Gearing Up for Personalisation: Training Activities Commissioned in the English Pilot Individual Budgets Sites 2006–2008

The transformation of social care in England is taking place though changes affording greater choice and control for people using services. Individual budgets were one key element of these changes and were piloted in 13 local authorities in 2006–2008. This article reports on interviews with training leads in these local authorities that took place in 2008 as part of an independent evaluation of the individual budget pilots. The aims of the interviews were to explore the role of training as part of the processes of transformation, the use of resources and establishment of training strategies within the local authority. Participants revealed that the subject of training was acquiring higher profile within their authorities, although uncertainties remain about the extent of local authority responsibilities for training. Within local authorities, training resources were yet to be determined and models of training were not fully developed. The article concludes that training will remain a central issue when implementing personalised social care services and that models of training for such changes should be shared and evaluated over the long term.     

User and Carer Experiences of International Social Care Workers in England: Listening to their Accounts of Choice and Control

Abstract

This paper develops a typology of people using social care services’ preferences for care workers and satisfaction with social care services from a large multimethod study that explored international recruitment to the English social care sector (home and health care, including residential homes). We developed this typology with two questions in mind: (a) what led to satisfaction of care and (b) what led to preference and satisfaction with workers? Data were collected from face-to-face interviews with 35 people who were using social care services and carers (2007–2009) and these data were used to develop the typology. Using the theoretical concept of homophily, we explored contentions that people might prefer to receive care and support from individuals resembling themselves. We observed that preferences for care workers and satisfaction with social care services may be linked, but highlighted that the concept of meeting a preference is personal to the individual. The implications of users’ preferences for certain care workers at a time where policy is promoting greater consumer-led care or self-directed support are discussed.     

Examining Depression,Anxiety, and Foster Care Placement as Predictors of Substance Use and Sexual Activity in Adolescents

ABSTRACT

This study investigated the impact of anxiety and depression on sexual activity and substance use behaviors in a sample of 56 community- (traditional living arrangements) and foster care-dwelling adolescents aged 12 to 17 years. It was hypothesized that higher levels of anxiety and depression would be related to higher rates of risky sexual activity and substance use. Regression analyses were used to examine impact of the internalizing predictors on the risky behaviors. Results of the sample were presented with group membership emerging as a robust predictor of both sexual activity and substance use. Results suggest that adolescents within out-of-home care are at increased risk for engaging in these behaviors when compared with community-dwelling peers, and they may benefit from specific interventions aimed at decreasing participation. Future research may focus on assessing the effectiveness of interventions for these youth.     

Sleep and psychological well-being

Although many studies have linked sleep problems with symptoms of psychopathology, fewer studies have examined the relationship between sleep and dimensions of psychological health as well as depression. To fill this gap, 502 community residents were surveyed about sleep habits, symptoms of anxiety and depression, as well as Ryff’s six dimensions of psychological well-being. Using cut-offs suggested by epidemiological research, participants were classified as either optimal sleepers (those reporting an average of 6 hours or less than 8.5 hours per night) or suboptimal sleepers (those sleeping less than 6 hours or 8.5 or more hours per night). After controlling for demographic differences (i.e., sex, age, education, ethnicity, employment status, marital status, presence of children), the Multivariate Analysis of Covariance (MANCOVA) suggested that optimal sleepers reported fewer symptoms of depression, and anxiety, and reported higher levels of environmental mastery, personal growth, positive relations with others, purpose in life, and self acceptance. Differences between optimal sleepers and non-optimal sleepers in depressive symptoms, positive relations with others, purpose in life and self-acceptance remained significant when people with mild to moderate symptoms of depression were eliminated from the data set. These results are consistent with a theoretical framework that defines sleep as a resource related to stress management and self-regulation.     

Adolescent Career Development in Urban‐Residing Aboriginal Families in Canada

The purpose of this study was to understand how urban‐residing Aboriginal adolescent–parent dyads (n = 11) jointly constructed and acted on goals and strategies with their social supports (n = 17) to facilitate the adolescents' career development. A modified protocol following the qualitative action‐project method was used. A discrete joint project was identified for each family. These joint projects can be clustered into 3 joint career development projects: (a) navigating toward a safe future, (b) negotiating school continuance, and (c) intergenerational continuity through tradition of care. A 4th project emerging from the data was family survival. Family survival projects supplanted participants' efforts to engage in career development projects.     

The experience of smoking in recovery settings: an ecological momentary assessment pilot study

ABSTRACT

Smoking continues to be the leading cause of preventable death in the United States, and people with substance use disorders (SUD) smoke at higher rates compared to their non-using counterparts. Individuals with SUDs may have different emotional experiences and expectancies than those without. The current study explored the relationship between smoking and emotional experiences among residents in recovery homes, a population that little is known about regarding their tobacco addiction. Using ecological momentary assessment (EMA), significant emotional differences were found between nicotine users and nonusers. Implications of these findings could help in the development of interventions directed toward reducing smoking cessation.     

Qualitative cost–benefit evaluation of complex,emergent programs

This paper discusses a methodology used for a qualitative cost–benefit evaluation of a complex, emergent program. Complex, emergent programs, where implementation varies considerably over time and across sites to respond to local needs and opportunities, present challenges to conventional methods for cost–benefit evaluation. Such programs are characterized by: ill-defined boundaries of what constitutes the intervention, and hence the resources used; non-standardized procedures; differing short-term outcomes across projects, even within the same long-term goals; and outcomes that are the result of multiple factors and co-production, making counter-factual approaches to attribution inadequate and the use of standardized outcome measures problematic. The paper discusses the advantages and limitations of this method and its implications for cost–benefit evaluation of complex programs.     

The Impact of Local Labor Market Conditions on Work and Welfare Decisions: Revisiting an Old Question Using New Data

Using Maryland administrative data between 1996 and 2005, this paper examines the impact of local labor market conditions on work and welfare use among single mothers. Our estimates rely on the new Census Bureau Quarterly Workforce Indicators database, which provides county-level economic indicators filtered by industry, gender, and age-group. We specify a multinomial choice model to estimate the effects of these local labor market variables on the full set of work–welfare combinations. The results indicate that lower unemployment rates and increased new hires and new hires’ earnings in key industries increase the likelihood that women choose alternatives that include work. African American women and those with fewer years of education respond differently to changing economic conditions. Our results are robust to controls for fixed effects, county-specific time trends, and endogenous migration.     

Racism, Sexism, and Candidate Evaluations in the 2008 U.S. Presidential Election

In an attempt to understand the extent to which racism and sexism influenced affect toward Barack Obama and Sarah Palin, we analyze data from a national survey conducted in October 2008. Situating our investigation in previous examinations of modern racism and modern sexism, we test competing hypotheses about the role of these attitudes in the 2008 presidential election. Our results suggest that racism had a significant impact on candidate evaluations while sexism did not. We find that respondents who hold racist attitudes expressed negative attitudes toward Obama and positive attitudes toward Palin. When interacted with party identification, racism continued to exert a strong effect, indicating findings that are robust across partisan affiliations. Sexism, on the other hand, did not significantly influence evaluations of either Palin or Obama .