Maybe ignorance is not always bliss: The disparate treatment of Hispanics within the child welfare system

Previous studies indicate that the proportion of culturally diverse children to White children is increasing in public social service agencies. In addition, culturally diverse children are more likely to receive more intensive and punitive services, are more likely to stay within the system for longer periods of time and are reported more often to Child Protective Services. The purpose of the study was to explore how child welfare practices with Hispanic children are different from those applied with White non-Hispanic children. This study was a retrospective, two year, longitudinal, survival analysis of differential child welfare placement outcomes of White non-Hispanic and Hispanic children/families which had substantiated cases of abuse/neglect (n=1001).Findings demonstrate that although cases reported for abuse/neglect are relatively proportionate between Hispanic and White non-Hispanic children, substantiated cases are more likely to occur with Hispanic children. These children are more likely to be placed out of the home more quickly and for longer periods of time than their White non-Hispanic counterparts. The current study demonstrates the need for increased cultural awareness among Child Welfare professionals, especially in terms of assessment and case decision making, and the need for the development of culturally sensitive training modules for CPS and case management personnel.     

What Is Valued in Gay and Lesbian Specific Alcohol and Other Drug Treatment?

Little is known about what gay and lesbian clients value about culturally specific alcohol and other drug treatment programs. This study involves a sample of clinical staff and former clients (N = 40) of four culturally specific alcohol and other drug treatment programs to clarify what is addressed and deemed valuable for the specific needs of gay and lesbian clients. Through the lens of the recovery capital conceptual framework, this qualitative research emphasizes resiliency and the supports necessary for long-term recovery. Results indicate three major themes that make this type of treatment valuable: (1) a separate treatment unit or facility, (2) a safe and supportive therapeutic milieu, and (3) specific tailored treatment approaches. Findings are discussed to include implications for ways to improve services for this all too often understudied population of potentially vulnerable individuals who can benefit from culturally sensitive care.     

Conducting a Hispanic Health Needs Assessment in rural Kansas: Building the foundation for community action

Healthy People 2020 states ethnic health disparities are a priority for the US. Although considerable national statistics document ethnic-related health disparities, information specific to rural areas is scarce and does not provide direction for implementing chronic disease prevention programming. Therefore, the purpose of our project was to use the Hispanic Health Needs Assessment (HHNA), a tool designed by the National Alliance for Hispanic Health (NAHH), in culturally diverse, rural Southwest Kansas. Our focus areas included: access to healthcare, heart disease, diabetes, overweight, nutrition, and physical activity.MethodsThe assessment followed six steps: (1) developing the assessment team, (2) data gathering using community member surveys, existing statistics and community leader interviews, (3) assembling the findings, (4) formulating recommendations for action at individual, institutional, community and policy levels, (5) sharing findings and program planning, and (6) sharing findings with NAHH. We identified several challenges collecting health related data in rural communities, but overall, the HHNA was a comprehensive and useful tool for guiding a community level health assessment.ConclusionThis process has provided our community partners with locally relevant statistics regarding the current status of health, health behaviors, and perceived community needs to inform resource allocation, program planning and applications for new funding initiatives.     

Cross-Cultural Competency Through Service-Learning

ABSTRACT

This article addresses the development of cross-cultural competency within the context of service-learning. The need to integrate cross-cultural competency into the academic curriculum has risen dramatically with the sharp increase in resident Hispanics and their families. Service-learning addresses the demand for culturally competent graduates who can address the paradigms of inequality and invisibility as well as the language barrier. Service-learning develops cultural competency through weekly direct contact and journal writing exercises. By venturing into the community, students see beyond the cultural walls that often divide neighborhoods, and they also make connections between economics, anthropology, history, political science, and other disciplines. Through service-learning, many university students develop maturity and ingenuity that they would not acquire in the classroom. Community partners—the families, students, and teachers—discover how to complement and advocate for each other to help ensure well-being and academic success. This article analyzes and evaluates the service-learning experience through a community practicum course in which students spend 40 hours working with Hispanic migrant families. It includes the evolution in service-learning in a university program and the value in the shift from a focus on language acquisition to the development of cultural competency as an integral part of the program. Working with a population that is culturally different from themselves and the textbook knowledge they have received has become a cornerstone of university language and teacher-training programs.     

Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

ABSTRACT

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the Southwest. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations. The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

"It Has Made College Possible for Me": Feedback on the Impact of a University-Based Center for Students in Recovery

Objective: The authors aimed to gain information on (1) the challenges for recovering students on a university campus and (2) the most helpful components of a collegiate recovery program.

