Social Service Providers Research Articles

Dementia Ideal Care: Ecosystem Map of Best Practices and Care Pathways Enhanced by Technology and Community.

Globally, much work has been done by nonprofit, private, and academic groups to develop best practices for the care of people living with dementia (PLWD), including Alzheimer's disease. However, these best practices reside in disparate repositories and tend to focus on one phase of the patient journey or one relevant group. To fill this gap, we developed a Dementia Ideal Care Map that everyone in the dementia ecosystem can use as an actionable tool for awareness, policy development, funding, research, training, service delivery, and technology design. The intended audience includes (and not limited to) policymakers, academia, industry, technology developers, health system leaders, clinicians, social service providers, patient advocates, PLWD, their families, and communities at large. A search was conducted for published dementia care best practices and quality measures, which were then summarized in a visual diagram. The draft diagram was analyzed to identify barriers to ideal care. Then, additional processes, services, technologies, and quality measures to overcome those challenges were brainstormed. Feedback was then obtained from experts. The Dementia Ideal Care Map summarizes the ecosystem of over 200 best practices, nearly 100 technology enablers, other infrastructure, and enhanced care pathways in one comprehensive diagram. It includes psychosocial interventions, care partner support, community-based organizations; awareness, risk reduction; initial detection, diagnosis, ongoing medical care; governments, payers, health systems, businesses, data, research, and training. Dementia Ideal Care Map is a practical tool for planning and coordinating dementia care. This visualized ecosystem approach can be applied to other conditions.

Provider perspectives on screening and treatment for opioid use disorder and mental health in HIV care: A qualitative study.

HIV, opioid use disorder (OUD), and mental health challenges share multiple syndemic risk factors. Each can be effectively treated with routine outpatient appointments, medication management, and psychosocial support, leading implementers to consider integrated screening and treatment for OUD and mental health in HIV care. Provider perspectives are crucial to understanding barriers and strategies for treatment integration. We conducted in-depth qualitative interviews with 21 HIV treatment providers and social services providers (12 individual interviews and 1 group interview with 9 participants) to understand the current landscape, goals, and priorities for integrated OUD, mental health, and HIV care. Providers were purposively recruited from known clinics in Mecklenburg County, North Carolina, U.S.A. Data were analyzed using applied thematic analysis in the NVivo 12 software program and evaluated for inter-coder agreement. Participants viewed substance use and mental health challenges as prominent barriers to engagement in HIV care. However, few organizations have integrated structured screening for substance use and mental health into their standard of care. Even fewer screen for opioid use. Although medication assisted treatment (MAT) is effective for mitigating OUD, providers struggle to connect patients with MAT due to limited referral options, social barriers such as housing and food insecurity, overburdened staff, stigma, and lack of provider training. Providers believed there would be clear benefit to integrating OUD and mental health treatment in HIV care but lacked resources for implementation. Integration of screening and treatment for substance use and mental health in HIV care could mitigate many current barriers to treatment for all three conditions. Efforts are needed to train HIV providers to provide MAT, expand resources, and implement best practices.

Social networks and societal position are key drivers of the spiritual well-being of the parents of migrants in rural West Bengal

ABSTRACT India has been upholding the traditional custom of multigenerational co-residence and is well known for its spiritual legacy. However, the era of globalization and urbanization has reshaped family structures, with adult migration influencing older parents’ spiritual journeys. The study investigates the differences in spiritual well-being among parents of migrants and non-migrants and the influence of social-familial position and social network on spiritual well-being using a cross-sectional survey conducted by 500 elderly parents. The study revealed that the mean score of spiritual well-being was significantly lower among parents of migrants compared to parents of non-migrants. Social networks enhance the spiritual well-being of elderly parents considerably. Social networks enhance spiritual well-being, particularly for parents of migrants, to a greater extent than among parents of non-migrants. Moreover, the study found that household decision-making roles emerged as a significant predictor of spiritual well-being, with more substantial effects observed among parents of migrants compared to non-migrants. Policymakers and social services providers should focus on strengthening social network structures for elderly parents, especially for parents of migrants. This could foster more robust social networks and empower older individuals to participate in household decision-making processes, which will ensure better spiritual well-being in the context of adult-child migration.

