University efforts to address confidentiality issues for STI services

Abstract

Objective: This study assessed university policies for addressing confidentiality issues for students seeking STI services. Participants: Universities with sponsored health insurance plans (SHIP) and/or wellness centers were selected from a university health services survey in 2017. Methods: STI service coverage and polices for addressing confidentiality issues related to explanation of benefit (EOB) forms were stratified by institution type (4-year versus 2-year) and minority serving institution (MSI) status. Rao-Scott chi-square tests were used to assess for differences in STI service coverage and polices. Results: More non-MSIs (61.6%) had SHIPs compared to MSIs (40.0%, p?<?.001). Only 40.8% of health centers had a policy for addressing EOB-related confidently issues. Of those, the most reported policy was that students could pay out-of-pocket to avoid generating an EOB (36.2%). Conclusions: Reducing confidentiality barriers are important for STI prevention in students. Universities may consider establishing policies for addressing EOB-related confidentiality concerns.     

Liability and the Internet: Risks and Recommendations for Social Work Practice

SUMMARY

Use of the Internet for counseling and information services has increased dramatically in the last five years. Although the Internet may benefit consumers by helping them secure needed services and resources, social workers and social service agencies who provide counseling over the Internet need to be aware of the legal risks associated with its use. Among the most salient concerns that need to be addressed are client confidentiality and privacy of records, appropriateness of treatment services, and the duty to warn others of harm that a client might pose to them. This paper looks at these legal concerns in light of appropriate Social Work practice and recommends methods to abate the risks that might occur when Internet counseling and service is provided.     

Disclosure of sexual assault experiences among undergraduate women at historically black colleges and universities (HBCUs)

ABSTRACT

Objective: To document the sexual assault disclosure experiences of historically black college or university (HBCU) students. Participants: A total of 3,951 female, undergraduate students at 4 HBCUs. Methods: All women at the participating schools were recruited in November 2008 to participate in a Web-based survey including both closed- and open-ended questions. Survey data were weighted for nonresponse bias. Results: The majority of sexual assault survivors disclosed their experience to someone close to them, but disclosure to formal supports, particularly law enforcement agencies, was extremely rare. Nonreporters had concerns about the seriousness of the incident and their privacy. On the basis of qualitative data, strategies identified by students to increase reporting included more education and awareness about sexual assault, more survivor services and alternative mechanisms for reporting, and better strategies for protecting the confidentiality of survivors. Conclusions: Official sexual assault victimization data are of limited utility in conveying the extent of sexual assault among HBCU students, and efforts to increase reporting, such as peer education and enhanced confidentiality procedures, are needed.     

Recognizing Abuse and Neglect in People with Severe Cognitive and/or Communication Impairments

ABSTRACT

It is widely acknowledged that physical abuse of persons with severe developmental disabilities is prevalent, usually perpetrated by a residential care provider and is rarely reported. However, no solid research on the topic has been reported. This article notes the lack of information about protective services directed to the developmentally disabled population and lack of coordination between agencies serving people with developmental disabilities and those providing protective services. The signs and symptoms of abuse in the developmentally disabled population, the alternative communication strategies required when interviewing, and the special skills needed for case assessment are presented. The author ends with a series of federal, state, and community level policy recommendations.     

Patient Rights: An Advocate's Perspective

Abstract

The current growing concern about patients' rights and the delivery of student health care precipitates an environment of fear, distrust, and uneasiness within university health services. This paper addresses several selected clinical, ethical, and legal issues which have come into conflict during recent years. Our examination surveys ethical and legal principles of confidentiality, defines areas in which breaches are most likely to occur, and suggests ways of preventing breaches of confidence between students and health services.

While the fundamental ethical principle underlying confidentiality is the individual's right of privacy, many issues of confidentiality are extremely difficult to resolve. University health services have expanded the concept of health care to encompass all the conditions — medical, emotional, social, economic and environmental — which affect the health of students. As a result, health service administrators should be fully aware of the laws and associated legal complexities in their own state which affect confidentiality. Furthermore, student health physicians, and particularly mental health therapists must be sensitive to needs for protecting the privacy of students.

Legal principles of confidentiality discussed in this paper with respect to specific problem situations which might arise in a student health center include: 1) right to privacy; 2) privileged communications; 3) releasing information from the medical record; 4) releasing information to the student; and 5) treating minors without parental consent. Finally, in addition to the responsibilities which must be assumed by the health professional, certain student responsibilities in the selection and utilization of health professionals are recommended.     

