Gerontological social workers' perceived efficacy for influencing client outcomes

Using a sample of practitioners (n = 269) from the 2004 National Study of Licensed Social Workers, this article employs a quality assurance structure-process-outcome model to examine factors at the practitioner, workplace, and service delivery levels that influence the perceived efficacy of licensed gerontological social workers to affect client outcomes in the context of a highly challenging health care environment. A regression model accounted for 33.9% of the variance (adjusted R (2) = .291) in perceived efficacy with 3 aspects of service delivery satisfaction having significant effects: ability to address complex/chronic care, to influence the design of services, and to help clients navigate the system.     

Community Service Use by Older Adults: The Roles of Sociocultural Factors in Rural–Urban Differences

ABSTRACT

This study examined the influence of sociocultural factors in explaining the rural–urban differences in home and community-based service (HCBS) use among older adults. Survey data of 228 older adults living in Alabama were analyzed. Sociocultural factors included participants’ perceptions of service availability, attitudes toward seeking formal help, informal support, and religious behaviors. Rural older adults were less likely to use HCBS than their urban counterparts (p < .05). An interaction effect between perceived service availability and church attendance was found. These findings suggest a need for collaborations between community aging services with religious organizations to ensure existing programs are accessible to older adults living in rural areas. Future research based upon large probability samples is needed to shed more light on the relation between church attendance and service use.     

Linking Perceived External Prestige and Intentions to Leave the Organization: The Mediating Role of Job Satisfaction and Affective Commitment

ABSTRACT

The present study examines social workers' beliefs about the prestige that outsiders (e.g., patients, suppliers, competitors, and the public) attribute to their organization and the way these beliefs influence the social workers' commitment to the organization they work for, job satisfaction, and turnover intentions (i.e., intentions to leave the organization). We collected two primary data sets (N = 160 and N = 489, respectively) from social workers in nonprofit social service organizations in Israel in 2001 and 2002. In general, the results show that perceived (construed) external prestige results in higher employee commitment and satisfaction, which, in turn, leads to lower levels of intention to leave the organization. The implications of these findings for research on organizational image and employee commitment are discussed, with particular emphasis on social workers in nonprofit social service organizations.     

An Exploration of Congruence in the Community Service Use Attitudes of Older Spousal Caregiver–Care Recipient Dyads

ABSTRACT

This study explored within-dyadic congruence in community service use attitudes of older spousal caregiver–care recipient couples. Primary data collection consisted of in-person, standardized survey interviews with 30 caregiver–care recipient pairs. The study employed the intraclass correlation coefficient (ICC) to examine within-dyadic similarities on caregivers' and care recipients' responses to 29 items from the Community Service Attitude Inventory (CSAI). To measure the degree of match between caregiver and care recipient pairs, ICCs were calculated for each dyad (n = 30) and ranged from ?.26 to .84, indicating variation in the degree to which caregivers and care recipients displayed congruence on community service use attitude scores. The distribution of the Index of Dyadic Similarity was highly negatively skewed (skewness = ?2.159), indicating overall patterns of similarity at the dyadic level of analysis. Service use preferences and values across the seven attitudinal domains (confidence in service system, wait-and-see attitude, concern for opinion of others, pride in family independence, rejection of government assistance, worry and fear about outside help, and preference for informal care) were similar between dyadically related individuals. Although the overall trend of dyadic similarity was notable in this sample, variation in the Index of Dyadic Similarity suggests the need for future dyadic-level research to better understand within-dyadic congruence on specific attitude constructs and in relationship to service use outcomes. Specific methodological challenges relevant to conducting dyadic-level primary research with older spousal couples are discussed.     

Care Leavers in Israel: What Contributes to Better Adjustment to Life After Care?

ABSTRACT

The present study examines the adjustment of youth leaving residential treatment in Israel in three core areas: military service, accommodation, and financial status. A sample of 277 adolescents (aged 17–18 years old) in educational and welfare residential placements were interviewed a few months before leaving care, and 236 of them were interviewed 1 year after. It was hypothesized that optimism, higher perceived sense of readiness to leave care, and higher social support of family, friends, and staff are associated with better outcomes in adjustment to military service, accommodations, and economic status. Findings show that 70% of care leavers were drafted to the (compulsory) military service, a sign of good adjustment in Israel. Yet, they have significant difficulties in the areas of accommodations and financial status. Optimism and perceived readiness for independent living while still in care were positively correlated with adjustment to the military service. Mother's support was positively correlated with care leavers’ economic status and stability in accommodations. These findings highlight the importance of designing programs that include specific attention to needs and challenges while youth are in care and immediately after they leave. Follow-up and longitudinal studies are suggested.     

