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.     

A Novel,Self-guided,Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Abstract

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a repeated measures design with the primary follow-up assessment occurring 6 weeks after enrollment. Results: Forty-five percent of men reported a reduced frequency of unprotected insertive penile–anal intercourse in the past 30 days compared with baseline (p = .01). Consistency of condom use improved (p = .013), as did motivation to use condoms correctly, condom use self-efficacy, and condom attitudes. All participants indicated that they were glad they participated, would recommend the program, and that overall, they had liked the program. Conclusions: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).     

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

Objective: The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants: Participants were 204 college athletes (M age = 20.16 years, SD = 1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88 years (SD = 16.68 years) and on their college team for 2.10 years (SD = 1.03 years). Methods: Participants completed a demographic and weight background questionnaire, Questionnaire for Eating Disorder Diagnoses, and the Bulimia Test-Revised. Results: The authors classified participants as eating disordered (n = 4, 2.0%), symptomatic (n = 52, 25.5%), and asymptomatic (n = 148, 72.5%). Few participants engaged in binge eating; most used exercise, as opposed to vomiting, dieting, laxatives, or diuretics, to control their weight. Conclusions: Female athletes suffer from eating disorders, and most experience symptom levels that are subclinical but problematic.     

Seeing the Same Thing Differently: Program Director,Faculty, and Student Perceptions of MSW LGBT Competence

ABSTRACT

This exploratory study examined MSW education’s organizational-level lesbian, gay, bisexual, and transgender (LGBT) competence. Data were gathered from a sample of MSW program directors, faculty members, and students (N=1385) from 34 MSW programs in the United States. Hierarchical linear modeling analyzed differences in perceptions of organizational LGBT competence between MSW programs and among participants in the same program. Results showed organizational LGBT competence varied significantly among MSW programs and indicated program directors, faculty members, and students had different perceptions of the competence of their shared program. Specifically, directors rated the LGBT competence of their program higher than faculty, and faculty rated their program higher than students did. Implications for research and suggestions for social work education are discussed.     

Design Teams as Learning Systems for Complex Systems Change

Summary

Systems change in child welfare and cross-systems change involving other service sectors are needed in response to two developments: (1) New policy mandates (e.g., TANF, AS FA) and (2) Research on the co-occurring and interlocking needs of many child welfare families. A four-state initiative was structured in response to these needs. Collaborative learning and action research groups called design teams were structured to identify competencies and to develop new service delivery systems. Faculty facilitators representing social work education programs were assigned to these teams and charged with their development and evaluation. Facilitators served as linkage agents for university-communitystate agency partnerships, and they promoted curriculum change. These study reports two sets of findings related to these design teams: (1) Findings from semi-structured interviews of design team members; and (2) Findings from the participatory action research completed by two faculty facilitators. Key themes related to design team processes are presented. Drawing on these emergent themes, components that help explain effective design team processes are identified. Selected implications for social work education programs and faculty also are identified     

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.     

Participants’ views on the strengths and limitations of drug court: Recommendations to enhance assessment and treatment of mental illnesses

ABSTRACT

Since 1989, drug courts have provided an alternative to incarceration for arrestees who have a substance use disorder. Previous research has suggested that participants who graduate from the program are less likely to recidivate than those who are terminated from the program. The majority of research on drug courts is quantitative; therefore, the benefits of qualitative methods are not fully seen in the literature. This qualitative study developed an in-depth understanding of participants’ (n = 42) views on the strengths and limitations of a Midwestern drug court. Two themes emerged from the data. First, participants felt that the drug court promoted camaraderie, which enhanced their motivation for change and supported them in graduating from the program. Second, participants felt that the drug court did not adequately treat their mental illnesses, which for some resulted in relapse and was perceived as a barrier to graduating from the program. Recommendations for drug court practice are discussed.     

Examining the Efficacy of a Brief Mindfulness-Based Stress Reduction (Brief MBSR) Program on Psychological Health

Abstract

Objective: The purpose of the study was to examine potential psychological health benefits of participating in a brief (5-week) mindfulness-based stress reduction (brief MBSR) program integrated into an academic course. Participants: Participants were 119 undergraduate students (treatment: n = 72; control: n = 47) enrolled in elective academic courses on addictive behaviors, between January 2010 and May 2012. Methods: This study employed a quasi-experimental pretest/posttest design comparing changes in psychological health between brief MBSR treatment and parallel control groups. Baseline and follow-up data were collected synchronously across semesters for both groups. Results: Analysis of covariance revealed significant improvements in psychological health, measured by mindfulness (Philadelphia Mindfulness Scale: p ≤ .001; Kentucky Inventory of Mindfulness Scale: p ≤ .001) and self-compassion (Self-compassion Scale: p ≤ .001), among brief MBSR participants compared with the parallel control cohort. Significant reductions in trait anxiety were not evident. Conclusions: Brief MBSR programs can improve psychological health; however, longer MBSR programs may be needed to improve psychological distress, such as trait anxiety.     

