Barriers to accessing HIV and sexual health services among gay men in Tasmania,Australia

We examined barriers to accessing HIV and sexual health services among gay and bisexual men (GBM) in Tasmania, Australia, using in-depth interviews. Most participants were satisfied with the care they had received at public sexual health services. Barriers included the limited number of services, concerns about anonymity and privacy in small communities, difficulties accessing services via a general practitioner, and perceived stigma and discrimination. Improving the accessibility and availability of HIV and sexual health services in Tasmania is crucial to promote the engagement of GBM, which could be achieved via combined efforts of government services and community organizations.     

Volunteers in Brazilian Hospitals: Good Citizens or Strategic Agents?

Volunteers are recognized as people devoting significant time to provide unpaid services to social organizations. In nonprofit hospitals, volunteers play three essential roles. First, they provide assistance and care to patients. Secondly, they generate strategic value through fundraising, marketing, and community relations’ activities. Third, they generate financial benefits for the institution by reducing hospital costs. This article examines such roles and contributions of volunteers at two Brazilian nonprofit hospitals. Managers at these organizations consider volunteers valuable for the psycho-social service they provide, the strategic actions they develop, the cost savings they generate, the goodwill they create, and the funds they raise. In conclusion, volunteers at both hospitals are key stakeholders whose altruistic motives as good citizens motivate them to join either of the organizations, help humanize their services, and assist with the development of strategies that make significant contributions to the improvement of performance at both locales.     

Community mobilization and health care in rural China

This study is based on interviews conducted in Xiao San Jiang Township, China. This article describes the health care system before and after the reforms of the late 1970s and the impact on community mobilization and health care provision. The success of the Chinese health care system is attributed to mass participation in disease prevention. There were the public health campaigns of the 1950s at the brigade level that mobilized people to adopt personal and environmental sanitation, pest control, and primary health education. There were organizations, such as the Youth Leagues and the Women's Federations. The large groups encouraged use of services, such as family planning services, gynecological screening, and immunization. The Barefoot Doctor and Cooperative Medical Care Insurance Schemes were introduced. Brigades became directly involved in health care delivery, and health workers increased access to primary health services. There was multisectoral collaboration between mass and government organizations. Each commune official had multiple roles and information flowed between sectors. The end result was community mobilization of resources in an organization-intensive social structure and increased hopes for improvements in health. The propaganda was effective in health promotion. In the late 1970s, township management districts and village committees replaced the brigades and communes. The responsibility system gave households responsibility for the productivity of specific plots of land in order to fulfill government quotas. Members of a health project funded by a Hong Kong-based primary health care organization discovered a number of problems. Community mobilization was waning, and mass organizations were not effective. The insurance system collapsed. People tired of political slogans. Although other countries are now adopting community health approaches, China is moving away from this approach.     

The Power of Peer Support: The Development of the Empowerment Center

ABSTRACT

This article discusses the events and influences that led to the author’s contribution to the development of a mental health consumer-run organization, The Empowerment Center in Mount Vernon, NY. The author traces some events that influenced him personally and the evolution of the Empowerment Center from an organization that provided advocacy services (to those with mental health problems who were hospitalized) and community-based support services to people in mental health recovery, to an organization focusing on economic empowerment and economic development for the community of those in recovery. The transition of the Empowerment Center into an organization focused on economic empowerment underscores the importance of economic independence for people in recovery and the consumer-run organizations that support them. The Empowerment Center endeavors to demonstrate that mental health consumer-survivors can take control of their economic health as well as their physical and mental health.     

The theory of change of the evaluation support program: Enhancing the role of community organizations in providing an ecology of care for neurological disorders

This paper discusses the Ontario Brain Institute’s theory of change for the Evaluation Support Program, a program designed to enhance the role of community organizations in providing care and services for people living with a brain disorder. This is done by helping community organizations build evaluation capacity and foster the use of evidence to inform their activities and services. Helping organizations to build capacities to track the ‘key ingredients’ of their successes will help ensure that successes are replicated and services can be improved to maximize the benefit that people receive from them. This paper describes the hypothesized outcomes and early impacts of the Evaluation Support Program, as well as how the program will contribute to the field of evaluation capacity building.     

Merging nonprofit organizations: Analysis of a case study

This article presents a case study of merging among nonprofit organizations that provide social and community services. The study sheds light on the dynamics and problems of merging nonprofit organizations, whose espoused ideology focuses on promoting the well-being of their clients. The author describes and analyzes a merger in metropolitan Jerusalem, Israel, and highlights the potential problems that may ultimately undermine its success. This merger is the outcome of an ongoing power and political struggle. The analysis focuses on the organizational ideologies and culture as well as the strategies and structure of the merging organizations. In addition, the author deals with the underlying motives for merging, the driving and restraining forces, and the implications of merging nonprofit community services organizations with other social and human services organizations.     

