Community-based Social Service Agency Research Articles

Sustainable development goals and post-pandemic resilience: lessons from a community-based social service agency

Sustainable development goals and post-pandemic resilience: lessons from a community-based social service agency

Social relationships and community end of life care in Hong Kong: a three-stage model of social capital development

ABSTRACT End-of-life (EOL) care is a crucial public health issue in Hong Kong, and one in which the community social service sector has become increasingly involved, as healthcare policy in the city shifts towards greater emphasis on social relationships in non-medical forms of EOL care. This study used abductive grounded theory methodology to illustrate the dynamics and mechanisms involved in social relationships between dying people (and their families), volunteers, and professionals in community-based social service agencies in Hong Kong. The aims are a) to understand how social relationships influence the experiences of dying people and their families, and b) to engage theoretically with concepts of social capital and compassionate communities to explicate the dynamic and relational processes involved in this phenomenon. Fourteen in-depth interviews with practitioners and two service users affiliated with two community-based EOL care agencies in Hong Kong were conducted. Findings inform a parsimonious three-stage model of social capital development in which relationships between service agency workers and families address a key precondition of social capital through establishing trust, facilitating the accessibility of social capital through cultivating mutuality, and mobilising social capital through collaborating in community EOL care. These processes in turn mitigate community detachment in the EOL experience.

Facilitators of COVID-19 vaccine acceptance among Black and Hispanic individuals in New York: A qualitative study

BackgroundBlack and Hispanic individuals experience poorer outcomes related to coronavirus disease (COVID-19), yet have alarmingly lower uptake of the COVID-19 vaccine compared to non-Hispanic White individuals.ObjectiveTo explore the perceptions of barriers and facilitators of COVID-19 vaccine acceptance among Black and Hispanic adults in the New York.MethodsA qualitative study consisting of one-on-one semistructured interviews with Black and/ or Hispanic adults in New York state was conducted. Participants were recruited from local businesses, community-based social service agencies and Black and Hispanic churches and a college. All data were collected between February and March 2021. Transcripts were analyzed using qualitative thematic analysis.ResultsA total of 50 individuals (32 [64%] women; mean [SD] age, 42.04 [15.99] years) participated. The majority of participants identified as Black (n = 34, 68%), 9 (18%) identified as Hispanic, 3 (6%) as Black and Hispanic, and 4 (8%) as White and Hispanic. Twenty-two participants (44%) had high-school level education or less. Mistrust emerged as a central barrier to COVID-19 vaccine acceptance. Facilitators of effective COVID-19 vaccine messages include (1) key informants: like me, (2) personalized community outreach, (3) present the facts, and (4) communicate across multiple media platforms.ConclusionsThis qualitative study found that among Black and Hispanic participants, receipt of reliable vaccine related information, social networks, seeing people like themselves receive the vaccination, and trusted doctors are key drivers of vaccine acceptance.

Internet Access, Social Risk Factors, and Web-Based Social Support Seeking Behavior: Assessing Correlates of the "Digital Divide" Across Neighborhoods in The State of Maryland.

We aimed to empirically measure the degree to which there is a “digital divide” in terms of access to the internet at the small-area community level within the State of Maryland and the City of Baltimore and to assess the relationship and association of this divide with community-level SDOH risk factors, community-based social service agency location, and web-mediated support service seeking behavior. To assess the socio-economic characteristics of the neighborhoods across the state, we calculated the Area Deprivation Index (ADI) using the U.S. Census, American Community Survey (5-year estimates) of 2017. To assess the digital divide, at the community level, we used the Federal Communications Commission (FCC) data on the number of residential fixed Internet access service connections. We assessed the availability of and web-based access to community-based social service agencies using data provided by the “Aunt Bertha” information platform. We performed community and regional level descriptive and special analyses for ADI social risk factors, connectivity, and both the availability of and web-based searches for community-based social services. To help assess potential neighborhood linked factors associated with the rates of web-based social services searches by individuals in need, we applied logistic regression using generalized estimating equation modeling. Baltimore City contained more disadvantaged neighborhoods compared to other areas in Maryland. In Baltimore City, 20.3% of neighborhoods (defined by census block groups) were disadvantaged with ADI at the 90th percentile while only 6.6% of block groups across Maryland were in this disadvantaged category. Across the State, more than half of all census tracts had 801–1000 households (per 1000 households) with internet subscription. In contrast, in Baltimore City about half of all census tracts had only 401–600 of the households (per 1000 households) with internet subscriptions. Most block groups in Maryland and Baltimore City lacked access to social services facilities (61% of block groups at the 90th percentile of disadvantage in Maryland and 61.3% of block groups at the 90th percentile of disadvantage in Baltimore City). After adjusting for other variables, a 1% increase in the ADI measure of social disadvantage, resulting in a 1.7% increase in the number of individuals seeking social services. While more work is needed, our findings support the premise that the digital divide is closely associated with other SDOH factors. The policymakers must propose policies to address the digital divide on a national level and also in disadvantaged communities experiencing the digital divide in addition to other SDOH challenges.Supplementary informationThe online version contains supplementary material available at 10.1007/s10916-021-01769-w.

