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

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.

Purpose: This article presents the systematization of a pilot nature-based intervention, Forest Mind, conducted with individuals experiencing homelessness in the Azores Islands, Portugal. The aim is to explore how structured engagement with natural environments can promote psychosocial wellbeing and foster social inclusion, within an evidence-based and ecosocial social work framework.

Materials and methods: A mixed-methods design was employed. Quantitative data were collected using the short version of the Profile of Mood States (POMS) and the Nature Relatedness Scale (NRS), administered before and after the intervention. Qualitative data were gathered through a focus group and a semi-structured interview. The intervention consisted of four nature-based sessions following the Forest Mind methodology, guided by trained facilitators and adapted to the context of homelessness.

Results: Quantitative findings show an improvement in emotional wellbeing, including reductions in tension and fatigue and increases in vigor and connection to nature. Qualitative data highlight the participants' sensory and emotional experiences with the forest environment, the emergence of mutual support, and a sense of belonging. The co-construction of meaning around nature and care was central to the intervention's perceived benefits.

Discussion: The study demonstrates that nature-based interventions can contribute to psychosocial wellbeing and community-building among socially excluded populations. It supports an evidence-based approach that integrates professional expertise, participant values, and emerging empirical knowledge.

Conclusion: Forest Mind is a promising practice for ecosocial work. The findings advocate for considering access to restorative natural environments as a fundamental right in social intervention frameworks.

Purpose: The shortage of competent behavioral healthcare professionals across the U.S. limits the availability of services, leaving primary care providers as the first point of access for many diverse populations, yet many lack training to provide high-quality care. This study discusses findings from four cohorts of a federally funded workforce development program that trained graduate social work (MSW) students in behavioral health skills and competencies, with a particular emphasis on interprofessional collaboration and care for diverse populations, including transition-aged youth and LGBTQ populations.

Methods: Student competencies were assessed through self-reported surveys across domains of interprofessional collaborative practice, utilizing a pre- and post-program test design.

Results: All cohorts demonstrated increased positive attitudes toward integrated healthcare teams, enhanced competencies in team skills, and improved interprofessional collaboration.

Discussion: Results yield important implications for ongoing interprofessional training among MSW students and indicate the significance of workforce development programs in preparing students for future work on integrated healthcare teams.

Conclusions: Interprofessional practice models offer practical solutions to current healthcare gaps. Workforce development programs advance interprofessional practice and provide the interprofessional education and training necessary to work effectively on integrated healthcare teams.

Purpose: Maternal depression represents a critical yet modifiable factor contributing to health inequity in pediatric asthma, particularly among Black families. Maternal mental health can directly affect a child's asthma management and outcomes; however, social work and behavioral health support remain largely absent from pediatric asthma care, and little is known about how mothers manage a child's asthma while also navigating their own mental health challenges. We sought to explore Black mothers' perceptions of depressive symptoms and how these symptoms affect their child's asthma.

Materials and methods: We conducted semi-structured interviews with 12 Black mothers of children at a community-based pediatric asthma clinic. Eligible participants screened positive for depressive symptoms (PHQ-9 > 4). Data were analyzed using thematic analysis, which included multiple coding strategies and analytic memoing to develop and refine themes.

Results: Mothers described extensive and chronic depressive symptoms, inadequate formal mental health treatment, and reliance on coping strategies and informal support. Mothers articulated the many ways in which their symptoms impaired their ability to manage their child's asthma,including responding to symptoms, medication use, and implementing environmental controls.

Purpose: The wellness experiences and needs of older youth impacted by foster care (YIFC), particularly in the area of spirituality, are an understudied area despite the large amount of scholarship addressing the outcomes of this population. To address this gap, this study aimed to identify strategies central to youth's wellness, which ultimately included spiritual practices.

Materials and methods: A research collective (n = 20) of YIFC, allies, and the author implemented a hybrid qualitative youth participatory action study. Drawing on photovoice and constructivist grounded theory methodologies, a diverse set of data was collected by the research collective, including audio recordings from individual interviews and group sessions, member-generated photographs and creative writing pieces, and collectively written pieces in response to wellness prompts. Group analysis using the SHOWeD photovoice analysis framework and author-led analysis using constructivist grounded theory approaches were used to generate findings.

Results: Spiritual practices were a fundamental wellness strategy for older YIFC. Youth's spiritual practices included communicating with nature, praying or manifesting, spiritually connecting with others, and engaging with spiritual texts or objects. Young people faced specific barriers to pursuing spiritual practices related to foster care.

Discussion: Findings support that current foster care system policies and practices may be inadequate to protect young people's rights to explore and engage in spiritual practices.

Conclusion: This study highlights the need for knowledge on how spirituality influences the lives of YIFC and provides recommendations for tailoring foster care policy to better support the spiritual needs and overall wellness of these young people.

Introduction: Benevolent childhood experiences (BCEs) have been shown to support positive adulthood outcomes, yet this framework has not widley applied to emerging Black Americans, who are disproportionately exposed to adversity and systemic inequities. This study examined the association between BCEs and flourishing in this population, with attention to the moderating roles of discrimination and Afrocentric cultural norms.

Methods: An online survey was administered to 619 Black young adults. Participants completed validated measures of BCEs, flourishing, discrimination, and Afrocentric norms. Descriptive statistics, correlations, and regression analyses were conducted to evaluate the relationships among these variables.

Results: Nearly all participants (96%) reported at least one BCE, while 25% reported all BCEs, a prevalence lower than that found in general populations. BCEs and Afrocentric norms were positively associated with flourishing, whereas discrimination was negatively associated. Moderation analyses indicated that discrimination weakened the positive association between BCEs and flourishing, while Afrocentric norms strengthened it.

Discussion: These findings identify BCEs as an important strength among emerging Black adults. The moderating effects observed highlight the need for targeted social interventions, and culturally responsive practices that expand access to BCEs, reduce discrimination, and enhance resilience. Community-based approaches that affirm cultural identity may be particularly critical for promoting flourishing and well-being in this population.