Indirect Services Research Articles

Keeping Schools for Blind Students Vital in an Era of Inclusion: Key Elements for Success

Introduction: This research aims to learn what schools for blind students in the United States are currently doing to teach students with visual impairments and further explore the services these schools provide in their states. Methods: This research used qualitative interviews with school administrators, staff members, and teachers at four schools for blind students in the United States. A constant comparison model was used to analyze common themes and trends within the data collected, allowing us to capture the voiced experiences of the interviewees. Results: All schools included in this research have built the capacity to serve a wide range of students with visual impairments through both on-campus programs and outreach services. To provide high-quality services, the on-campus programs and the outreach services embraced symbiosis with one another. In parallel to this effort, schools focused on building partnerships with districts and helped build capacity through indirect services. Discussion: Underlying ideologies within schools for blind students were the value of inclusion, belief in every student receiving a quality education, and aspiration towards schools for blind students to stay relevant in an era of inclusion. Schools were led by individuals who possessed inspirational and strategic thinking. Implications for Practitioners: This research documents the effective ways specialized schools for blind students are relevant in an era of inclusion, documenting the importance of creating new paths within traditional programs. This research outlines successful practices and ideologies that can be implemented by specialized schools, while acknowledging traditional on-campus programming combined with inclusive outreach models to create sustainable programming for all students with visual impairments throughout a state.

School Counselor Consultation Effects on Teachers’ Mindfulness, Stress, and Relationships

In this randomized controlled trial, we explored the effects of a combined mindfulness and social/emotional learning (SEL) school counselor consultation intervention. Participants included a diverse sample of 30 secondary educators teaching in Title 1 school districts. Participants received 5 weeks of consultation based on mindfulness and SEL. Results of hierarchical linear regressions revealed statistically significant improvement in teachers’ mindfulness disposition of acting with awareness. Further, results indicated a practically significant decrease in teacher-reported stress and conflict in the student–teacher relationship. We discuss implications for offering direct services to teachers through consultation with school counselors as a way of providing indirect services to students. Results of this study illustrate how teachers might benefit from school counselor consultation that supports their use of mindfulness strategies and SEL skills in coping with the demands of teaching and in building relationships with students.

Comparison of Utilized Resource Volumes by Grade of Seniors in Long-Term Care Facilities

Purpose: This study aimed to identify the time of care services provided by nurses, nursing assistants, care workers, physical therapists, and social workers during a 24-hour-period and the volume of resource utilization for residents in long-term care (LTC) facilities.Methods: We measured the providers' service time supplied to 3,295 residents in 32 LTC facilities. The utilization of resources each service facility provided was analyzed considering the services’ difficulty levels and providers’ wages.Results: The higher the long-term care grade, the longer the provider's service time and the greater the resource utilization. This phenomenon did not appear in the cognitive assistant grader. The service hours provided for the cognitive assistant graders were longer than those in grades 4 and 5, and longer than in long-term care eligibility points about the classification system. Compared to the long-term care eligibility points, the used resource volumes of excretion support, managing behavioral symptoms, and indirect services increased in all grades but, the used resource volumes of nursing treatment time decreased.Conclusion: It is necessary to discuss measures to raise the grade in the cognitive assistance grader with mild dementia. Additional research on the cause of the decrease in nursing treatment time for residents in LTC facilities and measures to satisfy nursing needs is necessary.

Implementation of Best Practice in the School-based Setting

ABSTRACT A clear gap exists between what evidence states as best practice for school-based occupational therapy and what is feasible for practitioners to implement. Evidence establishes that collaborative and contextual practice have a positive effect on student outcomes. Emerging evidence demonstrates that workload models, as opposed to caseload models, could help meet the range of demands on practitioners in order to improve student outcomes. This study aimed to answer the question: What does the implementation of best practices look like for practitioners following a caseload approach compared to those following a workload approach? As described in this study, a caseload approach is when expectations are based on the number of direct intervention minutes or assigned students, while a workload model considers all of the activities and range of demands on practitioners to meet students’ needs (e.g. indirect services, teacher consultation, and documentation time). School-based practitioners recruited via social media platforms and e-mail completed an online survey to explore their practices. Responses were analyzed using descriptive statistics and nonparametric tests. Results showed a statistically significant difference between the caseload and workload models and the following practices: professional learning community membership, collaboration with teachers, and the amount of time devoted to direct intervention, teacher/staff consultation, family/caregiver training/consultation, behavioral supports, and contextually-based services. The results support the hypothesis that workload models allow for practitioners to better implement best practices in the school setting. Implications for practice include the need for educating school staff on occupational therapy’s role and advocating for a transition to school-based models of practice, such as workload approaches.

