Vulnerable Families Research Articles

Review of Studies Regarding Assessment of Families Where Children Are at Risk of Harm Due to Parental Substance Misuse

Questions arise about links between the use of substances and violence, especially when parents misuse substances and there is potential to expose children to family violence. Background. The review has four aims: identify research into the harmful impacts of parental substance use on children; identify policies in Australia about the risks from parental substance misuse; identify interventions to manage unsafe parental substance use; and review practices involving confidentiality and collaboration when a parent has multiple complex needs. Method. The paper provides a rapid review of the literature, linking parental substance misuse, family violence, and parenting capacity and covering both policies and empirical evidence. Results. The main finding is that parental substance misuse does affect parenting capacity and is associated with family violence. The concept of the cumulative risk of harm to vulnerable children is supported by research but is not yet implemented in policy. Reports indicate that some parents who misuse substances have multiple complex needs including comorbid mental health issues, domestic violence, and difficulty in managing their children’s behavior. Early intervention therapies designed to address this cluster of issues are reviewed. Conclusion. There is a need to establish objective assessment instruments that are relevant to the cohort of parents who misuse substances and engage in family violence and to improve policy to ensure vulnerable children and families in which parents misuse substances are referred to appropriate therapies.

Role of the children's nurse in identifying and responding to medical neglect.

Children's nurses aim to keep children and young people safe and ensure that they are offered high-quality, accessible services and support when needed. However, it is estimated that one in ten children in the UK will experience neglect at some point during their childhood. With reference to the literature, this article critically analyses the complex barriers to effective safeguarding practice that contribute to medical neglect. These include suboptimal communication, not keeping the child at the focus of care, not being professionally curious and not attempting to understand the child's lived experience. The article explains the statutory guidance on safeguarding and the importance of using appropriate tools and safeguarding supervision in supporting nurses to work with vulnerable families. Nurses can improve the lives of children and young people in their care by adopting creative, holistic approaches to concerns raised, while not jeopardising the therapeutic relationship and losing open, honest access and communication between the family and nurse. The author explores the idea that a shift from attempting to control the child and family, and instead working collaboratively with them, can help reduce the incidence of medical neglect.

Social Policy Discourse as a Frame of a New Repertoire of Gender Contracts for Wives of the Mobilized

The article studies a model of social policy aimed at supporting families of the mobilized in Russia as a tool for promoting a preferred gender contract. Families of the mobilized, having no experience of interacting with the institute of the army in conditions of military conflict, are forced to adapt to the requirements of the state in a short time. The context of the study: family policy is becoming a priority in the Russian Federation not only as support for socially vulnerable families of SVO participants, but also as an ideological tool for forming a new balance of power and gender relations in Russian families affected by militarization. The study uses critical discourse analysis that allows us to research the discourse of social support measures in the official statements of lawmakers, evaluating these measures from the perspective of the wives in thematic online chats mobilized as collective discourses. As a result of the analysis, family policy in relation to families of the mobilized is characterized as traditional and paternalistic, it is shown that there remains a gap between the normative concepts of state aid and the measures being implemented. The wives of those mobilized note their satisfaction with the monetary level of support as well as the difficulty of obtaining indirect benefits, and the system's inability to provide personalized assistance. The repertoire of women's gender contracts is differentiated on an interactive level, the importance of market participation for Russian women is consolidated, and the role of the state in a woman's willingness to serve the army institute is small.

