Work rehabilitation programs: a 1997 survey

By adapting to the changing health care environment, legislative reforms, and consumer needs, work rehabilitation programs have experienced a metamorphosis. This study surveyed occupational therapists currently employed in work programs to ascertain a current demographic profile of work rehabilitation programs. Respondents indicated the delivery of services in the areas of prevention, assessment and rehabilitation. The majority of work rehabilitation programs in this study provide services in the form of ergonomics, education and training, and job analyses at the worksite. The area of work injury prevention services is forecasted for increased growth among work rehabilitation programs.     

Estimating the cost impact of three dual diagnosis treatment programs

Specialized intervention programs for people with concurrent severe mental illness and substance abuse reduce the total costs of care. Compared to baseline, cost savings of over 40% were achieved by 18 months, primarily due to significant reductions in the use of acute and subacute mental health services and despite an increase in outpatient mental health services. There also was an observable impact on cost reductions in medical and criminal justice services without an increase in family costs over the same time period.     

MEDIATING CUTBACKS IN HUMAN SERVICES: A CASE STUDY IN THE NEGOTIATED ORDER

The nexus between the social world of private nonprofit service organizations (NPOs) and their environment is examined through data from a national study of reductions in fiscal support and through focused interviews with a sample of chief personnel in agencies in Maricopa County, Arizona. As a study in how some organizations adjust to changes in their funding environment, these data provide a basis for assessing the relative impact of fiscal restraint on organizations, as well as accounting theoretically for the impact of structure through interpretive process, social order through social control, and the construction of a negotiated order. When faced with reductions in federal support, NPOs took different courses of action in order to avoid negative impacts. Interpreting the data from a negotiated order perspective suggests that agencies' adjustments were mediated by an awareness of the national and local contexts, the services they offered, the clients they served, and their general capacity to maximize their resource mobilization potential . In some instances this adjustment amounted essentially to redefining their relevant environment, which was accomplished by integrating the format, logic, and criteria of the external world of business. The agencies survived and in some instances prospered, but their distinctive symbolic structure was compromised.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

Educational and Financial Institutions Partnering to Implement CSAs: Evaluation of Financial Partners’ Perspectives from the 2011 GEAR UP Invitational Priority

Educational and financial institutions are increasingly partnering to open Children’s Savings Accounts (CSAs); however, little is known about these partnerships’ effectiveness for planning and implementing CSAs. A 2011 invitational priority from the Department of Education encouraged partnerships between Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) programs and financial institutions to open CSAs for low-income students, which provided an opportunity to evaluate these partnerships. In-depth interviews with 10 personnel from 6 financial institutions who partnered with 4 GEAR UP programs revealed that partnerships with stakeholders, time spent on planning, and strategies for overcoming barriers were important for implementing CSAs. Lessons for practice and policy are discussed.     

Where Do We Stand? Testing the Foundation of a Shared Site Intergenerational Program

Abstract

Shared site intergenerational care programs provide ongoing services simultaneously to old and young community members at a single facility, thereby, meeting the care needs of multiple generations. However, they face the challenge of sustainability common to all community-based programs. We employed the results management model to identify program elements that may enhance or inhibit sustainability of intergenerational programming at a shared site facility involving a child development lab school and adult day services program. The 4-step results management approach is a strengths-based model that supports community capacity and achievement of community and program goals. The current paper describes the first step in the results management approach, mapping the terrain, which involves gathering evidence of community needs and strengths. Focus groups were conducted with eleven staff members from both programs after a 4-month intergenerational program. The focus groups targeted the needs and strengths related to intergenerational programming. Respondents identified strengths that enhanced staff members' and clients' capacity for collaboration. These included affective and developmental benefits for both generations and strong partnerships between staff members. Respondents also identified factors that limited collaboration, such as the need for greater authority support and cross-training opportunities. Findings from our study have been used by program administrators to continue using the results management approach to further build intergenerational community and expand the scope of evaluating intergenerational shared site programs. Other intergenerational programs may utilize the results management model to enhance intergenerational programming and increase program sustainability.     

An examination of the problem of unwanted population growth in Africa and the existing facilities for training family planning personnel

Population planning is as important as economic planning and should be applied both at the national and personal levels. Population control and socioeconomic development are intrinsic to each other. Proverty, illiteracy, political instability, and social retardation are found in the countries with high birth rates. Most African nations tend to think of the population in terms of density rather than growth potential. Family planning programs should be accorded the same priority as maternal-child health, but African countries are often not equipped financially or professionally to support family planning workers under the same conditions as other medical personnel could be accomplished locally rather than overseas, thus saving about $204,000 in the East African Region and $213,000 in the West African Region. The success of the trainees' program will depend on the degree to whichf amily planning programs are integrated with other medical services; insight into traditiona l sexual patterns, and tact and skill of personnel.     

