Experiences Of Service Providers Research Articles

Neo-liberalizing social service provision: Reactions and responses to the limits and constraints of housing and settlement services for refugees in Toronto, Canada

ABSTRACT This article engages with the impacts of neoliberalism on the experiences of social service providers working with refugees searching for shelter and affordable housing in Toronto, Canada. The 1990s in Toronto consisted of intergovernmental restructuring, which downloaded federal housing responsibilities onto provincial and municipal governments. Additionally, changes made to settlement funding had direct impacts on non-profit organizations serving immigrants and refugees. This devolution and decentralization of Canada's housing and settlement services have led to a complex hybrid of informal and formal social networks. Based on semi-structured interviews with service providers, this study reveals institutional gaps in Toronto's housing and settlement support models. This paper enriches scholarly debates on (1) neoliberal cities, (2) social service provision for immigrants and refugees, and (3) informal social networks, by engaging with critical feminist frameworks that highlight the importance of a profound understanding of the types of informal networks developed by social service providers.

“Am I going to have to run to get out of this place?” A qualitative study exploring HIV clinical and service provider experiences from California regions heavily impacted by climate disaster

Maintaining continuity of HIV care and prevention resources is critical to the health, wellbeing, and at times survival of individuals who rely on those services. In California, disaster events and extreme conditions caused by climate change are becoming more frequent and intense, impacting many regions in what have become cycles of destruction and disruption. The HIV workforce, already under strain, must now contend with delivering services to clients during and in the wake of repeated climate-related events. From October 2021 to April 2022, using purposive and snowball sampling, we interviewed 18 HIV, sexual health, and harm reduction clinical and service providers in California counties heavily impacted by climate-related events. Participants were asked about their experiences providing services amid climate disasters, including reflections on client needs and strategies for maintaining continuity of care. Data were analyzed following the tenets of thematic analysis. We found that HIV, STI, and harm reduction service providers and their agencies play an integral role within their communities, both in maintaining continuity of essential services to clients during catastrophic events, as well as in disaster response as trusted community resources. We further found that individuals in these roles drive the innovations and adaptive strategies that allow their agencies to endure the shock and disruption of disaster events. Finally, we highlight the extent to which clinical and service providers experience harms due to cyclical climate disasters. We discuss existing research on health system resilience in the face of climate change, and identify a critical research gap: consideration of workforce needs is often limited to professional skills and capacity specific to caring for climate disaster survivors, rather than as support needed by workforce personnel who are survivors of disasters themselves. We propose recommendations for next steps and encourage further research on HIV workforce resilience in a new climate era.

Acute service and disability service providers experiences of joint working to improve health care experiences of people with an intellectual disability compared to non-joint working: A mixed-method systematic review.

Persons with intellectual disabilities require frequent access to acute services. Many also access disability services within the community. Reports and enquiries have highlighted the sub-optimal healthcare provided to this group when accessing healthcare in acute services. Joint working between acute and disability services has been identified as a measure to improve healthcare for this group. A mixed method systematic review was undertaken to explore current evidence of joint working between both service providers. Twelve publications were included, and the data were analysed using thematic analysis. Confusion around responsibility and limited training in acute services prevented joint working from occurring. Information-sharing is pivotal in promoting joint-working, but measures which facilitated it were not always used. Albeit acute services demonstrated a strong commitment to deliver quality care to those with intellectual disabilities. Much of the available research captures the experiences of staff in acute services. There is a paucity of research available exploring experiences of disability service providers.

Evaluating a social and emotional well-being model of service piloted in Aboriginal Community Controlled Health Services in Western Australia: an Aboriginal Participatory Action Research approach

IntroductionThe delivery of services to improve Aboriginal health and well-being must centre culture and integrate a social and emotional well-being understanding and approaches. These approaches are essential in increasing access...

Voices from Service Providers Who Supported Young Caregivers throughout the COVID-19 Pandemic in the Canadian Context.

