supporting older people and people with disabilities. In Ontario, Canada, amid a volatile policy landscape, the provincial government launched an effort to standardise PSW education. Using qualitative methods, this study considered the question: What are the central educational issues reflected by students, working PSWs and key informants, and are they addressed by the PSW programme and training standards? Phase one was a public domain analysis completed between January and March 2014 and updated for major developments after that period. Phase two, completed between August 2014 and March 2015, included 15 key informant interviews and focus group discussions and mini-phone interviews with 35 working PSWs and current PSW students. According to the participants, the central educational issues are: casualisation of labour that is not conveyed in educational recruitment efforts, disconnect between theory and working conditions, overemphasis on long-term care as a career path, and variability of PSW education options. While the standards should help to address the final issue, they do not address the other key issues raised, which have to do with the structural organisation of work. There is thus a disconnect between the experiences of students, PSWs and key informants and the policy decisions surrounding this sector. This is particularly significant as education is often touted as a panacea for issues in long-term and community care. In fact, the curriculum of some of the PSW programmes, especially those in public college settings, is robust. Yet, the underlying issues will remain barring a structural overhaul of the organisation of long-term and community care sectors founded on a social revaluing of older people and the gendered work of care.
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Affiliation(s)
- Christine Kelly
- Community Health Sciences, University of Manitoba, Canada, Winnipeg, Manitoba, Canada
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36
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Abstract
Person-centered care (PCC) has emerged over the last several decades as the benchmark for providing quality care for diverse populations, including older adults with multiple chronic conditions that affect daily life. This article critiques current conceptualizations of PCC, including the social work competencies recently developed by the Council on Social Work Education, finding that they do not fully incorporate certain key elements that would make them authentically person-centered. In addition to integrating traditional social work values and practice, social work's PCC should be grounded in the principles of classical Rogerian person-centered counseling and an expanded conceptualization of personhood that incorporates Kitwood's concepts for working with persons with dementia. Critically important in such a model of care is the relationship between the caring professional and the care recipient. This article recommends new social work competencies that incorporate both the relationship-building attitudes and skills needed to provide PCC that is authentically person-centered.
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Affiliation(s)
- Allyson M Washburn
- a Department of Psychology , National University , San Diego , California , USA
| | - Melanie Grossman
- a Department of Psychology , National University , San Diego , California , USA
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Dickson K, Sutcliffe K, Rees R, Thomas J. Gaps in the evidence on improving social care outcomes: findings from a meta-review of systematic reviews. Health Soc Care Community 2017; 25:1287-1303. [PMID: 26500053 PMCID: PMC5484323 DOI: 10.1111/hsc.12300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 06/05/2023]
Abstract
Adult social care continues to be a central policy concern in the UK. The Adult Social Care Outcomes Framework (ASCOF) is a range of measures nationally available to drive forward improvement on outcomes and quality in local councils. While there is an emphasis on improving transparency, quality and outcomes, drawing on research evidence to achieve these aims is often difficult because the evidence is not easily identifiable, is disparate or of variable quality. We conducted a meta-review to analyse and summarise systematic review-level evidence on the impact of interventions on the four outcomes set out in the ASCOF: quality of life, delaying and reducing the need for services, satisfaction with services and safeguarding of vulnerable adults. This paper focuses on the availability of review-level evidence and the presence of significant gaps in this evidence base. A range of health and social care databases were searched, including MEDLINE, ASSIA and The Cochrane Library in January and February 2012. All systematic reviews evaluating the efficacy of social care interventions for improving ASCOF outcomes for older people, people with long-term conditions, mental health problems or physical and/or learning disabilities were eligible. Two reviewers independently screened systematic reviews for quality and relevance and extracted data; 43 systematic reviews were included, the majority of which examined the impact of interventions on quality of life (n = 34) and delaying and reducing the need for support (n = 25). Limited systematic review-level evidence was found regarding satisfaction with services and safeguarding. There were also significant gaps in relation to key social care interventions and population groups. Research priorities include addressing these gaps and the collation of data on interventions, outcomes and populations more closely related to social care. Overall, a more relevant, comprehensive and robust evidence base is required to support improvement of outcomes for recipients of adult social care.
