Meeting the needs of abused older women? A british columbia and yukon transition house survey

ABSTRACT Older women victims of violence by a partner or family member are more often categorized as victims of elder abuse, not victims of family violence. Their needs are assessed, if at all, by social and health service agencies, often with little knowledge or understanding of domestic violence, while domestic violence policy initiatives, advocacy, and services focus on younger women and children. A survey of domestic violence services in British Columbia and the Yukon found that women over 60 years of age were a very small fraction, generally less than two percent, of women served, and those 50 to 59 years of age were also substantially under-represented. Only four percent of respondents had special services for older women. Comments from respondents confirm that abused older women face enormous difficulties in trying to establish a safe and secure future. It was also evident that better interaction is needed between those providing support and advocacy for abused women, and those who provide health and social services for older persons. A majority of the shelters provided community education to a wide range of agencies. Most have only partial accessibility to women with mobility handicaps.     

Organizational structure,leadership and readiness for change and the implementation of organizational cultural competence in addiction health services

Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed.     

Statute Definitions of Elder Abuse

ABSTRACT

Older women victims of violence by a partner or family member are more often categorized as victims of elder abuse, not victims of family violence. Their needs are assessed, if at all, by social and health service agencies, often with little knowledge or understanding of domestic violence, while domestic violence policy initiatives, advocacy, and services focus on younger women and children. A survey of domestic violence services in British Columbia and the Yukon found that women over 60 years of age were a very small fraction, generally less than two percent, of women served, and those 50 to 59 years of age were also substantially under-represented. Only four percent of respondents had special services for older women. Comments from respondents confirm that abused older women face enormous difficulties in trying to establish a safe and secure future. It was also evident that better interaction is needed between those providing support and advocacy for abused women, and those who provide health and social services for older persons. A majority of the shelters provided community education to a wide range of agencies. Most have only partial accessibility to women with mobility handicaps.     

Shifting the Focus:

Agencies that serve survivors of sexual violence have frequently failed to make services accessible to lesbians and gay men. Similarly, agencies serving lesbians and gay men have frequently overlooked the problem of sexual violence in this community. One hundred fort-five lesbians, gay men and bisexuals responded to a survey about their knowledge of services for survivors of sexual violence, the services they need and want, their perceptions of sexual violence in the gay and lesbian community, and the extent of sexual victimization in the gay and lesbian community. Forty-one percent of respondents reported that they had been sexually victimized, and the majority believed that education programs were the most important service needed.     

Mentoring as a Bridge to Positive Outcomes for Teen Mothers and Their Children

This paper compares historical and psychosocial realities of teenage parenting to prevailing contemporary myths. The authors explore the negative consequences of current remedies based on these myths. Community volunteer mentoring programs are suggested as a cost-effective intervention that can benefit communities and promote positive outcomes for at-risk pregnant teenagers. The authors suggest strategies for implementation of a community volunteer mentoring program based on an existing program in an urban community health center. Detailed information for social workers in community agencies is provided with regard to community education, recruitment, training, and ongoing support and supervision of mentors; funding requirements; and program evaluation.     

SASA! Together: An evolution of the SASA! approach to prevent violence against women

One in three women globally will experience intimate partner violence (IPV) with devastating consequences for individual survivors, their families and communities. While prevalence remains high, violence against women is not inevitable and community mobilization approaches have emerged as particularly promising for transforming the gender inequitable norms and practices that underlie violence. The SASA! Activist Kit to Prevent Violence Against Women (SASA!), developed by Raising Voices in 2008, provides a theory-based approach for mobilizing communities to transform power imbalances between women and men through critical discussion and positive action. In this article, we provide the rational for revising SASA! after ten years of program learning and formal research. We aim to contribute to the knowledge base around what works to prevent IPV by describing the core enhancements in the revised version--called SASA! Together—and linking these changes to Raising Voices’ program learning and broader advancements in the field. In addition, we reflect on how current debates—such as how best to “scale up” violence prevention programs—were considered and resolved in SASA! Together. The paper concludes by sharing lessons learned that may provide guidance for future revisions development and revisions of evidenced-based programs.     

The Revitalization of Community Practice: Characteristics,Competencies, and Curricula for Community-Based Services

Abstract

A recent move toward community-based services on the part of direct service agencies presents a major opportunity for the revitalization of community practice. Driven by funding from major philanthropic foundations and also by recent changes in federal entitlement legislation, these efforts at system reform are designed to make services for vulnerable populations more effective, accessible, integrated, and comprehensive in the context of the local community. Although this service reorganization requires the type of methods typically found in community practice, direct service workers employed in these agencies usually have not been trained in community work. To begin to address this concern, this article uses a computerized word search to review the community practice and community organization literature. A working definition of “community-based” practice is developed. The extensive literature review yields six characteristics of community-based service delivery: (1) neighborhood-based and family-focused; (2) strengths- and empowerment-oriented; (3) cultural sensitivity and multi-cultural competency; (4) comprehensive services; (5) access to integrated services and supports; and (6) teamwork and leadership skills. The article reviews what scholars have recommended in each of these areas as a way of understanding the characteristics of community-based service delivery and the skills needed by direct practitioners working in community-based programs. The article summarizes innovative curricula and specific courses which demonstrate ways of teaching community skills to direct practice workers. Future work for community practice scholars and educators is recommended.     