Exploration of Common Sensory Interventions Utilized in School-Based Occupational Therapy

ABSTRACT Occupational therapy practitioners provide sensory-based interventions to support children as they learn academically, develop self-regulation skills, and participate in play and activities of daily living skills alongside their peers. These interventions are used both for children who have a specific sensory-related diagnosis as well as children who do not have a specific diagnosis. This study explored common occupational therapy sensory interventions utilized within the United States school settings along with implementation barriers for sensory intervention services for children ages 3–18 years old. Occupational therapy practitioners completed an electronic survey and a focus group. Results indicated that many occupational therapy practitioners frequently used sensory interventions through indirect services with children in preschool and elementary school. Occupational therapy practitioners must provide interprofessional training for education teams for effective sensory intervention implementation in school-based settings.

Implementation and evaluation of the \u2018Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)\u2019 provider education pilot

BackgroundTransgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affirming HIV service delivery we implemented and evaluated ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’. This theoretically-informed community-developed intervention aimed to increase providers’ gender-affirming HIV prevention and care knowledge and competency and reduce negative attitudes and biases among providers towards trans women living with and/or affected by HIV.MethodsHealthcare and social service providers and providers in-training (e.g., physicians, nurses, social workers) working with trans women living with and/or affected by HIV (n = 78) participated in a non-randomized multi-site pilot study evaluating TEACHH with a pre-post-test design. Pre- and post-intervention surveys assessed participant characteristics, intervention feasibility (e.g., workshop completion rate) and acceptability (e.g., willingness to attend another training). Paired sample t-tests were conducted to assess pre-post intervention differences in perceived competency, attitudes/biases, and knowledge to provide gender-affirming HIV care to trans women living with HIV and trans persons.ResultsThe intervention was feasible (100% workshop completion) and acceptable (91.9% indicated interest in future gender-affirming HIV care trainings). Post-intervention scores indicated significant improvement in: 1) knowledge, attitudes/biases and perceived competency in gender-affirming HIV care (score mean difference (MD) 8.49 (95% CI of MD: 6.12–10.86, p < 0.001, possible score range: 16–96), and 2) knowledge, attitudes/biases and perceived competency in gender-affirming healthcare (MD = 3.21; 95% CI of MD: 1.90–4.90, p < 0.001, possible score range: 9–63). Greater change in outcome measures from pre- to post-intervention was experienced by those with fewer trans and transfeminine clients served in the past year, in indirect service roles, and having received less prior training.ConclusionsThis brief healthcare and social service provider intervention showed promise in improving gender-affirming provider knowledge, perceived competency, and attitudes/biases, particularly among those with less trans and HIV experience. Scale-up of TEACHH may increase access to gender-affirming health services and HIV prevention and care, increase healthcare access, and reduce HIV disparities among trans women.Trial registrationClinicalTrials.gov (NCT04096053).

Analysis of determinant factors affecting retail business customer loyalty

Demographic development is the first field that influences the growth of retail stores. The rising population allows all goods and services to increase. To establish customer loyalty, the company must try to try to offer the highest quality in any product or service it must create a positive sense of quality in the minds of its customers. This research is a descriptive research type, trying to explain and describe each variable's conditions in detail and see the relationship or relationship between these variables. In the context of this study, the independent variables are Service Quality (X1), Relationship Marketing (X2), and Customer Satisfaction (Y), while the dependent variable is Customer Loyalty (Z). Quantitative data were analyzed using descriptive analysis and Structural Equation Modelling (SEM) analysis. Partially service quality has a significant influence on customer satisfaction in modern stores. In the sense that the quality of service provided by modern store management in Makassar City can contribute positively to customer satisfaction with the five dimensions of Tangible, Reliability, Empathy, Assurance, and Responsiveness. Direct service quality significantly influences customer loyalty, and indirect service quality has a significant effect on customer loyalty (LP) through customer satisfaction at modern stores in Makassar City.

Strengthening the School in School Psychology Training and Practice

What does it mean to be a SCHOOL psychologist? Since the 1980s, multiple school psychology authors have recommended turning from the traditional individual assessment role, emphasizing student deficits, to a focus on enhancing school systems and supporting the adults who work with students. A realignment of training and practice is made more urgent by the societal effect of the Covid Pandemic on schooling and the increasing emphasis on implementing social justice and equity in the schools. The core function of schools in developing the academic competence of students continues to require attention by school psychology, even more so at this time. Given that change has been elusive, it is important to reassess the barriers that have limited change, including underlying values and beliefs that focus on the individual, as well as lack of skills to implement new practices. Although profoundly difficult to achieve at scale, some programmatic changes that would support new practice models are described, along with resources to support change. Impact Statement School psychologists have the opportunity to become more effective school partners to address the challenges that have emerged from the Covid Pandemic and the equity movement. Moving away from the focus on individual deficits to a systems orientation and indirect service delivery requires new beliefs/values and skills. Effectively impacting academic outcomes, a core function of schooling, requires trainers, students, and practitioners to develop and enhance skills related to academic assessment, consultation, teaming, and issues specific to addressing equity (e.g., second language issues, exclusionary discipline).