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Affiliation(s)
- Kelly Dickson
- Evidence for Policy and Practice Information and Co‐ordinating Centre (EPPI‐Centre)Social Science Research UnitUCL Institute of EducationLondonUK
| | - Katy Sutcliffe
- Evidence for Policy and Practice Information and Co‐ordinating Centre (EPPI‐Centre)Social Science Research UnitUCL Institute of EducationLondonUK
| | - Rebecca Rees
- Evidence for Policy and Practice Information and Co‐ordinating Centre (EPPI‐Centre)Social Science Research UnitUCL Institute of EducationLondonUK
| | - James Thomas
- Evidence for Policy and Practice Information and Co‐ordinating Centre (EPPI‐Centre)Social Science Research UnitUCL Institute of EducationLondonUK
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Demissie Z, Brener N. Demographic Differences in District-Level Policies Related to School Mental Health and Social Services-United States, 2012. J Sch Health 2017; 87:227-235. [PMID: 28260247 PMCID: PMC10947547 DOI: 10.1111/josh.12489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 05/03/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. METHODS The School Health Policies and Practices Study (SHPPS) 2012 collected cross-sectional data on school health policies and practices from a nationally representative sample of public school districts (N = 684). We used logistic regression to examine the association between district-level demographic characteristics and school mental health policies. RESULTS Southern and low-affluence districts had higher odds of requiring schools to have a specified counselor-to-student ratio as compared with Northeastern and average affluence districts, respectively. Northeastern and urban districts had higher odds of requiring educational and credentialing requirements for school mental health or social services staff, compared to other regions and rural districts, respectively. CONCLUSIONS Results describe the extent to which school mental health and social services programs in the United States are meeting various guidelines. More work is necessary to ensure that all schools have the resources needed to support their students' mental health and meet national guidelines, especially in districts with certain characteristics.
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Affiliation(s)
- Zewditu Demissie
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, 1600 Clifton Rd. NE, Mailstop E-75, Atlanta, GA 30329
| | - Nancy Brener
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, 1600 Clifton Rd. NE, Mailstop E-75, Atlanta, GA 30329
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Iudici A, Gagliardo Corsi A. Evaluation in the field of social services for minors: Measuring the efficacy of interventions in the Italian service for health protection and promotion. Eval Program Plann 2017; 61:160-168. [PMID: 28107694 DOI: 10.1016/j.evalprogplan.2016.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 11/24/2016] [Accepted: 11/27/2016] [Indexed: 06/06/2023]
Abstract
This article presents the availment of a new Methodology for the efficacy evaluation of interventions in the field of social science: the Method of Computerized Textual Data Analysis (M.A.D.I.T.). In the beginning, we present some elements of the international and Italian legislation referred to the efficacy evaluation and about the child protection. Subsequently this work describes the process of efficacy evaluation of an intervention of minor protection delivered by a public Italian Service, the Minor and Family Service, MiFa. The MADIT Methodology is applied to the efficacy evaluation and it is interested in discursive repertoires, defined as "a linguistically intended mode of construction of finite reality". The aim of the research is to show, through the description of every step of the implementation of the Methodology based on text analysis, how is possible to notice if there are progress in the direction of the objective of intervention of child protection. The results describes how from a starting situation of "first appearance of psychiatric career" referred to the minor, the work of the psychologist of the Service MiFa has enabled to produce a shifting in the direction of objective of the intervention, that was "developing the competence of the minor to identify objectives". Through this work, we show how a rigorous methodology for assessing effectiveness may contribute to improve the quality of service of Minor Protection and may also be suitable for new fields of social science.
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Affiliation(s)
- Antonio Iudici
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Via Venezia 8, Padova, Italy.
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40
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Macy RJ, Martin SL, Nwabuzor Ogbonnaya I, Rizo CF. What Do Domestic Violence and Sexual Assault Service Providers Need to Know About Survivors to Deliver Services? Violence Against Women 2016; 24:28-44. [PMID: 27777332 DOI: 10.1177/1077801216671222] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using survey data, we investigate perspectives of 80 program directors of domestic violence and/or sexual assault agencies regarding whether gathering specific information at intake is helpful in determining survivors' needs for five service areas: legal advocacy, medical advocacy, support group, counseling, and shelter. We explore whether directors' opinions of information-type usefulness differ by type of service agency (single- or dual-focus). Findings show directors perceive the information most helpful to early service provision includes survivors' goals, experiences of violence and trauma, and health status. MANOVA results show no significant differences among directors from single- or dual-focus agencies.