Exploring community stress and empowerment among stakeholders and youth in an urban community

ABSTRACT

Community-level stress, such as pervasive substance abuse and violence, can yield negative health and mental heath outcomes for youth from disadvantaged communities. Community empowerment is a process whereby community members work together to increase control in their community. This qualitative inquiry analyzed in-depth interviews with adult stakeholders (n = 17) as well as focus group interviews with token youth (n = 85) to explore perceptions of community stress and empowerment in one disadvantaged locale. Each of the 102 total participants helped interrogate the research questions: What does it mean to live in a stressed community? How might youth and adults perceive themselves capable of impacting a stressed community’s quality of life? Emergent themes, which include a nod to the utility of coalition building, are explored. Implications for policy, practice, and future research are also discussed.     

Beyond Clinical Complexity: Nonmedical Barriers to Nursing Home Care for Rural Residents

We conducted a qualitative content analysis of barriers to nursing home admission for rural residents. Data came from semi-structured interviews with 23 rural hospital discharge planners across five states (Georgia, Idaho, Minnesota, Pennsylvania, and Wisconsin). From those, we identified four themes around nonmedical barriers to rural nursing home placement with particular salience in rural areas: financial issues, transportation, nursing home availability and infrastructure, and timeliness. We also identified policy and programmatic interventions across four themes: loosen bureaucratic requirements, improve communication between facilities, increase rural long-term care capacity, and address underlying social determinants of health.     

Meditation Lowers Stress and Supports Forgiveness Among College Students: A Randomized Controlled Trial

Objective and Participants: The authors evaluated the effects on stress, rumination, forgiveness, and hope of two 8-week, 90-min/wk training programs for college undergraduates in meditation-based stress-management tools. Methods: After a pretest, the authors randomly allocated college undergraduates to training in mindfulness-based stress reduction (MBSR; n = 15), Easwaran's Eight-Point Program (EPP; n = 14), or wait-list control (n = 15). The authors gathered pretest, posttest, and 8-week follow-up data on self-report outcome measures. Results: The authors observed no post-treatment differences between MBSR and EPP or between posttest and 8-week follow-up (p > .10). Compared with controls, treated participants (n = 29) demonstrated significant benefits for stress (p < .05, Cohen's d = -.45) and forgiveness (p < .05, d = .34) and marginal benefits for rumination (p < .10, d = -.34). Conclusions: Evidence suggests that meditation-based stress-management practices reduce stress and enhance forgiveness among college undergraduates. Such programs merit further study as potential health-promotion tools for college populations.     

Comparing Advice from Military Parents,Partners, and Veterans about How Families Can Encourage Service Members to Seek Behavioral Health care

This study compared advice that three groups—military parents, partners, and Veterans—gave regarding how military families can encourage service members (SMs) to seek professional help when needed. Based on identity implications theory and the normative model of social support, common themes regarding how families might pursue task, relational, and identity goals were expected (RQ₁). Based on their unique positions, we investigated whether the three groups stressed different themes (RQ₂). Military parents (n = 51), partners (n = 74), and Veterans (n = 112) read a scenario in which a SM was having difficulty reintegrating after deployment; all three groups offered advice about how military families should handle similar situations. Common themes regarding task, relational, and identity goals emerged in the advice from all three groups; however, parents, partners, and Veterans also differed significantly in how often they mentioned six themes. Theoretical and practical implications are discussed.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

Meeting the Challenge of Preparing Social Workers for Integrated Health Practice: Evidence From Two MSW Cohorts

ABSTRACT

Changes in health care policy have led to an expansion of integrated care models that rely on collaboration among interprofessional health teams. Recent federal funding has encouraged the development of innovative training models to prepare social workers for integrated health practice. This article presents evidence from the first two MSW cohorts of the Integrated Mental and Behavioral Health Training Program funded by the Health Resources and Services Administration. Twelve students completing the program in 2014 (n = 5) and 2015 (n = 7) participated in evaluation activities at the time of program completion and at 1-year postgraduation. Findings highlight key components of the training program instrumental in student attainment of program goals and competencies. Implications for MSW education and training for practice in integrated care environments are discussed.     