The Role of Resilience in Social Services During the COVID-19 Pandemic

AbstractResilience is considered a significant concept in research on a variety of topics at the individual, organizational, and community levels. In this qualitative, grounded theory study based on 20 semi-structured interviews, we discuss a set of factors that emerged as contributing to resilience among social service providers working with homeless or homeless-adjacent vulnerable populations during the COVID-19 pandemic. This article specifically addresses the variation in resilience that emerged between providers in the face of these pandemic-related challenges. We found that the following four factors, in interaction with each other, influenced the degree of provider resilience: Restrictions providers had to implement to keep clients safe and associated feelings of guilt and helplessness, outbreaks and losses affecting the organization and its staff during the pandemic, isolation from the community, clients, and fellow staff, and existing vulnerabilities, such as personal struggles with mental health or complicated family situations. The article also discusses the implications of these findings for future research and social work practice.

Measuring effectiveness of holistic defense: social service provision and justice system outcomes

Measuring effectiveness of holistic defense: social service provision and justice system outcomes

Supporting whānau during COVID-19 pandemic in Aotearoa New Zealand: a systems thinking case study

BackgroundThe Aotearoa New Zealand COVID-19 pandemic response has been hailed as a success story, however, there are concerns about how equitable it has been. This study explored the experience of a collective of Māori health and social service providers in the greater Wellington region of Aotearoa New Zeland delivering COVID-19 responses.MethodsThe study was a collaboration between a large urban Māori health and social service provider, Tākiri Mai Te Ata whānau ora collective, and public health researchers in Aotearoa New Zealand. Two online workshops were held with staff of the Māori service provider, collectively developing a qualitative causal loop diagram and generating systemic insights. The causal loop diagram showed interactions of various factors affecting COVID-19 response for supporting whānau (Māori family/households) at a community level. The iceberg model of systems thinking offered insights for action in understanding causal loop diagrams, emphasizing impactful changes at less visible levels.ResultsSix interacting subsystems were identified within the causal loop diagram that highlighted the systemic barriers and opportunities for effective COVID-19 response to Māori whānau. The medical model of health service produces difficulties for delivering kaupapa Māori services. Along with pre-existing vulnerability and health system gaps, these difficulties increased the risk of negative impacts on Māori whānau as COVID-19 cases increased. The study highlighted a critical need to create equal power in health perspectives, reducing dominance of the individual-focused medical model for better support of whānau during future pandemics.ConclusionsThe study provided insights on systemic traps, their interactions and delays contributing to a relatively less effective COVID-19 response for Māori whānau and offered insights for improvement. In the light of recent changes in the Aotearoa New Zealand health system, the findings emphasize the urgent need for structural reform to address power imbalances and establish kaupapa Māori approach and equity as a norm in service planning and delivery.

“They [Doctors] Don’t Really Know What We’re Actually Experiencing”: Undoing Racializing Frames of Heart Health in Singapore by Centering Listening as Method

ABSTRACT The mainstream media and local health campaigns in Singapore racialize heart health disparities. Journalists and campaigners report differences in heart health outcomes from a model of race governance known as the Chinese, Malay, Indian, and Others (CMIO) model. This model is then used to frame heart health inequities as an outcome of poor cultural practices and behaviors tied to race. To (un)do the racializing frames of heart health as outcomes of cultural behaviors and practices, I instead center stories of heart health management by Malay participants from lower-income households, identifying the role information asymmetries play in incomplete heart health information retrieval during interactions with providers (social service providers, healthcare workers, doctors, nurses). Cultural and community resources were discussed as critical resources for alleviating urgent heart health episodes or assisting as guides for preventative heart health information. Health campaigners must delve deeper into these findings for more structurally responsive heart health interventions and move away from racializing health disparities based on the CMIO model.

Optimizing the Role of DKI Jakarta Province Social Services: Efforts to Prevent Child Exploitation for Begging

Children are one of the gifts given by God who will continue the ideals of the nation, therefore children must be protected from all forms of exploitation. This research focuses on the role of the DKI Jakarta Provincial Social Service in eradicating the exploitation of children to become beggars in DKI Jakarta Province and its optimization efforts. The research method used is normative juridical with a statutory regulatory approach; primary materials in the form of statutory regulations; Secondary materials include books, journals and legal articles. The qualitative data that was obtained was analyzed using descriptive writing techniques. The results of the research that has been carried out show that based on Article 6 of Governor Regulation Number 169 of 2014 concerning Handling Patterns for People with Social Welfare Problems (PMKS), the PMKS handling pattern carried out by the DKI Jakarta Provincial Social Service is divided into 4 (four) stages, namely prevention efforts, provision of social welfare services, guidance and further guidance. However, in its implementation, the DKI Jakarta Provincial Social Service can be more assertive in providing guidance to economically disadvantaged communities as an effort to reduce cases of exploitation of children to become beggars.

