Influence of a Community Health Worker Intervention on Mental Health Outcomes among Low-Income Latino and African American Adults with Type 2 Diabetes

This study investigated the influence of a community health worker (CHW) diabetes lifestyle intervention on mental health outcomes. Our study was guided by the principles of community-based participatory research. Data were collected from 164 African American (N = 94) and Hispanic adults (N = 70) participating in a randomized, 6-month delayed intervention group design for improving glycemic control. The intervention time periods were baseline to 6 months for the treatment group and 6–12 months for the delayed group. Linear mixed models were used to conduct longitudinal analyses of the Problem Areas in Diabetes (PAID) and Patient Health Questionnaire (PHQ) scales. In the model adjusted for demographics, the PAID dropped significantly from pre-intervention to post-intervention within both the treatment and delayed groups (p < 0.05) with an average intervention effect of ?6.4 (p < 0.01). The PAID dropped even further within the immediate group from 6 to 12 months. Although the PHQ did not change significantly, the PHQ-2 had an average intervention effect of ?0.3 (p < 0.05) in the model adjusted for demographics. This study contributes to an understanding of how a CHW-led diabetes intervention can result in positive mental health outcomes for Latinos and African Americans with Type 2 diabetes. It also highlights the importance of further exploring what factors may contribute to racial/ethnic variation in mental health outcomes for African Americans and Latinos with diabetes and the role CHWs can play.     

A Micro-Level Event-Centered Approach to Investigating Armed Conflict and Population Responses

In this article, we construct and test a micro-level event-centered approach to the study of armed conflict and behavioral responses in the general population. Event-centered approaches have been successfully used in the macro-political study of armed conflict but have not yet been adopted in micro-behavioral studies. The micro-level event-centered approach that we advocate here includes decomposition of a conflict into discrete political and violent events, examination of the mechanisms through which they affect behavior, and consideration of differential risks within the population. We focus on two mechanisms: instability and threat of harm. We test this approach empirically in the context of the recent decade-long armed conflict in Nepal, using detailed measurements of conflict-related events and a longitudinal study of first migration, first marriage, and first contraceptive use. Results demonstrate that different conflict-related events independently shaped migration, marriage, and childbearing and that they can simultaneously influence behaviors in opposing directions. We find that violent events increased migration, but political events slowed migration. Both violent and political events increased marriage and contraceptive use net of migration. Overall, this micro-level event-centered approach yields a significant advance for the study of how armed conflict affects civilian behavioral responses.     

Towards an interactional approach to reflective practice in social work

Reflective practice is a key aspiration within social work; being a reflective practitioner is considered to be a foundational attribute of the social work professional. However, achieving reflective practice is not straightforward. Reflection is inevitably subject to issues of memory and recall, so that the recollection of a case is likely to differ in important ways from the original instance. Moreover, giving an account of an event to one's peers or supervisors involves aspects of justification and self-presentation that may emphasise selectively and ignore key details of the original event, whether through a process of conscious omission or subconscious forgetting. This article reports on a knowledge exchange project that sought to enhance criminal justice social workers’ reflective practice through the use of the Conversation Analytic Role-play Method, an approach that is methodologically and theoretically grounded in the study of talk-in-interaction, drawing on video re-enactments of real encounters between practitioners and service users. We argue that by engaging collaboratively in this way, the practitioners and researchers learned a great deal about how practice in criminal justice social work is ‘done’ and also about the wider context within which criminal justice social work is practised.     

Sexual Orientation Curriculum in U.S. School Counselor Education Programs

The sexual orientation–related content of 60 school counselor preparation programs across 22 U.S. states is described. The findings include the percentage of curricular time devoted to sexual orientation–related topics, the specific sexual orientation–related topics addressed, and the locations of sexual orientation–related curriculum within programs (e.g., foundations, methods, and fieldwork/practica). The research also investigated any relationship between sexual orientation–related curriculum and faculty demographics and Council for Accreditation of Counseling and Related Education Programs (CACREP) accreditation. Findings and recommendations are addressed in light of CACREP and American School Counselor Association (ASCA) standards.     

