Strategies for engaging foster care youth in permanency planning family team conferences

The present study examines strategies conference facilitators used to engage foster care youth in decision-making in the context of permanency planning family team conferences. Data collection included observations of permanency planning family team conferences, followed by interviews with foster care youth and conference facilitators. Data analysis focused on gaining a deeper understanding of how facilitators incorporate youth into decision-making, with a specific focus on the strategies they employed. Four strategies were identified in the analysis: creating a safe space, encouraging the youth voice, re-balancing power, and establishing a personal connection. The study's policy and practice implications, limitations and areas of further research are presented.     

‘Tell Me and I Forget,Teach Me and I May Remember,Involve Me and I Learn. And That's What It's About.’ How a Co‐design Methodology is Used in the Delivery of Parents Building Solutions: A Qualitative Study

There are many parenting programs delivered in Australia and Parents Building Solutions (PBS) is one of these. Collaboratively designed by Parentzone staff of Anglicare Victoria, it has a twenty year history of building the evidence base. PBS stands apart from other programs because parents actively co‐design the sessions and content with skilled facilitators. Understanding the drivers, processes and practices that make the co‐design methodology work, is fundamental to the implementation science that underpins the program.This study aimed to examine the way co‐design was used in the delivery of PBS, specifically looking at program implementation and outcomes. Focus groups and interviews were conducted with Parentzone staff (team leaders and facilitators) and parents who had recently completed a program. Ethics approval was provided and analysis was conducted using NVivo software with co‐design as the unit of analysis. Three major themes about co‐design were present across team leaders, facilitators and parents: 1) responsiveness and flexibility are central to the functionality of co‐design within PBS; 2) facilitators implement the co‐design methodology using a suite of knowledge and skills; and 3) parents report tangible results from participating in a co‐designed parenting program. There was an overwhelming appreciation from both facilitators and parents about the co‐designed implementation style. Facilitators and team leaders highly valued the flexibility of the program which enabled their ability to respond to parent's needs. Furthermore, parents believed they achieved tangible outcomes derived from strategies and support delivered in the program. The co‐design methodology used in PBS was evident for all stakeholders and was a driver of program implementation and its outcomes. The methodology described in this has practice implications for family therapists and others who work directly parents and families.     

Smoking cessation and relapse prevention among undergraduate students: a pilot demonstration project

The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that peers were effective facilitators. Relapse-prevention interventions, which began immediately after participants quit smoking, included 6 monthly group programs and individual meetings. Each session provided education and training in stress management, nutrition and exercise habits, managing environmental smoking triggers, and coping in social situations. After participating in the relapse-prevention programs, 63.3% of the initial quitters remained smoke free, another indication that peers were effective facilitators. The success of the program, combined with the dearth of population-specific cessation and relapse-prevention tools, suggests that college administrators and health educators should develop integrated tobacco management strategies on college campuses.     

Using concept mapping to identify opportunities for HPV vaccination efforts: Perspectives from the Midwest and West Coast

Human papillomavirus (HPV) infection significantly contributes to the burden of cancer in the United States, despite the existence of a highly effective vaccine. While numerous interventions to address vaccination uptake exist, vaccination rates remain low. We conducted a concept mapping exercise to solicit perspectives on barriers and facilitators to HPV vaccination from state-level stakeholders in five states in the Midwest and West Coast of the U.S. We identified 10 clusters of barriers and facilitators based on participants’ statements. For rural areas specifically, clusters rated as most important included education and provider influence; those rated as most feasible were education and coordinated/consistent messaging. Our results suggest that a combination of important (but potentially more difficult to implement) strategies, combined with those rated as most feasible (but potentially less impactful) may be beneficial. Our findings highlight similarities across diverse states, suggesting that states can learn from each other and work together to improve HPV vaccination rates. Using concept mapping proved to be an efficient way to collect information from diverse, stakeholders in different locations, and is a methodology that could be used for program planning in areas beyond HPV vaccination.     

Stepfamily Education: Perceived Benefits for Children

This article explores ways in which stepfamily education benefits children. The study is based on interviews with 40 parents and 20 facilitators who were part of a multisite stepfamily program. Three main themes emerged from the interviews. Children were perceived to benefit by their parents' increased empathy, engagement in family time, and enhanced relationship skills. Children benefited from expressing their feelings and developing their own relationship skills. Normalizing and social support from peers and facilitators were also considered beneficial. The findings support educational efforts to strengthen stepfamilies and highlight the value of systemic interventions that involve the entire family.     

Drug education: the prevention issues

This article considers the major issues facing drug education by identifying and discussing eight dichotomies. These dichotomies capture the decisions faced by policy-makers, drug education planners, and practitioners. The dichotomies permit a cohesive, simplified, examination of the complex dilemmas currently faced by the field; they include: identification of the problems to be addressed, etiological under-pinnings, program objectives, target audiences, and effective strategies.     