Participants: The 15 students in the study were all in recovery from substance abuse. They entered the university and also entered the campus recovery program either in fall 2002 or fall 2003.

Methods: Semistructured interviews were conducted with students multiple times during their first academic year.

Results: Participants identified several challenges on the university campus. Many believed they would have dropped out of school or relapsed without the support of the recovery program, and they described aspects of the program that were particularly important to them.

Conclusions: Support from a campus recovery program is essential for many recovering students. There are a variety of recovery program components that can foster the sense of community that was so important to the students in this study.     

Acculturation,Socioeconomic Factors and Obesity Among Immigrants from El Salvador Living in the Washington,D.C. Area

Abstract

This study examined acculturation, SES and obesity in a convenience sample of 1205 Salvadoran immigrants from the Washington, D.C area. Acculturation was measured by language preference for print and electronic media and years residing in the U.S. Obesity was measured by the percent overweight based on body mass index norms. About 30% of respondents were overweight. Acculturation was positively associated with obesity and together with other variables in the model explained 45% of the variance in obesity. Preference for Spanish media was strongest in the older age group. Doctors and TV were the most frequently cited sources of health information. Social workers and health educators can use this information to develop culturally competent interventions and research in Hispanic populations.     

Mental Health Recovery

Abstract

Strengths-based approaches that emphasize culturally competent services and naturally occurring community support may be more appropriate than traditional mental health services for African American adults with psychiatric disabilities. An examination of the literature on service utilization and treatment needs for this population highlights the paucity of empirical studies in these areas, while an exploration of the literature related to psychiatric recovery, a prominent strengths-based framework, reveals insufficient application of the approach to the specific interests of African American service recipients. We suggest that recovery is in fact highly compatible with such culturally relevant approaches as the Afrocentric model, and argue that the concept of recovery may therefore provide a resonant and particularly useful framework for practice with this population. Implications for research, practice and policy are discussed.     

Factors Associated with Drug Treatment Entry Patterns Among Hispanic Women Injection Drug Users Seeking Treatment

SUMMARY

This paper examines patterns of drug treatment entry and factors that are associated with these patterns among 1,849 Hispanic women injection drug users (IDUs). The data analyzed originates from a statewide drug-treatment database covering seven years, 1996–2002. Through the use of logistic regression analyses, the study identified significant differences in predisposing, need and enabling factors in the use of detoxification only, residential treatment, or methadone maintenance. Compared to other Hispanics, Puerto Rican women were 40 percent less likely to use only detoxification services and one and a half times more likely to use methadone maintenance. Having health insurance was an especially important factor associated with methadone treatment utilization. Two of the most important factors associated with residential treatment use were history of mental health services utilization and involvement with the criminal justice system. This article discusses specific social work practice implications including the need for social work practitioners to promote services such as residential treatment, to be trained in treatment of co-occurring mental health disorders, especially among women in residential treatment, and the need to establish close linkages with the mental health and criminal justice systems.     

Hispanic and African American Youth

SUMMARY

This exploratory, qualitative study of 28 (10 Hispanic and 18 African American) former foster care youth attempts to capture the essence of their quest for self-sufficiency. While research on former foster care youth continues to highlight the problems confronting them after they emancipate from care, the depth of their struggles is often lost in the aggregation of statistics. The numbers themselves often fail to capture the hardships, isolation, hope, and despair many of them may face as they attempt to adjust to life after foster care. Furthermore, existing research often regards emancipated youth as a homogeneous population. Interviews with these respondents of color were coded to determine the themes and stories they held. The themes emergent from these interviews were: the importance of people in the independent living programs; vagueness in recalling the content of the independent living programs; family conflict; housing instability; regrets, fears, and lessons learned; and future goals. Implications for culturally sensitive practice and research are drawn from these data.     

An examination of the locus of desired control among young‐old and old‐old nursing home patients (1)

This research examined the locus of desired control among a sample of 218 nursing home residents. Two issues were addressed: (a) What is the predictive impact on locus of desired control of education, gender, race, functional ability, subjective health and length of stay among the residents in each of the two age groups? and (b) Was there a difference in the locus of desired control among the young‐old (74 years or less) and old‐old residents (75 years or more)? A discriminant analysis revealed that among the 95 young‐old residents, greater desire for control, internality, was associated with poorer functional abilities, poorer subjective health and longer lengths of stay. Among the 123 old‐old residents, greater desire for control was assciated only with poorer functional abilities and poorer subjective health. Further, a significantly greater proportion of old‐old residents had greater locus of desired control, 59 percent, in comparison to only 43 percent of the young‐old residents who expressed greater locus of desired control.     