Preparing for Social Work Practice in Diverse Contexts: Introducing an Integrated Model for Class Discussion

Understanding the context of practice is an essential component of social work practice as is providing service that respects diversity. These twin concepts are necessary to include in planning and delivering services across all levels of practice. However, while we might understand how the context impacts on service users (and such an understanding is a vital part of assessment processes), the context has greater and more far reaching impacts. For example, in rural practice research, there is evidence that the context strongly influences the choice of practice methods, the behaviour of the professional as an individual and as a community member, and the management of complex ethical situations. This paper proposes a model that may be useful in analysing the various impacts of diversity and context in social work practice, and is relevant for the education of social workers and other human service personnel. The SUPAmodel (Service User, Professional, Agency) uses practice examples to explore how changes in context impact on professional decision making and choices about intervention.     

Parent–Caregiver Experiences With the Autism Spectrum Disorder Service Delivery System

Autism spectrum disorder (ASD) diagnoses are increasing, leading to growing demands on the service delivery system to meet the needs of children and families. Further understanding individual enabling components such as perceptions of parents/caregivers and personnel, as well as community-level enabling components such as the availability of and quality of services, may help inform system improvements. In this qualitative study, 19 parents/caregivers of children with ASD in one state in the United States were interviewed regarding their experiences with the ASD service delivery system, as well as their individual responses in relation to these experiences. Emergent themes point to the importance of individual coping strategies such as social support, collaboration with service providers, advocacy and empowerment, determination, and luck. Characteristics of the service delivery system, positive and negative, also were described. Findings can inform the design of future programs, services, and policies to support parent/caregiver coping and improved service delivery.     

Which Elderly Home Owners Are Interested in Accessory Apartment Conversion and Home-Sharing

Previous researchers have found high levels of demand for, and utilziation of housing programs by the better off elderly. This pattern of self-selectivity is not shown in the present article which examines the determinants of interest in accessory apartment conversion and homesharing among a sample of elderly homeowners in the Baltimore metropolitan area. Respondents who were under financial stress, as indicated by large uninsured medical expenses, and who were in poor health, were especially interested in these programs. The results indicate the importance of implementing accessory apartment conversion and homesharing in conjunction with counseling, low interest housing rehabilitation loans and other ancillary services.     

Will population slowdowns yield resource conservation? Some social demurrers

Recent movements and social programs for American population limitation are premised on the expectation that reduced fertility will lower consumption, and hence conserve resources. This premise suffers from the fallacy ofceteris paribus: that, at the familial level, fertility reductions occur with no other familial change. In fact, recent history suggests that reduced childrearing has permitted greater income attainment and consumption by families foregoing childbearing. Moreover, even if families attempted to maintain lower consumption, the aggregate impacts on the economy would be defined as depressive, and lead to macrostructural counteractive strategies by the private and public sectors. This points to the automaticmutatis mutandis fallacy of the populationist movement: the notion that fertility reduction alone will cause economic and environment changes. Resource conservation efforts must deal with both these facts and social scientists have an obligation to present this realistic picture rather than accepting the assumptions of Zero Population Growth.     

Paid personal assistance services:an exploratory study of working-age consumers' perspectives

This study examined the experiences of individuals who use paid personal assistance services (PAS). Structured interview data were collected from a convenience sample of 24 working-age individuals from diverse backgrounds recruited from Centers for Independent Living in nine states. Respondents described their general satisfaction with current paid PAS, but many reported previous experiences with poor care related to the low wages, lack of training of PAS providers, and an inadequate supply of providers. Respondents reported many unmet needs because of a shortage of hours provided by state programs and the lack of help with daily living activities, transportation, childcare, and social activities. The respondents strongly preferred consumer-directed care.     

How much is enough? Willingness to participate in alcohol interventions

This study examined the willingness of drinkers to participate in alcohol interventions designed to cut down or stop alcohol use by degree of service-provider contact. One hundred fifty-six university students and staff who attended a campus health fair participated in an alcohol survey. Of the college drinkers, 73.7% reported they were willing to participate in one or more alcohol interventions with minimal provider contact, compared with 48.5% who said they would participate in programs with high provider contact. Respondents preferred minimal-contact strategies (use of nonalcoholic or low-alcohol beverages, information pamphlets, cash awards, television programs, and mailed instructions) to high-contact approaches. Men were significantly more willing (ps less than .05) than women to participate in nearly half (11 to 21) of the alcohol interventions. Three measures indicative of motivation to control drinking were significantly associated with greater willingness to participate in nearly all strategies. This study also suggested that drinkers who were highly motivated to control their drinking did not prefer minimal-contact interventions over high-contact interventions.     