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Affiliation(s)
- Rebecca J Macy
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sandra L Martin
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Cynthia F Rizo
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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41
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Abstract
This study investigated the factor structure of an instrument to measure preparedness perception among Florida licensed clinical social workers for work with elders’ end-of-life care. In a principle component analysis with varimax rotation, three factors were identified with eigenvalues greater than 1.0 and a cumulative variance of 66.982 percent. These factors include: 1) knowledge of end-of-life care, 2) knowledge of resources for elders, and 3) attitude toward elder assisted suicide. The development of this type of instrument may be useful for future research and for determining future educational needs of social workers and other professionals.
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Affiliation(s)
- Michael N Kane
- School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
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42
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Canny A, Robertson F, Knight P, Redpath A, Witham MD. An evaluation of the psychometric properties of the Indicator of Relative Need (IoRN) instrument. BMC Geriatr 2016; 16:147. [PMID: 27469006 PMCID: PMC4965886 DOI: 10.1186/s12877-016-0321-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/21/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Indicator of Relative Need (IoRN) instrument is designed for both health and social care services to measure function and dependency in older people. To date, the tool has not undergone assessment of validity. We report two studies aimed to evaluate psychometric properties of the IoRN. METHODS The first study recruited patients receiving social care at discharge from hospital, those rehabilitating in intermediate care, and those in a rehabilitation at home service. Participants were assessed using the IoRN by a single researcher and by the clinical team at baseline and 8 weeks. Comparator instruments (Barthel ADL, Nottingham Extended ADL and Townsend Disability Scale) were also administered. Overall change in ability was assessed with a 7 point Likert scale at 8 weeks. The second study analysed linked routinely collected, health and social care data (including IoRN scores) to assess the relationship between IoRN category and death, hospitalisation and care home admission as a test of external validity. RESULTS Ninety participants were included in the first study, mean age 77.9 (SD 12.0). Cronbach's alpha for IoRN subscales was high (0.87 to 0.93); subscales showed moderate correlation with comparator tools (r = 0.43 to 0.63). Cohen's weighted kappa showed moderate agreement between researcher and clinician IoRN category (0.49 to 0.53). Two-way intraclass correlation coefficients for IoRN subscales in participants reporting no change in ability were high (0.88 to 0.98) suggesting good stability; responsiveness coefficients in participants reporting overall change were equal to or better than comparator tools. 1712 patients were included in the second study, mean age 81.0 years (SD 7.7). Adjusted hazard ratios for death, care home admission and hospitalisation in the most dependent category compared to the least dependent IoRN category were 5.9 (95 % CI 2.0-17.0); 7.2 (95 % CI 4.4-12.0); 1.1 (95 % CI 0.5-2.6) respectively. The mean number of allocated hours of care 6 months after assessment was higher in the most dependent group compared to the least dependent group (5.6 vs 1.4 h, p = 0.005). CONCLUSIONS Findings from these analyses support the use of the IoRN across a range of clinical environments although some limitations are highlighted.
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Affiliation(s)
- Anne Canny
- Ageing and Health, University of Dundee, Dundee, UK
| | | | - Peter Knight
- Joint Improvement Team, Scottish Government, ᅟ, ᅟ
| | - Adam Redpath
- Joint Improvement Team, Scottish Government, ᅟ, ᅟ
| | - Miles D. Witham
- Ageing and Health, University of Dundee, Dundee, UK
- Ageing and Health, Ninewells Hospital, Dundee, DD1 9SY UK
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43
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Sands G, Chadborn N, Craig C, Gladman J. Qualitative study investigating the commissioning process for older people's services provided by third sector organisations: SOPRANO study protocol. BMJ Open 2016; 6:e010724. [PMID: 27194316 PMCID: PMC4874110 DOI: 10.1136/bmjopen-2015-010724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The commissioning of third sector services for older people may influence the quality, availability and coordination of services for older people. The SOPRANO study aims to understand the relationships between and processes of commissioning bodies and third sector organisations providing health and social care services for older people. METHODS AND ANALYSIS This qualitative study will be based in the East Midlands region of England. An initial scoping survey of commissioners will give an overview of services to maintain the health and well-being of older people in the community that are commissioned. Following this, semistructured interviews will be conducted with 4 sample groups: health and social care commissioners, service provider managers, service provider case workers and older service users. A sample size of 10-15 participants in each of the 4 groups is expected to be sufficient to reach data saturation, resulting in a final expected sample size of 40-60 participants. Informed consent will be gained from all participants, and those unable to provide informed consent will be excluded. The interview data will be analysed by 2 researchers using framework content analysis. ETHICS AND DISSEMINATION Approval for the study has been gained from the University of Nottingham School of Medicine ethical review board, and the relevant approvals have been gained from the National Health Service (NHS) research and development departments for interviewing NHS staff. Early engagement with a wide range of stakeholders will ensure that the research findings are extensively disseminated to relevant stakeholders (including commissioners and third sector providers) in an accessible format using the extensive communication networks available to the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care CLAHRCs (applied health research organisations covering all of England). The study will also be disseminated through academic routes such as conference presentations and journal papers.
