Youth-centred practice: Positive youth development practices and pathways to better outcomes for vulnerable youth

This paper reports on a longitudinal study of 1012 youth (aged 13–17 years). Half were clients of two or more services and were followed for three years to enable analysis of the impact over time of services delivered using positive youth development practices (PYD). Youth completed self-report questionnaires administered by trained interviewers. It was hypothesised that youth reporting two positive service experiences at Time 1 would report better wellbeing and resilience and lower risk at Time 3 than youth reporting inconsistent or two negative service experiences at Time 1. MANCOVA was used to determine the relationships between service quality and wellbeing, resilience, and risk, with three covariates that assessed the presence of positive relational resources (with caregivers, friends and school) around youth. Results indicated that service quality at Time 1 had a positive effect on wellbeing and resilience at Time 3, but not on risk levels. The importance of consistent use of PYD approaches across services is discussed, as is the need for services to more directly address risk levels for vulnerable youth.     

Using primary and secondary stakeholders to define facility-to-community transition needs for adjudicated youth with disabilities

Stakeholder participation, specifically the primary beneficiary, enhances evaluation results by increasing the overall validity of the evaluative measure. This article provides an example of how the addition of adjudicated youth, the primary beneficiary, as a stakeholder group in a needs assessment provided additional information important for program development of a multi-agency transition program. The needs assessment consisted of five regional community forums comprised of youth correctional facility and community-based service providers (n=127), as secondary stakeholders. A nominal group process was completed defining both supports and barriers to the development of the service delivery model. Additionally, qualitative in-depth interviews were conducted on adjudicated youth (n=33) to describe their perception of the barriers and supports necessary for a successful transition from either a youth correctional facility or off of probation. Both groups identified and ranked the top 12 supports and barriers. Common themes emerged from both groups with substantive differences providing information that helped shape the program service delivery model to accommodate needs of both the adjudicated youth and secondary stakeholder participants. Implications for the development of the service delivery model are described.     

Assessing client satisfaction among Hispanics

Data from two studies using community health center clients are analyzed to assess how a measure of client satisfaction operates when used with different ethnic populations. The eight-item version of the Client Satisfaction Questionnaire (CSQ-8) is a measure of general satisfaction with services that was developed to provide a brief, standard assessment procedure suitable for use in a wide variety of service settings. Based on the results of this survey, the CSQ-8 seems to operate about the same, whether administered to Anglos, blacks, persons of Mexican descent, or persons of other Hispanic origin, or whether in English or Spanish. There were essentially no differences among the various ethnic groups across statistical criteria of internal consistency reliability, central tendency, dispersion, item intercorrelation, or missing values. These results suggest that the CSQ-8 is a measure of general satisfaction with services suitable for use with a variety of client populations, including Hispanics.     

Relationship of service satisfaction to life satisfaction and perceived well-being

Two procedures for gaining patients' evaluations of health services were compared: (a) the Client Satisfaction Questionnaire (CSQ-18B), a direct approach assessing the setting and services actually encountered, and (b) the Patient Satisfaction Questionnaire (PSQ), an approach that indirectly assesses satisfaction with service by inquiring about general health care attitudes. Results from 148 public health patients indicated that the PSQ produced the most acceptability problems and was tapping aspects of life satisfaction other than service satisfaction. However, the PSQ produced significantly lower reports of satisfaction. Additional comparison and interpretation of typical responses generated from the two approaches suggested, on the whole, that the CSQ-18B data provided clearer, more efficient, and more useful information for program planning and evaluation. In this study, service satisfaction measured by the CSQ-18B did not have any significant relationship to global or multidimensional (LDQ-30) measures of life satisfaction and well-being. In contrast, over a third of the variance in PSQ scores was accounted for by measures of life satisfaction. It appears that the PSQ elicits attitudes toward the more generalized health care delivery system as well as aspects of life satisfaction rather than reactions to specific services actually received.     

A culturally relevant measure of client satisfaction in child welfare services

Child welfare professionals increasingly recognize the importance of the client's perspective in evaluating service outcomes, but there is a dearth of well-developed instruments that meet the needs of service providers and planners. This article describes the implementation of a measure of primary caregivers' satisfaction with mandated child welfare services. This measure is significant for its flexibility regarding the nature of the child welfare population to be surveyed and for its attention to cultural aspects of the clients' experience. The instrument is an adaptation of Harris, Poertner, and Joe's (2000) client satisfaction measure and includes selected items from related instruments in the field. The measure was developed with the help of an Aboriginal child welfare agency and piloted with that agency's clients. The adapted instrument also includes items requested by the pilot testing agency to reflect high quality child welfare practice including specific attention to the clients' racial, ethnic, and cultural identity. This project furthers Harris et al.'s (2000) prior work by using the instrument in another country (Canada) and with diverse populations, thereby adding to the body of evidence supporting the development of this measure. Future research with larger samples could further enhance the validation of the measure and its usefulness to policy makers and practitioners.     

