Support Services Research Articles

The Role of Mediation in the Settlement of Family Disputes in Kazakhstan: A Sociological Study

The study aimed to examine the importance and necessity of using mediation in resolving family disputes in Kazakhstan. From February to August 2020, a sociological study was conducted in Kazakhstan to identify the main causes of modern family problems, the functions of mediation and mediators in dispute resolution. The study involved 1,200 respondents. Data collection methods included both quantitative and qualitative approaches. The study was based on a survey of respondents in major cities of Kazakhstan. The study showed that factors such as lack of love and understanding, financial difficulties, and interference from relatives contribute to the escalation of family disputes leading to breakups. It also confirmed the important role of mediators in reaching appropriate and effective solutions, emphasizing the need to strengthen mediator training, legislative support for free mediation services for vulnerable groups, guaranteed payment for mediation services, and promotion of mediation through local media and service centers.

Growing Up Amidst Active Warfare: Understanding the Experiences of Ukrainian Adolescents Through Chat Data

Armed conflicts violate young people’s rights by exposing them to violence and trauma, disrupting their sense of safety. This study examines how Russia’s war against Ukraine affects Ukrainian adolescents’ lives. The study utilizes data from Let’s Chat, a free, low-threshold support service for Ukrainian-speaking children and youths. We analyzed 185 chat conversations between chat workers and Ukrainian adolescents using data-driven thematic analysis. The war emerged roughly every fourth conversation, affecting discussions on forced relocation, school disruptions, and social relationships. Although youths rarely initiate war-related conversations, its effects are evident. This study highlights the complex impact of war on youth development, adding to other stressors in their lives. War often emerges as an added burden, complicating their already delicate development. Digital channels like Let’s Chat can help adolescents cope with these challenges and plan their futures in a culturally sensitive manner across borders, providing crucial support in difficult times.

Enhancing healthcare outcomes and cost efficiency through patient support programs: a comprehensive analysis

Abstract Introduction Treatment retention is crucial for patients with chronic diseases, impacting both clinical outcomes and healthcare costs. Patient Support Programs (PSP), often sponsored by pharmaceutical companies as a wraparound support service for new and innovative medicines, have been shown to be a viable tool in supporting treatment retention and adherence1. Utilizing tools like Patient Activation Measure (PAM®) equips healthcare providers with a means to evaluate the impact of these PSPs on patients' activation and their potential to adhere to medication. The PAM is a behavioural concept focusing on a patient’s understanding of their role in their healthcare, and how competent they feel to fulfil that role. Crucially, there is substantial evidence indicating a strong association between higher PAM scores and improved clinical outcomes2. Aim This study objectives are to evaluate the effectiveness of PSP in reducing treatment drop-off; to investigate the impact of PSP on patient activation/PAM levels; and to analyse potential cost savings from patient activation through PSP participation. Methods The study population includes patients (n= 97795) diagnosed with chronic diseases receiving one of three services from a Clinical Homecare company: (1) Direct-to-patient medication delivery (DD); (2) DD plus self-administration training and (3) DD, self-administration training and PAM-based PSP. Patient “drop-off” from treatment was analysed across all three services and defined as discontinuation of medication due to unwillingness to engage, non-response to engagement attempts, or requests to put the service on hold. Additionally, change in PAM level/activation for patients who completed baseline and follow-up PAM surveys between October 2020 and March 2024 (n=1880) was considered. Finally, expected cost saving was examined, both as a result of the observed change in activation for PSP patients as well as in a hypothetical scenario where patients in DD and self-administration training are redirected to PSP. Ethical approval was not required because the study does not involve any patient interaction/intervention whatsoever. It was a retrospective data analytical study, using existing and fully anonymised patient data from routine clinical care. Results Fewer patients drop off from treatment when they are on the PSP (1.1%) compared to those that are on self-administration training (2.1%) or DD (2.8%). Participation in PSP also positively impacted PAM scores across all therapies, with average improvements ranging from 1 to 8.1 points per patient. Patients in the lower two activation levels (typically at the greatest risk of non-adherence) experienced the most substantial gains (ranging from 8.4 to 17.4 points) emphasizing the significance of intervention. These improvements in PAM scores by PSP translated to substantial cost savings for the health system, amounting to £1,028,669. Finally, where the same treatment drop-off rate and PAM performance ratio are applied to a hypothetical scenario involving the redirection of patients from DD and self-administration training to PSP, there is a further potential cost savings of £4,298,277. Conclusion Participation in PSP improves patient activation and the potential to adhere to prescribed medication, while producing significant financial benefits. Further research is needed to understand how these benefits may vary across different therapy areas and within primary, secondary, and homecare settings.