On Our Own

Abstract

While research has stressed the need for self-awareness on the part of social workers, few scholars have addressed the influence of organizational policies on spiritually-sensitive practice. Focus groups and interviews, conducted with 11 practitioners, suggested that agencies require information about clients' religious or spiritual background as part of an initial assessment; however, the parameters for using that information were ambiguous. Lacking clear guidelines, each social worker developed a personal policy for spiritually-sensitive practice, based on the practitioner's personal belief system and the NASW Code of Ethics. Recommendations are made to align spiritually-sensitive practice at the organizational and the practitioner level.     

How early is early intervention and who should get it? Contested meanings in determining thresholds for intervention

The latest wave of reforms of the child protection system in Australia have been based on attempts to provide support to all families with vulnerable children, rather than increasing surveillance of ‘at risk’ families and forensic responses to incidents of maltreatment. This includes a drive to widen the remit of child protection from the statutory child protection agency and involve other government agencies such as health and education as well as the non-government sector in child protection. This paper reports on the effects of one such reform, the NSW initiative Keep Them Safe. It focuses on the classification of families as needing either early intervention or intensive support, using thematic analysis of qualitative interview data.MethodInterviews and focus groups were conducted with practitioners and managers from human service agencies (total n = 115), and discussed their perceptions of the initiative and the changes it had introduced to service delivery.FindingsPractitioners discussed family needs in ways which contested the policy meanings of ‘early intervention’: whether families are conceptualised in terms of their needs or risk; whether engagement with services should be voluntary or mandated; and whether the agencies to support them should be the statutory agency or an NGO. The implications for these tensions, in terms of policy and practice, are discussed.     

Where We Are Now with Intergenerational Developments

ABSTRACT

Intergenerational programs are beginning to burgeon in England. They are relatively recent in their development. The systemic absence of connectiveness between policy developments and services relating to older people and those relating to children and young people is identified. The key strategic players are described. Questions about future developments and research are discussed.     

Self-Determination and Confidentiality

ABSTRACT

This article seeks to further clarify the ambiguous nature of two of social work's most important values: self-determination and confidentiality. Previous research indicates that many ethical decisions in social work practice are difficult to make; and, many times decisions are made based on the worker's values and experiences rather than on written ethics, laws, and agency policy. To explore this concept further, an open-ended survey instrument was distributed to 82 social work students after completing the required practice classes. The participants were asked whether they would break confidentiality based on a specific vignette and describe what decision was made and why. Results indicated that degree level (MSW versus BSW) proved to be a significant factor related to whether and/or why the respondent would break confidentiality. In addition, students with more paid work experience were more likely to question the issue of confidentiality and were more likely to break it. Two issues reflected in the decision-making process involved ensuring client safety and self-determination. In conclusion, this article explores possible reasons for breaching confidentiality and pitfalls that can occur for all professionals in making these types of decisions. Furthermore, it explores the ambiguous nature of problem solving in this area, and suggests ways that social workers can improve their decision-making skills.     

Computer Technology Utilization and Community-Based AIDS Organizations

SUMMARY

This study explores the computer utilization patterns of 107 community-based AIDS organizations in Canada. A questionnaire examined the current hardware/software capacities of agencies, knowledge and use of the Internet and its capabilities as a tool for psychosocial support, and barriers to computerized service provision. It also explored consumers' utilization and knowledge of computer-mediated technologies, and barriers to service. Results suggest agencies have resource-related dilemmas, relating to limited finances, time and personnel capacities. Consumers are challenged by a lack of access to computers, limited awareness of computer-mediated technologies, and other inhibiting factors. Future directions for community-based AIDS organizations are considered.     

Desktop Expert Systems

Summary

The introduction of commercial exDert systems shells for common desktop computers offers human service agencies a new area of computer application to add to the word processor and the spreadsheet. Expert systems can be used to develop knowledge based applications which automate policy manuals, provide tutorial support in training situations, provide support in decision making situations, etc. Further, the low cost, extensive documentation, and short learning time allow agencies to develop applications unique to their needs or allow individual employees to develop applications that help them with some aspects of their work.     

Desktop Publishing for Human Services

Abstract

Computers, especially microcomputers, are helping human service agencies gather and organize an ever-growing amount of information. The new area of desktop publishing can help agencies present that information to clients, funding sources, reporting agencies, and the community, in a clear and easy to understand manner. Desktop publishing can result in professional looking documents at a fraction of the cost of traditional typesetting methods. This paper outlines some of the concepts and benefits of desktop publishing for human services, and points out some of the potential pitfalls.     

Macro Practice and Policy in Cyberspace

SUMMARY

The integration of computer training within social work education is necessary for social workers to keep abreast of technological changes occurring within human service agencies. This article presents several techniques to integrate computer simulations and Internet research within the baccalaureate curriculum. Emphasis is placed on the use of these techniques to teach policy and macro practice.     

