Theoretical and Practical Imperatives for Reflective Social Work Organizations in Health and Mental Health

Summary

This article describes the common challenges to health and mental health organizations that require these agencies to become more “reflective” in their culture and structures. This necessitates integrating practice and research at all organizational levels. Schon's concept of reflective practice to health and mental health organizations is extended to develop the construct of a reflective organization, in which direct practitioners are integral to organizational learning through ongoing service evaluation and redesign. The theoretical and practical reasons why social work administrators and clinicians alike are obliged to integrate practice and research are discussed. University-based models of practice-research integration impede this process; Epstein's Practice-Based Research approach facilitates it.     

Evaluation Research System,Functions, Future

Abstract

The authors focus on evaluation research as a social phenomenon. After identifying the system of actors for whom this phenomenon has meaning, they trace the changing functions and dysfunctions of evaluation research for these actors over time. They find that: (1) there was initially a consensus among actors on the scientific utility of evaluation research; (2) this consensus has broken down as actors realize the various economic, political and value implications of evaluation research for their own interests, and as they struggle to control the process. Because of this interaction of interests and perceptions of function, the authors predict that evaluation research will be, increasingly, the activity of the “for profit” research organizations, rather than of university based social scientists.'     

Do “Clicker” Educational Sessions Enhance the Effectiveness of a Social Norms Marketing Campaign?

Abstract

Objective: Social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a “standard” social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology (“clickers”). Methods: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. Results: The authors find “clicker” technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. Conclusion: Poster SNM campaigns may be most effective when supported by group “clicker” heath-related sessions.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

Objective: This study examined college student drinkers by sexual orientation (SO), alcohol use, and negative consequences in a national sample that self-identified gender and SO. Participants: Students completing the Spring 2005 National College Health Assessment (N = 54,111). Methods: A secondary analysis was conducted examining student responses by SO to items regarding negative consequences associated with alcohol. Results: Bisexual students had the highest mean scores on an index of alcohol-related harm. Significant differences were found by SO among male high-risk drinkers for alcohol-related consequences of “fighting” and “injuring another,” and females for “injuring another” and “unprotected sex.” Bisexual students had significantly greater than expected cell counts for significant results, including a significant finding for bisexual low-risk female students for alcohol-related “regret.” Conclusion: These findings suggest that more research is necessary to discern real differences in alcohol-related risk among college students by sexual orientation.     

Bioactive compounds of the Mediterranean diet and prostate cancer

Abstract

Objective: The purpose of this review is to examine the evidence on the effects of bioactive constituents of the Mediterranean diet (MeDi) on prostate cancer (PCa) risk.

Methods: The search for articles came from extensive research in the following databases: PubMed, Scopus, and Web of Science. We used the search terms “Mediterranean diet,” “lycopene,” “vitamin E,” “vitamin C,” “Selenium,” “resveratrol,” “prostate cancer,” and combinations, such as “lycopene and prostate cancer” or “resveratrol and prostate cancer.”

Results: Numerous studies investigating the effect of various dietary nutrients on PCa have suggested that selenium is probably the most promising. Several studies reported reduced PCa risk associated with vitamin C and E intake, while other studies reported no association. Lycopene inhibits cell proliferation and inducts apoptosis, thus protecting against cancer. Also, it has been found in various in vivo and in vitro studies that resveratrol, inhibits PCa development.

Conclusions: The high content of bioactive phytochemicals in the MeDi is of particular interest in the prevention of PCa. Further large-scale studies are required to clarify the effect of MeDi bioactive compounds on prostate health, in order to establish the role of this diet in the prevention of PCa.     

From plan to action: Adapting evaluation to serve the developmental needs of a newly-funded multidisciplinary research center

The Southeastern Coastal Center for Agricultural Health and Safety (SCCAHS) is one of many newly-funded federal research centers, housing five multidisciplinary research projects and seven pilot projects, and serving a multi-state region. In the early stages of such a complex project, with multiple teams separated by geography and disciplines, the evaluation program has been integral in connecting internal and external stakeholders at the center and project levels. We used a developmental evaluation (DE) framework to respond to the complex political environment surrounding agricultural health and safety in the southeast; to engage external stakeholders in guiding the center’s research and outreach trajectories; to support center research teams in a co-creation process to develop logic models and tailored indicators; and to provide timely and feedback within the center to address communications gaps identified by the evaluation program. By using DE principles to shape monitoring and evaluation approaches, our evaluation program has adapted to the dynamic circumstances presented as our center’s progress has been translated from a plan in a grant proposal to implementation.     