Dementia and Its Profound Impact on Family Members and Partners: A Large UK Cross-Sectional Study.

Dementia can adversely affect the quality of life (QoL) of family members/partners of those affected. Measuring this often-neglected burden is critical to planning and providing appropriate support services. This study measures this impact using the Family-Reported Outcome Measure (FROM-16). A large UK cross-sectional online study through patient research platforms, recruited family members/partners of people with dementia, to complete the FROM-16. Totally, 711 family members/partners (mean age=58.7y, SD=12.5; females=81.3%) of patients (mean age=81.6, SD=9.6; females=66.9) with dementia completed the FROM-16. The FROM-16 mean total score was 17.5 (SD=6.8), meaning "a very large effect" on QoL of family members, with females being more adversely impacted. Dementia profoundly impacts the QoL of family members/partners of patients. Routine use of FROM-16 could signpost provision of care support, reducing family members' burnout. Such routine data could be used in economic analysis of the burden of dementia as well as in predicting institutionalization.

Anxiety, depression and access to mental health services among internally displaced persons in Mogadishu, Somalia: a cross-sectional survey

ObjectiveThe study aims to evaluate anxiety and depression levels and access to mental health services among internally displaced persons (IDPs) in Mogadishu, Somalia.DesignA community-based, cross-sectional survey was carried out in...

Efficacy of an mHealth intervention to support pain self-management and improve analgesia in patients with rib fractures: protocol for a randomised controlled trial

IntroductionIn light of the risks of over-reliance on opioid analgesia during recovery from rib fractures, there is increased interest in the efficacy of non-pharmacological approaches to pain management. This paper...

Exploring the Decision-Making Process of International Students: Factors Influencing their Choice of US Colleges

The United States is the top destination for international students seeking higher education. These students encounter various factors that shape their decisions throughout the college application journey. This research aims to pinpoint the main variables that influence international students’ choices to study in the US. Important factors include the reputation and rankings of universities, tuition costs, geographic location, personal recommendations, unique connections, and the complexity of the admissions process. Despite facing challenges like strict immigration policies and lengthy visa application procedures, US universities continue to attract students due to their global prestige and the numerous opportunities they provide for personal and professional development. The study sheds light on the preferences and considerations of international students when choosing colleges in the US. By doing so, it offers valuable insights for higher education institutions to improve their support services and refine recruitment strategies, ultimately enhancing the experiences and outcomes for international students.

Silver Rainbows in The Information Society: Aging-Related Information Needs and Barriers of LGBT+ Older Adults

Abstract Society is experiencing a global shift in which older people now outnumber children five years and younger in many countries. This demographic aging has profound implications for library and information professionals, and yet research into the information needs of older adults – especially from diverse backgrounds – remains underdeveloped. This study seeks to help address this gap by studying the aging-related information needs and barriers of LGBT+ older adults. Interviews with 25 LGBT+ older adults in East Tennessee were analyzed using thematic analysis to identify five need (e.g., culturally competent care, LGBT+ specific services, social support, planning, and caregiver services) and seven barrier (e.g., stigma, discrimination, fewer personal resources, identity concealment, staff limitations, personality, ageism and elder abuse) themes. Beyond the aging focus, the study brings attention to the need for more research on intersectional populations in general and offers one of the first – perhaps only – studies of the information needs of LGBT+ older adults. It also presents a challenge to librarians and other information professionals in considering how to fight inequities for intersectional populations. Future research will consider how to meet needs and address the barriers LGBT+ older adults face.

