An investigation of predictors of mental health in single men and women experiencing homelessness in three Canadian cities

Homelessness is related to poorer mental health, yet, there is limited understanding of the predictors of mental health of men and women experiencing homelessness. To support service providers in identifying individuals who might be at particular risk of poor mental health, this study investigated the predictors of mental health in 501 single men and women experiencing homelessness in Vancouver, Toronto, and Ottawa, Canada. Data were obtained via in-person, structured interviews. In order to identify whether predictors differ by gender, multiple linear regressions were conducted separately for men and women. Mental health status was measured by the Mental Component Summary score of the 12-item Short-Form Health Survey. Better mental health for men and women was associated with the presence of fewer chronic health conditions and a higher level of social support. An older age, not having experienced a recent physical attack, and absence of a mental health diagnosis were related to better mental health for women. The absence of unmet mental health needs within the past 12 months was associated with better mental health for men. The study highlights differences in factors associated with mental health for men and women. Service providers should be aware of the association of these factors with mental health to guide assessment and service planning.     

A process evaluation of an intervention to promote home smoking bans among low income households

Exposure to secondhand smoke occurs primarily in the home due to passage of smoke-free legislation. Creation of a total household smoking ban can reduce associated health conditions such as asthma, lung cancer, heart disease and stroke. This paper describes the results of a randomized control trial of a minimal intervention to create smoke-free homes. 2-1-1 callers were invited to participate in the trial and were randomized to an intervention (mailings and a coaching call) or a control group (no intervention). We assessed reach, dose, fidelity, and receptivity to the intervention through program records and a 3-month follow-up survey with intervention participants. For the intervention materials, materials were mailed to 244 participants (99.2%) and 227 participants (92.3%) received the coaching call intervention. 92.3% received all intervention components. Participants who had full household bans at 3 months were more likely to conduct behaviors leading to a smoke-free home (i.e., making a list of reasons, having a family talk, posting a pledge) than were those with no/partial ban. The intervention materials also were rated higher in relevance and usefulness by non-smokers than smokers. Results demonstrate that this minimal intervention had high fidelity to the delivery of components and relatively high receptivity.     

Somewhere to be permanent for a minute: Time and space perceptions of older adult men experiencing chronic homelessness in Detroit

Within the landscape of postwar era Detroit, space is vast, but places are hard to find. As people tumble down the side of Maslow’s pyramid into abject homelessness, they attempt to anchor themselves in locations that suspend the otherwise situational free fall. This article analyzes how time and space are perceived by people experiencing chronic homelessness and how those individual perceptions are informed by the objective time and space urban environment. We conducted our community-based participatory research into the experiences of chronic homelessness both from perspectives of chronically homeless older adult men and from front-line service providers. Themes that emerged are as follows: (1) temporary permanence, (2) permanent temporariness, and (3) lostness. The article concludes with policy implications regarding the procedures for measuring the extent of homelessness and the needs of those who live it.     

Family is NOT an institution: distinguishing institutions from organisations in social science and social theory

This paper addresses the use, and potential misuse, of the ‘institution’ as a key concept in sociology. The concept of the ‘institution’ is interrogated using ‘family’ as an example and new institutional economics (NIE) as a crucible. The sociological understanding of family as an ‘institution’ is challenged by the distinction between ‘institutions’ and ‘organisations’ in NIE. The blurring of generic non-sociological terms with critical sociological concepts causes confusion between institutions and organisations. This is highly problematic for understanding social change in increasingly complex systems. I conclude that the contextual embedding of sociological concepts remains important to the appropriate use of the term ‘institution’ in the social sciences.     

Factors related to meeting physical activity guidelines in active college students: A social cognitive perspective

Objective: To examine the relations of sex, exercise self-efficacy, outcome expectations, and social support with meeting physical activity guidelines (PAGs). Participants: Three hundred ninety-six college students participated in this study in the summer 2013. Methods: Students completed online questionnaires that assessed physical activity behaviors and psychosocial factors (ie, self-efficacy, outcome expectancies, and social support). Students' physical activity profile was categorized as meeting no PAGs, meeting aerobic PAGs only, meeting muscle-strengthening PAGs only, or meeting both PAGs. Results: A multinomial logistic regression revealed that students' sex and psychosocial factors significantly affected the odds of meeting any and all PAGs. Sex significantly moderated the relationship between outcome expectancy and meeting aerobic PAGs and between outcome expectancy meeting muscle-strengthening PAGs. Conclusions: Results indicate that interventions designed to increase psychosocial factors may increase the likelihood of students meeting any and all PAGs. Social support may be especially beneficial for increasing muscle-strengthening activity.     