Comparison of indirect and direct approaches to measuring patient satisfaction

One indirect (PSQ) and two direct (CSQ-18B and ERS) measures of patient satisfaction were compared across a series of psychometric, acceptability, and concurrent validity criteria. None of the three measures was significantly related to health status or demographic characteristics. Each measure performed as expected from prior research on their psychometric properties. The scales contrasted, however, in regard to acceptability, with the PSQ being much less acceptable to patients than the other two. The PSQ also produced more missing data. The results on the PSQ reflected patient inconsistency on cross-check items and patients tended to be uncertain in their responses to many items. In multivariate analyses the three measures were used as predictors of patient-rated indices of global service satisfaction. The CSQ-18B and the ERS were significant predictors of patient-rated indices of global service satisfaction, whereas the PSQ was unrelated to these indices. It was concluded that the direct and indirect approaches measure different satisfaction domains. The PSQ likely assesses more generalized attitudes about health services while the CSQ-18B and the ERS efficiently reflect opinions about the specific setting in which they are administered.     

Measuring youth connections: A component of relational permanence for foster youth

This article presents the development and preliminary validation of the Youth Connections Scale, a measure of youth connectedness as a component of relational permanence for youth in out-of-home placement. The instrument measures different domains of youth's connectedness, including the number and strength of connections to caring adults and the types of support perceived by youth. Results of a pilot validation study of the instrument, with a sample of 53 adolescents in out-of-home care, indicate good concurrent validity and high test–retest reliability. Child welfare and youth-serving agencies can use this instrument in their efforts to strengthen and measure the connectedness and relational permanence of youth.     

Development and validation of a measure of organizational capacity for implementing youth development programs

Accumulating evidence indicates that incorporating youth development (YD) principles, strategies, and supports into an organization promotes positive adult and youth outcomes. However, few validated measures assess this type of capacity. The YMCA commissioned a study to validate its Capacity Assessment for Youth Development Programming (Y-CAP), which examines the organizational infrastructure required to implement YD programs and processes in seven areas. Survey development was an iterative process informed by existing frameworks, instruments, and pilot testing of items. The Y-CAP was reviewed and revised three times prior to this study, with a final round of revisions made at the start of the validation phase as a result of thorough content, survey methodology, and psychometrics reviews. The revised Y-CAP was completed by 123 YMCA implementation teams. Rasch analyses were used to determine the extent to which validity evidence supports the use and interpretation of the Y-CAP scores. Convergent validity was assessed by comparing Y-CAP scales to the Algorhythm staff survey for youth-serving organizations, and focus groups informed the consequential validity of the Y-CAP. The results provide strong evidence for the reliability and validity of the Y-CAP, which can be used to guide continuous quality improvement initiatives that support capacity and functioning in youth-serving organizations and programs.     

Changing health culture in rural Appalachia: Implications for serving the elderly

This article explores the dual themes of place and time as influences on health care service delivery to the rural elderly, through a case study of rural Appalachia. Traditional patterns of indigenous health care practice and values are contrasted with more “professional” formal models of health care service delivery that have entered the region. The result has been a clash of health care cultures. The continuing validity of this perspective is appraised in relation to apparent generational differences between the old-old and the young-old in the degree to which contemporary health care practices and values are adopted. It is concluded that traditional and contemporary health care cultures can be reconciled through an expanded vision of health care service delivery premised on: understanding health care within a total community context; redefining the role of the health practitioner; improving education of both the rural elderly and service providers; and enhancing communication in the rural health care environment.     

A multidimensional inventory for assessment of parental functioning

This paper reports on the psychometric properties of a multidimensional inventory battery for the evaluation of the parenting behavior of participants in family support programs. This inventory was administered to 693 voluntarily enrolled participants in five family support programs aimed at reducing child abuse and neglect. The components of the inventory assess key aspects of parenting behavior as defined by ecological theories of human development. Included are measures of depression, parental knowledge of child developmental milestones, parental attitudes toward childrearing, and social support available to and used by the family unit. Response burden, internal consistency of each measure, and content, criterion, and construct validity are examined. The results show that the inventory can be administered in field settings with minimum disruption of service activities. Two of the four measures achieved satisfactory reliability and convergent validity (i.e., the depression scale and social support scale). Assessment of construct validity yielded results in accord with the ecological model of child development and family function.     