Searching for choice and control: Western Australian service provider experiences of health, housing and migration.

This research aimed to inform approaches to increase access to secure housing and improve mental health outcomes for migrants from culturally and linguistically diverse backgrounds (hereafter migrants) who are generally invisible in health and social policy and service provision in Western Australia. We used semi-structured, in-depth interviews (n = 11) and interpretative phenomenological analysis to explore service provider experiences and perspectives of issues impacting service provision and the needs of migrants in this context. Five superordinate themes reveal complex experiences for both service providers and the migrants with whom they work. Findings reflect tensions between contemporary notions of choice and control and a social service system that is difficult to navigate, reflects systemic racism and appears to rely heavily on the non-government sector. Insights have important and practical implications for health promotion policy, practice and research. Recommendations include improvements to housing access, provision, funding and policies; addressing service barriers via staff training and more accessible community resources; and co-design and community outreach approaches.

Support to ‘non-clients’: care managers’ role in direct and indirect carer support

ABSTRACT Social service provision in Europe has increasingly incorporated informal carers. Consequently, these carers are now included within the scope of all social workers, including care managers. Most support for carers is indirect support, where opportunities for respite are channelled through the care receiver’s needs assessment. This approach highlights the unique role of care managers providing carer support as they balance their public task directed towards clients with the concurrent policy-driven expectation to support carers. The aim of this article is to explore how care managers, as street-level bureaucrats, ‘make’ carer support policy on the ground. Using systematic text condensation of 10 qualitative interviews with care managers in Sweden, we present three themes to understand care managers’ experiences. Care managers work ‘Hand-in-hand’ and ‘hands on’ with carers, carers are within, yet outside one’s scope of work, and there are possibilities and practices towards a carer perspective. Following Lipsky’s dictum that street-level bureaucrats’ actions effectively ‘become’ the public policy they carry out, our results highlight care managers’ possibilities and challenges in shaping what direct and indirect carer support looks like on the ground.

ЗАСАДИ РОЗВИТКУ МІСЦЕВИХ БЮДЖЕТІВ В УМОВАХ РЕФОРМУВАННЯ МІСЦЕВОГО САМОВРЯДУВАННЯ

The article is devoted to an overview of some of the main organizational and economic foundations of the development of local budgets in the conditions of local self-government reform. It was determined that local self-government is a manifestation of the democratic management of social development, which is based on the idea of citizen participation in solving community problems. The main functions of local self-government are the involvement of citizens in issues of local development, management of communal property, socio-economic and cultural development, provision of social services to the population. The powers of local self-government bodies include the preparation of community socio-economic development programs, the involvement of enterprises and ensuring the efficient use of resources. The implementation of the organizational and economic mechanism benefits all participants in the process, because the accumulation of taxes in the local budget contributes to the growth of the quality of life of the population, creates additional conditions for the development of enterprises, the creation of new jobs, and affects the formation of the investment climate. In the conditions of martial law, changes were made to a number of regulatory and legal documents regulating budgetary issues to ensure the smooth functioning of budgets at various levels during the war. The changes concerned the provision of prompt, continuous and timely implementation of local budgets, which provide for the needs of both residents and business entities of the OTG. To ensure the restoration of the work of enterprises and organizations in the liberated territories, local self-government bodies redistribute state aid. At the same time, the biggest changes in legislation related to the cancellation of mandatory taxes and deductions to the budgets of the OTG. Further scientific research in this direction concerns the improvement of the methodology for analyzing the development of local budgets in the context of local self-government reform. A number of regulatory and legal documents regulating budgetary issues under martial law were reviewed.

Creating Family-Centred Support for Preschoolers with Developmental Disabilities in Low-Income Countries: A Rapid Review to Guide Practitioners.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably also in low-resourced areas of more affluent nations. Yet as this rapid review of the published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First, the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community: notably, traditional healers and leaders, health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

Adverse Childhood Experiences, Women Who Are Sex Trafficked, and Social Service Utilization: Implications for Social Work.

