A mixed-methods evaluation using effectiveness perception surveys,social network analysis,and county-level health statistics: A pilot study of eight rural Indiana community health coalitions

Community health coalitions (CHCs) are a promising approach for addressing disparities in rural health statistics. However, their effectiveness has been variable, and evaluation methods have been insufficient and inconsistent. Thus, we propose a mixed-methods evaluation framework and discuss pilot study findings. CHCs in our pilot study partnered with Purdue Extension. Extension links communities and land grant universities, providing programming and support for community-engaged research. We conducted social network analysis and effectiveness perception surveys in CHCs in 8 rural Indiana counties during summer 2017 and accessed county-level health statistics from 2015-16. We compared calculated variables (i.e., effectiveness survey k-means clusters, network measures, health status/outcomes) using Pearson’s correlations. CHC members’ positive perceptions of their leadership and functioning correlated with interconnectedness in their partnership networks, while more centralized partnership networks correlated with CHC members reporting problems in their coalitions. CHCs with highly rated leadership and functioning developed in counties with poor infant/maternal health and opioid outcomes. Likewise, CHCs reporting fewer problems for participation developed in counties with poor infant/maternal health, poor opioid outcomes, and more people without healthcare coverage. This pilot study provides a framework for iterative CHC evaluation. As the evidence grows, we will make recommendations for best practices that optimize CHC partnerships to improve local health in rural areas.     

Personality and community prevention teams: Dimensions of team leader and member personality predicting team functioning

The predictors and correlates of positive functioning among community prevention teams have been examined in a number of research studies; however, the role of personality has been neglected. In this study, we examined whether team member and leader personality dimensions assessed at the time of team formation predicted local prevention team functioning 2.5–3.5 years later. Participants were 159 prevention team members in 14 communities participating in the PROSPER study of prevention program dissemination. Three aspects of personality, aggregated at the team level, were examined as predictors: Openness to Experience, Conscientiousness, and Agreeableness. A series of multivariate regression analyses were performed that accounted for the interdependency of five categories of team functioning. Results showed that average team member Openness was negatively, and Conscientiousness was positively linked to team functioning. The findings have implications for decisions about the level and nature of technical assistance support provided to community prevention teams.     

Time out for team practice: structured participation as a method of training for team maintenance and development

The social Work service in most Social Services Departments is organised in distinct geographically based units. Indeed, such units have become synonymous with social work teams. These “teams” rely heavily for their success, as responsive and resourceful units, on their ability to work together. The authors believe there are advantages in a collective approach to a team's decision making and service delivery. They describe a method for developing teamwork, centred around a study day, organised on the basis of structured participation and planned in a way which addresses a range of team concerns.

The programme used on the study day stresses the importance of clear objectives, agreed democratically, and the active involvement of all team members. Although this training method developed gradually and pragmatically it is based on a model of team development which identifies a progression through stages of team functioning. The model of learning emphasises change through participation in a climate of openness and trust.

Examples of a programme used by the authors, together with a report prepared as feedback to a team, are included as appendices.     

‘So I Feel Like I'm Getting It and Then Sometimes I Think OK,No I'm Not’: Couple and Family Therapists Learning an Evidence‐Based Practice

This research concerns itself with the experiences of couple and family therapists (CFTs) learning about and using an evidence‐based practice (EBP). The engagement with EBP is growing across many aspects of the mental health and health care systems. The EBP model is now being applied in a broad range of health and human service systems, including mental and behavioural health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence‐based approaches in the practice of CFT and research literature is also evolving (Sexton et al., 2011; Sprenkle 2012 ). Interestingly, while the research delves into what are the best approaches with different populations and presenting issues, little research has explored the experience of CFTs themselves, particularly while learning an EBP. Using a phenomenological approach called interpretive phenomenological analysis (Smith, Flowers & Larkin, 2009), this research explores the experiences of CFTs learning and using an EBP. The paper reports on key issues, challenges, and areas for CFTs, educators, and supervisors. As researchers, educators, administrators, policy makers, and CFTs struggle with what works best with which populations and how best to allocate resources, this research contributes to dialogues about how best to educate and support CFTs, and the complexity of doing research in real‐life settings.     

Teamarbeit und Gesundheit – Der Einfluss von Teammerkmalen auf Stressbewältigung und Gesundheit bei Un- und Angelernten

To date, research on teamwork and health is sparse. This accounts for teams with low-qualified workers in particular. In this paper a work psychological model for resource and stress management in teams and a study with teams of low-qualified workers are presented (N?=?265 in 33 teams). Results of multi-level analyses show, that team resources in the social work system and understaffing in teams as a team stressor have significant influence on collective coping and explain team differences. Further, team resources in the technical work system, i.e. the quality of teamwork design have significant influence on psychosomatic complaints. These influences go beyond the influences of socio-demographic variables and individual job stressors and job resources.     

Self-rated health and mortality: does the relationship extend to a low income setting?

