The National Family Caregiver Support Program: A Multivariate Examination of State-Level Implementation

Research on caregiver support policy implementation has offered valuable insights but has not incorporated theoretical frameworks or multivariate analysis. This article describes how the communications model for intergovernmental policy implementation was used as a framework to examine predictors of successful statewide implementation of the National Family Caregiver Support Program (NFCSP). Using data from the National Center on Caregiving State of the States survey, U.S. Census, Administration on Aging, and historical records, implementation (extent of service delivery) was examined in 50 states and the District of Columbia. State-level characteristics (demographic, historical, political, and organizational) were tested for their ability to explain more or less successful implementation. Bivariate and multivariate findings suggest that historical characteristics predict the likelihood of delivering more counseling, support group, and training. States that recognize caregivers as both service recipients (through counseling and support groups) and service providers (through training) may demonstrate more effective implementation.     

Availability of caregiver support services: implications for implementation of the National Family Caregiver Support Program

This study examines the scope and range of existing resources for family caregivers from the perspective of the Area Agencies on Aging (AAAs), which are charged with implementing Title III-E of the reauthorized Older Americans Act. California is used as a case example because of its substantial experience in providing caregiver support services. In particular, we examine the extent and adequacy of resources available in California corresponding to each of the five Title III-E service areas, utilizing data from AAAArea Plans, a follow-up survey of AAAs, and an Internet search. AAAs identified more than 276 providers of caregiver support services, and our Internet search identified another 195. Nearly two-thirds of these programs offer access to respite care, while other support services (e.g., counseling, training, support groups) are less often available. Service gaps most frequently identified included culturally and linguistically appropriate caregiver services, transportation, respite care, financial assistance, and services in rural areas. These findings suggest the need for enhanced efforts to improve the service network for supporting family caregivers, as states implement the National Family Caregiver Support Program.     

Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

Evaluation of the U.S. Air Force Family Support Center Program

This article provides an overview of the implementation and evaluation of Family Support Centers (FSC) in the U.S. Air Force. After describing the FSC model, the quantitative aspect of the evaluation is discussed, including the evaluation design, implementation methods, survey response rates, and procedures for data analysis. A summary of evaluation results also are presented as well as a discussion of administrative and methodological issues encountered in performing the evaluation. The results of the evaluation suggest that the FSC has become an integral part of the base human service delivery system, especially for married members and civilian spouses.     

Support for the Family in the Post Industrial Society:

No abstract available for this article.     

Family leave legislation in the American states: Toward a model of state policy adoption

The issue of mandated family leave has drawn substantial attention in recent years. This article develops and tests empirically a model of adoption of family leave policies in the American states during the late 1980s. State family leave policies are seen as a function of three sets of variables: (a) institutional-elite variables such as partisan control of state government and the proportion of women in the state legislatures; (b) constituency disposition variables such as mass partisanship, mass ideology, and the likelihood of general support for “women's” issues; and (c) contextual-demand variables such as birth rates and women's participation in the workforce. The model provides impressive fit to the data, accurately predicting the family leave policies of 92% of the state cases. The results suggest the importance of partisan control of state government, proportion of women in the state legislature, urbanization, and feminism as a state policy as factors that affect the probability that states will adopt mandated family leave policies. His research interests include American politics, public policy, and domestic political economy. He is editor of theAmerican Politics Quarterly, and is former President of the State Politics Section of the American Political Science Association. He received his Ph.D. from the University of Kentucky. Her research interests include family policy and women's labor force participation. She received her Ph.D. in Family Science from the University of Georgia.     

Strengthening Support to Families: Basing a Family Support Worker at a Primary School in Melbourne,Australia

This mixed methods study examines the benefits of basing a family support worker (FSW) at a primary school in Melbourne, Australia. The school has a number of high needs families requiring extensive support from school staff. Pre and post intervention data was collected on the time spent on social problems in the school community. These included managing students with behavioural and emotional issues, providing support and practical assistance to parents with problems and liaising with agencies to access support for students and families. Pre and post intervention Strengths and Difficulties Questionnaires were completed by teachers whose students and families were clients of the FSW (n = 8) and compared with non clients (n = 10). Semi-structured interviews were held with FSW clients (n = 6), class teachers (n = 3) the assistant principal, principal and the FSW. Employing a FSW showed a reduction in the amount of time spent on welfare cases for teachers, and therefore a monetary saving for the school. Qualitative data collected from school staff and FSW clients was overwhelmingly positive. Having a FSW based at a primary school provides savings in teacher time, and expenses to the school. Teachers are freed to concentrate on education and the parents valued the relationship provided by the FSW.     

