A Person‐Centered Perspective to Welfare‐to‐Work Services: In Pursuit of the Elusive and the Unattainable

Because of changes in legislation regarding the U.S. welfare system, there is an urgency now that has never before existed, except perhaps during the Great Depression, for career counselors to advocate for those of their clients who are on welfare and for their minor dependents. E. B. Lent (2001) has revitalized the debate over the role Rogers's person‐centered perspective should play in career development with welfare‐to‐work (WTW) clients. The usefulness of such an approach with today's clients was explored within the context of inherent limitations of Rogers's person‐centered perspective. Potential ethical conflicts for career counselors working with WTW clients were identified.     

He's in a New Neighborhood Now: Religious Fantasy Themes About Mister Rogers' Neighborhood

Fred Rogers' death prompted many of his fans to post tributes to him and his show, Mister Rogers' Neighborhood, on the PBSkids.org Web site. Fantasy theme analysis was conducted for specifically religious themes on tributes posted during the 1st week after his death. Themes fell into one of three broad classifications. The first category, religious attribution, included applying directly religious meaning to Rogers and the program. Fans spoke of Rogers as "saintly," an "angel," and "sent from Heaven," along with other fantasy chains. The second category, religious language, included comments about prayers and blessings and the use of religious phrases. The third, religious ideals, provided a category for themes related to the program's moral values and Rogers' "compassion" and "personal character." Findings suggest long-term impact of the program's values on viewers of many ages. They also show that a group of fans reflected on Rogers' noble character by participating in a social reality constructed of religious metaphors.     

Large-scale changes in the German residential care system during the 1980s

In West Germany during the 1980s extensive and encompassing reforms took place in residential care. These reforms involved completely new approaches such as non-institutional individual care. This paper examines the question of how non-institutional individual care was able to establish itself on a national basis in the West German youth services while, at the same time, other innovations failed to take hold. The reasons presented here involve: specific historical contextual conditions; certain qualities of agents' actions; and changing education and labour market policies, particularly the rapid increase in the professional workers in the youth service during the 1970s and 1980s. These and other factors led to an alteration of collectively shared interpretation schemes within residential care that called into question the closed forms of prison-like residential care of children and young people. These changes, however, led to problems in areas where youth services encountered other professional and societal systems, which continued to expect that youth services deal with youth delinquency in a custodial manner. New forms of treatment were needed which would be accepted by other services and wider society, while at the same time being compatible with changing ideas in the youth services. Non-institutional individual care was able to assert itself in this situation, in contrast to other innovations, because of the key abilities of the agents involved in its development, primarily as a result of their ability to create strategic alliances to support change.     

Social network thresholds in the diffusion of innovations

Threshold models have been postulated as one explanation for the success or failure of collective action and the diffusion of innovations. The present paper creates a social network threshold model of the diffusion of innovations based on the Ryan and Gross (1943) adopter categories: (1) early adopters; (2) early majority; (3) late majority; (4) laggards. This new model uses social networks as a basis for adopter categorization, instead of solely relying on the system-level analysis used previously. The present paper argues that these four adopter categories can be created either with respect to the entire social system, or with respect to an individual's personal network. This dual typology is used to analyze three diffusion datasets to show how external influence and opinion leadership channel the diffusion of innovations. Network thresholds can be used (1) to vary the definition of behavioral contagion, (2) to predict the pattern of diffusion of innovations, and (3) to identify opinion leaders and followers in order to understand the two-step flow hypothesis better.     

Maternal morbidity and maternal mortality in the United States

The following interview with Dr. Donna Strobino on maternal morbidity and mortality in the United States was conducted in May 2008. Dr. Strobino is Professor and Vice Chair of Education in the Department of Population, Family and Reproductive Health at The Johns Hopkins Bloomberg School of Public Health. She received a PhD from Johns Hopkins University and a BA from Western Connecticut State University. Dr. Strobino is Director of the Maternal and Child Health Leadership Training Program, a core training program in the Department of Population and Family Health Sciences at the Women's and Children's Health Policy Center. Dr. Strobino's recent research includes studies of the social, psychosocial, and biologic risk factors for preterm birth among African American women, the impact of the Healthy Steps Program for Young Children, and the effect of maternal depressive symptoms on the growth of their young children.     