Waterpipe Smoking Among College Students in the United States: A Review of the Literature

Abstract

Objective: To review the literature on college student waterpipe use with a focus on undergraduates in the United States. Participants: Undergraduate students. Methods: Studies were accessed using the databases PubMed, MEDLINE, PsycINFO, and Academic Search Premier. Searches included combinations of the following keywords: “waterpipe,” “hookah,” “shisha,” “nargila,” “argileh,” “hubble bubble,” “college,” “university,” and “student.” Results: Results demonstrate that approximately 1 in 5 American college students report past-year waterpipe use. Results also suggest that there are a number of established correlates of waterpipe smoking, including male gender, Arab ethnicity, cigarette smoking, and the belief that waterpipe smoking is less harmful than cigarette smoking. Conclusions: Despite its harmful health effects, waterpipe smoking is quite common among college students. Future research with better methodologies and theoretical frameworks are needed to advance the field.     

Perceived Continuing Education Needs and Job Relevance of Health Education Competencies Among Health Education and Promotion Practitioners in College Health Settings

Objective and Participants: The author conducted this study to determine college health education and promotion practitioners' perceived continuing education needs and perceived job relevance in relation to national health education responsibilities and competencies. Methods: In Spring 2006, the author invited college health education and promotion professionals to participate in an online survey, using 3 listservs. Of 276 individuals visiting the Web site, 141 participants completed the survey (51%). Participants rated their perceived training needs and job relevance for the 35 National Commission for Health Education Credentialing (NCHEC) competencies as well as preferred training formats. Results: Participants identified the following competencies as those in which they needed additional training: designing data-collection instruments, securing fiscal resources, interpreting evaluation and research results, carrying out evaluation and research plans, and developing plans for evaluation and research. They identified the following competencies as being the most relevant to their jobs: demonstrating a variety of skills in delivering strategies, interventions, and programs; using a variety of methods to implement strategies, interventions, and programs; initiating a plan of action; and using health-related information resources. The most preferred methods of obtaining additional continuing education were attending the American College Health Association annual meeting (67%) and completing home self-study print materials (67%). Conclusions: Collegiate professional organizations should offer a variety of continuing education opportunities centering on NCHEC competencies, specifically those perceived as needed by study participants.     

Health Risk Appraisal at the College Level

Abstract

This study attempted to determine if health risk appraisals with personalized conferences affected the “health age” of undergraduates at a large, midwestern university. One hundred thirteen (113) students enrolled in four undergraduate health education classes served as subjects. A nonequivalent control group design was employed with two of the classes consisting of students majoring in health-allied disciplines.

On the first and last day of class during the ten week course, all students completed a health risk appraisal questionnaire—“Health Evaluation Learning Program”—used to acquire past and present health history and present lifestyle practices. Data from the questionnaires were analyzed by a computer into a printout known as the “Health Risk Index.” All groups received their instruction from lectures. The control groups followed a popular college text and did not receive any feedback via the index or personalized conference. Each student in the experimental classes received a personalized conference with the instructor at which time their index was interpreted indicating the degree of future mortality risk. Students were informed that their health age reflected their risk compared to the risk of the average person of the same age, sex, and race. The principal hypothesis was based on the difference between one's actual age (chronological) and one's health age (risk). A 4-factor, 2-between, 1-within, repeated measures analysis of variance was used to determine the effect, if any, of the health risk appraisal with the conference on each group's health age and comparisons between/among groups.

Students in the experimental groups increased the difference between actual age and health age from pretest to posttest time significantly more than students in the control groups, with those not majoring in health-allied disciplines displaying the largest pretest to posttest difference (p<.05). Sex status did not significantly influence the age differential.     

