Journal of evidence-based social work (2019)最新文献

Purpose: Accelerated demographic aging, alongside the digital transformation and ongoing development of information and communication technologies (ICTs), presents both challenges and opportunities for the digital inclusion of older adults.

Materials and methods: This qualitative study, conducted in the Community of Madrid, examines the experiences of men and women aged over 65 years in terms of ICT use, focusing on digital skills, intrinsic and extrinsic barriers, and the impact of ageism on their technological literacy.

Results: The findings indicate that although there are benefits to digital connectivity, significant obstacles remain, such as ageism, a lack of sustained community support and inaccessibility in key digital environments.

Discussion: The results align with the two main theories that underpin the article; however, the primary phenomenon that serves as the central focus following an in-depth analysis is ageism, including in its self-inflicted form.

Conclusion: The results highlight the urgent need for policies and interventions that promote digital literacy. The evidence shows that digital inclusion for older adults becomes achievable when tailored training is provided.

Background: Intimate partner violence is a pervasive issue in the United States, and survivors frequently experience co-occurring problems such as substance use disorders. Domestic violence shelters play a crucial role in providing safety and support. However, little is known about the extent to which shelters implement substance use management practices. This study examined the utilization of substance use management practices (SUMPs) across Kentucky's domestic violence shelters.

Methods: In July 2020, an online survey was conducted with executive directors from all 15 agencies operating domestic violence shelters in Kentucky. SUMPs were examined and compared between shelters in rural and urban locations.

Results: Most directors reported routine use of substance use screening tools by their domestic violence programs. Overall, programs implemented a medium level of SUMPs and policies aligned with harm reduction. Urban shelters tended to implement more SUMPs and be more aligned with harm reduction compared to shelters in rural locations.

Conclusions: Most participating domestic violence shelters included routinely screen for substance use and implement SUMPs aligned with harm reduction. However, a quarter of programs do not routinely screen for substance use. Some programs, especially those in rural areas, are lacking in their implementation of SUMPs. Shelter staff should inform survivors of available resources, communicate substance-related practices and policies to community partners who may need to refer survivors to shelter, and use emerging evidence to leverage support for funding and resources for survivors. Future participatory research that includes survivor and front-line staff perspectives is needed to drive practice and policy change.

Purpose: There is a dearth of literature examining the paraprofessional substance use disorder counselors (SUDCs) and their responsiveness to evidence-based substance use disorder (SUD) training. This study examined pre- and post-training knowledge related to three established SUD interventions - Screening, Brief Intervention, and Referral to Treatment (SBIRT), Mindfulness Oriented Recovery Enhancement (MORE), and Dialectical Behavior Therapy (DBT).

Materials and methods: Undergraduate students enrolled in a SUDC training program (N = 63) participated in brief, evidence-based workshops and completed structured pre- and posttest surveys evaluating knowledge related to workshop content. Paired sample t-tests were estimated with 1000 bootstrapped samples to examine changes in knowledge from pre- to posttest and Hedges' g and common language (CL) effect sizes were calculated.

Results: Results showed a statistically significant increase from pre- to posttest in participants' overall knowledge scores across all three evidence-based interventions. The largest effects on knowledge were noted for the DBT workshop.

Discussion: The results of this study suggest that brief workshops on evidence-based SUD interventions such as SBIRT, MORE, and DBT present a promising avenue for undergraduate students in a SUDC training program to acquire knowledge essential for practicing as paraprofessional SUDCs.

Conclusion: There is currently an insufficient number of SUDCs to meet SUD treatment needs across the United States. Substantial growth in SUDC workforce needs is also projected by 2030. Well-trained paraprofessional SUDCs can provide one approach to expanding access to SUD treatment in coming years.

Purpose: Supported Education Programs (SEPs) are innovative initiatives to empower persons with Severe Mental Disorders (SMDs) to successfully reintegrate into the educational system. The purpose of this study is to determine how, for whom, why, and in what circumstances SEPs help in academic reintegration of persons with SMDs.

Materials and methods: Realist synthesis was conducted in keeping with the six steps of Realist and Meta narrative Evidence Synthesis Evolving Standards (RAMESES) guidelines by using four databases (PubMed, ProQuest, EBSCO host, OVID). The analysis focused on building an explanatory framework of what works, for whom, in what context, and how in SEPs for people with SMDs.

