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

Purpose: This study explores the alignment between themes identified by Artificial Intelligence (AI)-powered tools and those from a traditional, manual scoping review, focusing on generative AI's role in streamlining time-intensive research processes.

Materials and methods: Thematic findings from a human-driven scoping review on peer support specialists in medical settings for opioid use disorder (OUD) were compared with outputs from NotebookLM, UTVERSE, and Gemini. Fifteen peer-reviewed articles were uploaded to each AI tool, and a standardized prompt directed the generative AI to identify themes using only the provided articles, which were then compared to the human-coded findings.

Results: The AI models identified between 53% and 80% of the themes found in the original manual analysis. While AI tools identified novel themes that could broaden the scope of analysis, they also generated inaccurate or misleading themes and overlooked others entirely.

Discussion: The variability in generative AI performance highlights its potential and limitations in thematic analysis. AI identified additional themes and misinterpreted or missed others. Human expert review remains necessary to validate the accuracy and relevance of generative AI, while addressing ethical considerations in alignment with the values of the social work profession.

Conclusion: A hybrid approach that combines generative AI with expert review has the potential to support current manual research approaches and establish a robust methodology. Continued evaluation, addressing limitations, and establishing best practices for human-AI collaboration and transparent reporting are crucial for the social work research field.

There is now prolific interest in Artificial Intelligence (AI) systems in social services and their application in practice is growing apace. However, research on systematic and evidence-based utilization is nascent and existing frameworks are ill-equipped to manage the complex ethical and methodological challenges posed by AI. Intervention development and evaluation must respond to profound uncertainties regarding effectiveness, ethicality and risk mitigation. The UK's Medical Research Council/National Institute for Health and Care Research (MRC/NIHR) updated framework for developing and evaluating complex interventions offers a promising meta-methodology to address these challenges. Yet, it lacks crucial perspectives on the socio-technical nature of AI systems and their dynamic and emergent properties. Drawing on the Socio-Technical research paradigm, this paper identifies six procedural dimensions to strengthen the framework. These are: (1) "Anticipatory Design" to identify and mitigate uncertain impacts; (2) "Ethical Considerations" to foreground transparency, accountability and equity; (3) "Continuous Impact Evaluation" to monitor emergent and unintended effects; (4) "Participatory Design" to co-produce systems aligned with stakeholder values; (5) "Socio-Material Contingencies of Automated Practice" to understand how AI reshapes professional roles and practices; and (6) "Re-configurations of Intervention Adherence" to capture adaptation, resistance and contextual variability. This conceptual paper advocates to reframe professional practice utilizing AI as "Socio-Technical Intervention" - one that intentionally accounts for the mutual constitution of human and AI systems in the pursuit of ethical, effective, and context-sensitive innovation. This conceptual shift can inform approaches to intervention research and development. Future work should focus on operationalizing it to generate an evidence base for AI utilization in social services.

Purpose: Spanish-speaking adults with chronic pain experience worse outcomes compared to their English-speaking counterparts. Identifying unmet needs, barriers, and facilitators can inform behavioral interventions to improve chronic pain management and reduce existing disparities. This study explores the perspectives of Spanish-speaking adults with chronic pain and healthcare providers on pain-related needs, barriers, and facilitators to participation in a mind-body and activity program.

Materials and methods: We conducted a total of four qualitative focus groups with 22 patients with chronic pain in Spanish and six focus groups with 21 healthcare providers (4 in English; 2 in Spanish). A bilingual team conducted a hybrid deductive-inductive analysis.

Results: Within the needs domain, we identified two key themes: the need to address co-occurring physical and psychological concerns and heterogeneity in treatment expectations and attitudes toward mind-body approaches. Within the barriers to care domain, themes were time poverty and economic hardship that deprioritized pain management, pain stigma leading to social isolation, and limited health literacy. Within the facilitators to care domain, themes were interest in walking with friends and family, and spirituality and religion as foundational sources of pain coping.

Discussion: Patients and providers discussed complex socio-economic and health-related needs, as well as diverse attitudes toward mind-body care. Barriers such as time poverty, stigma, and limited literacy ought to be considered and addressed in pain programs to achieve meaningful engagement of Spanish-speaking adults.

Conclusion: Findings underscore key factors that may increase the accessibility and generalizability of mind-body treatments for chronic pain among Latine adults.

Purpose: This study tested the effectiveness of a new kinship and adoption navigator program.