The future for Meals on Wheels? Reviewing innovative approaches to meal provision for ageing populations

Winterton R, Warburton J, Oppenheimer M. The future for Meals on Wheels? Reviewing innovative approaches to meal provision for ageing populations The global phenomenon of population ageing is impacting on how community care is delivered, and a key component of health and social care services for the frail elderly is Meals on Wheels (MOW), a service that has traditionally encompassed delivering meals to older people in their homes. However, aspects of this conceptualisation of MOW are being redefined in order to address challenges posed by tightening global financial contexts, a reliance on volunteers and increasing social isolation among ageing populations. Through a review of the literature and websites from selected countries (UK, USA, Canada, Australia), this article explores and critically evaluates models of MOW delivery addressing these challenges. Findings suggest that MOW services are utilising a marketised approach, moving outside of the home and incorporating diverse volunteer roles. These findings demonstrate how services such as MOW can develop sustainable approaches to service delivery in a contemporary context. Key Practitioner Message: ?A review of innovative MOW highlights service models of broader applicability;?Varied delivery models and more diverse volunteer roles appeal to new sources of volunteers;?Research into the development of sustainable models with positive client social outcomes is now required.     

A Model for Implementing an Evidence-Based Practice in Student Fieldwork Placements: Barriers and Facilitators to the Use of “SBIRT”

ABSTRACT

This article reports on focus group data analysis that was used to understand initial, largely positive outcomes from a university-based initiative to disseminate and implement an evidence-based practice (EBP)—Screening, Brief Intervention, and Referral to Treatment for Substance Use (SBIRT)—into student fieldwork placements, which are usual care social work settings. Focus groups were conducted with three groups of stakeholders involved in the ongoing project: social work department faculty (n = 10), bachelor- and master-level social work students (n = 8), and social work fieldwork instructors (n = 6). Dimensional analysis of the focus group data yielded results indicating that dissemination and implementation of SBIRT was influenced by agency- and school-level factors and perceived fit between the EBP and individual professional identity, intrapersonal characteristics, and timing. The resulting model, developed through the focus group analysis, is offered and shows how these factors interacted and affected training, supervision, and use of the EBP. The model provides social work educational programs and agencies a working tool for diagnosing and proactively addressing barriers and breakdowns in the EBP implementation process. Future research that tests the model as a diagnostic tool and generates knowledge about its influence in developing competent evidence-based practitioners is indicated. Future focus groups in relation to this initiative are needed to better understand these barriers and facilitators in the EBP implementation process and their critical roles in the process of translating SBIRT into standard social work practice.     

Does educational inequality predict exercise of users' choice? Survey evidence from domiciliary care services among elderly in Oslo,Norway

The traditional goal of equality in services remains at the heart of the Scandinavian welfare model; however, in recent decades, policymakers have also placed increased emphasis on user influence over services. Voice and choice are two channels to achieve this goal. The possibility to give feedback and voicing dissatisfaction to service providers (voice) is a well-established channel of service users' influence, however it is increasingly supplemented by user choice schemes (choice), where one can choose between different public and private service providers. We use the case of domiciliary care for the elderly to examine how the traditional goal of user equality is associated with the growing emphasis on user influence through voice and choice. The analyses are based on user surveys carried out by the municipality in the city of Oslo, which is arguably the only municipality in Norway where user choice plays a significant role in elderly care. Since the municipality subsidizes the private providers, individual economic resources should have less relevance. However, voicing dissatisfaction and choosing between different providers may anticipate cognitive resources that are not equally distributed among the users. The survey data indicate that there is an association between level of education and propensity to exploit all channels of user influence. Expanding user influence by introducing user choice thus confirms the differences between highly educated and less educated.     