Indirect Service with Direct Impact: Buying Diverse Children's Books with Community Partners

Indirect Service with Direct Impact: Buying Diverse Children's Books with Community Partners

Community service learning in the teen outreach program in non-metropolitan florida high schools

ABSTRACT Engagement of adolescents with their communities has been associated with lower rates of adolescent pregnancy. The purpose of this study was to qualitatively analyze Community Service Learning activities in the Teen Outreach Program (TOP) on a variety of dimensions. Data analyzed included CSL records submitted by TOP facilitators during the 2014–2015 school year implementation of TOP in non-metropolitan high schools in a Southeastern US state. CSL records included quantitative components such as type of projects, hours, and student participation. Qualitative data included thematic analysis of open-ended responses to questions regarding stages of CSL. A majority of projects were indirect service, indicating that students did not engage with the community. This study contributes to the literature by analyzing how CSL functions within an implementation of TOP, emphasizing the inclusion of civic participation activities in adolescent pregnancy prevention programs.

Understanding School-Based Consultation as Engineering Using a Mix of Methods

ABSTRACT The central purpose of school-based consultation is making psychological and educational knowledge accessible to teachers, parents, systems, and communities so that it becomes standard practice. Current research methods based on limited scientific paradigms have not adequately addressed that purpose. Applied research based on engineering is a better model to study the complex problems at the interface of psychoeducational science, indirect service, and classroom practice in a diverse, pluralistic society. Such research requires a mix of methods focused on producing usable knowledge about the practices and processes of school-based consultation. Mixed method research may be particularly well suited to that task because it a) recognizes the composite expertise of the participants; b) features pragmatic approaches to merge education science with application and implementation realities; and c) acknowledges that educational systems are inherently relational. We provide additional considerations that may be useful as researchers tackle the thorny problems of applied school-based consultation research.

The Role of Target Behaviors in Enhancing the Efficacy of Conjoint Behavioral Consultation

Conjoint Behavioral Consultation (CBC) is an evidence-based, indirect service delivery model that addresses children’s behavioral concerns across home and school. However, to date, researchers have not yet examined specific aspects of the intervention that maximize the effects of CBC. The current study examined whether a foundational aspect of consultation—the framing of target behaviors (i.e., positive behaviors to increase versus negative behaviors to decrease)—moderated the effects of CBC on children’s problem and adaptive behaviors. Participants were 267 children in Kindergarten through third grade (nCBC = 159, nControl = 108) and their parents and teachers. Results revealed positively framed target behaviors were associated with fewer behavior concerns at school for children who received CBC relative to other child participants. Children who received CBC and whose target behaviors were framed negatively showed more noncompliant behavior relative to all other participants. Implications of these findings for practice, study limitations, and areas for future research are discussed. Impact Statement In the absence of effective intervention, students with behavioral challenges face a lifetime of difficulty. Ample research documents the efficacy of conjoint behavioral consultation (CBC) for promoting prosocial behaviors and ameliorating school difficulties. This study demonstrates that the effects of CBC can be amplified by intentionally framing target behaviors in a positive (i.e., desirable behaviors to improve) versus negative (i.e., undesirable behaviors to decrease) manner, providing a simple but significant method for improving practice.

An Interview on District and School Transformation: Practical Approaches to Facilitating Sustainable Systemic Change

Illinois has an education system that includes regional cooperatives charged with supporting member districts in the provision of special education services for students from birth to age 22. Such support can include both direct services (i.e., early childhood services, special education classes in a separate building or in special education classrooms of the member districts) and indirect services (e.g., consulting services, professional development and coaching, assessment, related services). This interview is with three leaders in one such cooperative of 18 K-8 and high school member districts of varying size across 3 regions in 2 counties.