Dealing with Institutional Abuse in a Multicultural South African Society

SUMMARY

The climate of socio-political transformation in South Africa together with a society of complex multicultural diversities creates enormous challenges regarding the care of the elderly in institutions. Institutional abuse in South Africa may present in a unique way, as a result of issues relating to policy and legislation and care delivery systems. The need for previously segregated groups to integrate and understand the various cultural practices of people from different socio-economic backgrounds further compounds the opportunity for abuse in homes for the aged which are undergoing transformation.     

Policy recommendations for rare disease centres of expertise

AimRare diseases are a serious public health concern and are a priority in the EU. This study aims to develop policy recommendations for rare disease centres of expertise (CoEs) in order to improve standards and quality of care.Subject and methodsA modified 3-round Delphi technique was used. Participants included rare diseases patients, carers, patient representatives and healthcare professionals (HCPs) from CoEs in two countries—Denmark and the UK.ResultsThe results suggest the need to make improvements within current CoE environments, access to CoEs and the need for coordination and cooperation of services within and outside CoEs. It is recommended that CoEs are not overly ‘medicalised’, while at the same time they should be established as research facilities. The importance of including patient representatives in CoE performance management was also highlighted. Raising awareness and provision of appropriate training amongst non-specialist HCPs is seen as a priority for early and correct diagnosis and ensuring high quality care. Similarly, provision of targeted information about patients’ illness and care was considered essential along with access to social assistance within CoEs.ConclusionsPolicy recommendations were developed in areas previously recognised as having gaps. Their implementation is expected to strengthen and improve current care provision for rare disease patients. In member states where national plans and strategies are being developed, it is recommended to replicate the methodological approach used in this study as it has proven to be a helpful tool in rare disease centres of expertise policy development.     

A Feminist Policy Analysis Framework

ABSTRACT

Most policy analysis models, both inside and outside of social work, approach policy in a gender-neutral manner. This fact belies the many ways our society is organized around gender, which is often regulated through policy. This article outlines a model for looking at policies through a gendered lens by framing a set of questions to be asked in a feminist policy analysis. The complexities and underlying issues inherent in such a model are discussed, as well as the model's implicit goals and values. The model provides an important framework for policy analysts and teaching students about policy.     

Adoptions, 2000–2001

ABSTRACT

The number of domestic adoptions has remained relatively constant over the past 15 years, varying between 121,000 and 127,000, but placements have increasingly been completed by public agencies. Adoption of foreign-born children in the United States has nearly tripled in the past 20 years. Despite the increased national interest in adoption in the past decade and the efforts of many dedicated individuals and agencies, it is still difficult to determine the total number of adoptions in the United States. No one agency is charged with compiling adoption information on all adoptions in the United States, and the agencies that do have access to some types of adoption information have no mandate or incentive to compile that information so that it could be integrated with other sources of adoption information.     

Conveying campus sexual misconduct policy information to college and university students: Results from a 7-campus study

ABSTRACT

Objective: To examine the efficacy of different methods (ie, in-class policy reading; in-class policy reading and discussion; no reading or discussion) to deliver campus sexual misconduct policy information to students on 7 campuses. Participants: A total of 1,195 participants at 7 colleges and universities participated in the study from August to October 2014. Participants were randomly assigned at the class level and completed pretest and posttest surveys assessing knowledge of campus policy and resources and confidence to seek help for sexual assault. Results: Students exposed to a larger dosage of material (in-class policy reading plus discussion) showed greater positive changes in attitudes and knowledge than students who did not receive information or were only read the policy. However, on some indices, students who were only read the policy showed positive outcomes compared with students receiving no intervention. Conclusion: Colleges and universities must use engaging methods to disseminate campus sexual misconduct policies to students.     

Necessary Steps in Designing a Successful Contract

Abstract

Parents with a history of serious mental illness are vulnerable in many ways and are therefore likely to be accessing services from a range of government and community agencies. The use of multiple services, sometimes with conflicting practice frameworks, can result in sub-optimal management of these families. This study surveyed 77 service providers from a range of government and non-government agencies targeting their views regarding parents with a serious mental illness (specified in this study as schizophrenia, bipolar disorder and psychotic depression). They were asked what they perceived were difficulties for this population, interventions required to meet the needs of this group and finally, barriers to effective service delivery. We found that service providers reported that current services were inadequate for these parents. Parent-based interventions were seen as being more beneficial than those targeting children. Lack of liaison between agencies and lack of coordinated service provision were seen as the greatest barrier to effective service delivery. The results highlight the need for policy planners and service providers to develop strategies to ensure effective coordination between services that work with this population.