Overcoming barriers to access and utilization of hospice and palliative care services in African-American communities

While there is ample evidence to support the need for hospice and palliative care services for African Americans, only 8% of patients who utilize those services are from African-American communities. The underutilization of end-of-life and palliative care can be attributed to several barriers to service access including incompatibility between hospice philosophy and African-American religious, spiritual, and cultural beliefs; health care disparities; distrust of the medical establishment; physician influence; financial disincentives, and hospice admission criteria. Suggestions for dismantling barriers to care access include developing culturally competent professionals in the health and human services, expanding the philosophy of hospice to include spiritual advisors from client communities, and funding national initiatives to promote improved access to health care at all stages in the life cycle of members of all underserved communities.     

“What Colour Is Your English?”*

This paper raises questions about ways in which the “imagined community” is discursively patrolled through accents. Drawing on preliminary research with African immigrant women, we argue that “Canadian English” constitutes a border allowing only partial and provisional crossing for those with an “African English” accent. The accent border is material and figurative, affecting access to material benefits such as jobs or housing, as well as shaping perceptions of who belongs in Canada. Thus, accents form a site through which racialized power relations are negotiated and “Others” are reproduced materially and figuratively in Canada.

Citing Literature

Volume 40 , Issue 5 December 2003

Pages 565-573     

Stranger-Danger: What do Children Know?

The current practice in many schools of educating children on how to keep themselves safe from abuse and abduction tends to concentrate on teaching them about stranger-danger and how to avoid it. However, recent research suggests that children may have difficulty in understanding the stranger-danger message (Mayes, Gillies and Warden, 1990). The present study examines 6-, 8- and 10-year-old children's understanding of the concepts of ‘stranger’ and ‘danger’ by analysing their verbal responses to videotaped sequences depicting child encounters with a variety of known and unknown male adults. Results indicate that, although there is some evidence of developing wariness, children at ages 8 and even 10 years appear still to be vulnerable to approaches made by strangers. © 1997 by John Wiley & Sons, Ltd.     

From communication to co‐operation: Reconceptualizing social workers' engagement with children

Communicating and engaging with children is a foundational component of child care social work practice, but all too frequently, in the wake of serious incidents, it is the focus of criticism. Drawing on findings from a large‐scale ESRC‐funded research project conducted in the four U.K. nations, this paper explores, through a psychosocial analytic lens, how social workers anticipate, enact and reflect on their encounters with both children and their families. Close analysis of what social workers said about their practice alongside what they were observed to do in practice revealed perceptions, patterns and processes of communication that, first, minimize emotions and the complexity of the professional task and second, overly privilege verbal interaction. Drawing on Sennett's (2012) ideas this paper offers a reconceptualisation of this professional task, from a communicative to a co‐operative one. It affords and creates a space in which social workers can develop more attuned communicative practices that include rituals, gestures and the minimal use of force. The theoretical insights and evidence‐informed practice recommendations arising from this research have conceptual significance for the social work discipline and practical significance for the child care social work profession, across national and international contexts.     

The protective role of religious coping in adolescents' responses to poverty and sexual decision-making in rural Kenya

In this study, we explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-third (13) reported religious coping related to economic stress, HIV, or sexual decision-making; the majority (29) reported religious coping with these or other stressors. Adolescents reported praying for God to partner with them to engage in positive behaviors, praying for strength to resist unwanted behaviors, and passive strategies characterized by waiting for God to provide resources or protection from HIV. Adolescents in Sub-Saharan Africa may benefit from HIV prevention interventions that integrate and build upon their use of religious coping.