DETERMINING PRIORITY METHODS FOR COMBATING SOCIAL INEQUALITY IN SCHOOLS: CREATING A SAFE ENVIRONMENT FOR SCHOOLCHILDREN

It should be noted that the problem of social inequality in schools is becoming particularly relevant today since education is considered a key component of the formation of human capital. In our opinion, ensuring a safe environment in school cannot be effective without taking into account various manifestations of discrimination and bullying, as well as without proper psychological support for students from socially vulnerable categories. As part of this study, we identified six potential methods for combating social inequality (in particular, in-depth programs for the development of empathy and tolerance, the introduction of an "equality code", strengthening psychological services, and others). The results were obtained with the involvement of 40 experts (school principals, experienced teachers, psychologists, social workers and safety specialists) who participated in a two-stage survey using the Delphi method. The second stage of the analysis used the Analytical Hierarchy Process (AHP) method, which allowed for pairwise comparisons of criteria (effectiveness in reducing bullying and discrimination, impact on psycho-emotional state, economic feasibility, institutional support) and alternatives. It should be emphasized that the obtained quantitative data make it possible to assess the relative priority of each method taking into account the agreed expert assessments. The highest integral weights were given to measures to expand psychological support for students, the "equality code" and financial assistance for vulnerable families, which indicates the need to combine both psycho-emotional and material-institutional instruments. It can be argued that such results have significant applied potential since a comprehensive approach to combating social inequality can be integrated into school curricula, regulatory documents and educational development strategies at the state and local levels. In our opinion, further research should focus on developing step-by-step methodological recommendations and monitoring the implementation of the described tools in different types of schools.

Assuring Primary Healthcare Services to Vulnerable Children in a Disadvantaged Suburb of Rome Metropolitan City During the Pandemic: Responses to the Crisis

Background/Objective: This retrospective observational study describes the social, health, and psychological conditions of children living in a disadvantaged and degraded suburb of Rome Metropolitan City during the COVID-19 pandemic as registered by the primary healthcare service of the Solidarity Medicine Institute, with the aim of fighting social exclusion and health disparities during lockdown and offering free health care to vulnerable families. Methods: The access to pediatric interventions was assessed from April 2020 to December 2022. For each child, biometric parameters were recorded, and the physical and psychological states of health were assessed. Furthermore, data regarding family socio-economic variables were collected. Results: From April 2020 to December 2022, 638 children, aged 0 to 18 years, had access to the healthcare system, which was provided by the Solidarity Medicine Institute, with a total of 2300 pediatric visits. Moreover, food supplements, drugs, and hygiene kits that were necessary for the containment of the COVID-19 infection were freely distributed at the center. The highest proportion of children included in this study were from African and Eastern European families (46% and 35.8%, respectively), and 41% of these children did not have a pediatrician from the public health service. Children aged 0 to 5 years comprised 50.81% of the entire population of this study. Nutritional status assessment indicated that among the 117 infants aged 0–12 months, 5.7% were below the 3rd weight percentile, while 28.9% exceeded the 85th weight percentile. BMI assessment for children aged 2 years and older (i.e., 521 children) indicated that 21.7% of these children were overweight, and 9.5% were obese. Sixty-nine cases of psychiatric disorders were also detected among these children, with a high frequency of cases of Specific Language Disorder (31.8%), Attention Deficit Hyperactivity Disorder (21.7%), and Specific Learning Disorder (14.5%). Psychiatric and rehabilitative interventions were also offered. Conclusions: The Solidarity Medicine Institute responded to the request of the municipality of Rome to remain open and offer social and health assistance to the most vulnerable people during the pandemic. The Solidarity Medicine Institute has efficaciously served a fragile pediatric population, intercepting social, health, and psychological needs and overcoming social exclusion, health disparity, and the fragmentation of welfare services exacerbated by the COVID-19 pandemic.

Unmet needs and barriers to navigating care services in the low- and middle-income families with young children in Singapore: a qualitative study