Valuation of kelp forest ecosystem services in the Falkland Islands: A case study integrating blue carbon sequestration potential

Kelp forests provide many important ecosystem services to people, including mitigating storm damage, cycling nutrients, and providing commercially-harvestable resources. However, kelp forests’ ability to sequester carbon dioxide, and therefore help regulate the climate, has until recently, been overlooked in assessments of the beneficial services they provide. In this study we incorporate updated knowledge on the potential of kelp to sequester ‘blue carbon’, and use the extensive kelp forests of the Falkland Islands as a case study to assess the value of kelp forest to society through multiple associated ecosystem services. Our analysis shows kelp forests provide a highly valuable range of direct and indirect services, which if managed correctly, will continue to benefit people, both now and in the future. The total estimated value of the Falkland Islands’ kelp system is currently equivalent to ~ £2.69 billion per year (or £3.24 million km-2 year-1). However, the true value of the kelp forest surrounding the Falkland Islands is likely to be higher still, given that our estimate does not account for elements such as associated scientific research, tourism, and cultural services, due to the necessary data currently being unavailable. Similarly, the full value of these highly biodiverse ecosystems in supplying habitat and food to a large range of associated species is crucial, yet extremely difficult to fully quantify. This study illustrates the importance of maintaining kelp ecosystems in a healthy state to ensure they continue to supply valuable ecological processes, functional roles, and ecosystem services, including their overlooked role as significant long-term carbon sinks.

Waste Management in Makassar City Based on Regional Regulation Number 4 Year 2011

Garbage is a problem faced by almost all countries in the world. Increasing the volume of waste requires good and effective management. In Makassar City, waste management is regulated by the Regional Regulation Number 4 Year 2011 concerning Waste Management, which can be said to be a responsive regional regulation because it has accommodated the involvement of various parties, especially the community and the business world in waste management in Makassar City. The local government of Makassar City determines two types of solid waste or cleaning service policies, namely the Communal Service Policy (Indirect Service Policy) and Individual Service Policy (Direct Service Policy). Effective waste management in Makassar City is measured by the form of services provided by the government and the fulfillment of solid waste facilities and infrastructure in Makassar City. In terms of services, these services are provided every day by the local government of Makassar City through their apparatus. Then regarding the facilities and infrastructure, the Makassar City Government has made efforts to fulfill all facilities and infrastructure, especially related to waste transportation

Hybrid life cycle assessment of an onshore wind farm including direct and indirect services: A case study in Guajira, Colombia

To diversify and decarbonize its energy system, Colombia plans a sizeable increase in wind power by installing onshore wind farms in the Guajira region. While presumably superior to other alternatives in terms of environmental performance, this assumption cannot be tested due to the lack of studies in this region. To assess the potential environmental performance of wind power in Colombia, we conduct a hybrid life cycle assessment of a wind farm of 19.5 MW of installed capacity for various impacts. We include both direct (required on-site) and indirect (required in the supply-chain) services associated with the life cycle of the wind farm for completeness, an unprecedented feature in the LCA literature. The results show that the wind farm is associated with low global warming impacts (12.93 gr CO2 eq/kWh) compared with similar studies, mainly due to high wind speeds. Moreover, the inclusion of both direct and indirect services increases the environmental impacts across indicators (with respect to the results without services) from 0% (carcinogenic effects) to 21% (terrestrial eutrophication). Further, sensitivity analysis suggests that the results are highly dependant on the capacity factor, lifespan, and percentage of losses. We conclude that the inclusion of both direct and indirect services is not negligible in the life cycle assessment of wind farms and similar projects, particularly given the substantial services required, such as surveying, legal compliance, etc. Given the difficulty to obtain data on services, we conclude with some recommendations aimed at relevant stakeholders, such as tax benefits and public procurement guidelines.

Exploring how to deliver videoconference-mediated psychological therapy to adults with an intellectual disability during the coronavirus pandemic

Purpose The novel coronavirus and associated restrictions have resulted in mental health services across the UK having to adapt how they deliver psychological assessments and interventions. The purpose of this paper is to explore the accessibility and prospective acceptability of providing telephone and videoconference-mediated psychological interventions in individuals with intellectual disabilities. Design/methodology/approach As part of a service evaluation, a mixed-methods questionnaire was developed and completed by clients who had been referred for psychological therapy at an adult intellectual disabilities’ community health service in the north of England. All clients were assessed using the Red/Amber/Green (RAG) system by a consultant clinical psychologist for risk and potential suitability for indirect service delivery given their ability and needs. Findings Overall, 22 clients were invited to take part, of which, only seven (32%) were accepting of telephone or videoconference-mediated psychological therapy. Most of the clients were unable to engage in video-conference therapy and therefore, only suitable for phone therapy. This paper presents the remaining findings and discusses the clinical implications and unique considerations for intellectual disability services drawing on the existing literature. Originality/value This is the first paper that the authors are aware of, examining videoconference-mediated psychological therapy in this population. It is hoped the data will be used to help inform practice or policy when using such therapeutic approaches in adults with an intellectual disability.