Family Services: A Proposed Model for Coordinating Spouse Abuse Services

ABSTRACT

This article presents a proposed model to organize spouse abuse services within communities. It proposes that family service agencies take the lead in organizing and implementing the model program. The community team would consist of representatives from agencies and disciplines that serve spouse abuse families. The community would benefit from the coordination of both the direct services to affected families and the prevention and education activities designed to eliminate spouse abuse.     

Domestic Violence in the Second Half of Life

Providing an adequate and effective community response to women age 50 and older who experience domestic violence is complicated by the oftentimes disparate goals and expectations of service providers, emergency responders, and victims themselves. This article shares information provided by participants of focus groups designed to understand and identify what women age 50 and older want and need from agencies that provide services to enhance victim safety.     

CMHS/CSAT Collaborative Demonstration Program for Homeless Individuals

The Collaborative Demonstration Program for Homeless Individuals is providing an opportunity for several community agencies in the United States to explore innovative intervention and treatment strategies to address the needs of homeless people with co-occurring (mental illness and substance abuse) disorders. This cooperative agreement, funded jointly by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT), is a $3 million project supporting programs in various community agencies to develop, document, and evaluate programs for persons who are homeless with co-occurring disorders to be used as models in other communities. The program models include: Assertive Community Treatment, Psychosocial Rehabilitation, Therapeutic Community, and an integrated treatment model. The first phase of the two-phase project funded 16 programs in the U.S. to develop manuals within their primary treatment modalities for homeless people with co-occurring disorders. For Phase II of the project, six of the 16 model programs were competitively selected to demonstrate program impact through formal program evaluation efforts. The data derived from the various projects will be compiled into a compendium of information for state agencies and community service providers throughout the U.S.     

The impact of funding sources and board representation on consumer control of service delivery in organizations serving low-income communities

This article examines the influence of funding sources and board members on the degree to which an organization enhances consumer control of the organization or limits access to services for some groups of clients. Based on a study of decision making in organizations serving three low-income communities, a limited degree of board influence on an organization's choice of service strategies can be traced to both the power of donors to demand service strategies that reflect their interests and the efforts of staff members to limit the ability of the board to engage in policy-making. The high degree of dependence of low-income communities on external funding restricts the development of boards as decision-making bodies that effectively reflect community interests.     

'The more things change…': Barriers to community services utilisation in Queensland

Community services are central to the lives of many elderly Australians or Australians with disabilities if they are to remain in the community. Over the past two decades, significant advances have been made in policy and associated programs, significantly improving the standards of service delivery. This research reports on the perceptions of service providers in community services for people with disabilities in six communities in Queensland. It illustrates that significant barriers to service utilisation remain, despite reform. It suggests that continuous efforts to promote service access need to be built in at the program level.     

Moving Toward Collaboration

Summary

Traditionally, organizations serving children and families have focused service delivery by available funding stream criteria. Federal funding streams supported fragmented services by tightly channeling monies to specific programs for specific needs. The intensity of providing and improving the delivery of services has overshadowed building connectedness across organizations and systems. Service has been the major goal and intense effort has gone into maximizing opportunities and measuring effects through service frequency. Over the past several years, new funding incentives have provided the opportunity for new collaboratives. This article describes an innovative collaboration between the Idaho Department of Health and Welfare (IDHW) and Eastern Washington University (EWU) and the unique directions and support that a university/agency partnership can provide for both organizations. Key features of this collaboration include shifts in funding and staffing strategies that contributed to more flexible services and increased levels of collaboration between IDHW, EWU and other community and state organizations and institutions. This article describes how funding can be viewed as a tool to increase the level of collaboration between systems, thus potentially leading to a breakdown of the traditional service delivery system. Finally, this article describes how an agency/higher education partnership played a key role in documenting the success of a school based program in meeting the emergency assistance needs of children and families, and how program evaluation, like funding requirements, can provide a supportive role in building collaborative relationships.     