IntroductionChildren’s health and health behaviours primarily depend on their parental socioeconomic status backgrounds. There is limited research seeking to understand in depth the health needs and challenges of low- to middle-income families in Singapore. Understanding this can help the healthcare professional identify vulnerable families at an early stage, allowing for targeted interventions and preventive measures to address socioeconomic comorbidities and their consequences during childhood.ObjectivesTo explore the health needs of the low- and middle-income families with children aged 2 months to 6 years in Singapore, and their facilitators and barriers to engagement in existing health, social and education services.MethodsAn interpretive qualitative approach was adopted in this study. We conducted 34 semi-structured one-to-one interviews with purposively sampled low- and middle-income families with children aged 2 months to 6 years. In addition, four focus group discussions comprising 19 service providers were conducted to complement the findings. All interviews were transcribed verbatim. Thematic analysis was conducted to identify key themes and subthemes.ResultsThe bottom two tiers of Maslow's Hierarchy of Needs (physical, safety and security needs) constituted the larger proportion of unmet needs expressed by families. Physical needs encompassed food, exercise, sleep, screen time as well as needs related to smoking and alcohol consumption, while safety and security needs included social security needs, educational needs and physical health. Themes identified as enablers of service engagement included accessibility and convenience, financial and policy support, health awareness and engagement, trust and relationship-based engagement, interagency and technological support, and holistic family and workforce support. Conversely, themes identified as barriers to service engagement consisted of access and utilisation barriers, financial and policy inequities, challenges in information management and service coordination, and service delivery and support gaps.ConclusionsOur analysis assembled an objective picture of challenges and strengths in relation to the health status of caregivers and their children from low- and middle-income families. Good interpersonal relationships with families, improved health literacy, readily available competent healthcare professionals, better access to social services and financial assistance, and enhanced health information technology help overcome challenges faced by low- to middle-income households.

IMPACTO DA ALIMENTAÇÃO COLETIVA NA SAÚDE PÚBLICA: AVALIAÇÃO DOS EFEITOS DAS PRÁTICAS ALIMENTARES EM COMUNIDADES E COLETIVIDADES

Food insecurity has robust consequences, negatively affecting people's physical, mental and emotional health, resulting in nutritional deficiencies and predisposing them to chronic diseases such as diabetes and hypertension, as well as increasing the risk of mental health problems such as anxiety and depression. In this context, food banks have proven to be a positive social response, acting as intermediaries in the distribution of surplus food and providing a vital safety net for vulnerable individuals and families. In addition to alleviating economic pressure on beneficiaries, allowing them to allocate their financial resources to other basic needs, such as health and education, these institutions promote public health by ensuring the availability of nutritious food and contribute to reducing social disparities, promoting human dignity and equal access to basic resources. The objective was, therefore, to identify the main comorbidities associated with poor diet among food bank users, to describe the impact of comorbidities on the frequency and type of assistance received at the banks. Methodologically, an exploratory and comparative bibliographic review was carried out using qualitative research. It was concluded that the challenges faced by individuals with comorbidities when accessing food banks are complex, highlighting the urgent need for more integrated approaches sensitive to specific health needs. Through a collaborative approach between food bank managers, policy makers and healthcare professionals, it is pertinent to mitigate the negative impacts of comorbidities on food security, thus promoting greater equity in access to nutritious and suitable food for all individuals, regardless of the health conditions they face.

Transcending the Traditional Fieldwork Placement in Child and Youth Care through a Rural Community in Ndwedwe

Community engagement has been identified as a powerful pedagogical tool, despite its gradual integration into the core functions of teaching and research within the higher education landscape in South Africa. The initiation of university–community partnerships can strengthen the well-being of vulnerable individuals and families in marginalised communities, which resonates with child and youth care education. Using qualitative research methodology, this article seeks to explore how twelve students experienced being placed in a rural context for their fieldwork practicum placement. This was found to differ from traditional child and youth care settings (such as child and youth care centres), as they received mentorship and supervision from community-based child and youth care workers and the nature of their engagement activities were identified and supported based on community needs and the support of community members. Using thematic analysis, the data reflected that there were rich opportunities to learn within community spaces and to develop interventions within grandmother-headed households, strengthening the activities within the community safe park while simultaneously learning alongside rural child and youth care workers.

GUIDANCE STRATEGIES FOR VULNERABLE FAMILIES IN THE INCLUSION OF 3 TO 5-YEAR-OLD CHILDREN IN PRESCHOOL EDUCATION IN THE ZANGO DISTRICT

Family guidance in educational contexts is a set of training and intervention actions with the family on specific topics and realities, in the best interest of the children and the proper functioning of the family system as the foundational unit of social life. Thus, the purpose of this article is to propose a system of activities to guide vulnerable families of children aged three to five years old in Preschool Education in one of the neighborhoods of the Zango District, through participatory techniques that enable their integration into the educational context. In this regard, the study relied on a qualitative methodology, configured as a case study based on bibliographic and documentary review, which supported the observation and interview. Consequently, it was found that the study enabled family involvement in the education of their children; behavior modeling and control; motivation; and activities integrated into family routines. Therefore, it was possible to positively impact the families’ awareness of the importance of preschool education for their children.