Role of Organizational Capacity in Enabling Population Health Impact for Health Promotion Programs

Objective: To examine how organizational capacity of Area Agencies on Aging, a type of community-based social service agency, influenced their ability to achieve population-level impact through their health promotion programs. Methods: We used difference-in-difference regression models to examine how expansion of health promotion program offered by Agencies over the course of 2008-2016 was associated with change in county-level measures of health care use and spending by older adults. We examined impact separately for high capacity and low capacity agencies. Results: Offering any health promotion program was associated a with 0.94% percentage point reduction in avoidable nursing home use in counties covered by the agency (95% confidence interval = -1.58, -0.29), equivalent to a 6.5% change. Expanding breadth of program offerings was also associated with significant reduction in avoidable nursing home use. Stratified analysis showed reductions were evident only where agencies had high implementation capacity. Conclusions: Evidence-based health promotion programs offered by Area Agencies on Aging may help older adults avoid unnecessary nursing home placement; organizational capacity for implementation appears to be a prerequisite for impact. Policy Implications: Leveraging Area Agencies on Aging to deliver evidence- based health promotion programs for older adults could help avoid expensive nursing home placements but attention to management and organizational development will be critical.

Health, Quality of Homecare Services and Quality of Life: A Case of Frail Older Immigrant Adults

This study explores the roles of two health-related concepts on the relationship between quality of homecare services and quality of life among a group of frail older immigrants residing in a large city in the Midwest region of the United States. Analyzing data from a community-based social service agency, this study tested two hypotheses: (1) health-related quality of life mediated the relationship between quality of health-related social services and overall quality of life, and (2) perceived importance of health moderated the relationship between quality of health-related social services and quality of life. Results of this study show that health-related quality of life, measured by satisfaction with health, mediated the relationship between quality of health-related social services, measured by satisfaction with homecare services, and overall quality of life, measured by overall life satisfaction. In addition, perceived importance of health moderated the relationship between quality of health-related social services, measured by satisfaction with homecare services, and quality of life, measured by overall life satisfaction. Quality of homecare services is significantly associated with clients’ quality of life. Homecare services may contribute to clients’ satisfaction with health which, in turn, enhances clients’ overall quality of life. The association between quality of homecare services and quality of life is likely to differ, depending on how important health is perceived.