Restructuring Long-Term Care in Spain: The Impact of The Economic Crisis on Social Policies and Social Work Practice

ABSTRACT

Care needs of the aging population are increasing in Southern European countries. The purpose of this article is to explore the implications of meeting these needs while taking into account the recent economic crisis, which has deeply affected countries such as Spain. This study is part of a European project (ISCH COST Action IS1102) and is based mainly on qualitative information that focuses on in-depth interviews with social service workers (n = 19) who provide the service and program recipients or their caregivers (n = 14). In addition, two discussion groups were conducted with professionals (n = 9) and program volunteers (n = 5), as well as a workshop/discussion group (n = 28) with politicians, service providers, and participants. Six thematic premises were identified with differing views being highlighted relevant to the participants' roles in the program. Future research should explore social service strategies to deal with the increase in care needs as well as community-based responses.     

Client Experiences of Trauma-Informed Care in Social Service Agencies

This paper describes a qualitative study of individual client interviews (n?=?26) from four social service agencies to understand how clients experience trauma-informed care services and implementation challenges. We used the Fallot and Harris framework to explore client experiences of the five core concepts of trauma-informed care (safety, trustworthiness, choice, collaboration, and empowerment) using semi-structured interview questions with each client. The four agencies consisted of: refugees (n?=?4), substance abuse (n?=?8), older adults (n?=?12), and maternal/child health (n?=?2), and the agencies varied in size, service goals, and clientele. The results of the study suggest that clients’ experience of these concepts was shaped by the actions of other clients, and these experiences were either mitigated or hindered by actions of the agency employees. Agency policies either supported or enhanced their experiences as well. The results also suggest that it was challenging for agencies to provide for all of the trauma-informed care (TIC) concepts at the same time. We discuss the implications of these findings for social service delivery in a range of agency types. Future research should examine the effects of trauma-informed policies on client experiences of each TIC domain.     

Working and caring for a disabled adopted child during a pandemic

Integrating work and family demands can be challenging for families caring for a child with one or more disabilities. The pandemic and its changes to work, schooling and service delivery potentially added to these challenges. This exploratory mixed methods study sought to understand how the pandemic affected adoptive parents' work–life fit and service use. A total of 200 participants responded to survey questions about parenting an adopted child with a disability prior to, and after, the onset of Covid-19. More than half of the parents (59.2%) reported that it was somewhat to very difficult to integrate both work and family demands. Parents with greater access to workplace flexibility and supportive supervisors had significantly less difficulties combining work and family. Families who reported more problems with accessing mental health services, special education and respite care reported significantly more challenges with work–family fit. Parents reported increased stress due to the pandemic changes, but many also shared positive changes such as more time for family. Online services were experienced as effective for some children and reduced time spent driving to appointments. Recommendations for workplace and social service practice and policy supporting adoptive parents of children with disabilities are discussed.     

Perceptions of Students about Younger and Older Men and Women who May Be Homeless

ABSTRACT

Future human service providers will interact with homeless persons in health, mental health, and social service practice contexts. This study investigated the perceptions of students enrolled in social work courses who are pursuing degrees in human service programs toward older and younger female and male homeless individuals. Respondents (N = 207) were given one of four vignettes in which a character was identified as an older male, a younger male, an older female, or a younger female who was frequently seen near an interstate highway, talking to him/herself and appearing unkempt, thin, and frail. Most respondents perceived the vignette character as mentally ill, neglectful of health, likely to have HIV, tuberculosis, hepatitis A and/or hepatitis B and/or hepatitis C, likely to experience suicidal thoughts/ideation, and to have head lice/scabies/body lice. Older men were more likely to be perceived as military veterans with a history of mental illness and substance abuse. Older women were least likely to be perceived as having a history of substance abuse or using a handout to purchase ethanol. Older women were perceived to be homeless because they could not afford other living accommodations. A general linear model revealed significant differences in 7 of 41 items that respondents answered based on the gender and age of the vignette characters. These perceptual differences between male and female homeless persons will require additional investigation.     

Training foster carers in challenging behaviour: a case study in disappointment?

This paper sets out key features of a semi‐experimental investigation conducted between March 1999 and April 2001 into the impact of training foster carers in techniques to manage challenging behaviour. We identified a sample of children (n = 103) in foster care in four authorities in South Wales who were selected by a checklist as showing behaviours that could be defined as challenging. From this search procedure we identified their foster carers (n = 106) and created a training intervention group for 53 carers looking after 49 children and a non‐intervention comparison group of 53 carers looking after 54 children. Both groups of carers were interviewed using a range of measures before and after the delivery of the training in order to identify any changes they perceived in the conduct of children and changes they perceived in their own capacities as carers. The training was delivered in small groups and evaluative feedback was gathered from carers and from training officers in those agencies that participated in the study. The results suggested that training, as designed and delivered in this study, had limited impact on child conduct and carer capacity. The reasons for this are discussed in light of selected findings. We spend some time on describing our methods in order to expose our approach to the critical scrutiny of readers, whose views would be welcome as we make our future research plans in this field.     