Therapeutic Effects of an Outdoor Activity Program on Nursing Home Residents with Dementia

Abstract

Objective: The purpose of this one-year pilot study was to obtain preliminary information on the effects of an outdoor activity program, in comparison to an indoor activity program, on sleep and behavior in nursing home residents with dementia. Structured activity programs have been shown to improve dementia-related behavior problems, and there are some indications that improved behavior is associated with improved sleep. Previous research has shown that sleep disturbance is common in nursing home residents, and that limited exposure to light bright enough to entrain circadian rhythms contributes to their sleep problems. Thus, we expected to see improvements in behavior in both the outdoor and indoor activity groups, but improvements in sleep in the outdoor activity group only.

Methodology: A two-group (outdoor program, indoor program) two phase (baseline, intervention) design was used. Subjects were randomized to the outdoor or indoor program groups. Sleep and behavior disturbance were assessed over a 10-day period at baseline (usual activity conditions, which were expected to include little or no time spent outdoors) and at intervention (daily structured activity program offered outdoors or indoors). Sleep was assessed with wrist actigraphs with photocells, which also allowed for monitoring of light exposure. Behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory. Both activity programs were offered Monday-Friday over a 2 week period, included similar content and were offered by research project staff. The analytical approach emphasized primary changes between baseline and intervention measures of sleep and behavioral symptoms in the two activity groups. Because this was a pilot study, the significance level was set a priori at p< 0.10.

Findings: The outdoor activity group experienced significant improvements in maximum sleep duration. Both groups showed significant improvements in total sleep minutes. There also was a significant improvement in verbal agitation in the outdoor activity group.     

Family members’ experiences and management of resident-to-resident abuse in long-term residential care

ABSTRACT

Objectives: Resident-to-resident (RRA) abuse is increasingly recognized as a significant problem in long-term residential care.Families have a constant presence in this setting, yet their inclusion in research about RRA is minimal. The purpose of this study was to examine family members’ experiences and management of RRA. Methods: The methodology was critical ethnography.Twelve family members participated in in-depth interviews and 56 hours of participant observation were conducted. Data were analyzed thematically. Results: The main themes illuminate families’ experiences of RRA in a context that largely normalizes it.In the absence of formal supports, families developed a range of management strategies, ranging from passive to active intervention.Organizational factors, such as staffing levels and mix, and the physical environment also contributed to RRA. Discussion: Families are actively managing RRA in long-term residential care. Policies and programs, including educational supports, should be developed to validate and support families.     

The relationship between the community participation of disabled youth and socioeconomic factors: mixed-methods approach in rural Sri Lanka

Mixed methods were applied to examine the association of community participation by disabled youth with socioeconomic factors in rural Sri Lanka. There was a significant association between community participation and socioeconomic factors in the quantitative survey (n = 116): participants living in socioeconomically disadvantaged conditions had lower levels of community participation than those living without these disadvantages. Consistent with the findings of the survey, previous educational experiences, household economic conditions, and perceived resource information were common themes in the qualitative study (n = 26). The dynamics of these factors, including marginalisation of disabled youth within the household, were also observed.     

Using formative research to tailor a community intervention focused on the prevention of chronic disease

This case study attempts to illustrate and address in-depth the issues surrounding the collection, analysis, and application of formative research findings to program development and implementation. We provide an in-depth case study of tailoring a program for the residents of Berkshire County, Massachusetts. The formative research process includes collection and analysis of secondary data sources, extensive in-person interviews with community leaders, and in-depth focus groups with members of the population of interest. Findings from the formative research are then applied to tailoring the program materials and presentations and the training of the integrative team of health professionals that offer the program. Distinct components of program are tailored to the realities of the social, cultural, historical, and health and medical contexts in each community while other components of the program are tailored to individual participants. Overall, we believe this case study fully illustrates the utility of formative research in tailoring evidenced-based programs to increase program relevance and positive outcomes while maintaining fidelity to a program’s learning objectives and evaluation. We hope this in-depth account with specific examples proves useful as a guide to others when designing and conducting formative research to tailor health and medical interventions to the audience.     

The Real Book of Mormon Musical: Latter-day Saint Family Home Evening as a Weekly Ritual

Abstract

Scholars of religious ritual have noted that inadequate attention has been paid to religious ritual in the social sciences. Based on what has been done, it is apparent that sacred family rituals (when done well and with relational sensitivity) can enhance structure, meaning, and family unity. The present study examines the family-level ritual practice of weekly Family Home Evening among members of 26 Latter-day Saint (LDS) families (N?=?58 individuals). Qualitative analyses found the following three themes: (a) Family Home Evening as a Conversation; (b) Challenges of Family Home Evening; and (c) The Value of Family Home Evening. Primary data that support and illustrate the three themes are presented, along with implications and applications.