Results: SEPs were comprehensive and focused on participants' academic and psychosocial aspects. Mechanisms that worked for the success of SEPs were integrated approaches, bridge programs, augmenting cognitive remediation, psychosocial interventions as part of SEPs, and collaboration with education, health, employment, and rehabilitation - integration of classroom teaching and internship, availability and accessibility of a multidisciplinary team, availability of funding.

Discussion: SEPs are an essential intervention under the ambit of psychosocial rehabilitation for persons with SMDs. This review provides compelling evidence of mechanisms for the effectiveness of SEPs in addressing the multifaceted needs of individuals with SMDs. By fostering academic success, vocational stability, and psychosocial well-being.

Conclusions: SEPs would be delivered through an individualized case management approach. Tailored to each client's specific context and needs, mechanisms must be implemented to facilitate academic reintegration under contexts.

Purpose: This scoping review provided a broad overview of the research evidence on the impact of peer support programs for informal caregivers of adults with moderate to severe traumatic brain injury (TBI).

Materials and methods: Four online databases were used to identify records from inception to 28 August 2024. Quantitative and qualitative original research publications were included if participants were informal caregivers of an adult with moderate to severe TBI, and receiving peer-to-peer support from other caregivers with lived experience. The Template for Intervention Description and Replication (TIDieR) and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklists were used to chart and report data.

Results: Five studies with heterogeneous designs were included. A total of 191 adult caregivers participated, and were mostly female (n = 143) family members (n = 101) or significant others (n = 80). All peer support programs included a TBI-related education component, and were mostly social support groups (80%) delivered online (60%). A range of different measures and outcomes related to wellbeing and quality of life were evaluated. Overall, 80% of studies reported at least one significant quantitative outcome or qualitative impact.

Discussion: Findings on the impact of caregiver peer support interventions were mixed, and may be attributable to the diverse nature of intervention features.

Conclusion: Overall, peer support has a positive impact on outcomes of wellbeing and quality of life for caregivers of adults with moderate to severe TBI. Future peer support programs would benefit from cultural adaptions for translation to international settings.

Purpose: Evidence-based practices require fidelity scales to ensure widespread implementation. IPS (Individual placement and support) is an evidence-based supported employment practice for adults with mental health conditions. In 2021, the IPS program for young adults was launched nationwide in Norway, utilizing IPS-Y, a fidelity scale specifically designed for young adults. This study has three primary objectives: 1) to describe the variability in IPS-Y fidelity at scale and item levels, 2) to assess the scale's internal consistency, and 3) to assess IPS specialists' and IPS supervisors' experiences of participating in fidelity assessments.

Materials and methods: A total of 52 fidelity assessments (20 conducted by independent assessors and 32 self-assessed) of 47 IPS young adults' services were completed between March 14, 2022, and June 26, 2023. Additionally, 58 open-ended responses by IPS specialists and supervisors were analyzed.

Results: Fidelity assessment ratings varied between items and services. Items measuring collaboration with mental health services and community outreach received significantly lower ratings. The IPS-Y fidelity scale and subscales demonstrated good internal consistency. Analyses of the open-ended responses showed that IPS specialists and IPS supervisors responded positively to the fidelity assessments, although some found them time-consuming and challenging.

Discussion: These findings suggest that program fidelity was effectively measured through the fidelity assessments and that the practitioners experienced the fidelity assessments as necessary for their learning.

Conclusion: Regular fidelity assessments of the IPS young adults program help maintain its quality and provide valuable learning opportunities for those involved.

Purpose of the study: This scoping review aims to map the range of outcomes reported in studies of informal caregivers delivering home-based interventions to people with dementia, using the stress process model as a guiding framework.

Materials and methods: We followed the Arskey & O'Malley framework to conduct a scoping review. Data from nine databases were descriptively synthesized to map intervention types, caregiver roles, and outcome domains.

Results: An initial database search yielded 3,977 studies of which 22 were included in this review. Results revealed a high degree of heterogeneity in research with ten different types of home-based interventions delivered by informal caregivers to persons living with dementia at home. Nine out of 10 types showed some positive benefits for the caregivers. No intervention had only negative impacts on caregivers.

Discussion: Home-based, dyadic interventions for persons living with dementia showed promise in improving care recipient outcomes, but caregiver outcomes were mixed and often modest. Interventions that are flexible, feasible, and person-centered tend to be better received, yet challenges such as caregiver burden, intervention complexity, and lack of cultural inclusivity persist.