This empirical research is part of a larger project beginning in 2020 and ongoing until 2023, exploring the impact of the COVID-19 pandemic on young caregivers aged 5-25 years and their families in Canada. This qualitative research utilizes the social determinants of health as a conceptual framework and a collective case study design to emphasize the voices and experiences of service providers (professionals offering services to young caregiver clients) during the COVID-19 pandemic, and exploring their perspectives on the impact of the pandemic on young caregivers and their families. The central research question guiding this study was "How do service providers (professionals) working with young caregiver clients in Canada describe the impacts of the pandemic on themselves, their professional praxis, and on their young caregiver clients?" The aim of this study was to develop a deeper understanding of the impact of the pandemic on young caregivers in Canada, from the perspectives of service providers, as well as to understand the experiences of service providers in their own voices. Data were collected from service providers working within three (3) different organizations offering programs and services to young caregiver clients in Ontario, Canada. In total, six (6) individual interviews were conducted with service providers who were directors/program managers, and four (4) group interviews were conducted with thirteen (13) service providers who were frontline staff members who worked directly with young caregivers and their families. In total, nineteen (n = 19) unique service providers participated in this study. Our findings point to two primary overarching themes, namely (1) service providers' responses to the pandemic and (2) observations by service providers about the impacts of the pandemic on young caregivers, and a secondary theme, (3) positive outcomes from the COVID-19 pandemic on young caregivers, that emerged through the analysis. The pandemic led to increased demands for services by young caregiver clients. Service providers were required to adapt their service delivery methods in order to comply with public health guidelines. They shared how their work impacted their mental health as they struggled to maintain personal and professional boundaries while working from home during the pandemic. Importantly, service providers identified similar, simultaneous, and co-occurring impacts of the pandemic between their young caregiver clients, including isolation, difficulties in navigating online spaces, and challenges in navigating boundaries while working from home with family members.

Dementia care coordinator service in Kent and Medway: a realist evaluation protocol.

Dementia care is a key priority for both NHS England and the UK government. National guidelines highlight the importance of care coordination to address the challenges people living with dementia and their carers can encounter when trying to access the health and care system. To counter these challenges, Kent and Medway Integrated Care Board (ICB) have recently implemented a proactive dementia care coordinator (DCC) service to support people with dementia and their carers from pre-diagnosis to end-of-life care. To understand how the DCC service works (or does not work), for whom, and in what circumstances. The findings will inform service development and future investment decisions. This study will use a realist approach to evaluate the DCC service in Kent and Medway ICB, south-east England, which has a population of 1.9 million, comprising 42 primary care networks (PCNs; groups of general practices) each having a DCC. An initial programme theory will be developed from existing literature, and in collaboration with stakeholders. Mixed methods, including questionnaires to DCCs, service provider metrics, and qualitative interviews, will be used to collect data on service provider and service user experiences. Interpretive comparative analysis and narrative synthesis, including evaluation of service costs against outcomes, will produce a refined final programme theory. The results from this project will produce evidence-based recommendations to help improve service delivery and possible service expansion. This protocol describes a realist evaluation designed to investigate the recently implemented DCC service in Kent and Medway ICB.

Remote Intensive Intervention for Young Children on the Autism Spectrum During COVID-19: the Experience of Caregivers and Service Providers

ObjectivesCommunity-based early autism intervention programs in Geneva, Switzerland, converted their in-person services to a telehealth format during the COVID-19 home confinement period. The current study was aimed at measuring the engagement and satisfaction of service providers and caregivers as they experienced telehealth services for the first time and at monitoring child progress.MethodsForty-five families from diverse backgrounds and their 45 service providers had daily videoconferencing sessions of primarily parent-mediated intervention. Satisfaction questionnaires were completed at three time points over a 2-month period. Session frequency and program participation were recorded. Caregiver and service provider’s answers were compared. Results were also analyzed by family annual income. Child progress was monitored using the Early Start Denver Model Curriculum Checklist.ResultsCaregivers and service providers maintained high levels of participation and satisfaction throughout the telehealth service period and appreciated how the telehealth format allowed them to meet more frequently. Lower-income families tended to be more unanimously positive about the services when compared with mid- and high-income families. We found significant group differences in service providers’ and caregivers’ perceptions of each other’s comfort level with the remote sessions. Child progress followed a pattern of continued significant improvement across most developmental domains during the telehealth service period.ConclusionsThese findings underscore the potential of telehealth as a promising and appreciated approach for delivering intensive early autism interventions in community settings. Further research is needed to determine optimal session frequency for remote parent-mediated intervention and to determine ways to make telehealth services more accessible for low-income families.