Facilitators and barriers of accessing community health services for children in the early years: An Australian qualitative study.

Facilitators and barriers of accessing community health services for children in the early years: An Australian qualitative study.

Competing demands on adult children: How do they shape their provision of informal care?

Population ageing is increasing the demand for informal care, heightening the importance of adult children as potential carers to their older parents. Adult children, however, may be subject to competing demands for informal care provision when individual characteristics, such as gender and employment status, combine with household level characteristics, such as the presence of young children or vulnerable family members. Previous research often considers these competing demands as separate factors which can influence the provision of informal care, rather than in combination. Therefore, this study exploits data from Wave 13 (2021-2023) of the UK Household Longitudinal Study and applies multicategorical multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to assess the additive and interactive role of competing demands in influencing the provision of informal care. The results indicate that the provision of informal care is driven by the additive influence of the competing demands. Moreover, they also reveal the layering of certain social characteristics, which cumulate, rather than intersect, to create a social profile with a notably higher predicted probability of providing informal care.

Reducing Stunting Through Mapping Convergence Interventions in Padang Pariaman Regency

This research aims to reveal how to reduce stunting through mapping convergence interventions in Padang Pariaman Regency. This research used Mix Methods with a sequential explanatory design. Research targets focuses on families who give birth too young, too many, too close in spacing and too old. Families having no toilets for defecation and with inadequate water sources are as one of the target as well. The result shows; 1) Stunting are suffered from families with too many births, too close in spacing, and too young, 2) BKKBN conducted to outreach the families who give birth too old about the risks of giving birth, 3) BKKBN provided additional nutritional intake for pregnant women and children aged 6- 23 months, 4) BKKBN provided an assistance to poor and vulnerable families, 5) BKKBN campaigned to stop defecating in open area 6) a percentage of households that have access to adequate sanitation and adequate drinking water. Meanwhile, the types of treatment provided are 1) outreach to young women in consuming blood supplement tablets, 2) outreaching to mothers by socialization the importance of immunization and carrying out routine immunizations for children under five years, 3) Meal assistance for families who need it most 4) Ministry of Public Works prioritizes the vulnerable families to get adequate access drinking water and sanitation.

IMPACT OF COVID-19 INFECTION AND RELATED SOCIAL CONCERNS ON DEPRESSIVE SYMPTOMS: MEDIATING EFFECTS OF DAILY LIFE RESTRICTION

Abstract Background As the COVID-19 outbreak persisted, the accompanying increase in depression had emerged as a significant issues. Aims & Objectives This study examined the mediating effect of daily life restriction after COVID-19 pandemic on depressive symptoms, considering COVID-19 infection or social concerns about COVID-19 infection. Additionally, comparisons of path coefficients between groups were conducted based on gender and age. Method Data derived from the 2020 Korean Community Health Survey (KCHS) consisted of 229,269 individuals aged 19 to 110. This study used self-reported questionnaire including Patient Health Questionnaire-9 (PHQ-9), three items addressing social concerns related to COVID-19 infection (concerns about blame from the surroundings, economic impact, and infection of vulnerable family members), a self-questionnaire to confirm whether individuals had experienced quarantine or hospitalization due to COVID-19 infection within last 3 months, and scores of daily life restriction due to the COVID-19 pandemic. Structural equation model analysis was conducted to identify whether daily life restriction serves as a mediating factor in the association between COVID-19 infection and related social concerns and depressive symptoms. In addition, chi-square tests for comparing path coefficients based on age (below 65 years old, 65 and older) and gender were conducted. Results Structural equation models revealed significant direct effects of COVID-19 infection and related social concerns on depressive symptoms (COVID-19 infection to PHQ-9: β = 0.011, p <0.01; social concerns about COVID-19 infection to PHQ-9: β = 0.049, p <0.01), along with indirect effects through daily life restrictions after the COVID-19 pandemic on PHQ-9 symptoms (COVID-19 infection to PHQ-9: β = 0.014, p <0.01; social concerns about COVID-19 infection to PHQ-9: β = 0.001, p <0.01). When comparing path coefficients between subgroups based on age and gender, path coefficients associated with depression were higher in the groups under 65 years of age and females. Discussion & Conclusions Considering the impact of daily life restrictions on depression related to COVID-19 infection and related social concerns is essential, and more attention is needed for women and individuals under age of 65.