Practice Evaluation of Community Initiatives for Social Service Delivery in a Deprived Neighborhood in Scotland

ABSTRACT

Improving social service in local communities is a complex undertaking. Over the past few decades, the performance and sustainability of community initiatives have been questioned, while such factors as a lack of funding, insufficient community involvement, unsatisfactory community service, and lack of awareness of the impact of community initiatives have restricted community development. From a case study of community operations in Scotland, this article provides insights into how social service delivery is organized in the absence of public capital. This study utilized data from semi-structured in-depth interviews with a sample of 76 participants from a deprived area in Scotland, including community management team members (n = 6), local residents (n = 52) and community partners (n = 18). The findings illustrated how participants of all ages, local organizations, policy makers, funders and media came together to create a cohesive and responsive community environment. Residents' needs and funders' demands were identified. Results further revealed that a Community Partnership Mechanism helped strengthen the social service network and create flexible social services. Service benefits included improved resident wellbeing in the context of less government intervention. Future implications include suggestions for government and other stakeholders involved in community reform to focus on service recipient skill building and tracking changes between the indicators and service provision.     

The impact of familism on future care planning for Korean parents caring for their children living with disabilities

ABSTRACT

Future care provision is a pervasive concern of parents with children living with disabilities. This article aims to provide an overview of the impact of familism on future care planning for Korean parents. For this qualitative study, data were collected using semi-structured interviews with parents (n = 9) and professionals (n = 9). Using conventional analysis, the study revealed there is strong emphasis on familial care with minimal governmental service provision and intervention; ultimately, this has a negative impact on the planning process. In support of the planning process taking its place as a standard phase of caring, a number of recommendations are made.     

Efficacy and agency among poor families with and without children

Families with children and living in poverty are vulnerable to decreased control over their lives and the ability to act in self‐interest. While having children may reduce efficacy among these families, their presence may also, in turn, increase their resilience. Using cross‐sectional data from n= 194 poor families in Southeastern USA, this study compares the constructs of self‐efficacy and agency between families with and without children. Results showed that among families with children, lack of agency was negatively correlated with self‐efficacy Δχ² (1, n= 194) = 12.65, P < 0.001, r=?0.37. Implications are directed towards practice and policy that may increase the efficacy and agency of poor families with children.     

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

ABSTRACT

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.     

A Qualitative Exploratory Study on the Service Delivery System for the New Long-Term Care Insurance System in Korea

ABSTRACT

To cope with the rapid growth in its aging population, the Korean government introduced a new social long-term care insurance (LTCI) system for elderly people beginning in July 2008. This study aims to understand how National Health Insurance Corporation (NHIC) staff and home-visiting service providers experienced and evaluated the new service delivery system. A total of 26 semistructured in-depth interviews were conducted with NHIC staff primarily responsible for the functional assessment of the elderly and the home-visiting service providers responsible for providing direct services to elderly clients. In summary, interviewees had negative experiences with the new service delivery system such as difficulties in carrying out their roles. The findings suggest that Korea's new LTCI service delivery system faces challenges and that a more active role for the Korean government, especially regarding the introduction of a proper care management system, is needed to address the issues. Future research with larger sample sizes is needed to examine and understand the issues in detail.     

Contributing Factors of Depressive Symptoms Among Elderly Korean Immigrants in Texas

This study examined various life stresses associated with relocation that may contribute to depressive symptoms among Korean immigrant elders in Texas. A sample of 120 elders was assessed using the Geriatric Depression Scale–Short Form and a 90-min face-to-face interview. Over 1/3 of respondents (37.5%) had symptoms of depression. Regression analyses (R² = .331) indicate that self-rated health, stressful life events, English language proficiency, satisfaction of visiting one's birth place, and watching TV were correlates of depressive symptoms among them. The findings of this observational study may be used as a baseline for designing service program for this population.