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.     

Poverty affects access to regular source of primary care among the general population in Hong Kong

A territory‐wide two‐stage stratified random sample of 2,282 community‐dwelling Hong Kong adults were surveyed between 2014 and 2015 to investigate the association between poverty and regular source of primary care utilization. Poverty was operationalized by income‐poverty and deprivation. About 94% of our sample reported having regular source of primary care (Western and/or Chinese medical practitioner) and about 69% among them were in private sector. Multivariable logistic regression showed that people who were income‐poor and deprived were less likely to have regular source of primary care (income‐poor: OR = 0.523, p = .027; deprived: OR = 0.488, p = .007) and visit private primary care doctors (income‐poor: OR = 0.445, deprived: OR = 0.222, both p < .0001). Those who had chronic diseases were more likely to have regular source of primary care (multimorbid: OR = 10.709, p < .0001), but less likely to access care in the private sector (one chronic disease: OR = 0.690, p = .019; multimorbid: OR = 0.374, p < .0001) than those without. Further, being older and less skilled were significantly associated with less likelihood of visiting a private doctor. Path analysis showed that the number of chronic diseases had significant indirect effect on having regular source of primary care with being income‐poor and deprived as the mediators (β = ?.0183, p = .0016). Therefore, despite a public health‐care system that aims to deny no one from adequate health care for lack of means, regular source of primary care in Hong Kong is found to be pro‐rich. Future policies should tackle the problem of health‐care inequalities to meet the needs of the underprivileged.     

Solutions to the Challenge of Meeting Rural Transportation Needs: Middle-Aged and Older Adults’ Perspectives

This study aimed to explore how the aging population in Appalachia manages its transportation and plans for the transition to non-driving and to seek possible solutions to the challenge of meeting rural transportation needs. Four focus groups (N = 38) were conducted, supplemented by a questionnaire, in Appalachian Kentucky. The results showed that few alternative transportation existed except a local paratransit service and informal transportation support. Compared to older adults, middle-aged adults reported a greater willingness to use mobile phones and the Internet to arrange transportation if they were available. Participants also recommended expanding the use of existing transportation in the community – such as church vans – to better meet the aging population’s needs. The findings suggest that partnership between government, non-profit, and private sectors is needed, not solely focusing on a tax-dependent solution. Additionally, information and communication technology-based transportation management system would help maximize the use of scare but existing resources in rural areas.     

Immigration and the Family Circumstances of Mexican‐Origin Children: A Binational Longitudinal Analysis

Using data from the birth cohort of the Early Childhood Longitudinal Study (n = 1,200) and the Mexican Family Life Survey (n = 1,013), this study investigated the living arrangements of Mexican‐origin preschool children. The analysis examined children's family circumstances in both sending and receiving countries, used longitudinal data to capture family transitions, and considered the intersection between nuclear and extended family structures. Between ages 0–1 and 4–5, Mexican children of immigrants experienced significantly more family instability than children in Mexico. They were more likely to transition from 2‐parent to single‐parent families and from extended family households to simple households. There were fewer differences between U.S. children with immigrant versus native parents, but the higher level of single parenthood among children of natives at ages 0–1 and the greater share making transitions from a 2‐parent to a single‐parent family suggest ongoing erosion of children's family support across generations in the United States.     

A comparison of soil organic carbon stocks between residential turf grass and native soil

A central principle in urban ecological theory implies that in urbanized landscapes anthropogenic drivers will dominate natural drivers in the control of soil organic carbon storage (SOC). To assess the effect of urban land-use change on the storage of SOC, we compared SOC stocks of turf grass and native cover types of two metropolitan areas (Baltimore, MD, and Denver, CO) representing climatologically distinct regions in the United States. We hypothesized that introducing turf grass and management will lead to higher SOC densities in the arid Denver area and lower densities in the mesic Baltimore area relative to native cover types. Moreover, differences between turf grass soils will be less than differences between the native soils of each metropolitan region. Within Baltimore, turf grass had almost a 2-fold higher SOC density at 0- to 1-m and 0- to 20-cm depths than in rural forest soils, whereas there were no differences with soils of urban forest remnants. Moreover, urban forest remnants had more than 70% higher SOC densities than rural forest soils. Within Denver, turf grass (>25 years of age) had more than 2-fold higher SOC densities than in shortgrass steppe soils, while having similar densities to Baltimore turf grass soils. By contrast, the native soils of Baltimore were almost 2-fold higher than the native steppe grass soils of Denver using SOC densities of remnant forests as representative of native soils in the Baltimore region. These results supported our hypothesis that turf grass systems will be similar in SOC densities across regional variations in climate, parent material, and topography. These similarities are apparently due to greater management efforts in the Denver region to offset the constraint of climate, i.e., anthropogenic factors (management supplements) overwhelmed native environmental factors that control SOC storage.     