Understanding service provision and utilization for vulnerable youth: Evidence from multiple informants

Research has demonstrated that the ability of children to cope well with risk exposure can be partly attributed to the social ecology that surrounds them, including their access to resources. Few studies however have explored the interaction of services that many vulnerable children receive in relation to surrounding risks and available resources. This study reviews data of a paired sample of 166 Canadian multiple service using youth (at least using two of five public service systems) and a youth-nominated person most knowledgeable (PMK) focused on the contextual risk factors, service use variables, and pscychosocial outcomes of youth participants. Despite low to moderate correlations between youth and PMK (the person who is most knowledgeable about youth's lives) reports, findings showed that both PMKs and youth perceive service provision as a mediator between risk and pscychosocial outcomes. For youth however, better quality of service provision is key to improved developmental outcomes. Furthermore, the more risk factors youth face at home and at school, the less likely they are to perceive their services as helpful or appropriate to their needs. Youth data also reflects far more complex interactions between risks, service provision and outcomes than PMK data. Greater sensitivity is needed to both an adult and youth's perceptions of risk and related service needs if service access is to be provided optimally.     

Using Social Work Theory and Values to Investigate the Implementation of Community Treatment Orders

Abstract

This paper establishes the value of a social work investigation of good practice with people on Community Treatment Orders in the context of social work's longstanding interest in the ethical challenges of working with involuntary clients. The emancipatory values of social work were used to guide this research, thereby ensuring the participation of consumers and their families or carers. Critical social work theory provided an important theoretical base. A mixed methods approach was undertaken, including a cluster analysis and case studies. Five principles of good social work practice emerged from the qualitative data: (a) use and develop direct practice skills; (b) take a human rights perspective; (c) focus on goals and desired outcomes; (d) aim for quality of service delivery; and, (e) enhance and enable the role of key stakeholders. These principles are briefly presented along with recommendations for practice and service development.     

Strengthening youth citizenship and social inclusion practice — The Australian case: Towards rights based and inclusive practice in services for marginalized young people

This article provides a framework for understanding disadvantaged young people from a youth citizenship perspective that includes social inclusion principles and a rights based approach to service delivery. This paper will argue that a rights based and inclusive practice approach can help to enable the self-confidence, resilience and capacities of marginal youth in efforts to counter social exclusion. A social inclusion strategy that is derived from the European Union helps frame inclusive practice and is explicitly linked to an emerging national human rights and inclusive agenda for marginalized youth in Australia. Elements of inclusive service practice include youth participation in services, issues of access and equity, service responsiveness, joined-up services and user-led accountability. These elements provide a basis for bringing a citizenship framework into services, and for professional learning and education in work with marginal youth. A framework is suggested that seeks to recognise and respond to highly disadvantaged youth that includes the marginalizing ‘intersections’ of gender, racial and disability identities. Brief excerpts of secondary qualitative data on two highly vulnerable youth populations-homeless youth and Aboriginal youth-are used to highlight the need for a citizenship approach that listens and responds to these vulnerable young people in both research and practice.     

Design and validation of the revised Regional Identity Scale (RIS-2) / Diseño y validación de la Escala de Identidad Regional revisada (RIS-2)

With the objective of theoretically and psychometrically updating the Regional Identity Scale (RIS) proposed by Zúñiga and Asún in 2004 and expanding the population for which it shows evidence of validity, a revision and revalidation of this instrument was performed via two studies. The first study included 1,113 university students from four regions of Chile, and the second included 1,200 adults from the same regions. Both samples were obtained via a random design through multistage conglomerates. The results enable us to propose a new version of the original scale (RIS-2) with suitable reliability indexes, solid evidence of both convergent validity and internal structure validity, and items with satisfactory psychometric quality. Furthermore, we verify the presence of a multifactor structure with three highly correlated dimensions. We conclude that the RIS-2 is a reliable, valid and conceptually broader instrument than the preceding version, so it is a useful tool to measure the intensity of regional identity in both university students and the adult population.     