Perceptions and experiences of Forensic Medicine Department service recipients and providers during male sexual dysfunction assessment following filing for divorce: a qualitative study in Iran

Background: In the current era, divorce has become quite commonplace. One of the significant reasons for divorce is sexual dysfunction. the aim of this study was to explore the perceptions and experience of Forensic Medicine Department service recipients and providers during male sexual dysfunction assessment following filing for divorce. Methods: This study was a qualitative study that was analyzed through a content analysis approach. Individual interviews were used for data collection. The data were collected through in-depth semi-structured interviews with Twenty service recipients and nine service providers of Forensic Medicine Department in Tehran from Jan 2022 and ended in March 2022. Results: The analysis of the data led to the extraction of two main categories, including: existing challenges of the forensic medical system in the sexual assessment process with 3 sub-categories (Absence of the plaintiff during the assessment process, sharing a common room with other clients, The psychosocial pressure associated with a Rigi Scan test) and features of desirable evaluation services with 5 Sub-categories (Service delivery to couples, Service delivery by observing ethical principles, confidentiality and human dignity, Comprehensive physical-psychological-communicative assessment, Service delivery that emphasizes informing couples about the road ahead, Provision of services if the authenticity of the sexual problem is proven). Conclusion: Based on the results of the present study, Service recipients expected the claimant to be present throughout the evaluation process and to cover the expenses too. Moreover, they expected a better atmosphere to be available for these individuals and that human dignity and ethical principles be safeguarded. Furthermore, based on their opinions, a comprehensive physical-psychological-communicative assessment was necessary and couples should be informed and aware of the process when they enter it –particularly when the complaint is proven to be unreal, and all evaluations should be performed on both spouses, not just one.

Challenges and Adaptations Experienced by Intimate Partner Violence Service Providers During COVID-19 Pandemic

Purpose: COVID-19 is an unprecedented pandemic that has caused an increase in the intimate partner violence (IPV) victims rate, and social service-providing agencies shifted to emergency online and distance service-providing systems. In our study, we aimed to explore the experiences of IPV service providers during this pandemic.Method: We used a cross-sectional qualitative method containing some quantitative questions. Data were collected by conducting 15 in-depth interviews and a survey with the service providers (22–65 years old) from six IPV service-providing agencies that are located in the Dallas-Forth Worth metroplex in North Central Texas. We used a phenomenological hermeneutical method to capture the service providers’ experiences.Results: Four key themes highlight the essence of the experiences of the IPV service providers while providing the services during COVID-19. The four major themes are (a) experiences with telehealth, (b) barriers to social and legal services, (c) altered relationships, and (d) mental health impacts. In addition, a few subthemes are explored under the first three major themes. The service providers we interviewed provided details and vital information regarding challenges, adaptations, and resilience they experienced to assist the most disadvantaged group of the population.Conclusion: This study will contribute to making attention to improving facilities, accessibility, and resources for both service providers and their clients. Findings highlight the need for agency owners and policymakers to consider more multimodal and creative solutions for such a vulnerable population and their service providers.

Assessing the Quality of Student Services at King Faisal University from Students' Perceptions

The quality of student services has a role in smoothing the teaching and learning process and achieving the desired levels of quality for learning outcomes. Therefore, it is an integral part of the educational process and a practical exercise for shaping the student's personality and developing his capabilities. This study collected data using a questionnaire distributed to a random sample of 991 male and female students from King Faisal University. The descriptive analytical design was employed and the results were analyzed by SPSS. This research study attempts to assess the quality of student services at King Faisal University from students' perceptions and the purpose of this study was to examine whether there were differences in students' perceptions due to gender and academic specialization. The results of the study showed that the level of student satisfaction at King Faisal University regarding the quality of student services was moderate. The study found that there were statistically significant differences in the level of student satisfaction at King Faisal University regarding the quality of students' services due to gender, in favor of males; due to academic specialization, and in favor of scientific and health specializations. The researcher recommends that there is a necessity to improve the level of the university services, and Develop the knowledge, skills, and experiences of service providers through behavioral programs that enhance their communication skills, Provide material and moral incentives, and appreciate their outstanding performance.

Older adults' and service providers' experiences of a settings-based health promotion initiative in English football.