Materials and methods: Prior to implementation, 10 regions of a state were randomized to an intervention group or minimal intervention control group. Kinship and adoptive caregivers seeking program services were assigned to the intervention or control group based on the region in which they lived. Eligible caregivers were enrolled in the effectiveness trial and completed a survey at baseline (n = 1,728), 3 months after their intake (81% retention), and 6 and 12 months after the end of the intervention (78% and 76% retention from baseline respectively).

Results: Multi-level regressions showed that relative to the control group (n = 828), caregivers in the intervention group (n = 900) reported higher levels of satisfaction with the program's services, accessibility of community resources, and resourcefulness to meet their children's needs three months after intake. Six months after the end of services, the intervention group reported lower levels of concrete needs and better caregiver-child relationships. Favorable effects for accessibility of community resources and resourcefulness were sustained 12 months after the end of services. Effect sizes were small (g = .08 to g = .23) but statistically significant (p < .05). There were no differences in child well-being, safety nor permanency outcomes.

Discussion: Findings contribute to the limited knowledge of navigator programs with positive effects on proximal caregiver well-being outcomes for a broad population of informal kinship, formal kinship, and adoptive families.

Purpose: To analyze the knowledge, competences, and challenges of Social Work in addressing loneliness and social isolation among older people, and how these dimensions shape professional practice.

Material and methods: An exploratory mixed-methods study was conducted in Barcelona (Spain) with a total sample of 425 participants: thirty semi-structured interviews with older people, social workers and technical managers (n = 30), a questionnaire administered to practising professionals (n = 351), and four focus groups with older people, professionals and other stakeholders (n = 44). Qualitative data were analyzed inductively and quantitative data descriptively, integrating findings across three dimensions: knowledge, competences, and challenges.

Results: Social workers reported frequent contact with older adults experiencing loneliness or social isolation and demonstrated strong relational and ethical sensitivity. However, 43% felt little or not at all prepared to address these situations, and only 5.1% felt very well prepared. Although 57.3% claimed to differentiate between forms of loneliness, this ability was rarely systematic, and existential loneliness was the least recognized. The most valued competences included respect for diversity, promotion of dignity and self-determination, and support during processes of loss and life transitions. Major challenges involved limited time and resources, excessive caseloads, difficulties in reaching certain groups, insufficient training and systematization, and emotional strain linked to relational work.

Discussion: Findings reveal a gap between relational sensitivity and the lack of methodological and systematic tools for evidence-based practice.

Conclusion: Progressing toward evidence-informed relational practice requires consolidating frameworks, integrating loneliness and aging into professional training, and developing indicators legitimizing accompaniment as a measurable professional intervention.

Purpose: Investigating understudied risk and protective factors for opiate misuse among young adults who were serious violent juvenile offenders may inform prevention and intervention strategies. Young adults misuse opiates at higher rates than other age groups, with a history of serious violent juvenile offending constituting an especially high-risk population.

Materials and method: Our study uses data from the Pathways to Desistance prospective study of serious juvenile offenders, which includes participants from Phoenix, Arizona (n = 549) and Philadelphia, Pennsylvania (n = 483). Participants were enrolled between November 2000 and January 2003 and followed for seven years until April 2010. First, we conducted bivariate analyses using Chi-square analyses and simple logistic regression. Then, we conducted a multiple logistic regression model to determine whether the following variables would influence the odds of young adult opiate misuse (during wave 11) violence exposure and victimization (during wave 8), a PTSD diagnosis (during wave 9), maternal warmth (during wave 1), moral disengagement (during wave 11), identifying as White, Hispanic, and/or male.

Results: We found that young adults exposed to violence and/or victimized (OR = 1.17, p = .029), those with PTSD (OR = 4.18, p = .039), those who were morally disengaged (OR = 8.11, p = 000), those who were White (OR = 7.27, p = .000) and those who were Hispanic (OR = 2.26, p = .024) were more likely to misuse opiates. Maternal warmth did not protect against opiate misuse.

Conclusion: Our study underscores the important role trauma, particularly PTSD, plays in predicting opiate misuse.

Purpose: Rural communities often have a high incidence of medical and behavioral health problems along with more limited access to care. This paper describes an innovative approach to providing integrated care in rural school-based health clinics in which graduate students serve as behavioral health interns. The purpose of this manuscript is 1) to describe a model for providing school-based integrated health services in a rural community and 2) to evaluate services provided by graduate interns embedded in school-based clinics.

Materials and methods: Graduate interns completed a session checklist to track services provided in each session and collected data from participating students who received behavioral health services. Students completed the Outcome Rating Scale (ORS) after each session. Repeated measures MANOVAs were used to analyze the data for changes over time.