Constructing the digital patient: Patient organizations and the development of health websites

In order to understand the constraints and challenges of realizing the democratic potentials of the Internet, this paper focuses on the attempts of three Dutch patient organizations to develop health websites. The authors describe how these patient organizations had to overcome specific barriers to develop their digital services. All three organizations faced certain constraints that had negative consequences for the plans they wanted to realize. Lack of financial resources and manpower were the main reasons why these patient organizations could not develop interactive parts of their website or provide personal advice services. Other barriers the patient organizations had to overcome were getting access to digital expertise to build the websites. The paper shows that the development of a website is a very demanding task, even for patient organizations that have in-house expertise with computers and Internet. Moreover, the paper shows that patient organizations do not consider the involvement of patients as crucial for the design of health websites. This research thus confirms previous research findings that users, in this case patients, are largely absent from the design process of information and communication technologies Finally, the paper shows how patient organizations' websites contribute to a redefinition of the patient from being a passive actor towards one who is an active participant in his or her care.     

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.     

Social workers’ perspectives on the recovery-oriented mental health practice in Tshwane,South Africa

The challenge facing the mental health field today is the lack of knowledge related to interventions and services that will help people recover from severe mental health problems. In addition, the reluctance of social workers to embrace the recovery-oriented mental health practice is attributed to their lack of knowledge. Hence, they regard recovery in mental health as misleading and unrealistic.The article provides the findings on the social workers’ lack of knowledge and understanding of the recovery-oriented mental health practice. The social workers are based in non-governmental organizations in Tshwane, South Africa. Semi-structured interviews were conducted to gather data from social workers. Findings confirmed the lack of knowledge regarding the recovery-oriented approach, which has not yet been implemented in South Africa. Mental health services continue to be informed by the traditional medical model.     

Community Foundations: A Growing Resource for Community Development

Like many nonprofit organizations, community development corporations (CDCs) rely on various sources of funding and support for their activities in poor and distressed neighborhoods. Funders often include the federal government, state and local government agencies, financial institutions, and philanthropic organizations. The author explains how community foundations are different from other philanthropic organizations and describes the various mechanisms that community foundations use to support community development. She suggests that there is a natural fit between the purpose of community foundations and the philosophy of community development, concluding that it is important for CDCs, as well as other nonprofit organizations, to understand how community foundations are different from other philanthropic organizations so that they may better position themselves to take advantage of the many resources that community foundations bring to their communities.     

The role of voluntary organizations in the care of the elderly in Norway

This paper describes the contributions of voluntary organizations to the provision of social services for the elderly in Norway. It presents data on the volume of social services provided by Norwegian voluntary organizations and discusses the recognition that the central government gives to such organizations, as well as the conditions for supporting voluntary organizations in the Norwegian welfare state. The analysis indicates the scope of the contributions made by these organizations in caring for older people. Though the size of contributions made by the voluntary organizations has been declining rapidly in recent years, the Norwegian government still recognizes their past contributions and the role they can play within the framework of the welfare state's social services for the aged.     

Coalition for a Healthier Community: Lessons learned and implications for future work

The Coalition for a Healthier Community (CHC) initiative was implemented to improve the health and well-being of women and girls. Underpinning CHC is a gender-based focus that uses a network of community partners working collaboratively to generate relevant behavior change and improved health outcomes. Ten programs are trying to determine whether gender-focused system approaches are cost-effective ways to address health disparities in women and girls. Programs implemented through coalitions made up of academic institutions, public health departments, community-based organizations, and local, regional, and national organizations, are addressing health issues such as domestic violence, cardiovascular disease prevention, physical activity, and healthy eating. Although these programs are ongoing, they have made significant progress. Key factors contributing to their early success include a comprehensive needs assessment, robust coalitions, the diversity of populations targeted, programs based on findings of the needs assessments, evaluations taking into consideration the effect of gender, and strong academic–community partnerships. A noteworthy impact of these programs has been their ability to shape and impact public, social, and health policies at the state and local levels. However, there have been challenges associated with the implementation of such a complex program. Lessons learned are discussed in this paper.     

Global Health Volunteering; Understanding Organizational Goals

This paper examines the goals of organizations that sponsor short-term volunteer trips in global health, whether they be NGO’s, faith-based, educational, or corporate organizations. Results from a U.S.-based national survey of 177 such organizations and 27 interviews with trip organizers suggest that organizations often sponsor volunteer trips to achieve goals that are quite different from the improvement of health outcomes in poor countries. While providing health services is often cited as the most important goal, volunteer activity is also considered important in enhancing the organizations’ reputation, recruitment and retention, and financial well-being. The prominence of other goals has the potential for diverting resources and focus from what is presumably the primary purpose of serving host communities in the most effective manner possible.     