Marital Discord and Subsequent Dissolution: Perceptions of Nepalese Wives and Husbands

The author examined the influence of marital discord on separation and divorce in a rural South Asian setting. Little is known about how marital discord influences marital outcomes in settings with low personal freedom and limited access to independence. Using a sample of 674 couples from the Chitwan Valley Family Study in Nepal, the author investigated the impact of marital discord on the rate of marital dissolution and the extent to which wives' and husbands' perceptions of discord influence dissolution. The results revealed that (a) spouses' perceptions of marital discord increase the rate of marital dissolution, (b) both husbands' and wives' perceptions of discord have an important influence, and (c) the influence of wives' perceptions of discord is independent of their husbands' perceptions. Overall, these findings suggest that both spouses' perceptions of discord are important for marital outcomes, even in settings where the costs of marital dissolution are relatively high.     

Public health policy and social support for immigrant mothers raising disabled children in Canada

A literature review regarding the social support of immigrant mothers of disabled children in Canada was undertaken with a focus on settings where supports need to be shored up. An integrative review of published papers and policy reports concerning key aspects of social supports for immigrant mothers and disabled children was undertaken. Immigrant mothers experience numerous barriers to social supports for themselves and their disabled children. Maternal immigrant populations experience unique challenges in the setting of childhood disability as well as the challenges of mothers in the dominant culture. There are negative impacts on maternal health as a result of inadequate policy offerings. Public health policy needs to be refashioned in light of weak systems and supports for both immigrant mothers and disabled children and to acknowledge that the current system poses concerning implications for the long-term health of both groups.     

A trio of talented women: abolition,gender, and political participation, 1780–91

This study presents new information about three influential women, Mary Morris Knowles, Anna Seward, and Jane Harry Thresher, who supported abolition during the formative period when anti-slavery sentiment crystallized into the national campaign against the slave trade. Focusing on their connections, political ideologies and pro-abolition activities indicates important ties to radical Patriot ideas, ‘the politics of complexion’ and the power of poetry in shaping early support for abolition. By 1791, attitudes toward gender, slavery and abolition had become intertwined across the spectrum of support for and opposition to slave holding and slave-trading. This study indicates that female participation constituted an important element in the origins of the public movement and documents the social and political importance of this female friendship network in the early abolition campaign.     

Critical race pedagogy 2.0: lessons from Derrick Bell

In this article, we attempt to honor the rich legacy of Derrick Bell by detailing how exploring his specific contributions to critical race theory (CRT) provided lessons for developing and refining critical race pedagogy (CRP). We examine Bell’s racial realism thesis in connection with his pedagogical work. In doing so, we find that he was as committed to developing a ‘community-based’ law classroom as he was to articulating a strong critique of the law (Radice 1991). As part of his teaching philosophy, Bell wrote extensively about the value and importance of a student-centered humanist pedagogy (Bell 1980, 1982, 1997; Bell and Edmonds 1993; Delgado and Stefancic 2005). We draw parallels between Bell’s humanist student-centered pedagogy and the tenets of CRP as a way to expand the accessibility of this framework. Finally, as the ultimate homage to the work of Derrick Bell, we end with a futuristic mini-chronicle that takes place in a school district boardroom. The chronicle features a fictitious character who happens to be a distant relative of Bell’s. As we will discuss, we believe that the use of chronicles and storytelling hold the possibility for helping us to name extant challenges and illuminate further possibilities of CRP as a tool for battling globalized oppression at the intersection of race, class, gender and sexuality in education.     

The role of need for contraception in the evaluation of interventions to improve access to family-planning methods

A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on met need (i.e., contraceptive use by women who need contraception) but not on contraceptive use (i.e., contraceptive use by women who may or may not need contraception). Met need captures the woman's success in overcoming barriers to access to family planning, whereas contraceptive use confounds this construct with risk of pregnancy and fertility desires. Exceptions to this rule are identified.