Non-formal educator use of evaluation results

Increasing demands for accountability in educational programming have resulted in increasing calls for program evaluation in educational organizations. Many organizations include conducting program evaluations as part of the job responsibilities of program staff. Cooperative Extension is a complex organization offering non-formal educational programs through land grant universities. Many Extension services require non-formal educational program evaluations be conducted by field-based Extension educators. Evaluation research has focused primarily on the efforts of professional, external evaluators. The work of program staff with many responsibilities including program evaluation has received little attention. This study examined how field based Extension educators (i.e. program staff) in four Extension services use the results of evaluations of programs that they have conducted themselves. Four types of evaluation use are measured and explored; instrumental use, conceptual use, persuasive use and process use.Results indicate that there are few programmatic changes as a result of evaluation findings among the non-formal educators surveyed in this study. Extension educators tend to use evaluation results to persuade others about the value of their programs and learn from the evaluation process. Evaluation use is driven by accountability measures with very little program improvement use as measured in this study.Practical implications include delineating accountability and program improvement tasks within complex organizations in order to align evaluation efforts and to improve the results of both. There is some evidence that evaluation capacity building efforts may be increasing instrumental use by educators evaluating their own programs.     

Implications of Sex Guilt: A Meta-Analysis

A meta-analysis of the literature examining the outcomes related to feelings of sex guilt was conducted. The analysis demonstrates gendered differences in the experience of sex guilt and myriad attitudinal and behavioral impacts. Specifically, men report lower levels of sex guilt, r?=??.227 than do women and implications of sex guilt experience are vast, including its association with engagement in less sexual activity, r?=??.337, less favorable attitudes toward sex and lessened use of contraceptives, r?=??.276, reduced reports of sexual arousal in response to an explicitly sexual media content, r?=??.308, less positive emotional response to sexually explicit media content, r?=??.367, reduced level of sexual information accuracy, r?=??.324, and less positive attitudes toward sexual behavior, r?=??404. Sex guilt is positively related to level of religiosity/religious behavior, r?=?.439. The findings suggest that sex guilt provides a consistent set of responses to sexual information and media content as well as a motivational basis for behavior. These outcomes are further explicated and discussed.     

Serving families with child maltreatment and substance use disorders: A decade of learning

ABSTRACT

An increase in parental substance use disorders (SUD) and the number of infants and toddlers entering foster care has prompted federal and state efforts to change the treatment paradigm toward more integrated and family-centered strategies. The Regional Partnership Grant (RPG) program demonstrated that family-centered strategies can improve child and parent outcomes. The current challenge is to bring effective strategies to scale. This conceptual article highlights the lessons learned from 10 years of implementing and evaluating programs to meet the needs of families affected by parental SUD and child maltreatment. Effective family-centered strategies identified by the RPG program are illustrated with specifics from the Sobriety Treatment and Recovery Team program. These effective strategies could be implemented in any jurisdiction and include (1) collaboration toward integrated services between child welfare and SUD treatment, (2) timely access to SUDS treatment, (3) recovery management and support, (4) tailored family services, and (5) adaptation to local jurisdiction needs. When these strategies are operational, children are more likely to be safe and remain in parent custody, and parents are more likely to achieve sobriety and improve their parental capacity. Future research might examine the unique impact of each of the five strategies independently.     

Social unrest and the Highway Beautification Act of 1965

The recent series of very senseless shootings of both African American males and police officers are chilling visual demonstrations of the current degree of racial tension and social unrest in the United States. Stricter gun control laws are critically important but only part of the issue. Basic human and civil rights are at the heart of the issue. We must move toward a society in which individuals from varied backgrounds are valued, respected, and included. We must all accept the fact that we are all human beings and very much alike. This will require a national effort very similar to the Highway Beautification Act of 1965. We must adopt and implement policies that will specifically address multiple issues (discrimination, racism, marginalization, exclusion, implicit bias, and the lack of economic mobility) serving as drivers of our current social state. A key component should be increased investment in the educational system (starting in primary school) resulting in an increased college graduation rate and the development of curricula on race and racism and supporting cultural sensitivity and implicit bias training from kindergarten through professional schools.