Measuring the quality of health care

This Issue Brief examines some of the issues involved in defining and measuring the quality of health care and in implementing quality measures. It discusses the importance of measures of health care quality in the evolving health care delivery system, examines some of the conceptual issues involved in defining quality of care, and discusses some of the measures of health care quality and how these measures have been implemented in the health care delivery system. The major impetus for quality assurance programs is cost management: it is an attempt to allocate scarce health care resources efficiently. This requires making choices among alternatives, which may mean that maximizing quality of care for whole populations may not maximize the quality of care for individuals. Quality, in terms of any single good or service, has a number of dimensions. Health care is a complex bundle of services, and each component service within an episode of care affects the other components and the patients differently. Moreover, patients differ in numerous ways, which means that similar symptoms may require different services if care is to be effective. Measuring quality of health care services requires accounting for all of these factors. In attempting to manage health care costs, employers and other private health plans have begun to employ process measures of quality, i.e., evaluating caregivers' activities, the decisions made at each step in an episode of illness, and the appropriateness of the care provided. Process is an important component of quality measures because it focuses directly on the uncertainty in the efficacy of treatment. Given this uncertainty, the logic of medical decision making is an important determinant of quality and cost effectiveness. Examining the process of care involves assembling a panel of physicians who review medical records to determine the appropriateness of the care received. Providers have increasingly found that their medical decision making and practice styles are being monitored by purchasers as new health care delivery systems are being formed. The American Medical Association found that 39 percent of surveyed physicians were subject to clinical profiling.     

Convoys of care: Theorizing intersections of formal and informal care

Although most care to frail elders is provided informally, much of this care is paired with formal care services. Yet, common approaches to conceptualizing the formal–informal intersection often are static, do not consider self-care, and typically do not account for multi-level influences. In response, we introduce the “convoy of care” model as an alternative way to conceptualize the intersection and to theorize connections between care convoy properties and caregiver and recipient outcomes. The model draws on Kahn and Antonucci's (1980) convoy model of social relations, expanding it to include both formal and informal care providers and also incorporates theoretical and conceptual threads from life course, feminist gerontology, social ecology, and symbolic interactionist perspectives. This article synthesizes theoretical and empirical knowledge and demonstrates the convoy of care model in an increasingly popular long-term care setting, assisted living. We conceptualize care convoys as dynamic, evolving, person- and family-specific, and influenced by a host of multi-level factors. Care convoys have implications for older adults' quality of care and ability to age in place, for job satisfaction and retention among formal caregivers, and for informal caregiver burden. The model moves beyond existing conceptual work to provide a comprehensive, multi-level, multi-factor framework that can be used to inform future research, including research in other care settings, and to spark further theoretical development.     

Managing the process of change in residential child care: A consultancy approach

This article explores the impact of a consultancy undertaken with groups of residential child care staff within a large local authority who were experiencing considerable changes in their working environment as a result of a review of residential care structures. The authors were invited to engage directly with staff on an individual and group basis to help them work through the barriers they perceived to changing their approach to practice. The theoretical underpinning for the work was Charles Handy's [1993, Understanding Organisations (Harmondsworth, Penguin)] belief that change is more likely to have a positive outcome when staff have an investment in and contribution to the change processes. The model of change utilised within the sessions with staff was Kurt Lewin's three stages of 'unfreezing', 'change' and 'refreezing'. The consultancy raised a number of issues about the process of change and how this can be achieved within the residential child care context. In particular, it highlighted the problems of assuming that change is a linear process which can be directly controlled and managed in the flux and uncertainty which characterises this sector.     

Child resilience in out-of-home care: Child welfare worker perspectives

The study of resilience and its associated factors is highly applicable to the child welfare population as children living in out-of-home care have often experienced much adversity and are particularly vulnerable to the development of problems in numerous domains of functioning. The use of qualitative research in this area is scarce, and the majority of such studies have been based on the U.K. or U.S. child welfare systems. Therefore, the goal of the current study was to gain child welfare workers' perspectives on resilience and to explore the factors that they believe might influence resilience. Semi-structured interviews were conducted with 11 child welfare workers from Ontario (Canada) to accomplish this goal. The interview was developed using an ecological perspective that inquired about possible sources of resilience from within children themselves, their family, their community, and the child welfare worker and agency. The workers identified a number of factors associated with resilience (e.g., child intelligence, worker communication skills); however, the critical importance of a child's relationships and social support from others underpinned all factors discussed. The findings highlight the importance of including the perspectives of all those involved in the child welfare system in assessing the well-being of children in out-of-home care. In addition, the dynamic interrelationships between the various levels of the ecological model and how these can impact on how a child is doing in out-of-home care were highlighted.     