Results: Services provided most often by interns included assessment, engagement, positive reinforcement, coping skills, goal setting, and clinical intervention. The data suggest that students receiving at least three sessions improved over time on self-reported wellbeing.

Discussion: The results demonstrate the feasibility of providing integrated health care via school-based clinics that rely on graduate internships for behavioral health services. Challenges to implementing and sustaining school-based integrated health clinics are discussed.

Conclusion: The ongoing challenges to meeting the medical and behavioral health needs of rural communities call for innovative approaches to providing integrated care. The clinics described here responded to these challenges through teamwork and strong university-community partnerships.

Purpose: The U.S. leads the world in incarceration, and individuals with incarceration histories have poorer health outcomes. Inflammation has been proposed as a mechanism linking incarceration and chronic disease, but empirical evidence remains limited. This study tested whether inflammation mediates the association between incarceration and chronic health conditions.

Materials and methods: Data were drawn from the Health and Retirement Study (HRS). Incarceration history was assessed via self-report of spending ≥3 consecutive days in jail or prison. Inflammation was measured using C-reactive protein (CRP). Chronic health conditions were assessed as both an index of six diagnoses (heart disease, hypertension, lung disease, diabetes, cancer, stroke) and individual conditions. Regression-based mediation models with bootstrapping were used to examine indirect effects of incarceration through CRP, adjusting for demographic and health behavior covariates. Analyses accounted for the HRS complex survey design.

Results: Participant history of incarceration associated with higher CRP and higher CRP associated with more chronic conditions. Bootstrapping confirmed significant mediation. Further testing indicated that cancer, stroke, and lung disease may be main drivers of this effect.

Discussion: Findings suggest incarceration associates with chronic disease risk partly through elevated inflammation. While direct effects between incarceration and specific health conditions were inconsistent, the association between incarceration and CRP highlights inflammation as a plausible indirect pathway.

Conclusion: Incarceration may increase the risk for multiple chronic health conditions by elevating inflammation, particularly the risk of cancer, stroke, and lung disease. Addressing carceral healthcare quality and strengthening community supports are critical roles for health professionals and social workers.

Building upon existing literature on physical barriers experienced by higher-needs patients and marginalized communities, this paper presents a targeted analysis of qualitative data under a parent study on healthy cities. To optimize equity in access to health care as one of the many life opportunities affected by transportation, semi-structured interviews were conducted with community members reflecting diverse statuses of marginalization in addition to both mental and physical health challenges (n = 17), supplemented in dialogue with global policymakers (n = 5). Participant responses reveal how transportation time, costs, and risk strongly determine the actual confines of the world where they experience sufficient autonomy to access life opportunities. How these daily opportunities intersect with research on food deserts, education deserts, childcare deserts, and health care deserts indicates that physical barriers can emerge as a baseline consideration affecting ongoing experiences of socio-structural determinants. Most notably, the act of accessing care in itself, when involving transportation, can also present its own health risks requiring further integrated care services - given the body of evidence on injury, crime-related mental health stressors for marginalized groups, in addition to longitudinal public health concerns related to cardiovascular health and climate change risks. Access to both mental health care and physical health care can both be linked to urban development, intersecting with socioeconomic positionality amidst urban-rural environments - as physical access emerges with significant intersections with social work that is sensitive to the housing and employment needs of families. A four-part framework for integrated health care toward equitable outcomes in social work concludes the study.

Purpose: Internal female migrant workers (FMWs) in Asia, often employed in low-paid informal sectors, face unique vulnerabilities concerning sexual and reproductive health (SRH). Limited access to services, sociocultural taboos, and workplace discrimination contribute to adverse health outcomes.

Aim: To synthesize available evidence on knowledge, attitudes, practices, and access to SRH services among internal FMWs in Asia, and to identify gaps for future research and policy reform. Materials and Methods: A scoping review was conducted following Arksey & O'Malley's six-stage framework. A literature search across six databases - Pubmed, Scopus, Web of Science, EBSCO, Cochrane Reviews and Google Scholar (2010-2024) - yielded 41 eligible studies across eight Asian countries. Inclusion criteria focused on internal FMWs aged 15 to 49 years working in informal sectors.

Results: The findings reveal poor SRH knowledge, liberalizing sexual attitudes, and risky sexual and reproductive practices. Barriers to SRH access were cultural, structural, institutional, and interpersonal. Contraceptive use was inconsistent; high rates of unplanned pregnancies and unsafe abortions were reported.

Conclusion: The review highlights the urgent need for culturally sensitive, gender-responsive SRH interventions for internal FMWs. Targeted education, employer involvement, improved policy enforcement, and stakeholder collaboration are essential to advance SRH equity in Asia.