Stand Up for Health: Programme theory for an intervention to reduce sedentary behaviour in contact centres

BackgroundContact centre staff spend up to 95 % of their day seated, which can lead to a range of negative health outcomes. The aim of this study was to develop a programme theory for a complex intervention to reduce sedentary behaviour in contact centres.MethodsThe 6SQuID model was used. A literature review, and focus groups at one contact centre were used to: understand the problem (step 1); identify modifiable factors (step 2); and develop a theory of change (step 3). A workshop shaped a theory of action (step 4), and the programme theory was refined after testing activities over 6 months (step 5). The intervention is currently undergoing further evaluation and feasibility testing in a larger scale stepped wedge randomised controlled study in 11 contact centres (Step 6).ResultsStep 1: Limited opportunity to sit less, and move more at work was identified as the main problem. Step 2: Modifiable factors were identified at four levels of the centre. Step 3: A theory of change was developed around cultural norms and individual behaviour change. Step 4: Actions were developed to ‘activate’ the theory of change. Step 5: Activities were implemented, and adapted over 6 months and the programme theory was refined.ConclusionThe programme theory behind this intervention is robust, evidence based, adaptive and transferable.     

The impact of the crisis on homelessness in Spain: social intervention in a context of greater need and fewer resources

The purpose of this article is to deepen the understanding of the impact of the social and economic crisis on homeless people in Spain. To this end we present the results of research carried out prior to the crisis and later updated in the midst of the economic recession, underscoring the main results obtained in both periods and tracing their evolution. The number of homeless people in Spain has risen as a result of the crisis. Moreover, while some characteristics of this group remain the same, others have changed. Hence, difficulties in access to the labour market and cuts in certain economic benefits are resulting in an increase in the duration of social inclusion processes. This results in a worsening of the personal situation of the homeless, especially in relation to mental illness and substance abuse. The immigrant population is the group most affected by these impacts. The situation clearly demonstrates the need to reflect on how to deal with the problem of homelessness in Spain, and to rethink the way professionals intervene, especially during periods of economic recession.     

Using social norms theory to explain perceptions and sexual health behaviors of undergraduate college students: an exploratory study

The authors and associates conducted a social norms-based intervention targeting high-risk sexual behaviors among undergraduate students at 4 college campuses. Social norms theory predicts that widely held misperceptions may encourage risky behavior in a misguided attempt to conform to perceived norms and that information correcting these misperceptions will lead to a decrease in such behaviors. Students overestimated their peers' levels of sexual activity, numbers of partners, incidence of sexually transmitted infections, and rates of unintended pregnancies, but underestimated rates of condom use. Rates of HIV test taking, however, were accurately estimated. Although some components of sexual risk behaviors lend themselves well to social norms-based interventions, others, specifically inconsistent condom use and avoiding HIV tests, do not. Although no changes in reported beliefs or practices were apparent at the end of a 9-month intervention period, longer or modified interventions may be needed to make a fair assessment of the efficacy of this approach.     

The importance of networking in development co‐operation: A social network analysis‐based evaluation of an international development programme

This article aims to demonstrate that networking activities, if properly planned, applied and monitored, can help increase the long‐term impact of development co‐operation actions. We demonstrate the added value of networking within development actions, focusing on dynamics of trust and reciprocity and on the rationales beyond different collaboration patterns, demonstrating the impact of networking on program effectiveness, intercultural learning and sustainability. Using social network analysis coupled with participant observation, it was possible to trace the development of a large multi‐stakeholder development programme and to understand a number of dynamics not considered by the donor when evaluating the action, thereby reaching a better understanding of the challenges and success of the programme.     