Implementation of drama therapy services in the North American school system: Responses from the field

AbstractDrama therapy is an emerging mental health practice in North American schools. Yet little research has focused directly on the role of drama therapists in schools or their service navigation practices and challenges. From February to July of 2018, drama therapists affiliated with the North American Drama Therapy Association currently working in North American schools were invited to participate in an online Qualtrics survey. A qualitative thematic analysis was conducted on open‐ended response items, the results of which reflect drama therapists' experiences pioneering direct and indirect services and responding to implementation challenges. Findings suggest that while drama therapists provide a number of critical school services, there are identifiable barriers to full integration into the system. Implications for drama therapists include the need for a further specified and structured role, formalized inclusion in student support teams, consistent opportunities to support both students and staff, more secure funding sources, clear implementation logistics, and increased awareness and education about drama therapy among school administrators, faculty, and mental health support staff.

Картографирование эколого-экономической ценности экосистем национального парка «Тункинский» Республики Бурятия

The underestimation of ecosystem services that exists today is explained by the complexity of the value expression of its various functions and interrelationships. Naturally, it is impossible to fully determine the economic value of nature, since the value of goods irreplaceable for life tends to infinity. At the same time, the value indicator of these benefits in a market economy is a determining condition for financial support for the preservation and self-reproduction of natural ecosystems. In the context of the formation of global markets for ecosystem services, the prospects for the ecological and economic assessment of specially protected natural areas are great. Such assessments should become mandatory for the regions and be taken into account in their development strategies. This also applies to the territory of Tunkinsky National Park, located in the Republic of Buryatia, which has become an object of mapping. Based on the concept of total economic value, the component and aggregate values of the cost of direct use of a number of services of the national park were calculated. The information on the nature and use of natural resources in the study area served as the basis for ecological and economic calculations. A map of the natural-territorial complexes of Tunkinsky National Park was compiled, the analysis of which made it possible to get an idea of the distribution of the main natural-territorial complexes within the study area, as well as to determine their areas. The assessment of direct ecosystem services was carried out based on the productivity of biological resources for a number of species of animals, fish, wild plants, as well as recreational and pasture resources. The assessment of indirect services is calculated on the basis of carbon sequestration by forests and swamps, filtration capacity of swamps. The conducted ecological and economic assessment and its visual display on the maps of the studied territory can help in the development of ways to optimize nature management, which will contribute to the careful use of natural resources, diversification of its structure in order to preserve the ecological framework of the territory, ethnocultural and landscape diversity.

Análise da Eficiência do Modelo de Contratação de Execução Indireta e de Serviços Baseado na Prestação e Remuneração Mensuradas por Resultado em Dois Hospitais Públicos do Estado de Minas Gerais

Este trabalho analisa o modelo de contratação de execução indireta de serviços baseado na prestação e remuneração mensuradas por resultados. Por meio de estudos de casos, apresenta uma discussão acerca das normas que regem esse modelo de contratação, bem como analisa a eficiência da sua aplicação na administração, segundo as três categorias principais definidas no processo de metassumarização realizado por Santos (2015): eficiência administrativa, eficiência econômica e eficiência jurídica. Inicialmente denominado Acordo de Nível de Serviço (ANS) e posteriormente renomeado como Instrumento de Medição de Resultado (IMR), pela Instrução Normativa 05/2017, do Ministério do Planejamento, Desenvolvimento e Gestão esse modelo de contratação passou a ser amplamente empregado na administração pública federal, sendo que não se observa seu emprego com a mesma intensidade na administração do Estado de Minas Gerais, não obstante seu potencial para gerar maior eficiência na gestão pública. Para o estudo, foram selecionados dois hospitais públicos e analisados os contratos de serviços terceirizados de dieta hospitalar, sendo que um adota o modelo de contratação em estudo, e o outro, não. Foi observado que, no hospital contratado segundo este modelo, todas as irregularidades contratuais constatadas tiveram impacto econômico - sancionatório e/ou remuneratório - na empresa, enquanto na contratação do tipo convencional apenas 17,5% dessas irregularidades tiveram impactos remuneratórios e/ou sancionatórios. Isto sugere que tal modelo de contratação é mais eficiente, do ponto de vista jurídico. Além disso, os dados indicaram que o modelo conduz a uma maior eficiência administrativa, economizando recursos e levando a resultados mais satisfatórios para a administração pública. Não foi possível afirmar se o modelo de contratação foi um fator que contribuiu com eficiência econômica de gestão, vez que o foco desse modelo é melhorar a qualidade das contratações.