Although a relationship between poor self-reported health status and excess mortality risk has been well-established for industrialized countries, almost no research considers developing countries. We use data from Indonesia to show that in a low-income setting, as in more advantaged parts of the world, individuals who perceive their health to be poor are significantly more likely to die in subsequent follow-up periods than their counterparts who view their health as good. This result characterizes both men and women, holds for multiple time periods, and remains after inclusion of measures of nutritional status, physical functioning, symptoms of poor physical health and depression, and hypertension. We also consider the correlates of self-rated health. Symptoms and physical functioning are strong predictors of reporting poor rather than good health, but neither these indicators nor other covariates we consider distinguish between reports of excellent rather than good health.     

Pulling together: building a community debriefing team.

1. Research shows that many emergency workers are affected physically and emotionally by critical incident stress. 2. Debriefings conducted by trained team members are an effective method to mitigate the impact of critical incident stress. A debriefing is a structured, time-limited group intervention. 3. Cooperation among community agencies is essential for the development and effective functioning of a critical incident stress debriefing team. 4. Several teams in Illinois have organized to form a Critical Incident Stress Debriefing Network. The Illinois network is part of an international organization composed of critical incident stress debriefing providers.     

The art and science of teamwork: enacting a transdisciplinary approach in work rehabilitation

Teamwork, collaboration and interprofessional care are becoming the new standard in health care, and service delivery in work practice is no exception. Most rehabilitation professionals believe that they intuitively know how to work collaboratively with others such as workers, employers, insurers and other professionals. However, little information is available that can assist rehabilitation professionals in enacting authentic transdisciplinary approaches in work practice contexts. A qualitative study was designed using a grounded theory approach, comprised of observations and interviews, to understand the social processes among team members in enacting a transdisciplinary approach in a work rehabilitation clinic. Findings suggest that team members consciously attended to a team approach through nurturing consensus, nurturing professional synergy, and nurturing a learning culture. These processes enabled this team to work in concert with clients who had chronic disabilities in achieving solution focused goals for returning to work and improving functioning. Implications for achieving greater collaborative synergies among stakeholders in return to work settings and in the training of new rehabilitation professionals are explored.     

Juvenile offender rehabilitation in Estonia: interprofessional collaboration in written assessments and specialists’ perceptions

Qualitative and quantitative research methods were used to study an interprofessional assessment model in rehabilitation services and its implementation in Estonia based on (1) a sample of rehabilitation plans for 160 juvenile offenders aged 7–18 and (2) expert interviews with 10 members of an interprofessional assessment team. Each specialist’s role was compared with the assessments. While each team member is assigned a discrete role based on discipline, in practice, the disciplines’ work overlapped considerably during the assessment process. The overlap seems to occur because team members conduct their assessments individually, rather than following the collaborative best practice model for interprofessional teams described in the literature. The expert interviews indicate that rehabilitation specialists perceive the individual-level elements of interprofessional teamwork to be consistent with the ideals articulated in the Perception of Interprofessional Collaboration Model, while the substantial overlap in assessments that occurred in practice could be related to lack of interprofessional collaboration at group and organizational levels. Recommendations to improve the functioning of teams serving juvenile offenders include establishing an interprofessional education system, increasing the flexibility of the legal framework for service provision, and improving the interprofessional assessment instrument.     

Working with a multidisciplinary team in secure psychiatric environments

1. Research on working with a multidisciplinary team in inpatient mental health care is underdeveloped. 2. Knowledge of how to work as part of a team is taken for granted within the realm of professional training. 3. In effective teams, members value the support, knowledge, and professional development that membership offers. 4. Training teams to be more effective requires diverse educational strategies.     

Social inequalities and exercise during adulthood: toward an ecological perspective

Grounded in ecological theory, this study examines the association among participation in regular vigorous exercise and social status, aspects of prominent life settings, interactions between life settings, and more proximal individual resources and processes using data from the National Survey of Midlife Development in the United States (N = 3,032). Among women, a higher level of earnings was associated with more vigorous exercise, yet those women with more education had a steeper decline in exercise across adulthood. Among men, those with the lowest level of education had the steepest decline in physical activity across adulthood, and earnings did not affect exercise patterns. Less participation in vigorous exercise among blacks, in contrast to nonblacks, was explained by their tendency to live in less safe neighborhoods and having more functional health problems. Finally, contextual factors from multiple domains were independently associated with participation in regular exercise. Consistent with ecological theory, these results suggest that interventions to promote exercise habits among adults need to consider the independent and interactive effects of multiple contextual factors.     