Social Ecological Factors of Sexual Subjectivity and Contraceptive Use and Access Among Young Women in the Northwest Territories,Canada

Adolescent women in the Northwest Territories (NWT), Canada, experience many sexual health challenges that are linked to a history of colonization and intergenerational effects of trauma. This study was informed by social ecological theory and explored how young women in the NWT develop sexual subjectivity within the context of contraception use and access during this time of decolonization. A total of 41 participants (aged 13 to 17 years) attended the Fostering Open eXpression among Youth (FOXY) body-mapping intervention in six NWT communities and then completed semistructured interviews. Framework analysis identified barriers to the development of sexual subjectivity that included a culture of stigma and shame surrounding sexuality; pervasive alcohol use in communities; predatory behaviors by older men; poor quality sexual health education offered in schools; and issues with accessing health services. In addition, analysis identified the following facilitators: comprehensive sexual health education; widespread access to free condoms; and positive health support networks with female relatives, peers, and some teachers. Our findings suggest the need for multiple intervention strategies within a complex social ecological framework, including arts-based interventions that focus on developing self-esteem and self-efficacy of youth, combined with interpersonal interventions that strengthen communication skills among supportive adults, and community-level campaigns that target stigma reduction and shift cultural norms.     

Design Teams as Learning Systems for Complex Systems Change

Summary

Systems change in child welfare and cross-systems change involving other service sectors are needed in response to two developments: (1) New policy mandates (e.g., TANF, AS FA) and (2) Research on the co-occurring and interlocking needs of many child welfare families. A four-state initiative was structured in response to these needs. Collaborative learning and action research groups called design teams were structured to identify competencies and to develop new service delivery systems. Faculty facilitators representing social work education programs were assigned to these teams and charged with their development and evaluation. Facilitators served as linkage agents for university-communitystate agency partnerships, and they promoted curriculum change. These study reports two sets of findings related to these design teams: (1) Findings from semi-structured interviews of design team members; and (2) Findings from the participatory action research completed by two faculty facilitators. Key themes related to design team processes are presented. Drawing on these emergent themes, components that help explain effective design team processes are identified. Selected implications for social work education programs and faculty also are identified     

The Use of Religion and Spiritual Strategies in Rehabilitation

Abstract

Recently the helping professions have reopened the debate about utilizing religion or spirituality in both education and practice. In this study, in-depth interviews were completed to identify what, if any, strategies rehabilitation professionals had utilized in practice. Four major themes evolved from participants: (1) denial of having used strategies; (2) use of the concepts for their own benefit; (3) use of the concepts for client benefit; and (4) the use of multiple religious or spiritual strategies. Implications for professional and continuing education are addressed. Lastly, suggestions for future research are highlighted.     

Subversive political praxis: supporting choice, power and control for people with learning difficulties

This paper is drawn from research conducted with gay and bisexual men with learning difficulties, a project that included participants' various struggles to self-identify within these alternative sexualities. Significant parts of this identity work were mitigated by participation in what is referred to here as 'politically radical support groups'. Three facilitators of these groups, professionals in the areas of sex education, were interviewed and a common itinerary was uncovered, namely a subversive and political praxis. At its heart, such praxis argues that educational endeavours for people with learning difficulties must not only account for disabling practices, but more importantly, maximally prioritise the mitigation of such prejudice within educational activities. Furthermore, it is argued that political praxis is not merely theoretical; six practical strategies are offered. In these ways, caregivers are offered concrete approaches to (genuinely) support the choice, power and control for people with learning difficulties.     

I'm going back to work: back injured clients' perceptions and experiences of their worker roles

This study aimed to elicit perceptions and experiences of facilitators and barriers that affected individuals who received back rehabilitation and their ability to resume their worker roles. Qualitative research methods were used in order to explore the research question. Participants were selected by means of simple random sampling and the data were collected by means of semi-structured focus groups. Some factors that were seen as facilitatory in maintaining the worker role of an individual who received back rehabilitation included injury management strategies, a positive work culture and having meaningful/satisfactory work experiences. Factors or barriers that prevented individuals from resuming their worker roles included physical and psychosocial stressors of the job, a lack of education by the employer and inadequate workplace policy. The results indicated that occupational therapists need to reassess their role within the wider context of the helping professions where they should become more involved in on-the-job evaluations, work placements and training of individuals who received back rehabilitation.     

The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study

Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home.

Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis.

Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3).

Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.     