Impact Findings From a Randomized Controlled Trial of a Supportive Housing Demonstration Programme for Homeless, Child Welfare–Involved Families

ABSTRACTA “Housing First” approach to homelessness, showing promise for single adults, might also be effective for families whose homelessness combined with other challenges bring them to the attention of the child welfare system. This paper reports impact findings from the evaluation of a randomized, controlled trial in San Francisco that tested the effectiveness of an intervention designed to provide permanent housing and supportive services to such families, with the goal of safely reducing the use of foster care. Compared with families in the control group (33 families with 60 children), we found no significant impact on the likelihood of out‐of‐home placement up to 2 years after randomization. For families whose children were already in foster care, children in the treatment group (43 families with 63 children) reunified faster than those in the control group (42 families with 68 children), although nearly always before being housed. There was no difference between groups in time to case closure or likelihood of subsequent child welfare involvement. We discuss these findings in the context of important implementation challenges that have implications for further testing this intervention in tight housing markets.

Straw Craftsmanship from Port of Sauípe-BA: Possibility of Become a Geographic Indication

Objective: Present the potential of the Geographical Indication for straw handicrafts from Porto de Sauípe – Bahia based on the Methodology for Identifying Potential Brazilian Geographical Indications, developed by the Micro and Small Business Support Service (Sebrae). Theoretical Framework: The article shows some reports that provide information about the history and context of straw crafts in Porto de Sauípe, including local traditions and the role of artisans in the production of the products. Method: The research has a qualitative approach with data collection through bibliographic survey and interviews with local artisans. Results and Discussion: The results showed that the Porto de Sauípe region has factors that provide a quality product (handicrafts) with unique characteristics. The handicrafts have market potential, notoriety and great socioeconomic importance for local artisans. One of the main restrictions for the Geographical Indication is related to the criteria that require more attention, such as governance, research involved and vision of the future. Research Implications: The research makes it possible to analyze the potential of Geographical Indications in other regions that have potential for manufacturing products with notoriety and requirements for registration. Originality/Value: The study provides support to academics and artisans in Brazil, demonstrating the importance of the piassava production chain for maintaining crafts and generating local employment and income.

Impact of psycho-social support and counselling services in mitigating the risk of radicalisation among youths

The purpose of this study is to examine the effectiveness of psycho-social support and counselling services in mitigating youth radicalisation in Mombasa County, Kenya. Violent extremism poses significant risks to youth in vulnerable regions, and while psycho-social interventions have been implemented, their impact remains uncertain. This study specifically investigates whether these services enhance mental health, promote behavioural change, and build resilience against radical ideologies. Using a mixed-methods design, data were collected from 384 youth participants through structured questionnaires and semi-structured interviews. Findings indicate that sixty-one per cent of participants are aware of the available support services, revealing a need for improved outreach. Notably, sixty-eight per cent reported improvements in mental health and coping skills, and seventy-three per cent observed positive behavioural changes, which reduced their susceptibility to radicalisation. These results highlight the potential of psycho-social support in fostering resilience among at-risk youth, though limitations in awareness and accessibility persist. To enhance these services' impact, recommendations include targeted outreach programs, stigma reduction campaigns, and expansion of services to marginalised areas.

Zooming In and Out of Programming: Developing an Approach to Trauma-and Violence-Informed Physical Activity “Post-Pandemic”

Researchers have found that physical activity is an effective health promotion tool due to its positive effect on wellbeing, however, despite the overwhelming evidence on the benefits of physical activity, many structural and systemic inequities exist that affect access and uptake particularly for women. These barriers have been exacerbated over the last few years as conditions surrounding the COVID-19 pandemic has made engagement in physical activity even more difficult for equity-deserving populations. Community organizations have reported an increase in gender-based violence and a strain on support services. In this qualitative research study, we present findings that demonstrated how COVID-19 complicated the delivery of in-person programs for equity-deserving populations. Using a feminist participatory action research approach, community-specific barriers to physical activity from the perspectives of individuals who deliver physical activity programming and social services to self-identified women were generated in three themes using thematic analysis: 1) Increased Need, Decreased Services; 2) Online Service Provision was Not Effective for Clients or Providers; 3) Physical Activity was Not Deemed an “Essential Service”-Transitioning from Survival Mode to a New Normal. Taken together, findings underlined the importance of effective and sustainable resources and strategies to improve access for women to engage in physical activity programs.