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Affiliation(s)
- Gina Sands
- NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM), Institute of Mental Health, University of Nottingham, UK
| | - Neil Chadborn
- NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM), Institute of Mental Health, University of Nottingham, UK
| | - Chris Craig
- NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM), Institute of Mental Health, University of Nottingham, UK
| | - John Gladman
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
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McCaskill GM, Bolland KA, Burgio KL, Leeper J. Development and validation of a diabetes self-management instrument for older African-Americans. Soc Work Health Care 2016; 55:381-394. [PMID: 27045578 DOI: 10.1080/00981389.2015.1129012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this study was to develop and validate a new diabetes self-management instrument for older African-Americans 65 years of age and older. The Self-Care Utility Geriatric African-American Rating (SUGAAR) was developed using the American Diabetes Association's standards for the management of type 2 diabetes in older adults and cognitive interviews with older African-Americans. The instrument underwent extensive review by a panel of experts, two rounds of cognitive interviews, and a pilot test before it was administered in an interview format to 125 community-dwelling older African-Americans. The instrument demonstrated content validity and significant, but modest, convergent validity with items from an established diabetes self-management instrument. Social workers and health care professionals can use the SUGARR to assess diabetes self-management and to identify areas for education and support for older African-Americans with type 2 diabetes.
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Affiliation(s)
- Gina M McCaskill
- a Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC) , Department of Veterans Affairs , Birmingham , Alabama , USA
- b Comprehensive Center for Healthy Aging, School of Medicine , The University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Kathleen A Bolland
- c School of Social Work , The University of Alabama , Tuscaloosa , Alabama , USA
| | - Kathryn L Burgio
- a Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC) , Department of Veterans Affairs , Birmingham , Alabama , USA
- b Comprehensive Center for Healthy Aging, School of Medicine , The University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - James Leeper
- d Department of Community and Rural Medicine , The University of Alabama , Tuscaloosa , Alabama , USA
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45
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Seltzer MM. New Directions for Social Services: Much Ado About Nothing. Journal of Gerontological Social Work 2016; 59:140-148. [PMID: 27135555 DOI: 10.1080/01634372.2016.1169842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article raises the question about whether or not our social services programs are taking new directions or whether there is much ado about nothing. Demographic data and their social implications are presented as background for the discussion. While rhetoric may have changed, the general impression is that we are walking in an Heraclitian stream in which there is both sameness and change.
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Affiliation(s)
- Mildred M Seltzer
- a The Scripps Foundation Gerontology Center and Department of Sociology and Anthropology , Miami University , Oxford , Ohio , USA
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46
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de São José J, Barros R, Samitca S, Teixeira A. Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature. Health Soc Care Community 2016; 24:1-11. [PMID: 25660372 DOI: 10.1111/hsc.12186] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 06/04/2023]
Abstract
The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research.
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Affiliation(s)
- José de São José
- Faculty of Economics, University of Algarve, Research Centre for Spatial and Organizational Dynamics, Faro, Portugal
| | - Rosanna Barros
- School of Education and Communication, University of Algarve, Faro, Portugal
| | - Sanda Samitca
- Institute of Social Sciences, University of Lisbon, Lisbon, Portugal
| | - Ana Teixeira
- Faculty of Economics, University of Algarve, Research Centre for Spatial and Organizational Dynamics, Faro, Portugal
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47
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Antipova EI, Shibkova DZ. [EVALUATION OF THE LIFE QUALITY OF SPECIALISTS IN THE SOCIAL WORK WITH THE USEOF THE SF-36 QUESTIONNAIRE]. Gig Sanit 2016; 95:369-375. [PMID: 27430070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In the article there are presented results of the analysis of the life quality of social workers in the relation with the impact of risk factors of the professional environment. There was investigated the profile of the life quality of managers and specialists of departments of social protection of the population with different levels of working capacity, there were revealed main areas of their life troubles: state of the physical and mental health, social functioning and others. There are considered quantitative characteristics of physical, emotional and social component of life quality of examined persons, and also there are reported results of psychophysiological examinations of the functional state of the central nervous system and the working capacity level of specialists. There was shown the necessity of the delivery of the professiogram, a complex of preventive and rehabilitation measures for the preservation and strengthening of the general and occupational health of specialists, as well as the program for their professional selection.