Conclusion: This scoping review underscores the impact of home-based, dyadic interventions on caregivers of persons living with dementia, highlighting that benefits for care recipients do not always translate into caregiver well-being. Future research should prioritize longitudinal, culturally responsive, and scalable studies to optimize outcomes for both caregivers and care recipients.

Purpose: This article presents a theory-driven evaluation of an intervention focused on child neglect, an often-overlooked form of child maltreatment. The evaluation examined whether the program's original program theory, which included eight principles, remained intact during a five-year implementation of the pilot stage of the program.

Materials and method: The theory-driven evaluation utilized data from individual and group interviews, site observations, and program records.

Results: Data revealed that four principles of the program's theory remained unchanged, while two principles were modified during implementation. Additionally, two new principles emerged from the data, turning implicit knowledge into explicit principles.

Discussion: Program's theory emphasized a relational, accessible, ecological, and outcome-oriented approach to intervening with child neglect. These four components were explicit at all stages of the implementation. Addressing parents' emotional needs and staff's commitment emerged as modified principles of the program's theory. Finally, implicit knowledge pointed to the professional as a learner, as well as to joint resistance to human rights violations.

Conclusion: Program theory may shift over time during program implementation. Thus, it is vital to examine such changes, focusing on both explicit and implicit components. This theorization of program principles may aid in the transition from the pilot stage to the stage of wider implementation, as well as offer guidance for similar interventions worldwide.

Purpose: Assisted Outpatient Treatment (AOT) is a court-ordered intervention for individuals with serious mental illness (SMI) who are unlikely to adhere to voluntary treatment and are at high risk of repeated hospitalizations or crisis service use. In 2017, Kentucky enacted Tim's Law, enabling AOT for individuals with a history of multiple involuntary hospitalizations and treatment nonadherence. This study evaluates the impact of Kentucky's AOT program on healthcare utilization and Medicaid expenditures and discusses implications for ethical social work practice.

Materials and methods: Using Medicaid claims data from 2018 to 2024 for 67 AOT participants, we calculated monthly rates of encounters, hospitalizations, and Medicaid spending across three periods: before, during, and after AOT participation.

Results: AOT participation was associated with significant reductions across all outcomes. Monthly encounters declined by 39% during AOT and 48% after AOT. Hospitalizations decreased by 53% during AOT and 67% post-AOT. Medicaid expenditures dropped by an average of $1,326.22 per participant per month during AOT and $1,105.45 post-AOT. No significant moderation effects were found based on demographic characteristics, diagnosis, or service agency.

Conclusions: Findings suggest that Kentucky's AOT program is associated with sustained reductions in costly healthcare services and improved system efficiency. Beyond cost outcomes, results underscore the importance of implementing AOT with safeguards that protect self-determination while promoting recovery. This analysis contributes new evidence from a program and region not previously represented in the literature and highlights implications for social workers engaged in balancing client rights, community safety, and recovery-oriented care.

Objective: This study examined a social work-led, treatment-first model for hepatitis C virus (HCV) treatment embedded in an integrated primary care clinic serving individuals with substance use disorders (SUDs). This approach affirms the critical role of social workers in leading integrated HCV treatment models that expand access and improve outcomes for people with SUDs.

Methods: We conducted a retrospective cohort evaluation of patients with confirmed HCV seen between 2018 and 2021. Eligible participants were identified through psychiatric and SUD programs, community referrals, and primary care. Individuals medically appropriate for treatment in primary care were offered direct-acting antivirals regardless of substance use or social circumstances. A licensed clinical social worker coordinated treatment, harm reduction counseling, social determinants of health screening, and care navigation. Electronic health record data were analyzed using descriptive and bivariate statistics (χ² tests, t-tests) to compare treatment initiation and sustained virologic response (SVR12) outcomes across demographic and SUD subgroups.

Results: Of 190 individuals diagnosed with HCV, 88 (46.3%) initiated treatment and 75 (85.2%) achieved SVR12. All treated patients received three core social work services and received a mean of seven social work encounters. Cure rates were consistent across SUD subgroups. However, individuals with stimulant (p < .03) or sedative-hypnotic use disorders (p < .003) were significantly less likely to initiate treatment.

Conclusions: Social workers can effectively lead HCV treatment within integrated primary care. Treatment-first, harm reduction - oriented models address structural barriers, expand access, and achieve high cure rates for populations historically excluded from specialty-based or abstinence-based care.