Ethical Considerations in Adoption Research: Navigating Confidentiality and Privacy Across the Adoption Kinship Network

Abstract

Adoption research often includes multiple members of the adoption network, each of whom has distinctive perspectives. Participants may include adopted individuals and their siblings as well as adoptive parents, birth parents, and adoption professionals. Due to these multiple informants and the sensitivity of the topics explored in adoption research, researchers encounter several unique ethical concerns when working with populations impacted by adoption. The current article addresses confidentiality and privacy issues that arise when conducting adoption research. Examples from a longitudinal study on openness in adoption are provided to highlight strategies that can be used to address these issues.     

Entrepreneurial development for U.S. minority homeless and unstably housed youth: A qualitative inquiry on value,barriers, and impact on health

BackgroundHomeless and unstably housed youth in the U.S. have high rates of unemployment and often rely on survival strategies that negatively impact their economic, emotional, and physical health. While integrated health and entrepreneurial development initiatives targeting the poor have been successfully implemented in developing countries, little is known regarding interests in similar initiatives among vulnerable U.S. youth, particularly racial minorities who are disproportionately impacted by poverty and homelessness. This study examined African-American homeless and unstably housed youth's interests in entrepreneurial development programming to enhance economic self-sufficiency and health-related outcomes.MethodsQualitative methods using nine focus groups and one in-depth interview were conducted from December 2013 to March 2014 with 52 purposively-selected youth, aged 15 to 24, who had experienced homelessness within the prior 18 months in Baltimore, Maryland and Washington, D.C. An emergent, open-ended topic guide was used to examine reasons why youth may want to participate in entrepreneurial development initiatives, what barriers they anticipated in becoming an entrepreneur, and how engaging in entrepreneurial and other economic empowerment activities might impact their physical and emotional well-being. All focus groups and interviews were recorded, transcribed, and analyzed.ResultsThe majority of youth were unemployed in the formal sector, but actively engaged in income generating activities in the informal sector. Four themes related to youth's interest in entrepreneurial development initiatives: the perceived inadequacy of traditional income and educational pathways, wanting to be one's own boss, desires for alternatives to joblessness and illicit income risks, and interests in building on current entrepreneurial activities. Commonly perceived barriers were lack of business mentors and opportunities, not knowing “what was possible”, difficulty in changing prior mindsets, and anticipated negative reactions from peers. Youth envisioned entrepreneurial development activities would inspire a range of health protective behaviors by minimizing poverty-related depression, hopelessness, and anxiety.ConclusionThis study underscores the need to address the intersection of poverty and health outcomes. Integrated health and entrepreneurial development programs should target low-income U.S. minority youth, particularly those with the greatest housing, health, and economic needs. More research is needed in understanding the behavioral dynamics between economic empowerment and health risk reduction among disadvantaged youth.     

Social motivation and health in college club swimming

ABSTRACT

Objective: Participation in recreational sport clubs on campus is a popular student activity nationwide. These sport-based organizations provide a host of benefits within recognized dimensions of health and wellness. Understanding participants’ motives for engaging in these types of activities can provide insight in design and delivery and enhance participant health. This study focuses on outcomes related to the social motivations for participation in a recreational sport swim club and their potential relationship to social health. Participants: Current members of recreational swimming clubs were contacted for participation in the study from March-April 2016. Methods: A Leisure Motivation Scale (LMS) survey was sent electronically to 196 collegiate swim clubs nationwide. Aggregate and multivariate analyses from 1011 responses were conducted to examine the social motivation and motivational differences of participants. Results: Social motivations emerged as the predominate motivational construct, indicating important implications for social health improvement through participation. Demographically, results indicated no statistically significant differences in social motivation factors based on participant gender, and statistically significant differences within participant race, university affiliation and practice frequency. Conclusions: Impacts of these findings are important for practitioners and participants when evaluating the potential these programs have to influence participant social health.     

Future Planning and Financial Education Needs for Asset Building Among Persons with Multiple Sclerosis in Rural Areas

Abstract

This paper presents findings from a study of individuals with multiple sclerosis examining their planning and preparation activities for their future independent living and long-term care needs. Data collected from a representative sample of National Multiple Sclerosis Society members in the greater metropolitan St. Louis and eastern Illinois area indicate significant differences in income, assets, education, health and functional limitation status between individuals living in rural versus urban areas. Additionally, findings show respondents with greater levels of education and assets, and those living in urban areas, are more likely to have saved for retirement, made legal preparations, or engaged in planning activities for future needs. Recommendations for asset building programs include incorporating education and training on planning for independent living and long-term care into financial planning curriculum, particularly for people with multiple sclerosis living in rural areas.     