The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p < .001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings.

Palliative Social Work Services for Cancer Patients in Southeast Nigeria: An Exploration

Palliative social work services are essential for addressing the complex psychosocial needs of cancer patients, particularly in resource-constrained areas like Southeast Nigeria. Despite the recognition of social work in palliative care for cancer patients, effective delivery faces significant challenges impacting both social service delivery and patient outcomes. This study investigates the provision of palliative social work services for cancer patients using in-depth interviews with 18 participants (six social workers and twelve cancer patients) from two hospitals in Southeast Nigeria. Participants were purposefully sampled based on their roles in providing or receiving palliative care support. Thematic analysis of the data revealed that social work palliative services encompass psychosocial support, spiritual guidance, and educational resources. However, social workers encounter barriers such as emotional stress, burnout, communication gaps, financial constraints, and socio-cultural factors. The study suggests that regular debriefing sessions and educational programs could improve palliative care delivery. Policy advocacy is recommended to recognize and support the pivotal role of palliative social workers in cancer care. Future research should explore innovative strategies using quantitative methods to overcome barriers and enhance palliative social work effectiveness across diverse cultural and healthcare contexts, ultimately improving social service delivery to cancer patients and advancing social service research.

Reporting on Health Care and Social Service Provider Approaches to Promoting Alcohol Abstinence During Pregnancy

ABSTRACT Despite the known detrimental health effects of alcohol use during pregnancy, there are still health care (HCP) and social service providers (SSP) who do not promote complete abstinence. The purpose of this study was to explore the current practices of HCPs and SSPs when discussing alcohol use during pregnancy, and to understand their rationale for their specific recommendations. An online survey was completed by 1123 HCPs (n = 588) and SSPs (n = 535) that asked them to identify their approach to discussing alcohol and pregnancy. Participants had the option to further explain their current recommendations regarding alcohol use during pregnancy in an open-ended format. Open-ended responses were analyzed using a content analysis approach (n = 156). The majority of respondents recommend abstinence (83.9% of HCPs, n = 493; 78.4% of SSPs, n = 419), while 9.8% of HCPs (n = 57) and 2.2% of SSPs (n = 12) responded that low levels of consumption may be acceptable. HCPs may recommend low levels of consumption based on other international guidelines, limited evidence to suggest that one unit of alcohol is harmful, and as a harm reduction strategy. SSPs stated that they refer clients to HCPs for recommendations related to alcohol consumption, and that they prefer to provide information based on public health guidelines. This exploratory work may inform the development of resources to support HCPs and SSPs to recommend abstinence from alcohol throughout gestation.

Service Provider Perspectives on Advance Care Planning Use in Rural Dementia Patients and Caregivers: A Qualitative Study

ABSTRACT Advanced care planning (ACP) utilization remains very limited in rural communities compared to urban areas. ACP earlier in the disease trajectory is particularly important for people with dementia (PWD) due to its progressive nature affecting their decision-making ability. Considering the well-documented benefits of ACP in improving the quality of end-of-life (EOL) care, the rural vs. urban disparity may indicate poorer EOL quality for rural PWD. This study aimed to explore barriers and current resources for ACP of PWD from the perspectives of health or social service providers serving rural communities. Using a qualitative approach, semi-structured face-to-face interviews were conducted with 11 health or social service professionals serving older adults and their caregivers in rural Alabama. Thematic analysis revealed three major barriers: (1) lack of knowledge, (2) psychosocial barriers, and (3) limited access to healthcare. Participants also showed misconception that a lawyer or a notary is required for ACP. Two themes arose in the participants’ recommendations to address the barriers: (1) providing ACP-relevant information and (2) addressing psychosocial stressors about ACP. This study highlighted an urgent need for social policy in ACP education for caregivers and service providers in rural settings.