How to integrate digital media into a drop-in for homeless young people for deepening relationships between youth and adults

This paper reports on a curriculum called New Tech for Youth Sessions, designed for homeless young people, aged 13-25. Motivated by the ordinariness of digital media and its importance in communicating with society's institutions, the primary goal of the curriculum was to develop students' life skills for information technology and digital media. A crucial secondary goal was to position students to recognize their self-worth, through meeting challenges, positive communication with adults, and reciprocal peer support. The paper describes how these goals were addressed by incorporating a community technology center into a multi-purpose drop-in for homeless young people and by a curriculum that guides students through an integrated series of activities related to finding employment. The paper discusses the principles underlying the curriculum, the class processes, and the social structure that supports the learning environment. A far-reaching result, based on offering 13 classes to over 75 youth over 16 months, is the hypothesis that instruction in digital media can create visceral, life-affirming experiences of challenges overcome, which can help strengthen relationships between the youth and the drop-in staff. The paper concludes with a discussion of lessons learned for incorporating digital media into drop-ins for enabling access and for improving life skills.     

An Aging Workforce in an Increasingly Global World

Summary

The aim of this article is to demonstrate the diversity in delivery of long-term care at the provincial level, within a national legislative framework that provides universal health insurance and public administration. Not all provinces have legislated provision of long-term care, but mandates for provincial long-term care programs typically address the needs of those with chronic health needs and maintain them in the community for as long as possible. Eligibility is based on common criteria of residency, health need, facility, assessment, and consent. The three common components of the service delivery system are institutional care, community-based services, and home-based services; the kinds of services within each component and the mix among them vary from province to province. There are also five common features in provincial service delivery systems: single point of entry, assessment, client classification, case management, and single administration. Throughout the article, examples from different provinces show the varying ways in which these aspects of service delivery have been addressed, and recent innovations have furthered this diversity. A detailed account of quality management systems also shows that while all provinces have adopted a common set of principles, they use a range of methods to pursue quality of care and to promote good practice.     

A cross-national validation of the client satisfaction questionnaire: the Dutch experience

A Dutch translation of the eight-term version of the Client Satisfaction Questionnaire (CSQ-8) was administered to community mental health outpatients in the Netherlands (n = 110). Data analyses indicate that the Dutch CSQ-8 has highly similar operating characteristics and psychometric properties compared with the English language version. Results also indicate that one general satisfaction factor was found in the Dutch CSQ-8 data. All eight of the scale items loaded heavily on this general factor, strong inter-item correlations were found, and the scale demonstrated high internal consistency. On these grounds, we can conclude that the Dutch CSQ-8 has the same properties as the original questionnaire and can be used as such in Holland. It was also found that those clients who decided to stop therapy on their own were less satisfied than other clients. Clients who made a common decision with their therapist or let him/her make that decision were more satisfied than clients who stopped by themselves. Additional research is planned to investigate whether clients who complete treatment goals are indeed more satisfied and whether this line of research could be a means of studying the external validity of the scale.     

National consistency and provincial diversity in delivery of long-term care in Canada

The aim of this article is to demonstrate the diversity in delivery of long-term care at the provincial level, within a national legislative framework that provides universal health insurance and public administration. Not all provinces have legislated provision of long-term care, but mandates for provincial long-term care programs typically address the needs of those with chronic health needs and maintain them in the community for as long as possible. Eligibility is based on common criteria of residency, health need, facility, assessment, and consent. The three common components of the service delivery system are institutional care, community-based services, and home-based services; the kinds of services within each component and the mix among them vary from province to province. There are also five common features in provincial service delivery systems: single point of entry, assessment, client classification, case management, and single administration. Throughout the article, examples from different provinces show the varying ways in which these aspects of service delivery have been addressed, and recent innovations have furthered this diversity. A detailed account of quality management systems also shows that while all provinces have adopted a common set of principles, they use a range of methods to pursue quality of care and to promote good practice.     

Organizational culture influence on service delivery: A mixed methods design in a child welfare setting

Despite the growing acknowledgement that mixed methods can be useful to better understand complex organizational cultures, there are few examples of studies, which demonstrate how organizational culture studies combine quantitative and qualitative methods in a single study within the child welfare setting. The purpose of the article is to illustrate how a concurrent triangulation was accomplished in a single organizational culture study in a child welfare agency. A sample of 92 employees was selected from a Midwestern private, non-profit, faith-based child welfare agency. Four distinct methods were used to measure organizational culture and its influence on service delivery which allowed for greater validity by collecting different data bearing on the same organizational culture phenomena. Strengths and implications are discussed.