Portland West Time Dollar Exchange Dataset

The Portland West Time Dollar Exchange (PWTDE) dataset contains the recorded transactions from a local currency group that existed in Portland, Maine for over four years. Such voluntary organizations allow participants to exchange services and goods without the use of federal money (see Collom, Lasker, and Kyriacou 2012). Unlike bartering (a direct swap between two parties), local currencies create a network of people and organizations in which transactions are tracked with an alternative currency. Time banks use time as their currency. The amount of time that a member spends helping another is entered in a database so that the provider is credited with “time dollars” (or “hours”) and the recipient’s account is debited. The other major form of local currency in the United States, the Ithaca Hours model, employs printed bills that members exchange for services or goods (see Collom 2005). The PWTDE began in February, 2002 and was embedded in Portland West, a community-based social service agency. The organization ran out of grant funds to support its community outreach programs and was forced to close the time bank in June 2006 (Doherty 2006). At that time, all PWTDE members were invited to join Portland’s larger and better-known time bank, the Hour Exchange Portland (see Collom et al. 2012). The data consist of the 2,316 recorded transactions involving 6,712 hours of services exchanged among the 319 members at PWTDE over the course of its history. A multitude of social network analyses are possible with this dataset. It is longitudinal, directed, and valued. The date of each transaction is included, making it possible to investigate the evolution of the network across time (see analyses by quarter in Collom 2012). The ties are directed; one member has provided a service to another. The amount of time that the exchange took (the number of time dollars earned) is the value of the tie. Moreover, investigations of qualitative aspects of the ties are also possible as the services exchanged in the transactions have been categorized into 13 broad types (see Collom 2012; Collom et al. 2012): 1) Health and Wellness (e.g., yoga, acupuncture, meditation), 2) Beauty and Spa (haircut, massage, facial), 3) Office and Administrative Support (clerical help, bulk mailing), 4) Computers and Technology (computer repair, website design, audio/ video production), 5) Tutoring, Consultation and Personal Services (lessons, tutoring, basic computer assistance, childcare), 6) Construction, Installation, Maintenance and Repair (carpentry, painting, yard/ garden maintenance), 7) Cleaning, Light Tasks and Errands (cleaning, mending and alterations, errands), 8) Food Preparation and Service (cooking, catering), 9) Transportation and Moving (transportation, moving assistance, hauling), 10) Entertainment and Social Contact (companionship, performances, telephone assurance), 11) Events and Program Support (assistance with project/event, committee meetings), 12) Sales and Rentals of Items (purchase of used goods, space rental), and 13) Arts and Crafts Production (arts and crafts, artwork).

Claiming immigrant cultural citizenship: applying postcolonial theories to social work practice with immigrants

This paper presents immigrant cultural citizenship as a conceptual frame for applying postcolonial theories to social work practice with immigrants, using a case study based on the author’s practice as a social worker at a community-based social service agency in the US. Postcolonial theories may help social workers to critique marginalising discourses that often reduce the immigrant experience to acculturation, to critically reflect on their role in reproducing or contesting such constructions, and to imagine creative and empowering interventions. The case of Mrs Moon, an Asian immigrant elderly client with depressive symptoms, illustrates an application of postcolonial theoretical framework to social work practice that generated a critical and contextual assessment and multi-level interventions (including individual treatment, community linkage and advocacy, and participation in collective political action), which made a transformative impact on the client and the social worker. The paper concludes with implications for postcolonial social work practice in the current climate of austerity and restrictive immigration measures.

Psychosocial service use and unmet need among recently diagnosed adolescent and young adult cancer patients

Adolescents and young adults (AYAs) with cancer demonstrate biomedical risks and psychosocial issues distinct from those of children or older adults. In this study, the authors examined and compared the extent to which AYAs treated in pediatric or adult oncology settings reported use of, and unmet need for, psychosocial support services. Within 4 months of initial cancer diagnosis, 215 AYAs ages 14 to 39 years (99 from pediatric care settings and 116 from adult care settings; 75% response rate) were assessed for reporting use of information resources, emotional support services, and practical support services. Statistical analyses derived odds ratios and 95% confidence intervals for service use and unmet needs after controlling for race, employment/school status, sex, relationship status, severity of cancer, treatment, and treatment-related side effects. AYAs ages 20 to 29 years were significantly less likely than teens and older patients ages 30 to 39 years to report using professional mental health services and were significantly more likely to report an unmet need with regard to cancer information, infertility information, and diet/nutrition information. Compared with teens who were treated in pediatric facilities, AYAs who were treated in adult facilities were more likely to report an unmet need for age-appropriate Internet sites, professional mental health services, camp/retreats programs, transportation assistance, and complementary and alternative health services. Substantial proportions of AYAs are not getting their psychosocial care needs met. Bolstering psychosocial support staff and patient referral to community-based social service agencies and reputable Internet resources may enhance care and improve quality of life for AYAs.