Countertransference Bias in Child Custody Evaluations Is Just a Horse of a Different Color: A Rejoinder to Martindale and Gould

ABSTRACT

The authors' reply to Martindale and Gould's critique of Pickar's article (2007a, this issue), “Countertransference Bias in the Child Custody Evaluator.” Martindale and Gould's objections to considering an evaluator's countertransference reactions as a potential source of bias are addressed by focusing on these four areas: (1) Whether it is useful to introduce the term “countertransference bias” to identify a potential source of distortion in custody evaluations; (2) How the empirical literature on countertransference in the context of psychotherapy might apply to the child custody evaluation process; (3) Clarification of areas of agreement and disagreement with Martindale and Gould, and (4) The importance of evaluator attempts at “debiasing.” We conclude that gaining awareness of countertransference reactions can only enhance the evaluator's ability to provide the most objective custody evaluation possible.     

Housing Concepts For and By the Elderly: From Subjects of Design to a Design Resource

ABSTRACT

The perception of elderly residents as a homogeneous group is challenged by the diversification of lifestyles and emphasis on individuality in housing. Recently, there has been a rise in Finland in housing projects initiated by groups of elderly people, where the seniors themselves are seeking to fill in qualitative gaps in the offering of housing. This article presents a comparative analysis of four senior housing concepts that represent both a producer-driven (“for the elderly”) and a resident-driven (“by the elderly”) approach. The study shows that elderly people can be a resource for residential development and that this necessitates a different “design logic” than in conventional senior housing.     

Marketing Postsecondary Health Services

Abstract

This article reviews the major elements of marketing as applied to college and university health service programs. Changes in the health care industry, institutional debate about the advisability of institutionally based health centers, and the erroneous equation of promotion as marketing are reviewed. The necessity for research data to determine campus health program offerings is articulated as the most important aspect of successful marketing programs for health services. Types of segmentation for user groups are detailed, as well as the basic elements of an environmental analysis. The four fundamental aspects of health care marketing are discussed: the need to define the “core of service” for the health center; the issues associated with the access corridor to care; the task of refining communication channels; and the difficulty of measuring the effect of price on service usage rates. For marketing efforts to have a positive effect, colleges and universities must have an institutional commitment to health services. The article concludes by noting that marketing is a major management task.     

Use of Various Health Care Services by Students in Helsinki

Abstract

Review of the working of various health care schemes has revealed predominant use by a certain group of “large-scale consumers.” The concomitant use of various services (health, dental, and mental health care) was studied within the Helsinki Health Center of the Finnish Student Health Service from January 1, 1980 to August 31, 1980. The group consisted of 16,174 students. The characteristics of the groups of patients who used only the mental health care service and of those who used all three services were also studied. Within each sector, there were fewer patients than expected who did not use the services of other sectors. The number of patients visiting dental and health care services, mental health and health care services, and all three services were greater than expected. The groups of patients who used only the mental health care service and those who used all three services were surprisingly similar. The greatest difference between the groups probably lay in their need for somatic and dental care. The organization, which incorporates mental health, dental, and health care services in the same building offers improved possibilities for care of the patient as a whole. On the basis of this study, there is no reason to think that such an organization leads to misuse of the various services.     

Project Discovery: Social Work Research @ Southern Health

Abstract

The health sector uses a “person-in-environment” perspective reflected in multidisciplinary teamwork to understand and influence human lives. This standpoint accords closely with social work's knowledge and theory base, recognising that material, economic, political, organisational, and social structures interact, creating a complex array of factors impacting on individuals and families. Practice research activities are an effective way of exploring social work's particular contribution to health service provision. We describe and critique various models of practice research reported in the literature. A unique model of practice research that we are developing is discussed. Called Project Discovery: Social Work Research @ Southern Health 18 June 2011, this model demonstrates ways in which practice research may exemplify theoretically-driven and service-based research and in so doing advance social work's knowledgebase.     