The Relationship Between Israeli Youth Participation in Physical Activity Programs and Antisocial Behavior

Many intervention programs, including physical activity programs, have been developed to deal with youth involvement in delinquency. The current study explored whether youth participation in sport and physical activity programs reduces their involvement in delinquent behaviors. It examined the interaction effects of the features of the sports program with participation in the sports program. The sample consisted of 126 Israeli adolescents aged 13–18 (M?=?15.68, SD?=?1.32) who completed questionnaires about involvement in delinquency at the beginning of their sports program and again 6 months later. We found significant reductions in adolescents’ involvement in all the delinquent acts explored: crimes against a person; crimes against property, and public disorder crimes. However, no interaction effects were found between program features (sport type; program intensity; training and supervision in the program; and interaction with community services) and participation in the sports program. The findings highlight the importance of including sports programs in the interventions provided for at-risk youth and call for further investigation of the factors that may increase the benefits provided by participation in physical activity programs.     

Career Development and Guidance Programs Across Cultures: The Gap Between Policies and Practices

The authors summarize the presentations and discussions contributed to the symposium International Perspectives on Career Development by members of Group 5, who considered the topic of the structure and organization of career development programs in different nations. A capsule picture of the national setting, primary goals, components, objectives, and implementation strategies is presented. Papers fell largely into 4 categories: national programs with several components; large, but more specific programs, serving a national population; smaller programs serving diverse populations; and focused programs. One theme emerged strongly from virtually every presentation: There is a gap, often profound, between policy or vision and reality. Although every nation about which participants heard had laudable policies and had made genuine attempts to assist its people with life career development, many individuals do not have access to quality, or even any, services.     

Perception of Substance Use Problems in Asian American Communities by Chinese,Indian, and Vietnamese American Youth

SUMMARY

The study was a cross-sectional survey using a convenience sample of 87 Asian American youth respondents to examine their perceptions of substance use problems in the Asian American community. The authors examined respondents' perceptions of the severity of substance use problems in the Asian American community, perceived characteristics of persons with problems of substance use, perceived etiology of substance use problems, beliefs about treatment, perceived help-seeking preferences and helpful services. The youth demonstrated an increased awareness of the severity of substance use problems in the community, although such awareness was more prominent for drinking problems than drug use problems. Respondents showed a positive attitude toward treatment, although such an attitudinal change was not yet accompanied by a change in their behavioral preferences. Findings suggested a tendency for Asian American youth respondents to utilize personal resources rather than professional help or formal treatment programs in response to substance use problems. In addition, respondents shared similar “myths” of Asian problem drinkers and drug users. Implications for developing culturally relevant interventions for prevention and treatment as well as future research are discussed.     

Most Successful Intervention Strategies for Abused Older Adults

ABSTRACT

In this Project CARE study, intervention plans for 83 cases, with a total of 473 strategies, are analyzed in a qualitative content analysis method. The 473 strategies are designed and implemented by an abuse-trained, multidisciplinary, health and social service agency, home care team. Each strategy is rated by the team for its acceptance/refusal by clients and levels of success. The most accepted and successful strategies for abused older adults are concrete: nursing and other medical care and homemaking assistance, followed by empowerment strategies, such as support groups for abused older adults, information about rights and resources and volunteer buddy/advocates. Less successful strategies for abused persons are referrals to general community activities and programs. For caregiver abusers, the most successful and accepted interventions involve individual supportive counselling to reduce anxiety, stress and depression and education and training. Abuser-oriented strategies are most accepted and successful in the study. Thus, it would seem pertinent for intervenors to focus services and strategies on abusers and not only on abused older adults, in particular offering them supportive individual counselling to reduce anxiety, stress, and depression. For abused care receivers, home-based services can offer the necessary support to move out of their abuse situation with the help of volunteers and support group activities.     

A part of something: The importance of transitional living programs within a Housing First framework for youth experiencing homelessness

Young people experiencing homelessness face severe threats to their health and well-being and while we know quite a bit about these risks, much less is understood about the usefulness of the services currently being provided to mitigate them. Transitional living programs (TLPs) are one of three core strategies executed by the federal government of the United States to address youth homelessness. The purpose of this phenomenological, qualitative study was to understand the impact over time of the housing and support services provided by a TLP directly from the perspectives of formerly homeless youth. Data was collected through in-depth, semi-structured interviews with 32 young people who exited a TLP located in Chicago, Illinois between 1 and 11 years ago. Participants believed TLPs to be an essential part of our solution to address youth homelessness, identifying themes of family, individual connections, community and preparedness that they believe uniquely qualify TLPs as a developmentally-appropriate program model for youth in times of housing crisis.     

‘Ain't nothin' here in Buffalo’: Residents' perceptions about living in a racially isolated,high-poverty neighborhood

Research documents how spatial location in American metropolitan areas influences individuals' and families' life chances due to differential access to opportunity. Racial residential segregation and concentrated poverty interact to create an especially vulnerable population within American cities. Less research has been performed about the detailed perceptions of residents who live in spatially isolated neighborhoods with high levels of poverty. Using in-depth interviews in a Buffalo, New York, neighborhood, we develop a better understanding of how geographic isolation influences individuals' attitudes about and perceptions of their lives. Respondents discuss subjects ranging from transportation to employment and outline the ways in which concentrated disadvantage impacts their daily lives.