Critical social work and competency practice: a proposal to bridge theory and practice in the classroom

Social work education in North America is increasingly focused on competency criteria and micro skills training for future practitioners. Market forces are transforming the nature of social work practice in Canada, and social work regulators are concerned about the lack of evidence-based competencies in social work education. Since the Controlled Act of Psychotherapy was proclaimed in 2017, social work practitioners are in a position to offer psychotherapy services; as a result, universities are under greater pressure to shift to competency-based learning that meets the requirements of a regulated profession. This has raised concerns about the narrowing focus on critical social work theory in preparing students for practice. The divergence between anti-oppressive and direct practice schools is widening with the result that many students have difficulty bridging the gap between critical theory and competency-based practice. This paper attempts to integrate both traditions by offering students a course that directly links critical analysis of structural barriers and client centered interventions. The course is part of a developing critical competency curriculum that focuses on methods of facilitating empowerment and change in the helping process by articulating key relational components between service user and practitioner from a critical-competency perspective.     

The contribution of the intervention in social networks and community social work at the local level to social and human development

ABSTRACT

The primary task of community social work is building social networks by reinforcing people's resources and those of the different environmental and social contexts from three dimensions: personal development, social development and organisational development. The new information technologies today establish a relationship of communication with local communities and citizens that promotes proximity to social networks. Social intervention is supported by a set of methods from human geography that can be used as tools to create maps of the territory and the networks for planning, diagnosing and classifying the management of community network intervention. In this discussion we set out to analyse the contribution of the intervention in social networks as a means of achieving a new configuration of social networks at the local level. This information is obtained from semi-structured interviews with social workers and other professionals in the social sphere in municipalities with over 100,000 inhabitants in the Madrid region (Spain). The research results show that intervention in social networks locally multiplies the opportunities to enhance the quality of people's social relationships, thus expanding their social support by strengthening their bonds, their personal network and support systems; secondly, it increases empowerment to facilitate a type of intervention to strengthen human potential and to gain autonomy and full citizenship.     

The (postcolonial) return of grand theory in American sociology: Julian Go on postcolonial thought and social theory

Julian Go's BJS annual lecture is discussed in reference to his landmark OUP text Postcolonial Thought and Social Theory (2016). Go is one of the most prominent names in a "third wave" of post-colonial thought, now spearheading a post- (or de-) colonial turn in sociological theory, something that has professionally revived the sub-field of "grand" social theory in mainstream US sociology. While endorsing the aims and substantive themes of this turn, the review raises questions about the delayed timing of this post-colonial wave in the discipline, both relative to the humanities more generally, and to the impact of post-colonialism in other national contexts. Go's challenge is, in effect, something quite particular to teaching social theory in the US sociology context. The review goes on to question how effectively the critique speaks to mainstream empirical practitioners, given its lack of focus on transforming technical methods. It concludes by raising concerns about the relationship of Go and other "third wave" decolonial theorists to Marxism and Marxist politics.     

Breastfeeding interventions in Kansas: A qualitative process evaluation of program goals and objectives

Across the state of Kansas, eighteen public health departments received funding through the 2011 Breastfeeding Grant Initiative to start a breastfeeding intervention. The main objective of this study was to evaluate the progress toward program goals and objectives. This study was a process evaluation. Qualitative data were collected from recipient health departments at two time-points during the program year. Structured, open-ended questions were asked through telephone interviews. This study examined: (1) progress toward program goals and objectives, (2) problems encountered during implementation, and (3) evaluation measures employed to assess program impact. All health departments reported making significant progress toward program goals and objectives and reported successful collaboration with other healthcare providers. The use of breast pumps, educational classes, and professional training of staff were reported as providing the best outcome in the promotion of breastfeeding. The majority of respondents did not measure program impact. From a public health perspective, it is important that infants receive breast milk for the first six months of life. It appears that goals and objectives set a priori guided health departments with the administration of their breastfeeding program. Results may be used to enhance and sustain delivery of breastfeeding support programs in Kansas communities.     

Usability testing,initial implementation,and formative evaluation of an evidence-based intervention: Lessons from a demonstration project to reduce long-term foster care

The field of child welfare faces an undersupply of evidence-based interventions to address long-term foster care. The Permanency Innovations Initiative is a five-year federal demonstration project intended to generate evidence to reduce long stays in foster care for those youth who encounter the most substantial barriers to permanency. This article describes a systematic and staged approach to implementation and evaluation of a PII project that included usability testing as one of its key activities. Usability testing is an industry-derived practice which analyzes early implementation processes and evaluation procedures before they are finalized. This article describes the iterative selection, testing, and analysis of nine usability metrics that were designed to assess three important constructs of the project's initial implementation and evaluation: intervening early, obtaining consent, and engaging parents. Results showed that seven of nine metrics met a predetermined target. This study demonstrates how findings from usability testing influenced the initial implementation and formative evaluation of an evidence-supported intervention. Implications are discussed for usability testing as a quality improvement cycle that may contribute to better operationalized interventions and more reliable, valid, and replicable evidence.     