Physical health characteristics of student service members and veterans by sexual orientation

Abstract

Objective: Little is known about the health status of the diverse population of student service members and veterans (SSM/V) enrolling in higher education in great numbers. The objective of this study was to explore the differences in physical health characteristics by sexual orientation among a national sample of SSM/V. Methods: Using secondary data, a series of maximum likelihood (ML) logistic regression models were estimated to explore physical health characteristics by sexual orientation in a sample of SSM/V. Results: SSM/V that identify as lesbian or gay reported higher rates of treatment and diagnosis for some physical health matters (respiratory illness and HIV) when compared with their heterosexual counterparts. Conclusions: Our findings support the need for campus health officials and policymakers to develop services to address the physical health needs of this population that differ from their peers.     

Putting the “S” Back into Sexual and Reproductive Health

ABSTRACT

Sexuality is the most fundamental aspect of our lives and yet it has long been the silent partner in sexual and reproductive health (SRH). Growing awareness of the rights-based approach to health, the commitment of governments and international bodies to promote sexual health and well-being, and the failure of many of the interventions to combat the HIV/AIDS epidemic are helping the reproductive health community put the “S” back into SRH even as the Millennium Development Goals fail to address SRH directly. The disconnect is due to the fragmented, non-holistic approach to reproductive health, short-sightedness in neglecting violations like gender-based violence, a lack of training for students and health care professionals in sexuality, a dearth of indicators and sexuality research and discrimination against vulnerable groups like youth and sexually diverse populations. Recommendations include reaching consensus about the nexus between sexuality and reproductive health and strengthening the commitment to gender equity, empowerment, sexuality and sexual rights among policymakers. Ensuring that explicit and positive references to sexuality are universal, especially in comprehensive sexuality education, youth-focused programs and the integration of HIV and other SRH programs, and strengthening the ability of program managers and service providers to work on sexual health issues are key to successful integration and program sustainability. Strengthening understanding, acceptance and competence in serving sexually diverse populations and improving the research and evaluation specific to sexuality are longer processes, but equally important in the paradigm shift to non-stigmatizing, gender-equitable, rights-based, pleasurable sexual health services.     

A participatory evaluation framework in the establishment and implementation of transdisciplinary collaborative centers for health disparities research

ObjectiveWe describe the formulation and implementation of a participatory evaluation plan for three Transdisciplinary Collaborative Centers for Health Disparities Research funded by the National Institute of Minority Health and Health Disparities.MethodsAlthough different in scope of work, all three centers share a common goal of establishing sustainable centers in health disparities science in three priority areas – social determinants of health, men’s health research, and health policy research.ResultsThe logic model guides the process, impact, and outcome evaluation. Emphasis is placed on process evaluation in order to establish a “blue print” that can guide other efforts as well as assure that activities are being implemented as planned.ConclusionWe have learned three major lessons in this process: (1) Significant engagement, participation, and commitment of all involved is critical for the evaluation process; (2) Having a “roadmap” (logic model) and “directions” (evaluation worksheets) are instrumental in getting members from different backgrounds to follow the same path; and (3) Participation of the evaluator in the leadership and core meetings facilitates continuous feedback.     

Latino youth participation in community-based participatory research to reduce teen pregnancy disparities

BackgroundCommunity-based participatory research can provide a framework to build community capacity to do health equity research, particularly from community members who may not typically participate in research design and intervention.PurposeThe purpose of this paper is to describe a community-based coalition's partnership and engagement with Latino youth throughout the research process addressing health disparities in unintended teen pregnancy rates in a local community. Israel and colleagues' components of CBPR provide a framework to develop youth participation throughout the research process.MethodHigh school and college Latino youth participated in health equity research from community assessments to design an intervention and dissemination of results.ResultsWorking with youth can improve the integrity and validity of the research process and can also provide benefits to the community and individual youth members, resulting in increased community capacity for health equity research.DiscussionLessons learned about the direct and indirect benefits and challenges are presented. Community-based partnerships working with youth should consider documenting the individual and collective impact of community engagement on the youth from the onset of participation.     

“It's Really Not Easy to Get Help”: Services to Drought-Affected Families

Abstract

The present paper details the results of research conducted with drought-affected farm families in New South Wales (NSW), Australia. The study reveals the significant health and welfare stresses experienced by families and the lack of access to services and support. The research was conducted in three sites in rural and remote areas of NSW in 2003. Farm family members, service providers, and other community key informants were interviewed. The paper outlines ways that the social work profession can respond to significant natural disasters.     

Not in employment,education or training: Mental health,substance use,and disengagement in a multi-sectoral sample of service-seeking Canadian youth

BackgroundYouth who are not engaged in employment, education or training (NEET) face multiple health, economic and psychosocial challenges. Despite the popularity of the NEET metric internationally, there is a paucity of research describing Canadian NEET youth.MethodThe proportion of NEET youth aged 12 to 24 presenting for services across multiple service sectors in Canada was examined. Their sociodemographic characteristics and mental health concerns were compared with those of their non-NEET peers.ResultsOver a quarter of youth were NEET, and they presented for services across all sectors. NEET youth showed multiple psychosocial risk factors. They were also more likely to endorse substance use and crime/violence concerns than their non-NEET service-seeking counterparts. Gender-based differences were observed.DiscussionSince many youth presenting for services across sectors are NEET, youth-serving agencies should be prepared to offer a wide range of services to address their diverse needs. Implications for systematic screening and integrated service provision are discussed.     