Building a Community-Academic Partnership to Improve Health Outcomes in an Underserved Community

East Garfield Park, IL, is an impoverished community with 59.7% of residents falling below twice the poverty level and 42.6% of its children in poverty. In 2001, the leading causes of hospitalizations were heart disease (10.3%), diabetes (2%), and asthma (3.9%), all of which occur at frequencies 33% greater than the Chicago average. Finally, a review of the health care facilities in the community suggests that there is a need for accessible primary health care services in the area. The purpose of this project was to improve health outcomes in an impoverished, underserved community with documented health care needs and lack of adequate health care services by creating a community-academic partnership to provide on-site, interdisciplinary, health care services within an established and trusted community-based social service agency, Marillac House. The short-term objectives for this project included creating a community-academic partnership between Marillac House and Colleges of Nursing, Medicine, and Health Sciences; providing comprehensive health care services; and developing an innovative clinical education model for interdisciplinary care across specialties. Long-term objectives included providing preventative services; evidenced-based management of acute and chronic illness; evaluating client's health outcomes; and creating a sustainability plan for the long-term success of the health center.

Differentiating the Social Service Needs of Homeless Sexual Minority Youths from those of Non-homeless Sexual Minority Youths

While homeless youths and sexual minority youths are at greater risk for negative life experiences, and homeless sexual minority youths are at greater risk than homeless heterosexual youths, little is known about the differential risks for homeless sexual minority youths compared to non-homeless sexual minority youths. Using a sample of 187 sexual minority youths from a community-based social service agency in Denver, Colorado, the findings of this study suggest that homeless sexual minority youths are at greater risk for victimization, mental health issues, substance abuse, and illegal or dangerous activities than their non-homeless counterparts. Implications for social work practice and social service provision are discussed.

E-Care: A Telecommunications Technology Intervention for Family Caregivers of Dementia Patients

This study evaluated the effectiveness of a technology-based psychoeducational intervention for family caregivers of dementia patients. An additional objective was to determine if the intervention could be implemented by a community-based social service agency. Forty-six caregivers were randomly assigned to either a technology-based intervention or an information-only control condition. Caregivers assigned to the intervention condition reported a significant decrease in burden postintervention and those who evidenced high depression at baseline experienced a significant decline in depression. This study provides evidence that technology offers a cost-effective and practical method for delivering interventions to caregivers.

Engaging African American Parents in the Schools: A Community-Based Consultation Model

Although it has been well established that parental involvement in school is linked to positive outcomes for children, there are a myriad of issues that make it challenging for some African American families to engage school personnel in collaborative problem solving (e.g., Hill & Craft, 2003). Some of the barriers that decrease involvement include parents' poor school experiences, intimidation by school personnel, and inconvenient meeting times. When parents' initial advocacy efforts are not effective, we must seek alternative methods. A recommended method is the collaborative efforts of community-based social service agencies and school consultants to engage African American families in mutually beneficial partnerships with schools to facilitate successful academic careers for their children (Witty, 1982). In this article, we discuss the barriers that African American families face when attempting to collaborate with schools and describe a multiphase model for engaging African American families with school to effectively advocate for their children's needs. A case study is presented describing the use of this model with a student exhibiting behavior problems in school.

Reaching the Homebound Elderly: The Prescription Intervention and Lifelong Learning (PILL) Program

SUMMARY This article describes the Prescription Intervention and Lifelong Learning (PILL) program, a three-year pilot project to develop in-home pharmacy care services to clients of a community-based social service agency. Clients who were homebound, at least 62 years of age, and taking at least five medications were eligible for inclusion. Potential participants were referred by care managers to the pharmacist, who conducted an in-home evaluation of the medication regimen and assessed the risk for medication-related problems. The pharmacist provided instruction for hypertension and diabetes mellitus self-monitoring, extensive medication counseling for clients with complex medications regimens, and conducted other activities to promote positive medication-related outcomes. The clients served were primarily female, between 70 and 90 years of age, and almost one-half lived alone. They were taking an average of more than nine medications daily, and had at least one chronic disease. The clients of the social service agency were highly vulnerable to medication-related problems and were in need of in-home pharmacy care services.