Psychosocial Variables That Enhance Marital Stability Among Couples in Southeast Nigeria

The rising divorce rates in Nigerian society stress the need to prioritize marital stability. This study seeks to contribute to mitigating this issue by investigating key psychosocial factors that promote marital stability. Specifically, the study explores the psychosocial variables that enhance marital stability among couples in Nsukka Local Government Area (LGA) of Enugu State. Data were sourced from 24 married couples through Focus Group Discussions (FGDs). Purposive sampling was employed, and data generated for the study were meticulously translated, transcribed and analyzed thematically. The findings revealed the pivotal role of love, effective communication and cultural factors in sustaining marital stability. To enhance marital stability, the study recommends the need for social service providers such as social workers and guidance/family counselors to provide adequate counseling to married couples. The goal of promoting resilience, strengthening relationships, and supporting the well-being of married couples and their families in diverse cultural contexts underscores the importance of social service research in addressing complex social issues and improving outcomes for individuals and communities. Future research should expand to include larger and more diverse populations and assess the longitudinal effects of social service programs on marital stability in Southeast Nigeria.

Access to primary health care: perspectives of primary care physicians and community stakeholders

BackgroundAction on the social determinants of health is important to strengthen primary health care and promote access among underserved populations. We report on findings from stakeholder consultations undertaken at one of the Canadian sites of the Innovative Models Promoting Access-to-Care Transformation (IMPACT) program, as part of the development of a best practice intervention to improve access to primary health care. The overarching objective of this qualitative study was to understand the processes, barriers, and facilitators to connect patients to health enabling community resources (HERs) to inform a patient navigation model situated in primary care.MethodsFocus groups and interviews were conducted with primary care physicians, and community health and social service providers to understand their experiences in supporting patients in reaching HERs. Current gaps in access to primary health care and the potential of patient navigation were also explored. We applied Levesque et al., (2013) access framework to code the data and four themes emerged: (1) Approachability and Ability to Perceive, (2) Acceptability and Ability to Seek, (3) Availability and Accommodation, and Ability to Reach, and (4) Appropriateness.ResultsDeterminants of access included patient and provider awareness of HERs, the nature of the patient-provider relationship, funding of HERs, integration of primary and community care services, and continuity of information. Participants’ perspectives about the potential scope and role of a patient navigator provided valuable insight for the development of the Access to Resources in the Community (ARC) navigation model and how it could be embedded in a primary care setting.ConclusionAdditional consultation with key stakeholders in the health region is needed to gain a broader understanding of the challenges in caring for primary care patients with social barriers and how to support them in accessing community-based primary health care to inform the design of the ARC intervention.

NEW TECHNOLOGIES OF SOCIAL WORK WITH THE ELDERLY (review of the monograph by A. Karkach and T. Semigina «Digital competence of older people»)

The monograph analyzes the specifics of the formation of digital competence of the elderly in the conditions of the university of the third age of the territorial center of social service. The content of the work on the formation and approval of the experimental program in the territorial center of social service (provision of social services) of the social protection department of the Podilska district in the city of Poltava Rada is disclosed; data proving the effectiveness of this program, which can be implemented in universities of the third age, are given. The publication is intended for practitioners of social work, graduate students and teachers of social work.

노인 대상 비대면 사회서비스 제공 경험 및 효과적 제공 방안에 관한 연구: 종사자 FGI 분석을 중심으로

In response to the COVID-19 pandemic, a surge in the adoption of non-face-to-face services within the social services sector has been observed. Despite these advancements, the accessibility and effectiveness of non-face-to-face services for older adults, a significant beneficiary group of social services, remain constrained due to factors such as low digital literacy and insufficient physical environments. This research aimed to explore more effective ways of delivering non-face-to-face social services to older adults who continue to rely on such services. The study conducted focus group interviews (FGI) with staff from major institutions providing social services to older adults, aiming to comprehend the overall status of non-face-to-face social service provision and to explore factors influencing the level of service provision and effective delivery. The analysis results prompted the formulation of specific recommendations for the effective provision of non-face-to-face social services for older adults, organized according to influential factors. Firstly, it is imperative that the purpose of non-face-to-face services prioritizes interpersonal communication, with effectiveness contingent upon the activation of communication. Secondly, at the institutional level, flexibility in service provision, strategic decision-making in service delivery methods, resident education initiatives, enhancement of digital capabilities among institutional staff, deployment of support personnel, encouragement of experiential learning, and the provision of non-face-to-face services for physical health were identified as crucial elements. Lastly, at the policy level, there is a pressing need for support in physical environments for both service providers and users, the development of user guides and user-friendly devices to enhance convenience, and flexibility in budget utilization. These recommendations collectively contribute to the enhancement of non-face-to-face social services, ensuring their efficacy and accessibility for the older adult population.