State behavioral health agency website references to evidence-based program registers

PurposeEvidence-based program registers (EBPRs) are important tools for facilitating the use of evidence-based practices or programs (EBPs) by state statutory agencies responsible for behavioral healthcare, broadly defined as substance misuse, mental health, HIV/AIDS prevention, child welfare, and offender rehabilitation. There are currently no data on the purposes for which such state agencies reference EBPRs on their official websites.MethodA webscraping method was used to identify and classify relevant “hits”, defined as a state behavioral health webpage with single or multiple references to a study EBPR. A total of 778 hits (unique combinations of webpage and register) were coded. Up to three codes were applied to each hit for the “reasons for the EBPR reference” (EBPR use) dimension, one code was applied to each hit for the “purpose of the EBPR reference” and “intended audience of the webpage containing the hit” dimensions, and up to two codes were applied to each hit for the "funding mentions” dimension.ResultsThree EBPRs out of 28 accounted for 73.6% of the hits. The most frequent reason for referencing EBPRs were as a resource for selecting EBPs or validating existing programs and practices. The references tended to appear in reports from the state, in training materials, or guidelines. The references tended to address broad groups of behavioral healthcare professionals. EBPRs were frequently referenced in the context of federal block grants or other federal funding.ConclusionsIncreasing state agencies’ awareness and use of the entire range of existing EBPRs may improve implementation of EBPs nationally.     

Barriers to Utilization of Mental Health Services amongst Male Child Sexual Abuse Survivors: Service Providers’ Perspective

ABSTRACT

Most research on child sexual abuse has been on survivors to the exclusion of service providers. This paper focuses on one group of findings from a larger qualitative study. The aim of the paper is to identify existing services and highlight the gaps in the current programs available for male CSA survivors from the perspective of service providers. Semi-structured interviews were conducted with 11 mental health service providers, recruited from two Southern and Central Ontario cities. Findings presented here report service providers’ perspective of gaps in services for male CSA survivors. “Limited Male CSA Programs”, “Institutional Barriers”, “Attitudinal Barriers”, and “Systemic Gaps” emerged as four major themes from the data analysis. Findings demonstrate the need to re-evaluate currently available service and highlights gaps in mental health service available for male CSA survivors. Implications for policy, practice, and research are discussed.     

A Preliminary Understanding of Search Words used by Children,Teenagers and Young Adults in Seeking Information about Depression and Anxiety Online

Abstract

There is a dearth of research related to mental health search word literacy for under 25's. The knowledge of a young person's mental health information search practices is piecemeal, derived from general search literacy studies. A young person’s access to mental health information online is highly due to the level of stigma and poor mental health literacy surrounding depression and anxiety. This study explored what search words young people aged 5–26 (N?=?630) used to identify information and/or help for depression and anxiety. The research hypothesis was supported that those under age 13 would have a more limited use of “disorder” phrases (compared to “thoughts/feeling” phrases) in their search for mental health information related to their symptoms. All age and gender groups were as likely to use thoughts/feelings terms, however, those over 13?years were almost three times more likely to combine their thoughts/feelings terms with disorder terms, compared to those less than 13?years. Results give indication that search engine optimization by expert mental health sources should take into account feeling-based vocabulary used by specific age and gender groups, in order to guide these young people to authoritative mental health information.     

One Hundred Years of College Mental Health

Abstract

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, “mental hygiene” was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

Creating and Sustaining a Practice-Based Research Group in an Urban Adolescent Mental Health Program

Summary

This article describes the initiation, implementation, and accomplishments of a practice-based research group within a mental health program serving inner-city adolescents. Begun in 1995 and co-led by a program manager and a clinical social work practitioner, the group fosters and supports practitioner-driven research projects as part of a “reflective” organizational development strategy.     

Infant-led Research: Privileging Space to See,Hear, and Consider the Subjective Experience of the Infant

ABSTRACT

The subjective experience of infants is seldom considered in research directly concerning them. Commonly, infants are not believed to possess self-agency or innate communicative abilities, obscuring space for researchers to consider the infant’s subjectivity. Rather, measuring and coding behaviour or seeking the parent’s perspective is privileged. Making meaning is not limited to the capacity to verbalise; as meaning encompasses feelings, behaviours, and contexts. In this paper, a novel “infant-led” qualitative research methodology is presented utilising infant observation techniques, drawing on theories of “intersubjectivity” and using a constructivist grounded theory method. Distinct to this methodology is how data collection begins with the infant before any other, as does the process of data analysis; providing the basis upon which all other data are interpreted. The application of such an approach is nonintrusive and has much to offer social workers working with infants in high risk situations in community, health, and mental health settings.

IMPLICATIONS

• The experience of infants is entitled to be included in research that directly impacts them.

• Adopting an infant-led approach brings alive the experiences of infants and challenges assumptions that minimise the competencies and contributions infants make.