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48
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Visvanathan PD, Richmond M, Winder C, Koenck CH. Individual-Oriented Relationship Education: An Evaluation Study in Community-Based Settings. Fam Process 2015; 54:686-702. [PMID: 25522822 DOI: 10.1111/famp.12116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The effects of relationship education aimed at individuals, rather than couples, have not yet been widely investigated. However, increasingly, relationship education is provided to large and diverse groups of individuals who may be in varying stages of relationships. Several programs have been developed to strengthen relationship competencies among single individuals as well as among partnered individuals who, for a variety of reasons, seek relationship education without their partners. The current study is an exploratory evaluation study that examined self-reported outcomes for 706 single and partnered individuals who attended Within My Reach classes delivered in community-based agencies. Participants were from diverse backgrounds and exhibited many of the risk factors for poor relationship outcomes including unemployment, low income, and childhood experience of abuse or neglect. Pre-post analyses indicated that the program was beneficial for both singles and partnered individuals. Singles reported increased belief in ability to obtain healthy relationships. Partnered individuals reported increased relationship quality, relationship confidence, and reduced conflict. Regardless of relationship status, participants also reported improvement in general relationship and communication skill. Results support the utility of individual-oriented relationship education for singles and partnered individuals with diverse background characteristics.
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Gervais C, de Montigny F, Lacharité C, Dubeau D. The Father Friendly Initiative within Families: Using a logic model to develop program theory for a father support program. Eval Program Plann 2015; 52:133-141. [PMID: 26036612 DOI: 10.1016/j.evalprogplan.2015.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 03/04/2015] [Accepted: 04/23/2015] [Indexed: 06/04/2023]
Abstract
The transition to fatherhood, with its numerous challenges, has been well documented. Likewise, fathers' relationships with health and social services have also begun to be explored. Yet despite the problems fathers experience in interactions with healthcare services, few programs have been developed for them. To explain this, some authors point to the difficulty practitioners encounter in developing and structuring the theory of programs they are trying to create to promote and support father involvement (Savaya, R., & Waysman, M. (2005). Administration in Social Work, 29(2), 85), even when such theory is key to a program's effectiveness (Chen, H.-T. (2005). Practical program evaluation. Thousand Oaks, CA: Sage Publications). The objective of the present paper is to present a tool, the logic model, to bridge this gap and to equip practitioners for structuring program theory. This paper addresses two questions: (1) What would be a useful instrument for structuring the development of program theory in interventions for fathers? (2) How would the concepts of a father involvement program best be organized? The case of the Father Friendly Initiative within Families (FFIF) program is used to present and illustrate six simple steps for developing a logic model that are based on program theory and demonstrate its relevance.
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Affiliation(s)
- Christine Gervais
- Center of Research and Studies in Family Intervention Coordinator, Fathers-in-Families Friendly Initiative (FFFI), Université du Québec in Outaouais, St-Jérôme, Gatineau, QC, Canada.
| | - Francine de Montigny
- Psychosocial Family Health, Center of Research and Studies in Family Intervention, Université du Québec in Outaouais, Gatineau, QC, Canada
| | - Carl Lacharité
- Center of Interdisciplinary Studies and Research on Child and Family Development, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Diane Dubeau
- Université du Québec in Outaouais, Gatineau, QC, Canada
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Abstract
Many providers recognize the importance of creating culturally competent services for lesbian, gay, bisexual, and transgender (LGBT) older adults. Although multiple resources list steps to make professional practices more LGBT-welcoming, these resources provide no empirical data to support their recommendations. LGBT older adults (N = 327) were asked to describe what signals that a provider is LGBT-welcoming. Six of the top 10 signals related to provider behavior and suggest the importance of staff training; the balance included display of signage and rainbow flags, use of inclusive language on forms and the presence of LGBT-identified staff. Results provide evidence-based recommendations for working with LGBT older adults.
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Affiliation(s)
| | | | - Andrea M Olson
- c Psychology Department , St. Catherine University , St. Paul , MN , USA
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