“A lot of work needs to be done”—Service provider perspectives of mental health services available to Croatia- and Bosnia-born migrants

Research suggests that migrants have higher rates of mental health disorders but are less likely to access mental health services, which highlights both their vulnerability to mental illness and inequity in service provision. Despite being large and established culturally similar migrant cohorts in Australia, Croatians and Bosnians are invisible in mental health research. This qualitative study collected practice-based evidence from eight mental health service providers who have had direct professional contact with these communities, in order to understand how they engage with services, barriers to uptake and provide suggestions for service improvements. Thematic analysis was used to identify themes across interviews, which were then compared against Yang and Hwang's Migrant Mental Health Service Utilisation Model. The study identified unique factors specific to Croatia- and Bosnia-born migrants that impact how they engage with services, including mandated/prescribed services, religious resources, knowledge resources, referral pathways and procedures, and service provider competencies. This study will promote a better understanding of the limitations of the current mental health service offerings for Croatia- and Bosnia-born migrants, making it significant to practitioners, mental health organizations, policymakers and the general public.     

Reinventing a Large Nonprofit: Lessons from Four Voluntary Health Associations

This article describes attempts by four voluntary health associations to obtain their member organizations' consent to an emphasis on national rather than local goals and to new structures that centralized the members' management and governance functions while keeping service delivery decentralized. It argues that at three of the four associations, the member organizations agreed to a restructuring because the national organizations won their trust through a broadly inclusive decision‐making process and because the members were persuaded that the restructuring would increase resources available for local programs and services. Although the shift in focus to national goals risks diminishing local support, the reorganizations are evidence of a broadly felt need in nonprofit associations for a new decision‐making model and for new roles for volunteers that take better advantage of their community relationships.     

Reflections on experiential learning in evaluation capacity building with a community organization,Dancing With Parkinson’s

This paper discusses what was learned about evaluation capacity building with community organizations who deliver services to individuals with neurological disorders. Evaluation specialists engaged by the Ontario Brain Institute Evaluation Support Program were paired with community organizations, such as Dancing With Parkinson’s. Some of the learning included: relationship building is key for this model of capacity building; community organizations often have had negative experiences with evaluation and the idea that evaluations can be friendly tools in implementing meaningful programs is one key mechanism by which such an initiative can work; community organizations often need evaluation most to be able to demonstrate their value; a strength of this initiative was that the focus was not just on creating products but mostly on developing a learning process in which capacities would remain; evaluation tools and skills that organizations found useful were developing a theory of change and the concept of heterogeneous mechanisms (informed by a realist evaluation lens).     

“No Home,No Place”: Addressing the Complexity of Homelessness in Old Age Through Community Dialogue

The aging-in-place agenda supports the right of seniors to live in their preferred environment, as the place where they can retain a sense of independence and control in old age. This right is compromised for vulnerable seniors who are homeless or at risk of becoming homeless. Causes of homelessness in old age are complex, and pathways into and out of homelessness are multifaceted, including financial insecurity, relationship breakdown, and addiction, compounded by barriers to accessing services, shrinking social support networks, and complex health challenges. Addressing the multidimensional nature of homelessness in old age requires holistic solutions that bring together the knowledge and expertise of multiple stakeholders, not least seniors themselves. With this aim, this paper reports on findings from multistakeholder community dialogue sessions conducted across Metro Vancouver with seniors’ organizations, service providers, and local government to prioritize the challenges of senior homelessness in Metro Vancouver and propose strategies and solutions for addressing the issue. The paper highlights some of the ways in which services and housing supports can be designed to support older adults who are homeless or at risk of becoming homeless.     

Human Service Education Programs: Their Nature and Significance for Social Work

This paper examines emerging human service education programs at the community college, baccalaureate, and graduate levels. These programs bear a variety of titles such as mental health, social services, community development, and applied social sciences, as well as the more general human services label. Because they are relatively new phenomena, the nature and purposes of these programs are not widely known or understood. They appear to share some common purposes with social work education, while at the same time the potential for competition or conflict exists. Their significance for social work education programs and their graduates are considered.     

The Case for Better Maps of Social Service Provision: Using the Holy Cross Dispute to Illustrate More Effective Mapping

Third-sector organizations provide essential services, but not all types of organizations operate equally well given different intensities of public problems. This article argues for maps that would help social service funding bodies. Those maps would include three elements: (1) a measure of service demanded by a community, (2) data on the full range of organizations able to supply those services, and (3) a chart that identifies those organizations that provide services at different intensities of need. By providing information about the supply of organizations in a community, with measures of demand for services, state funding bodies, foundations, and individual philanthropists can make informed decisions about where to allocate funds. An ideal map is illustrated by using the case of the Holy Cross Dispute (2001), whereby a host of voluntary sector organizations provided a voice for residents in this divided Belfast community. The result is a call for more intensive mapping exercises of voluntary sector social service provision.