Narrative Coherence and Relational Agency: Unraveling Transitions Into and Out of Alberta Correctional Facilities for People Living With HIV.

Incarcerated populations in Canada face significant health and social challenges during transitions into and out of correctional facilities. These transitions around facilities pose disproportionate barriers to care for people living with HIV. Further research is crucial to comprehend these challenges and reimagine care concepts for people who experience structural marginalization. In this article, experiences of transitions into and out of Alberta correctional facilities for people living with HIV are explored using narrative inquiry. Conducted in a Western Canadian city from 2021 to 2022, the inquiry revolved around two men living with HIV and a history of incarceration. Through co-creating field texts and narrative accounts, their unique experiences of transitions were explored through a collaborative process of analysis. Narrative threads from Bruce and Kyle showcased a lack of narrative coherence and the presence of tensions in their lives, while also emphasizing relational agency. The findings provide avenues for health, social, and justice practitioners who support and care for individuals living with HIV and a history of incarceration to think differently about transitions. By highlighting the importance of attending to the unique identities of individuals and relationships from a position of relational agency, the study advances our understanding of transitions. Recommendations for practice and policy include (a) fostering relational agency among practitioners; (b) challenging conventional views of transitions around correctional settings; (c) incorporating peer-based programming into support services; and (d) reconsidering health, justice, and social systems to better support communities disproportionately affected by high rates of incarceration and HIV.

Teacher perspectives and barriers in implementing inclusive education for Indian children with special needs: A pilot study

AbstractInclusive education is crucial for integrating children with special needs into mainstream educational settings. This pilot study explores the attitudes of teachers in India toward providing inclusive education to children with disabilities, and the challenges they face. As the Indian education system continues to evolve, there are significant gaps in teacher preparedness and the availability of resources, especially given the socio‐cultural and economic diversity of the country. The study aims to assess the perspectives of 30 primary and secondary school teachers regarding their experiences with inclusive education, focusing on their attitudes, challenges, and the resources available for supporting students with special needs. A mixed‐methods approach was employed, utilising surveys and interviews to gather both quantitative and qualitative data. The results indicate that while many teachers hold a positive attitude toward inclusive education, they face numerous challenges in its implementation, including a lack of specialised training, insufficient support services and inadequate teaching materials. Teachers expressed particular difficulty in supporting students with severe disabilities due to the lack of behavioural and psychological services in schools. This study emphasises the importance of continued teacher training and infrastructure improvements to foster effective inclusive education. It also highlights the need for policy changes, such as the integration of the Samagra Shiksha scheme and recognition of the 2016 Rights of Persons with Disabilities Act, to support teachers in overcoming the barriers they face. The findings from this pilot study will inform a larger, more comprehensive study, and provide the foundation for future reforms of inclusive education in India.

Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability

The US Department of Veterans Affairs (VA) partners with community organizations (grantees) across the US to provide temporary financial assistance (TFA) to vulnerable veterans through the Supportive Services for Veteran Families (SSVF) program. The goal of TFA for housing-related expenses is to prevent homelessness or to quickly house those who have become homeless. To assess the cost-effectiveness of the SSVF program with TFA vs without TFA as an intervention for veterans who are experiencing housing insecurity. This study used a Markov simulation model to compare cost and housing outcomes in a hypothetical cohort of veterans enrolled in the SSVF program. Enrollees who are homeless receive rapid rehousing services, while those who are at risk of becoming homeless receive homelessness prevention services. The SSVF program with TFA for veterans who are experiencing housing insecurity. The effectiveness measure was the incremental cost-effectiveness ratio (ICER) with quality-adjusted life-years (QALYs). The model was parameterized using a combination of inputs taken from published literature and internal VA data. The model had a 2-year time horizon and a 1-day cycle length. In addition, probabilistic sensitivity analyses were conducted using 10 000 Monte Carlo simulations. The base case analyses found that the SSVF program with TFA was more costly ($35 814 vs $32 562) and yielded more QALYs (1.541 vs 1.398) than the SSVF program without TFA. The resulting ICER was $22 676 per QALY, indicating that TFA is the preferred strategy at a willingness-to-pay threshold of $150 000 per QALY. This ICER was $19 114 per QALY for veterans in the rapid rehousing component of the SSVF program and $29 751 per QALY for those in the homelessness prevention component of the SSVF program. At a willingness-to-pay threshold of $150 000 per QALY, probabilistic sensitivity analyses showed that TFA was cost-effective in 8972 of the 10 000 Monte Carlo simulations (89.7%) for rapid rehousing and in 8796 of the 10 000 Monte Carlo simulations (88.0%) for homelessness prevention only. This economic evaluation suggests that TFA is a cost-effective approach (ie, yields improved health benefits at a reasonable cost) for addressing housing insecurity for veterans enrolling in the SSVF program. Future research could examine the cost effectiveness of large, nationwide housing interventions such as this one among subpopulations of veterans such as those with certain comorbidities including severe mental illness or substance use disorders, those with chronic diseases, or those experiencing long-term housing instability vs acute loss of housing.

Service Providers' Perceptions of Psychological, Emotional, and Behavioral Issues Among Children and Adolescents During COVID‐19 in South Korea

ABSTRACTVarious emotional and psychological support services for children and adolescents were implemented in South Korea during the COVID‐19 era. However, little is known about the limitations and future directions of current support services from the perspective of service providers. The purpose of this study was to explore service providers' perspectives on emotional and psychological support services for children and adolescents. The present study purposively recruited 11 clinical practitioners providing support services for children and adolescents to conduct semistructured focus group interviews. Thematic analysis identified four major themes: (a) a noticeable increase in problematic behaviors among children and adolescents (e.g., intrinsic and extrinsic problem behaviors); (b) changes in service use patterns (e.g., increased non‐face‐to‐face services); (c) frustrations with inadequate support systems (e.g., the absence of qualified professionals); and (d) identifying future directions (e.g., improving awareness of support services). The findings highlight the necessity of enhancing awareness of how to access services by reducing stigma. The findings also emphasize the need for improved cooperation between public and private facilities, as well as a greater number of skilled professionals to provide high‐quality programs. The practical and political implications are discussed based on the findings.

Access to University Mental Health Services: Understanding the Student Experience: L'accès aux services universitaires de santé mentale : comprendre l'expérience des étudiants.

To describe student access to university mental health services and barriers and gaps in support. This multiple cohort study used self-report data from 4,138 undergraduate students who completed the U-Flourish Well-Being Survey at the start and completion of first year from 2018 to 2023. The survey incorporated validated measures of mental health symptoms, barriers to care, and open-text questions about the mental health care experience and perceived gaps. Quantitative analyses summarized utilization patterns and barriers. An interpretive qualitative analysis identified common themes about support services and opportunities for improvement from the student perspective. At university entry, 43% of students screened positive for anxiety and/or depression, 30% reported a lifetime mental disorder and 23% a lifetime history of self-harm. Over first year, 15% of students surveyed accessed university mental health services. Access was more likely in students identifying as older, gender diverse, female, having a prior mental disorder and those who screened positive for anxiety or depression. Common attitudinal and practical barriers reported included thinking problems would resolve (74%), being uncomfortable sharing (73%), and not knowing how to get help (50%). Common stigma barriers included concerns about what family or friends might think. Students expressed that both campus-based well-being and mental health care offered during flexible hours and accessible through online booking were important. Student-tailored mental health literacy may be a sustainable approach to address the attitudinal and practical barriers identified. If such barriers are reduced, an increased service demand would be expected and improved efficiencies needed. A clear Statement of Services, an online singular point of access with embedded triage to signpost students to indicated levels of care, and clearly worked-out care pathways including to community-based services would better align with a stepped care model, improve efficiency and access, and foster realistic expectations around university mental health support.