Team factors that predict to sustainability indicators for community-based prevention teams

Because they often set out with a guarantee of only short-term funding, many community partnerships will face a threat to their sustainability almost as soon as the first money runs out. Research into the factors that enable some coalitions and partnerships to meet the challenge when others fail is limited. This study begins to fill this gap in our understanding by examining influences on the process of sustainability planning in the context of a collaborative partnership focused on youth development. We report on a longitudinal examination of the quality of planning and attitudes underpinning the sustainability of PROSPER community prevention teams whose members implement evidence-based programs designed to support positive youth development and reduce early substance use and other problem behaviors. The current research concentrates on a particular dimension of partnership effectiveness to establish whether perceptions about team functioning in play at 6 and 18 months predict the quality of sustainability planning at 36 and 48 months. How well teams functioned in the early stages was found to be strongly related to the quality of their later preparations for sustainability. Recruitment and integration of new team members, and the encouragement they subsequently received were also found to be key factors. The results strengthen the argument for providing technical assistance to meet the needs of those who promote prevention partnerships, and they provide longitudinal empirical data to support the hypotheses of other researchers who have similarly found a correlation between effective sustainability and early planning and support.     

Multidisciplinary Team Perspectives on Older Adult Hoarding and Mental Illness

This qualitative study examined multidisciplinary team members' perspectives of their involvement in older adult hoarding cases. Fifteen informants, as representatives of four hoarding teams, described cases in which teams did or did not work well together. Specifically, informants described their (a) team characteristics, (b) awareness of hoarding as a mental health illness, (c) barriers to providing mental health services for older adults who hoard, and (d) components of successful teamwork within the team and with the older adult as hoarder. Implications include research to better guide interventions, team training to develop common perspectives, and policy development that supports mental health representation on teams and in-home mental health treatment.     

Visual Dominance and Visual Egalitarianism: Individual and Group-Level Influences of Sex and Status in Group Interactions

This study investigated visual dominance and visual egalitarianism of men and women (N = 94; 17 teams) in team meetings at diverse workplaces. Two novel gaze-related measures were developed: (a) a group visual dominance ratio (group-VDR) assessing each member’s visual dominance vis-à-vis all other members, and (b) a gaze distribution index (GDI) assessing each member’s visual egalitarianism to all group members. Multilevel analyses were conducted to account for influences of the team members’ sex and status on the individual level and for influences of sex and status composition of the teams, and the team leaders’ sex on the group level. Results suggested that high-status individuals displayed more visual dominance than low-status individuals. The significant interaction of individuals’ sex and status indicated that the positive relationship of status and visual dominance applied particularly to women. The more women in a team, the more visual dominance was displayed. The team leader’s sex significantly influenced visual egalitarianism: Gaze distribution was less egalitarian when the team leader was male.     

Assessment and collaboration: Key elements in comprehensive and cohesive transition planning

The relatively recent study of adolescent transitions into adulthood has compiled little consensus on exemplary practices or theoretical models. Despite this, transition planning teams are mandated to develop plans that result in successful achievement of adult roles. This task is predicated upon choosing appropriate assessments, and assembling them into a comprehensive and cohesive transition profile through collaboration among transition team members. States have provided broad guidelines or frameworks but few offer detailed listings of domains to address in the planning process. This article addresses some of the major issues team members face and identifies strategies for their successful resolution.     

Requests, Blocking Moves, and Rational (Inter)action in Survey Introductions

We draw on conversation analytic methods and research to explicate the interactional phenomenon of requesting in general and the specific case of requesting participation in survey interviews. Recent work on survey participation has given much attention to leverage-saliency theory, but has not engaged how the key concepts of this theory are exhibited in the actual unfolding interaction of interviewers and potential respondents. We do so using digitally recorded and transcribed calls to recruit participation in the 2004 Wisconsin Longitudinal Study. We describe how potential respondents present interactional environments that are relatively discouraging or encouraging, and how, in response, interviewers may be relatively cautious or presumptive in their requesting actions. We consider how the ability of interviewers to tailor their behavior to their interactional environment can affect whether the introduction reaches the point at which a request to participate is made, the form that this request takes, and the sample person's response. Our analysis contributes to understanding how we might use insights from the analysis of interaction to increase cooperation with requests to participate in surveys.     

Team incentives and leadership

We study, experimentally, how two alternative incentive mechanisms affect team performance and how a team chooses between alternative mechanisms. We study a group incentive mechanism (team output is shared equally among team members) and a hierarchical mechanism (team output is allocated by a team leader). We find that output is higher when a leader has the power to allocate output, but this mechanism also generates large differences between earnings of leaders and other team members. When team members can choose how much of team output is to be shared equally and how much is to be allocated by a leader they tend to restrict the leader’s power to distributing less than half of the pie.     

Health conditions and job hazards: Union and nonunion jobs

Blue-collar union members are more likely than nonunion blue-collar workers to report health conditions caused by job accidents and by bad working conditions caused by noise, smoke, heat, and dust. This is consistent with blue-collar union members’ evaluation of hazardous job conditions and with their indemnity claims filing behavior for industrial injury or occupational disease. Union members are also more likely to be found in industries with higher injury rates. Age and marital status are positively associated and being female and education are negatively associated with a self-reported job related health condition. We thank Steve Zrebiec for research assistance and Bill Greene for the maximum likelihood routines. The views expressed are those of the authors and not necessarily those of the National Council on Compensation Insurance or Brigham Young University.