Community perceptions and foster care placement: A multi-level analysis

Signs of physical and social disorder in a community have the potential to influence the perceptions about community, which could, in turn, impact the decision making processes involved in child maltreatment investigations. While extant research has demonstrated a link between community context and child maltreatment rates, there is a dearth of research examining the potential relationship between social conditions in a community and the child welfare system's response to allegations of neglect. This study examined the relationship between child- and community-level characteristics and the decision to place a child in foster care. Two data sets were linked, one containing detailed observations of community conditions (e.g., cigarette and alcohol advertisements) and a second with individual child level information about child welfare investigations. Multilevel models allowed for the simultaneous understanding of child- and community-level characteristics. The results indicated strong associations between individual characteristics and foster care placement. The race or ethnicity of the child was a strong predictor of entry into foster care, and young children were much more likely to be placed in foster care than older children. Furthermore, community factors were also associated with placement into foster care. Specifically, the presence of litter and graffiti and the lack of security signage in a neighborhood appeared to impact the decision making process for foster care.     

Judgements about parenting: what do social workers think they are doing?

This paper describes a study that looks at interrelationships between social workers' beliefs about the important elements of parenting to ensure a child's well‐being and their perceptions about what underpins their decision‐making about child care and protection. Q methodology is used to explore the range of views of a group of Scottish social workers. Eight different strands of opinion were revealed, three of which will be discussed in detail. They indicate that there is broad consistency of opinion within factors. That is, there is a link between views about children's needs and decision‐making. However, the different factors also demonstrate that there are clusters of significantly different opinions about priorities in assessing parenting. Copyright © 2000 John Wiley & Sons, Ltd.     

Sponsored day care in a changing world

Sponsored day care is the term generally used to describe the purchase of places by local authorities in independent day care services (such as childminders, nurseries and playgroups) for children in need. This paper considers the development and operation of sponsored day care services in 12 English local authorities, in the context of current policy developments within early childhood services. It suggests that provision for children in need is in danger of being marginalised by the current focus on early education and child care for working parents, and highlights the importance of developing services for children in need within an overall strategy for children's services. Copyright © 2000 John Wiley & Sons, Ltd.     

The Effect of Age and Background of Religious Broadcasting Executives on Digital Television Implementation

This study follows previous research, which showed a significant difference between secular and religious television broadcasters in terms of the timetable for digital implementation. Using Rogers's (1962) diffusion of innovation theory, the study sought to investigate whether the personal backgrounds of religious broadcasting executives played a bigger role in this delay, compared to other variables such as economics. Results of the study show a significant difference between religious and secular broadcasters in terms of background and digital implementation, especially compared to other variables. The study also reveals a significant gulf between older and younger religious broadcasters in terms of background, attitude, and management style.     

Breakdown of foster care placement: carer perspectives and system factors

A crisis in foster care is suggested by many of the national and international published reports. One seemingly intractable problem is placement instability, particularly for adolescents with behavioural problems. A qualitative study of foster carers who had ended a placement because of the young person's disruptive behaviour (n = 19) was conducted to examine ways in which system shortcomings might be affecting placement outcomes. Data were collected on the process of placement deterioration, the incident(s) that precipitated the decision to end placement, formal carer support, and the carer's response to the breakdown. All placements fell into one of two categories: those that, with certain interventions, might have been sustained (n = 9); and those that, regardless of intervention, appear to have been unsustainable (n = 10). This study contributes to the alternative care literature by highlighting the potential of some faltering placements to be maintained and of some failed placements to be renegotiated.     

Maternal child care preferences for infants,toddlers, and preschoolers: the disconnect between policy and preference in the USA

While much research exists looking at parental preferences for child care, much of that research uses child care choice as a proxy for preference. In an effort to examine the types of care mothers prefer if no constraints were placed on their decision, this quantitative study investigated how family demographic factors and family role ideology relate to the types of child care (parental and non-parental forms) mothers prefer ‘in an ideal world’ using a sample of 345 employed mothers of children under 6 years of age in a suburb of a large metropolitan area in the southern USA. Participants completed a questionnaire examining the types of care they viewed as ideal for infants (0–12 months old), toddlers (13–30 months old), and preschoolers (31–72 months old) if no constraints were placed on the decision. Results indicated that the preferences for type of care for mothers in this sample varied according to the child's age, with a large majority of mothers preferring parental care for their children. Ideological and demographic factors predicting preferences for first and second choice of child care were also explored through binary and multinomial logistic regression, revealing the influence of ethnicity, education, and family role ideology to preferences for infant care. These results add to the existing literature by confirming previous findings about the influence of child age to child care preferences, as well as highlighting the disconnect between these preferences and the way family policies are structured in the USA.     