Leaning Out: Exploring Organizational Advocacy Activities From an Open Systems Perspective

This article explores the effect of organizational culture on engagement with advocacy activities, both traditional and electronic. The Competing Values Framework offers a model for understanding how organizations’ culture influences behavior. Using a sample of nonprofit providers from across the country, the author hypothesized that organizations that use electronic advocacy tools are more involved with advocacy activities of all types. A paper and pencil survey was used to collect data on organizational culture, advocacy tools and techniques, perceived effectiveness of the advocacy tools, policy goals, organizational sustainability goals as well as barriers and facilitators of electronic advocacy. The study used path modeling to describe the connections between organizational culture and engagement in advocacy activities. The article examines the barriers and facilitators of electronic advocacy, the penetration of electronic advocacy use in this sample of agencies and the perceptions of effectiveness associated with using these strategies; lastly, the implications of these findings for managers and organizational leaders are discussed.     

‘We are not anything alike’: marginalization of health professionals with disabilities

Despite inclusive rhetoric, disabled peoples’ participation in the Health and Human Service (HHS) professions remains limited. This study explores the perspectives of individuals in the HHS sector regarding inclusion-related barriers and facilitators. We found three mechanisms that marginalize disabled people in HHS education and professions: dominant disabling discourses; discriminatory design within programmes and universities; and oppressive interactions. The inclusion of disabled individuals is vital for ensuring HHS professionals represent the populations they serve. By challenging the views of educators, professionals, and scholars, these findings may become part of the foundation upon which change can be created.     

Factors influencing service coordination in rural South Australia

This paper discusses those factors identified in both the review of literature and from the results of nine focus groups held in rural communities that influence service coordination. The paper shows that the practice wisdom of service coordination is congruent with the findings from research on this topic. It discusses the facilitators, inhibitors and triggers to service coordination within these communities. Informal networking and the support given by management are recognised as important facilitators and the competitive tendering funding process and ‘professional elitism’ are seen to be major inhibitors to service coordination. Important triggers of service coordination were perceived to be the efforts of key individuals in providing leadership of the coordination process and the keenness of human service workers to reduce duplication.     

The Transitional Discharge Model: comparing implementation in Canada and Scotland

Effective discharge planning is needed to facilitate clients' transition from psychiatric hospital wards to community care. Previous studies have shown that client outcomes can be improved by using a Transitional Discharge Model (TDM) that includes peer support and an extension of inpatient-practitioner relationships that are introduced prior to discharge. However, countries vary in many ways that may affect implementation of the model. This article describes some of the similarities and differences related to introducing transitional discharge in two countries: Canada and Scotland. It is important to elucidate facilitators and challenges in implementing the TDM to identify and disseminate strategies to aid implementation. Implications for future implementation of the model are also discussed.     

Social Work and Interprofessional Education in Health Care: A Call for Continued Leadership

A report from the Interprofessional Education Collaborative and another from the Institute of Medicine cite working as part of interdisciplinary teams as a core proficiency area for improving health care. This article discusses the core competencies of interprofessional education and the essential role for social workers as leaders and facilitators of this practice. Educators will learn how to help students discover the knowledge, skills, and attitudes for successful interprofessional work. Specifically, this article has the following objectives:

1. Discuss essential elements of effective interprofessional practice;

2. Present exemplars of interprofessional education involving social work;

3. Identify the roles for social work in leadership, education, and practice in interprofessional education.

     

Barriers and facilitators for walking in individuals with intermittent claudication

This study aimed to identify barriers and facilitators associated with walking for exercise among people who experience intermittent claudication. Fifteen individuals (7 men and 8 women) participated in 3 focus groups that were tape-recorded and content analyzed. A social-cognitive framework was used to categorize barriers and facilitators as those related to the person, to the activity, or to the environment. Variables identified included those specific to intermittent claudication and those common among the general population. Barriers to walking included irregular or graded walking surfaces, uncertainty about the outcome of walking, ambiguity regarding pain, the need to take rest breaks, and the presence of leg pain. Facilitating factors included availability of a resting place, use of cognitive coping strategies, companionship support, and availability of a treadmill-walking program. Findings are interpreted in light of current research on exercise determinants and encourage prospective examinations of the predictive validity of these factors for walking.     

A qualitative study of attitudes, beliefs, and practices among 40 undergraduate smokers

OBJECTIVE: Because little is known about college-age smokers, the authors conducted a qualitative study to better understand this population. PARTICIPANTS: Forty college student smokers from 12 Pacific Northwest colleges participated in the study. METHODS: The authors identified themes and built models to ascertain important factors related to smoking and smoking cessation. Four models emerged: smoking facilitators, smoking barriers, cessation facilitators, and cessation barriers. RESULTS: The authors observed physical, psychological, and social influences across models, and social influences were strongly associated with both smoking and cessation. Many smokers were unlikely to define themselves as regular smokers. Most smokers had made prior quit attempts. CONCLUSIONS: College students are a unique category of smoker and colleges can play a role in helping them achieve cessation.