The study was undertaken to explore the experiences of older adults and service providers in a settings-based health promotion initiative in a football club. We conducted semi-structured interviews with 10 older adults attending an 'Extra Time Hub' (ETH) and two staff delivering the initiative. Our reflexive thematic analysis generated six themes. Findings revealed the brand of the sports club attracted some to join the ETH, but through partnerships with local agencies, the initiative was also successful in widening participation beyond older adults with an interest in football. Participants perceived that the ETH was beneficial for their mental health, helped them develop social connections, and promoted positive physical activity experiences. Moreover, the variety of pleasures derived from participation were also discussed. Our findings also illustrate the central role of staff in older adults' experiences of this form of health promotion. Overall, this study contributes to understandings of settings-based health promotion activities in sports clubs, and also demonstrates the potential for sports clubs to widen engagement with the local community through health promotion for older adults.

Examining the experiences of pediatric mental health care providers during the early stage of the COVID-19 pandemic

BackgroundThe COVID-19 pandemic fundamentally impacted the way that mental health services were provided. In order to prevent the spread of infection, many new public health precautions, including mandated use of masks, quarantine and isolation, and closures of many in-person activities, were implemented. Public health mandates made it necessary for mental health services to immediately shift their mode of delivery, creating increased confusion and stress for mental health providers. The objective of this study is to understand the impact of pandemics on the clinical and personal lives of mental health providers working with children during the early months of the COVID-19 pandemic, March -June 2020.MethodsMental health providers (n = 98) were recruited using purposive sampling from a public health service in Canada. Using qualitative methods, semi-structured focus groups were conducted to understand the experiences of mental health service providers during the beginning of the COVID-19 pandemic.ResultsData from the focus groups were analysed and three main themes emerged: (1) shift to virtual delivery and working from home; (2) concerns about working in person; (3) exhaustion and stress from working through the pandemic.DiscussionThis study gave voice to mental health providers as they provided continuity of care throughout the uncertain early months of the pandemic. The results provide insight into the impact times of crisis have on mental health providers, as well as provide practical considerations for the future in terms of supervision and feedback mechanisms to validate experiences.

TalkingMats as a decision aid to promote involvement in choice and decision-making around home care services for older people with mild to moderate dementia – study protocol for a randomized controlled trial

BackgroundIn Sweden, 72% of people with dementia live in ordinary housing. Of these, 50% receive home care services. Older people with dementia may benefit from developments in decision-making support which aim to facilitate their ability to communicate their personal needs and preferences with care managers and staff in home care services. In this study, we will test and evaluate the use of TalkingMats in Swedish municipal home care services for older people with mild to moderate dementia. TalkingMats is a low-technology communication tool, to help people with communication difficulties express their views. It uses a simple system of picture symbols which are placed on a textured mat. This study will provide insight into the extent to which TalkingMats benefits older people with dementia to feel more involved in decisions related to home care services. In addition, this study will assess the extent to which the use of TalkingMats promotes service providers’ efforts to involve service recipients in decision making. The implementation of TalkingMats in home care services will also be studied.MethodsA parallel group, two-armed randomized controlled trial design in which TalkingMats and Usual Conversation Method will be compared. Two specific situations where older people with dementia must make decisions about home care services will be studied. First, a follow-up needs-assessment conversation between study participants and care managers will be studied. Second, a conversation between participants and home care staff regarding the delivery of the decided home care services will be studied. In addition, a qualitative approach will be used to gain an understanding of study participant and service provider experiences of the impact and implementation of TalkingMats.DiscussionThe combined exploratory, descriptive, and experimental study design is considered an important strength which will facilitate multi-facetted knowledge production concerning the involvement and communication needs of older people with dementia generally and within the context of home care services specifically. Combining qualitative and quantitative methods will maximize our ability to assess the effects of TalkingMats.Trial registrationClinicalTrials.gov ID: NCT05561998. Registered in September 28, 2022.