Patterns of child care subsidy use and stability of subsidized care arrangements: Evidence from Illinois and New York

Given the prevalence of short child care subsidy spells and program churning documented in prior studies, researchers and policymakers have been concerned about the implications of discontinuity in subsidy receipt for the stability of children's care arrangements. Yet little research has studied the stability of subsidized arrangements or how subsidy discontinuity relates to changes in subsidized providers. Using child care subsidy program administrative records from a cohort of children in four diverse sites across Illinois and New York states, this study examines patterns of subsidy use and stability of subsidized care arrangements, as well as the relationship between the two. Results suggest that the length of states' eligibility periods is related to the duration of subsidy spells; however, significant variation in patterns of subsidy use within states suggests that local level factors are also important. Results show that subsidy discontinuity is related to children experiencing more total changes in subsidized providers. Focusing on provider changes across spells, we also find that the timing of subsidy exits, the length of gaps in subsidy receipt, and within spell provider instability are each related to whether or not children re-enter the program with a different subsidized provider after a break in subsidy receipt. We discuss these findings' implications for understanding how new program requirements established in the 2014 reauthorization of the Child Care and Development Block Grant may matter for subsidy continuity and care stability.     

Group long-term care insurance: decision-making factors and implications for financing long-term care

This study proposes and tests a systemic family decision-making framework to understand group long-term care insurance (LTCI) enrollment decisions. A random sample of public employees who were offered group LTCI as a workplace benefit were examined. Findings reveal very good predictive efficacy for the overall conceptual framework with a pseudo R2 value of .687, and reinforced the contributions of factors within the family system. Enrollees were more likely to have discussed the decision with others, used information sources, and had prior experience when compared to non-enrollees. Perceived health status, financial knowledge, attitudes regarding the role of private insurance, risk taking, and coverage features were additional factors related to enrollment decisions. The findings help to inform policymakers about the potential of LTCI as one strategy for financing long-term care.     

Instability in patchworks of child care when moving from welfare to work

We use longitudinal, qualitative interview data collected from 38 initially welfare‐reliant women in Cleveland, Ohio to examine the factors driving instability in child‐care arrangements when women transitioned from welfare to work. Grounded theory analysis revealed that decisions about care were circumscribed by scarce social and economic resources, women went to extraordinary lengths to patch together arrangements that typically involved multiple providers, relative care was central to patchworks of care, and patchworks of child care were often highly unstable. These complex arrangements and their instability were influenced by mothers’ desires to find the most suitable arrangements for their children within resource and job constraints, dissatisfaction with providers, difficulties accessing subsidies, and changes in provider availability. Findings suggest that policymakers must consider instability in patchworks of multiple child‐care providers as they consider alternatives for meeting low‐wage working women's and children's needs for safe, affordable, accessible, and enriching nonmaternal child care.     

An empirical test of a model of academic expectations among youth in residential care

In the last decade accumulating evidence across many countries points to the poor educational outcomes of youth formerly placed in care and their under-representation in higher education. Academic expectations in late adolescence are considered a key marker for educational attainments in young adulthood. Although these expectations were studied extensively, they have seldom been examined among youth in substitute care. The goal of the present research was to develop and test a model to predict academic expectations of Israeli adolescents placed in residential facilities. The study sample consisted of 1360 adolescents from 34 youth villages who responded to self-report questionnaires tapping their academic expectations, current academic achievements and various aspects of their family, school and facility's environment, expected to be associated with their academic expectations.Structural equation modeling indicated that parents' level of education was indirectly related to youths' expectations, an association mediated by youth's current academic achievements and parents' aspirations for their children's educational success. Higher levels of teacher and staff support were also found to contribute to higher academic expectations; however, whereas teacher support effects were mediated by youth achievements, staff support was found to have direct, as well as moderating effects, on achievement-expectations relationship.The findings suggest the importance of an integrative approach in the efforts to promote educational expectations among adolescents in residential facilities. Such an approach, encompassing the multiple adult functions responsible for youth development within such settings, could be an important step in enhancing the chances for future academic success of this vulnerable group.     

Temporal stability of entries and predictors for entry into out-of-home care before the third birthday: A Danish population-based study of entries from 1981 to 2008

Objective

Placing a child in out-of-home care is one of the most radical measures a child protection system can decide to take. There is an essential interest in understanding the probability of entering care and what circumstances are related to the decision to place a child in out-of-home care. This study investigates the temporal stability of rates and predictors for entry into care.

Method

Data were obtained by linking several registration systems. The study population was defined as all children entering care before their third birthday from birth cohorts 1981–2008 (N = 11,034). Furthermore, a control population consisting of a randomly assigned quarter of the Danish child population from the same birth cohorts was used (N = 515,773). Rates of entry and Cox regression models from six periods from 1981 to 2008 were used to model co-variates associated with entry into out-of-home care.

Results

The overall likelihood for entering care is found to be decreasing over time. Furthermore, results reveal two trends: relative rates of entry are significantly decreasing for children whose mother has a psychiatric history prior to the child's birth; relative rates are significantly increasing for children whose mother or father was unemployed in the year prior to the child's birth.