The Workers' View: Strategies and Coping Skills in a Family Preservation Program

This article examines the family preservation model from the perspective of workers involved in a program using the model. It describes a pilot study using qualitative research methods completed with all workers in a family preservation program. The study's focus explored the coping mechanisms of the workers specifically related to boundary and termination issues, and ways workers viewed families with whom they worked. Boundaries appeared to be managed by workers through cognitive mechanisms, application of program structure with clients, role clarification, supervision, and self-assessment. Role clarification particularly helped workers set limits for tasks that could be accomplished with families in a short-term model. Comfort and discomfort with termination issues included both personal and professional explanations. Coping mechanisms for managing termination issues were similar to those mentioned in regard to the maintenance of professional boundaries.     

A Preliminary Qualitative Analysis on the Feasibility of Using Gaming Technology in Caregiver Assessment

This exploratory qualitative study examined the feasibility of utilizing gaming technology that will ultimately assess task performance and stress among caregivers of dementia patients. The long-term goal is to use this unobtrusive application (app) to detect caregiver burnout for the purposes of early intervention. This preliminary study examined participant interface with a specific gaming technology called CAST (Caregiver Assessment Using Serious Gaming Technology). Ten dementia caregivers participated. Participants attended a demonstration and then interacted with a preliminary version of the CAST tablet application. Social work researchers interviewed participants using open-ended questions to gauge interest, technology skill level, and comfort with the app. Participants expressed interest and identified potential ways to further develop the system in order to increase ease of use, decrease time commitment, and improve suitability for daily use. The provided feedback will be used to refine the user interface of the application, which will then be used to monitor caregivers’ stress in future development.     

Non-traditional Student Retention: Exploring Perceptions of Support in a Social Work Graduate Program

This study examines non-traditional student perceptions of social support in the context of a group intervention offered by a graduate program at a predominantly white university in the southern United States of America. The goal of the group intervention was to enhance perceptions of social support, as measured by a standardized instrument administered pre and post the group intervention. Data analysis showed no significant differences in pre–post changes in perceptions of social support between intervention and comparison groups. A follow-up survey questionnaire administered to group intervention participants provided feedback that shed light on these unanticipated results: it is recommended that future interventions for improving non-traditional student retention focus on supporting the development of social support networks among incoming and first-year graduate students.     

The Family Interaction Test A Preliminary Study of a Method for Interpreting Narratives about the Family

The Family Interaction Test is a narrative projective method designed to elicit children's perceptions of family life and patterns of interaction by way of stories around particular themes and events. Drawing on a post-modern interpretive approach, the paper proposes that traditional psychometric research methodologies underpinned by the logico-empirical paradigm are inappropriate in the study of narrative meaning. It is argued that practitioners, rather than seeing themselves as separate from the story teller and thus objectifying the ‘true’ meaning of the narratives, can instead enter into a discourse with the story teller as a way of testing hypotheses and thus establish the verisimilitude of story meanings. The results of a preliminary clinical study using this methodology with the Family Interaction Test are presented and discussed.     

The Perspectives of Older Greek-Australians Toward Changes in the Nature of Family Support: Implications for Family Care Policies

Internationally, public policies encourage “aging in place,” and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n?=?27) and five focus groups (n?=?63 total participants) with older Greek-Australians in modern Greek. While “cultures of care” remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.     

Canadians in Crisis: the Nature and Source of Support for Leadership in a National Emergency*

Cet article analyse un cas ou la position théorique de Parsons concernant «l'in-flation de confiance» dans les autorités politiques est opérant dans un groupe à l'occasion d'une crise nationale. Un analyse de contenu de 1047 lettres à lèditeur démontre que leurs auteurs arriverent aux mêmes conclusions mais à partir de significations subjecteurs les plus diverses et une grande variété de prises de positions idéalogiques. Dès lors, le consensus dans les systèmes de valeur devenait aleatoire: on chercha à le susciter par le biais de deux stratégies de leadership. D'une part on cherche à revaloriser l'attachement aux valeurs les plus fondamentales; d'autre part on veut créer la crainte par un dénigrement de l'ennemi. Une analyse plus poussée évonce les conséquences possibles pour le système de la répugnance chez les membres a mener une analyse critique des politiques de leurs dirigeants. This paper explores a case where Parsons' inflation of trust in political authorities was operating among system members during a national crisis. A content analysis of 1047 letters to the editor shows that writers reached the same conclusion but through widely different subjective meanings and ideological positions. Hence, value consensus was seen as problematic, and its source was sought in an exploration of two leadership strategies: inculcation of attachment to core values, and mobilization of fear through vilification of the enemy. Further analysis suggests the consequences for the system of a reluctance among members to scrutinize the policies of political leaders.     

Vestiges of the medical model: a critical exploration of the Ontario Disability Support Program in Ontario,Canada

Although ample literature exists on workfare in Ontario, Canada, research on the social assistance programme for disabled people, the Ontario Disability Support Program (ODSP), is relatively scant. What we do know points to similar shortcomings. We present a critical disability study considering four policy domains to explore how disabled people are identified and accommodated in Ontario. Discussing the principles of universal design, we argue for policy design that meets the needs of as many individuals as possible, while accounting for significant human variability. We conclude that the ODSP, in failing to adopt a rights-based framework, violates the dignity and rights of disabled people.