Developing Culturally Responsive Supervision Through Yarn Up Time and the CASE Supervision Model

ABSTRACT

This article explores a culturally focused supervision training program supporting Aboriginal and non-Aboriginal supervisors to provide cross-cultural supervision for Aboriginal staff within mainstream and Aboriginal community and human service organisations. The key features of the training program, Yarn Up Time and the CASE supervision model are a culturally respectful approach to cross-cultural professional supervision practice with the purpose of contributing to the development of culturally responsive supervision with Aboriginal staff and their clients. The article concludes with feedback from participants who attended the training and supports the future advancement of cross-cultural supervision practice and models in Australia.

IMPLICATIONS

• There continues to be a need for more culturally responsive supervision for Aboriginal staff and for non-Aboriginal social work practice with Aboriginal people.

• Yarn Up Time and the CASE model is a culturally appropriate approach for supervising Aboriginal staff and non-Aboriginal social workers’ supervision of social workers’ practice with Aboriginal communities.

• Social work supervisors need to be able to use an effective cultural supervision model to support Aboriginal staff in Yarn Up Time.

     

Acculturation Status and Substance Use Prevention with Mexican and Mexican-American Youth

SUMMARY

This study examined whether language preference, as an indicator of acculturation, moderated the effects of a culturally grounded substance use prevention intervention for Mexican and Mexican American middle school students (N = 2,146) in Phoenix, Arizona. The main hypothesis was that levels of program effectiveness would vary based on the language preference of the students and the specific culturally grounded version of the intervention they were assigned. Findings show that matching language preference to particular versions of the intervention did not influence substance use related program outcomes, but that overall program effects (intervention versus control) did vary by language preference. English-language dominant participants, the most at risk sub-group, responded more positively to the intervention, while Spanish dominant, who had low substance use rates at baseline, and bilingual participants did not demonstrate significant differences between the intervention and control groups. Implications for school social work prevention interventions and prevention science in general, are discussed.     

Applying an Ecological Framework to Understanding Drug Addiction and Recovery

ABSTRACT

A new conceptual model of drug addiction and recovery, the Acculturation Model, is presented, with “addiction” and “recovery” understood as distinct sociocultural phenomena with their unique prescribed behaviors, rituals, symbols, and language that serve to construct and consolidate a cultural identity. The model suggests that individuals in recovery from drug addiction will need to make a cultural transformation in order to maintain sobriety. Examples of specific rituals that may help facilitate movement from addiction to recovery are detailed.     

Predictors of Nursing Home Admission: A Social Work Perspective

Abstract

Institutionalisation of geriatric patients is a growing trend in ageing societies, such as Singapore. Earlier studies focused on the sociodemographic profile and attributes of nursing home residents and applications, but neglected to address the predictors of nursing home admission from a social work perspective. The present retrospective study identifies independent risk factors that predispose a patient to a nursing home discharge from a general rehabilitation ward in a community hospital in Singapore, with a multidisciplinary emphasis on clinical intervention. Factor analysis results reinforced findings that functional impairment and dementia are consistent predictors of nursing home admission. Multivariate logistic regression analysis showed that positive predictors of nursing home admission include older age, length of hospital stay, low socioeconomic status, dementia, and functional disability. Social work interventions include early referrals to the medical social worker, so that options for social and family support can be explored prior to deciding to place patients in a nursing home. Other interventions include suitable family therapy and counselling for patients and their families.     

Racial and Ethnic Differences in the Prevalence of Depressive Symptoms Among U.S. Nursing Home Residents

This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms (score ≥ 10 on the 9-item Patient Health Questionnaire [PHQ-9] scale) and whether associations were explained by resident and nursing home covariates. Stratified analyses further determined independent associations in subgroups of residents. We found that the prevalence rate of PHQ-9 scores ≥ 10 was 8.8% among non-Hispanic White residents (n = 653,031) and 7.4%, 6.9%, and 6.6% among Black (n = 97,629), Hispanic (n = 39,752), and Asian (n = 16,636) residents, respectively. The reduced likelihoods of significant depressive symptoms for minority residents compared to non-Hispanic Whites persisted after sequential adjustments for resident and nursing home covariates, as well as in stratified analyses. The persistently lower rate of significant depressive symptoms among racial and ethnic minority residents suggests that training of nursing home caregivers for culturally sensitive depression screening is needed for improved symptom recognition among minority residents.