Experiences of service providers delivering care for street involved and homeless pregnant and early parenting women

ABSTRACT Service delivery and care of street-involved pregnant women is recognized as a complex issue, and as such comorbidities, addictions, and risky behaviors can result in significantly higher risks of contracting HIV. We inquired into the experiences of service providers who work in community-based supportive intervention programs for vulnerable street-involved, pregnant, and early parenting women in precarious housing situations who are living with HIV or are at risk of contracting HIV, across the continuum of care. We used a qualitative descriptive design and interviewed 22 service providers from local government and non-governmental community agencies about their experiences delivering services to this population. Four key themes emerged from the data: focus on outcomes and success, understanding tensions in service delivery, challenges in accessing appropriate services and resources, and attention to moving forward. We highlight the complex tensions experienced by service providers in a health and social care system that centers on measurable and quantifiable outcomes while overlooking larger issues that shape equitable care. Our study highlights the need for alternative approaches to service delivery that are focused on the lives of women.

Provision of drug and alcohol services amidst COVID-19 pandemic: a qualitative evaluation on the experiences of service providers

BackgroundThe impact of COVID-19 pandemic on the provision of drug and alcohol (D&A) services and associated outcomes have been under-researched.AimThis study aimed to understand the experiences of service providers in relation to how drug and alcohol (D&A) services were affected during COVID-19 pandemic, including the adaptations made and lessons learnt for the future.MethodFocus groups and semi-structured interviews were conducted with participants from various D&A service organisations across the UK. Data were audio recorded, followed by transcription and thematic analysis.ResultsA total of 46 participants representing various service providers were recruited between October and January 2022. The thematic analysis identified ten themes. COVID-19 required significant changes to how the treatment was provided and prioritised. Expansion of telehealth and digital services were described, which reduced service wait times and increased opportunities for peer network. However, they described missed opportunities for disease screening, and some users risked facing digital exclusion. Participants who provided opiate substitution therapy service spoke of improving service provider/user trust following the shift from daily supervised treatment consumption to weekly dispensing. At the same time, they feared fatal overdoses and non-adherence to treatment.ConclusionThis study demonstrates the multifaceted impact of the COVID-19 pandemic on UK-based D&A service provisions. The long-term impact of reduced supervision on Substance Use Disorder treatment and outcomes and any effect of virtual communications on service efficiency, patient-provider relationships and treatment retention and successes are unknown, suggesting the need for further study to assess their utility.

Professional Development and Use of Evidence-Based Practice in Autism Early Intervention

We investigated the experiences of Australian autism early intervention service providers, including the professional development they receive on the job and how they translate research evidence into their practice. Semi-structured interviews were conducted with 15 providers drawn from three locations. Participants described the crucial role of paraprofessionals in early intervention services, and indicated that, within multidisciplinary teams, allied health professionals, and teachers are the ones who select intervention practices and upskill paraprofessionals. Furthermore, participants reported using practices supported by research evidence, but also some emerging and unsupported practices. The use of unsupported practices is examined in light of the daily challenges faced by centers. Results may inform further professional development in early intervention services for children on the autism spectrum, to support the best possible outcomes for this population. The findings highlight the potential need for job-embedded hands-on professional development conducted in real time.

The Lived Experience of Caregiving and Perception of Service Provision among Family-Caregivers of People with Late-Stage Parkinson's: A Qualitative Study.

The complex nature of late-stage Parkinson's requires multiagency support and leads to an increased burden on family members who assume a multiplicity of responsibilities. The aim of this study is to further understand the lived experiences of family-caregivers and their perception of, and satisfaction with, service provision. This qualitative substudy was a part of the European multicentre Care of Late-Stage Parkinsonism (CLaSP) project. Purposive sampling resulted in a sample of eleven family-caregivers of people with late-stage Parkinson's, who were interviewed using semistructured open-ended questions. Thematic analysis followed. Findings. Three overarching themes were developed from the data: ensuring continuous support is vital to providing care at home, perceiving unmet service provision needs, and advocating and co-ordinating all aspects of care take their toll. These themes include not only experience of services that caregivers find supportive in order to deliver care but also of disjointed care between multiple agencies, a perceived lack of Parkinson's expertise, and there was a lack of anticipatory future planning. The constancy and scope of the family-caregiver role is described, including the need to project manage multiple aspects of care with multiple agencies, to be an advocate, and to assume new roles such as managing finances. Multiple losses were reported, which in part was mitigated by gaining expertise through information and support from professionals and organised and informal support. The intricacies and consequences of the family-caregivers' role and their experience of service provision indicate the need to acknowledge and consider their role and needs, fully involve them in consultations and provide information and joined-up support to improve their well-being, and ensure their continuous significant contribution to the ongoing care of the person with Parkinson's.