Blood pressure status, quality of life, and emotional states in adults with different disease awareness and treatment adherence

This study aimed to examine the association between blood pressure (BP) with health-related quality of life (HRQoL) and emotional states, considering the disease awareness and commitment to treatment among the Iranian adult population. This cross-sectional study uses the data of 7257 and 2449 individuals aged ≥ 20 who had completed data on HRQoL and emotional states, respectively. Linear and logistic regression were used to evaluate the mentioned association. The results showed that commitment to treatment had an inverse association with physical HRQoL in both sexes, except for bodily pain in men. Concerning mental HRQoL, in women, poor medication adherence was linked to a decline in mental HRQoL and social functioning, while good treatment adherence was associated with a reduction in the mental health domain. However, except for a decrease in vitality of hypertensive males with high treatment adherence, no significant association was found between their mental HRQoL and BP. In women, increased commitment to treatment was associated with anxiety, whereas poor commitment was related to depression and stress. The undiagnosed disease was not associated with any HRQoL and emotional state deficits. This study highlights the significance of psychiatric assessment, counseling, and support services while taking into account gender-specific differences among hypertensive patients. It also emphasizes the necessity for customized interventions for both men and women to improve their mental well-being and adherence to treatment.

Intimate partner violence (IPV) among sexual minority men (SMM) during the COVID-19 pandemic: A scoping review and a call for research

There is a dearth of literature documenting the impact of the COVID-19 pandemic on intimate partner violence (IPV) victimization among sexual minority men (SMM). This review examines studies conducted since the onset of the COVID-19 pandemic, focusing on the experiences and changes in IPV experiences among SMM. We conducted a comprehensive search, and article screening and selection adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only 7 studies were identified and met the eligibility, all of which utilized cross-sectional design. Studies were conducted in the U.S (n = 4), Spain (n = 1), China (n = 1), and a study using global samples (n = 1). Measurements and assessment tools for IPV victimization vary across these studies. SMM were observed to experience a relatively high rate of IPV victimization, and some reported experiencing more severe and frequent IPV victimization since the pandemic. IPV victimization was associated with multilevel factors such as younger age, substance use, mental illness, economic and structural vulnerabilities. None of the studies had examined the impact of the pandemic on help-seeking. There is a need to explore the long-term effects of the ongoing pandemic on IPV victimization among this vulnerable population. Developing safe intervention strategies and ensuring confidential access to health and supportive services are particularly urged.

Culturally Aligned Aged-Care Services: Addressing Needs and Barriers in General Santos City, Philippines

The aging population in General Santos City, Philippines, presents unique challenges in accessing and delivering appropriate aged-care services. This study aimed to identify the preferred aged-care services among the elderly population in General Santos City, considering their cultural values and needs, and to propose a framework for developing culturally aligned aged-care support services for the elderly in General Santos City. A mixed-methods research design was employed, combining qualitative and quantitative approaches. In-depth interviews with 30 elderly residents, community leaders, and caregivers were conducted to gather information on their preferences and needs for aged-care services. Thematic analysis was used to analyze the qualitative data. A survey questionnaire was also used to collect quantitative data on the demographic characteristics of the respondents and their perceptions of the importance of various aged-care services. The findings indicated healthcare services, home-based care, and social support as essential components of aged-care services. Barriers to accessing services included availability, affordability, accessibility, and awareness. Culturally sensitive, family-centered, and community-based care was preferred. The study also found that the elderly in General Santos City have a strong preference for culturally aligned aged-care services that are family-centered and community-based. They also expressed a need for affordable and accessible healthcare services, as well as social support services to reduce isolation and promote mental well-being. In conclusion, the study highlights the need for a holistic aged-care approach that integrates healthcare services, home-based care, and social support, while considering cultural values and addressing barriers to access. The proposed aged-care services emphasize culturally sensitive, family-centered, and community-based models of care. These models should be tailored to the specific needs of the elderly population in General Santos City, taking into account their cultural values and beliefs.