Inclusion of caregiver supports and services in home- and community-based service programs: recent reports from state units on aging

Caregivers have an important role in assisting frail and/or disabled individuals to maintain their independence in the community. Support to assist caregivers in this often stressful and demanding role is critical to sustaining the caregivers' health and ability to provide care. This paper reviews federal policy changes since 2000 that have expanded and enhanced services for informal caregivers. Next, data collected from State Units on Aging and other state agencies are presented to describe the extent to which caregiver services are included in home- and community-based programs under three funding streams (Medicaid waivers, Centers for Medicare and Medicaid Services-funded programs, and state-funded programs). Program characteristics, such as eligibility and consumer-directed options, are included. Finally, the accomplishments and initiatives reported by state respondents related to supporting informal caregivers are also explained. Results indicate that services for informal caregivers are receiving greater attention and are frequently offered under home- and community-based service programs by the states that participated in this study.     

Inclusion of Caregiver Supports and Services in Home- and Community-Based Service Programs: Recent Reports from State Units on Aging

Caregivers have an important role in assisting frail and/or disabled individuals to maintain their independence in the community. Support to assist caregivers in this often stressful and demanding role is critical to sustaining the caregivers' health and ability to provide care. This paper reviews federal policy changes since 2000 that have expanded and enhanced services for informal caregivers. Next, data collected from State Units on Aging and other state agencies are presented to describe the extent to which caregiver services are included in home- and community-based programs under three funding streams (Medicaid waivers, Centers for Medicare and Medicaid Services–funded programs, and state-funded programs). Program characteristics, such as eligibility and consumer-directed options, are included. Finally, the accomplishments and initiatives reported by state respondents related to supporting informal caregivers are also explained. Results indicate that services for informal caregivers are receiving greater attention and are frequently offered under home- and community-based service programs by the states that participated in this study.     

Implementing the family preservation program: Feedback from focus groups with consumers and providers of services

There is a growing understanding that preventative child welfare efforts can be both more cost effective and are more desirable philosophically than strictly remedial programs. The Family Preservation Act provides funds to assist communities in strengthening and preserving at-risk families. In order to implement this program effectively, local communities must design new programs and procedures which will be both attractive to consumers and effective in meeting their needs. This study it identifies problems with contemporary child and family services and suggests solutions to those problems. This study uses a focus group format and presents ideas generated by those individuals who will be most directly affected by this legislation; front line service providers and service consumers. Several areas of weakness in the current service delivery system are identified, including bureaucratic barriers, limited resources, problematic consumer/provider relations and a range of collaborative issues, both within and between agencies and the communities they serve.     

Always begin with a story: memoirs of Mary Lewis

Competing discourses have always figured prominently in policy debates about violence against women and children. Legislation and services to address it have largely been developed from theory and empirical knowledge of domestic violence occurring in intimate relationships. Knowledge from an Indigenous perspective about family violence, embedded in a context of colonisation and involving a broader range of relationships, has been less influential. One of the consequences of this is that when Indigenous communities identify solutions to address family violence holistically, these solutions are difficult to implement. Research with a remote South Australian Aboriginal community, looking for ways to reduce the level of family violence, resulted in new understandings of it. Linking issues of economic deprivation, dispossession and the breaking down of culture, the community devised a holistic community development approach to reduce family violence. This paper identifies the waves of understanding about family violence and argues that community-initiated solutions must be supported by policy and funding options based on an Indigenous understanding of family violence.     

Multisectoral approaches to addressing youth violence

Youth violence is a public health concern that has devastating consequences for communities and requires a collaborative community response. While public health approaches underscore the importance of collaborative efforts to address public health concerns, violence prevention programs are often siloed and lack a multisectored response that includes the education system, criminal justice system, local government, university, and service providers. This article explores the successes and lessons learned from the emergence of a multisectoral community-based initiative to address youth violence in southeastern North Carolina. The model for this initiative evolved from the Harlem Children’s Zone and includes identifying existing resources and coordinating a continuum of support and services to increase availability of after-school, summer enrichment, life-skills, and parenting programs to reduce youth violence. Implications of applying multisectoral community-based interventions are discussed in terms of capacity building, promotion of well-being, and research.     

Summer programming in rural communities: unique challenges

During the past several decades, child poverty rates have been higher in rural than in urban areas, and now 2.5 million children live in deep poverty in rural America. Studies indicate that poor children are most affected by the typical "summer slide." Summer programming has the ability to address the issues of academic loss, nutritional loss, and the lack of safe and constructive enrichment activities. However, poor rural communities face three major challenges in implementing summer programming: community resources, human capital, and accessibility. The success of Energy Express, a statewide award-winning six-week summer reading and nutrition program in West Virginia, documents strategies for overcoming the challenges faced by poor, rural communities in providing summer programs. Energy Express (1) uses community collaboration to augment resources and develop community ownership, (2) builds human capital and reverses the acknowledged brain drain by engaging college students and community volunteers in meaningful service, and (3) increases accessibility through creative transportation strategies. West Virginia University Extension Service, the outreach arm of the land-grant institution, partners with AmeriCorps, a national service program, and various state and local agencies and organizations to implement a program that produces robust results.     

Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.