Navigating post-trauma realities in family systems: Applying social constructivism and systems theory to youth and family trauma

Trauma affecting youth and families takes a variety of forms, from random one-time events such as accidents and natural disasters to chronic and highly personal trauma from child abuse or intimate partner violence. Though trauma has received increasing attention in theory and intervention research over the last several decades, the prevailing theories and treatments have limitations due to a linear perspective focused on the trauma problems of the individual. This is particularly concerning given the high dropout rates for trauma-focused treatments and the complexities of intergenerational trauma that cannot be adequately conceptualised at the level of the individual. To inform and improve family-based treatment of youth and family trauma, this paper proposes a theoretical framework informed by social constructivism and systems theory. Social constructivism upholds that reality is constructed through communication as an adaptive process for survival, with multiple potential realities possible. Systems theory promotes a non-linear view of causality within a system, such that the structure and properties of a system determine outcomes more than the inputs that go into the system. Together, the principles of these meta-theories contradict the orthodox focus on traumatic events causing trauma symptoms, and instead imply that family-based treatment should focus on helping families shift assumptions and dynamics that sustain the problem in the present. The joint application of a social constructivism–systems theory framework for trauma introduces several new principles to inform family-based treatment: (a) post-trauma realities; (b) mutual survival; (c) power–justice balance; and (d) adaptive reorganisation. The implications of these principles for youth and family trauma treatment will be discussed. Future intervention development and research should consider these principles in the ongoing effort to improve family therapy for youth and family trauma.     

Adoption and feasibility of a communication app to enhance social connectedness amongst frail institutionalized oldest old: an embedded case study

The risks of social isolation and loneliness are becoming emergent issues for older adults (aged 65+) in industrialized countries, particularly for oldest old people (80+) who are frail and institutionalized. Socially isolated and lonely older people are more likely to experience depression, social disengagement, cognitive and physical decline, morbidity, and early mortality. In response to these significant negative health and socioeconomic costs, research suggests using new technologies to enhance opportunities for social connectedness as a strategy to help alleviate both social isolation and loneliness. In this context, following a participatory design method, we developed an accessible communication app with and for frail institutionalized older adults. To test the adoption of this innovative technology and its feasibility to address social isolation and loneliness, we conducted a two-month deployment of the app in a long-term care home with five oldest old and their relatives. Due to access, recruitment, and ethical challenges, the oldest old are a specially understudied group. Using an embedded case study (based on interviews, psychometric scales, field observations, and usability and accessibility testing) and a recursive approach to technology studies, our findings show that technology adoption is based on a complex set of interrelated factors: social, attitudinal, physical, digital literacy, and usability. We also discuss the feasibility of the app to enhance perceived social connectedness amongst our target population, provided that at least one strong tie is involved and communication norms and expectations across generations are considered.     

Effectiveness of an educational intervention to increase knowledge and reduce use of risky behaviors associated with cumulative trauma in office workers

OBJECTIVE: This pilot project assessed the effectiveness of an intervention to increase knowledge and reduce risky behaviors related to cumulative trauma disorders (CTD) in office workers. STUDY DESIGN: All 124 employees from the administrative offices of a health maintenance organization were invited to participate. Subjects were followed across time using an identification number. Data were collected via questionnaire in June 1994 (pretest1) (N=84), August 1994 (pretest II) (N= 63) and September 1995 (posttest) (N=40). The yearlong intervention focused on functional activities to prevent CTD. RESULTS: of chi-square analyses for the 40 subjects who completed all surveys indicated this intervention significantly increased overall knowledge of CTD (p =.002). Significant changes in self-reported hand/wrist (p =.016) and neck/shoulder (p =.003) posture were also found. CONCLUSIONS: This study is a first step in identifying effective educational interventions to increase knowledge and reduce risk factors related to CTD in office workers.