Ethical issues surrounding the use of assisted reproductive technologies in Ghana: An analysis of the experiences of clients and service providers

Since the advent of Assisted Reproductive Technologies (ART) in Ghana about three decades ago, IVF and ICSI treatments have enabled infertile Ghanaian couples to fulfill their aspirations and dreams of having children. In this extremely pronatalist society, ART has provided relief to many childless couples by reducing, if not eliminating, the shame of childlessness that they would otherwise have to suffer. However, as the provision and utilization of ART continue to increase, so do worries regarding the ethical difficulties surrounding this field of medicine, which challenge cultural ideals and personal desires. The study explores client and service provider experiences with ART in urban Ghana. Observation and in-depth interviews were employed to collect data, and the ethical dimensions of people's experiences relative to Ghanaian cultural and ethical values were analyzed. The results show that the provision of ART services for heterosexual couples in marital unions, the availability of PGT for sickle cell clients, the preference for multiple births emerging from embryo transfers, the lower preference for cryopreservation, the high cost of ART treatment, and the need for regulation of the provision of ART services in Ghana were some of the ethical concerns expressed by both clients and service providers.

What Do the Health-care Providers Perceive and Experience about Health and Wellness Center Façade Branding? A Study in a Tribal District of Chhattisgarh

Abstract Introduction: Brands for services and health-care services for that matter can permeate unique meanings to consumers. Objective: The main objective of this study was to understand the perception and experiences of service providers about the health and wellness enter (HWC) branding. Materials and Methods: The study adopted a qualitative research method in which in-depth interviews of health-care service providers were carried out to capture their perceptions and experiences on HWC branding. Results: Two thematic areas emerged after the analysis of the collected data. Bada Hospital (Big Hospital): the service providers stated that the local inhabitants ask about the six thematic circles portrayed on the wall of HWCs and their role in this newly renovated building. After knowing the six priority service packages available, the locals perceived that this facility has now become a Bada hospital that can cater to their wider health-care needs. Incremental Trust: the service providers stated that the local tribal inhabitants, after perceiving this as a Bada Hospital, have started accessing health services in HWCs with less trust in faith healers. The locals also knew that the HWCs can provide them with medications including the injectables that they prefer the most and can also conduct some procedures, both medical and surgical, with adequate drugs, instruments, and consumables, thereby creating an incremental trust of the locals with 3–4 times more outpatient department footfall. Conclusion: The service providers perceive that the branding has created trust for the HWCs and improved the health-seeking behavior in the catchment areas.

Experiences of Gender-Based Violence Among Disabled Women: A Qualitative Systematic Review and Meta-Synthesis Protocol

Background Gender-based violence (GBV) is a major public health concern and a human rights issue disproportionately affecting disabled women. Disabled women are twice as likely to experience GBV than nondisabled women, yet there has been a lack of attention to this issue. This review aims to gain a greater understanding of the experiences of GBV of disabled women through a systematic and qualitative meta-synthesis. The qualitative meta-synthesis will be conducted by a research team of academic and community members and students with varying lived and service provider experiences with disabilities and GBV. The study findings aim to promote best practices by offering solutions to increase accessible and inclusive resources and services responsive to disabled women. Methods A systematic review of qualitative studies will be performed based on searches of 12 academic databases, including MEDLINE (Ovid), APA PsycINFO (EBSCO), Sociological Abstracts (ProQuest), Social Services Abstracts (ProQuest), and SocINDEX (EBSCO). A search of the gray literature will be performed by searching the Google search engine, Google Scholar, the Community Health Online Digital Archive and Research Resource (CHODARR), and the Global Database on Violence Against Women. In addition to the database and gray literature searching, we will complete backward and forward citation tracing. Two research team members will be involved in all screening, review, data extraction, and quality assessment of studies. A third reviewer will resolve any disagreements and consult with the research team. Thematic synthesis steps will include becoming familiar with the data, developing a thematic framework, indexing the data to identify themes and codes, charting the data, and mapping and interpreting the data. The Critical Appraisal Skills Programme checklist will be used to appraise the quality of included studies. Confidence in the meta-synthesis findings will be assessed by applying the GRADECERQual approach. Review Registration This protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023400410.