The Family Team at Boston Healthcare for the Homeless Program: an integrated approach to care in outreach settings

Since 1986, the Family Team at Boston Health Care for the Homeless Program has implemented an integrated, inter-professional, team-based model of care to serve families experiencing homelessness. The Family Team employs key strategies delineated by the well-established Health Care for the Homeless model, which emphasizes the importance of outreach medicine and a case management “one-stop shop approach”. We include an account of a specific case where the Family Team’s unique model helped a refugee family in Massachusetts access medical and social services otherwise more difficult to obtain. The Family Team’s onsite presence in the hotel-shelter and the team-based approach facilitated diagnosis of and successful treatment for cervical cancer in a mother of eight children. This case report suggests that the Health Care for the Homeless model of care should be more widely adopted in order to best serve homeless families.

Abbreviations: Boston Health Care for the Homeless Program (BHCHP); Emergency Assistance (EA); Health Care for the Homeless (HCH); Massachusetts General Hospital (MGH)     

Coping strategies used by LGB older adults in facing and anticipating health challenges: A narrative analysis

ABSTRACT

Given that lesbian, gay, and bisexual (LGB) older adults face notable health disparities compared to their heterosexual counterparts, there is a need for understanding how LGB adults cope with health challenges in late life. The current study analyzes narratives from nine LGB adults age 65 and older living in an urban area in the Southeast United States. Participants spoke of coping strategies related to health promotion behaviors, shifting perspectives of health and body, trusting in spirituality for comfort, and accepting the end of life. We discuss implications for social services professionals who work with older LGB adults and for future research.     

Fathers and Their Infants: Caregiving and Affection in the Modern Family

Despite social work's expressed interest in families and belief in the importance of parents to children, social work researchers have done little to explore the importance of fathers in children's everyday lives. This is especially true for infants. Moreover, as more and more infants and children grow up in single-mother homes, step-families, and other family configurations, knowledge is needed about how these demographic trends affect parents' interactions with their young children.

This article examines men's caregiving of infants and their displays of affection in a longitudinal study of a diverse sample of infants and their mothers, using both person-centered and variable-centered statistical methods. Comparisons are made among various “types” of fathers, including those who live with and separately from their children and men who are not biological fathers but live with and care for infants.

Results indicate that caregiving and expressions of affection appear to represent two distinct domains of fathering behaviors for residential fathers. We found two classes of residential fathers: one with low levels of both types of fathering behavior and one with higher levels, particularly higher expressions of affection. Similarly we found two classes of non-residential fathers with dramatically different levels of fathering behavior. Though surrogate fathers did provide affection to their infants, their levels of caregiving were low.     

Identification of factors influencing dispersion in split-plot experiments

As split-plot designs are commonly used in robust design it is important to identify factors in these designs that influence the dispersion of the response variable. In this article, the Bergman-Hynén method, developed for identification of dispersion effects in unreplicated experiments, is modified to be used in the context of split-plot experiments. The modification of the Bergman-Hynén method enables identification of factors that influence specific variance components in unreplicated two-level fractional factorial splitplot experiments. An industrial example is used to illustrate the proposed method.     

Identifying Higher‐Order Rationality

Strategic choice data from a carefully chosen set of ring‐network games are used to obtain individual‐level estimates of higher‐order rationality. The experimental design exploits a natural exclusion restriction that is considerably weaker than the assumptions underlying alternative designs in the literature. In our data set, 93 percent of subjects are rational, 71 percent are rational and believe others are rational, 44 percent are rational and hold second‐order beliefs that others are rational, and 22 percent are rational and hold at least third‐order beliefs that others are rational.     

Perspectives on determinants of social welfare: introduction

In this commentary we discuss and elaborate on a number of topics that have been raised in the articles in this issue. The first topic treated is causality. All scientists are aware of the difficulties of making causal inferences in non‐experimental settings, and in many cases arguments are forwarded that support the causal interpretation of the reported relationships. Questions of bi‐directional causality, nonlinear relationships and the importance of omitted variables are discussed, as is the supporting evidence that in some cases comes from experimental studies. The second topic is the level of analysis employed in the empirical analyses and the difficulty of interpreting findings at a different level of aggregation than the level applied in these analyses. In this context, the importance of applying a person‐orientation is pointed out to ensure that the findings are interpretable at the level of the single individual. Even in individual‐level analyses, this can be problematic if one relies on group statistics produced within a variable‐oriented framework. The third topic concerns how to handle interactions and nonlinear relationships. The fourth topic concerns the importance of improving measurements so that a good correspondence is achieved between them and the theoretical conceptualisations. The fifth and last topic is concerned with the argument that different ways of investigating the generalisability of the results to different populations should be tried.     

Prevalence, perpetrators, and characteristics of witnessing parental violence and adult dating Violence in Latina, East Asian, South Asian, and Middle Eastern women

The present study describes and compares the prevalence, perpetrators, and characteristics of witnessing parental violence during childhood and experiencing adult relationship violence in 251 college-educated South Asian/Middle Eastern (n = 93), East Asian (n = 72), and Latina (n = 86) women residing in the United States. Results showed that more than 50% of each ethnic group witnessed parental and adult relationship violence. For all three groups, adult psychological violence was more prevalent than physical violence, which, in turn, was more prevalent than injury violence. Significant differences were found for paternal and maternal psychological, physical, and injury violence witnessed within ethnic groups. High prevalence rates and significant differences emerged for psychological, physical, and injury violence experienced as a victim and enacted as a perpetrator within ethnic groups. The implications of college-educated, higher socioeconomic status (SES) women of color being at risk for witnessing and experiencing family violence are discussed.     

Perspectives on determinants of social welfare: commentary

In this commentary we discuss and elaborate on a number of topics that have been raised in the articles in this issue. The first topic treated is causality. All scientists are aware of the difficulties of making causal inferences in non-experimental settings, and in many cases arguments are forwarded that support the causal interpretation of the reported relationships. Questions of bi-directional causality, nonlinear relationships and the importance of omitted variables are discussed, as is the supporting evidence that in some cases comes from experimental studies. The second topic is the level of analysis employed in the empirical analyses and the difficulty of interpreting findings at a different level of aggregation than the level applied in these analyses. In this context, the importance of applying a person-orientation is pointed out to ensure that the findings are interpretable at the level of the single individual. Even in individual-level analyses, this can be problematic if one relies on group statistics produced within a variable-oriented framework. The third topic concerns how to handle interactions and nonlinear relationships. The fourth topic concerns the importance of improving measurements so that a good correspondence is achieved between them and the theoretical conceptualisations. The fifth and last topic is concerned with the argument that different ways of investigating the generalisability of the results to different populations should be tried.