Educational Ingredients for Occupational Social Work Practice

Abstract

This article reports on the procedures and findings of an exploratory study to determine future educational requirements for engagement in the re-emerging field of occupational social work. This study utilized the “Delphi method” to determine what an informed group of geographically dispersed social work educators and practitioners from across the United States and Canada could agree upon with respect to the educational offerings considered essential in preparation for engaging in occupational social work in the 1990s. A combined total of fifty-one educational ingredients were accorded an above-average priority rating and ranked within the categories of knowledge and skill. With the identification of the items of agreement, a strong basis is provided for sound curriculum planning and development. The study concludes with a discussion of educational issues and implications.     

Help Seeking and Treatment Use Among Suicidal College Students

Abstract

Objectives: Many suicidal college students do not receive mental health treatment, and the reasons for this are not fully understood. This study examines how attitudes, beliefs, and social network factors relate to help seeking among suicidal students. Participants: A random sample of 8,487 undergraduate and graduate students from 15 US universities participated. Methods: A Web-based survey administered in spring 2009 examined correlates of mental health service utilization among students reporting serious thoughts of suicide in the previous year (n = 543). Results: Correlates of treatment use included perceived need, beliefs that treatment is effective, contact with service users, lower personal stigma, higher perceived stigma, fewer positive relationships, and sexual minority or Caucasian identity. Conclusions: Help seeking among suicidal students is associated with a range of personal and social network factors. Campus strategies to enhance help seeking should be tailored to address identified facilitators and barriers to treatment use among target populations.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

Effects of Premarital Medical Examination on Engaged Endogamous Couples in Rural Lebanon

Abstract

This article discusses the findings of a survey of Shiite Muslim engaged couples to assess their knowledge of the risks of congenital disease in endogamous marriage and the importance of the premarital medical examination. The engaged couples live in the Chmistar and Tarayya villages, located west of Baalbeck, in Lebanon. In-depth interviews were conducted with a group of mothers and key informants (religious leaders, general practitioners, geneticists, biologists and social workers) who are charged with providing information on the risks of marriage between first cousins. The qualitative analysis of their discourse revealed that: (i) endogamous marriage is preferred and fulfills the normative social tradition, and (ii) premarital medical examination, as practiced, seems to give the engaged couple a false sense of security. Results of this research emphasized that a health promotion program aiming at responding to a 1000-year-old tradition, such as endogamous marriage, should take into account the potential conflicts it introduces concerning the anthropological and sociological bases typical of this practice.     

Teaching Note—Meeting the Demand for Behavioral Health Clinicians: Innovative Training Through the GLOBE Project

ABSTRACT

The national move toward integrated mental health and substance abuse service delivery has a significant impact on social work education and necessitates changes in how we train students. To address this need, the Global Leaders of Behavioral Health Education (GLOBE) training project was developed. GLOBE is a student training and stipend program that prepares students for clinical behavioral health practice in integrated care. This teaching note describes GLOBE, reports challenges encountered in its implementation, and provides strategies for overcoming them. The challenges include assigning students to grant-compliant field placements, engaging other health care professionals in the educational efforts, and implementing curriculum changes. Suggestions for social work program administrators interested in integrated care training are provided.     

Health Staff Responses to Domestic and Family Violence: The Case for Training to Build Confidence and Skills

ABSTRACT

Domestic and family violence (DFV) is a serious, worldwide public health concern and the literature suggests that women who have experienced violence identify health care providers as the professionals they would most trust with disclosure of abuse. Social work is well positioned to respond to women presenting in hospitals after experiencing DFV and in advocating for systems and policy initiatives to support health staff in becoming adequately trained and supported to detect and respond appropriately. This paper reports on research that surveyed health staff in two hospitals in Queensland, Australia, to identify what DFV training they had received, whether this training increased their knowledge, skills and confidence to address DFV and what services they would access to support women presenting with DFV. The results showed that the respondents were an experienced staff group who had worked in the health sector for 10–20 years but despite having access to State-based training, the majority of them had not completed any in-house training and only 12% had received face-to-face training, and when they did undertake training, it was usually only a two-hour session. Seventy-five per cent of respondents would refer to their hospital-based social worker and 40% would make referrals to other support services, primarily social work.

IMPLICATIONS

• Hospitals need to prioritise, commit to, and resource appropriate and regular training to better equip health staff to identify and respond to DFV.

• Training needs to build the knowledge and skills of staff members to address their confidence to intervene and offer support.

• Social work can provide an important role in advocating and developing training and procedures to sustain health staff members’ capacity to respond appropriately to DFV.

     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).