Impacto de los programas de transferencias monetarias sobre la pobreza multidimensional en Colombia, 2013-2020

Cash transfer programs have been implemented as a strategy to reduce poverty and improve the well-being of the most vulnerable families. This paper uses the Quality of Life Survey and the Propensity Score Matching technique to analyze the impact of the Colombia Mayor and Familias en Acción programs on the Multidimensional Poverty Index (MPI) in Colombia. The results show that participating in these programs significantly impacts the reduction of the MPI. However, the analysis also reveals deficiencies in the complementarity between the beneficiaries of the programs and the people identified as poor, which indicates errors of inclusion and exclusion of a part of the most vulnerable population in the cash transfer programs. This demonstrates the need to improve the targeting mechanism to effectively reduce multidimensional poverty.

Outreach by Municipal Public Health Nurses to Vulnerable Pregnant Women During the COVID-19 Pandemic: A Qualitative Study.

The coronavirus disease 2019 (COVID-19) pandemic posed substantial challenges for public health nurses (PHNs) in delivering outreach services to vulnerable pregnant women and families requiring assistance. Despite restrictive measures, the importance of maintaining face-to-face support and implementing adaptive strategies was evident. This study aimed to identify the key characteristics of outreach practices conducted by PHNs during the pandemic, the challenges they encountered, and the strategies needed to address these issues effectively. A qualitative descriptive study was conducted using semi-structured interviews with 11 PHNs from seven Japanese municipalities of varying population sizes. Data were analyzed using thematic coding, focusing on outreach characteristics, challenges, and resource requirements. The outreach practices included maintaining face-to-face home visits, fostering trust through casual interactions and written correspondence, leveraging collaborative networks, and utilizing digital tools. Major challenges involved balancing infection control with face-to-face support, overcoming the limitations of online consultations, and ensuring service accessibility for families without internet connectivity. Participants advocated for integrated digital tools, flexible communication approaches, and robust data management systems. Our findings underscore the resilience and adaptability of PHNs in supporting vulnerable families during crises. Addressing these challenges can enhance outreach practices and provide valuable insights for responding to future pandemics or similar emergencies.

A comparison of the outcomes of families with children aged less than 2 who received universal versus sustained nurse home visiting services in Korea: a cross-sectional study.

This study aimed to compare maternal outcomes and the home environment between non‑vulnerable families with children under 2 receiving universal home visiting services and vulnerable families receiving sustained home visiting services. This study was conducted in Seoul, Korea, where the country's first nurse‑led early childhood home visiting program was introduced. A total of 551 mother‑child dyads participated in cross‑sectional surveys conducted at various child ages (6±2 weeks, 6±1 months, 12±1 months, and 24±1 months). Universal home visiting services were provided within six weeks postpartum to non‑vulnerable families, while vulnerable families received sustained services consisting of 25 visits over 24 months. Maternal knowledge of sudden infant death syndrome (SIDS) and childcare, maternal distress, and the Korean Infant‑Toddler Home Observation for Measurement of Environment (K‑IT‑HOME) were assessed. Overall, the universal home visitation group demonstrated higher levels of maternal knowledge regarding SIDS and childcare compared to the sustained home visitation group (all p-values < 0.05), while the sustained home visitation group reported higher levels of maternal distress (p<0.0001). The total K‑IT‑HOME score was 1.47 points higher in the universal home visitation group than in the sustained home visitation group (p<0.0001). No significant differences were observed in the acceptance, organization, or involvement subscales of the K‑IT‑HOME (all p-values > 0.05). This study demonstrated that disparities in maternal outcomes and home environments persisted in early childhood between the sustained and universal home visitation groups.

A multi-disciplinary analysis of adult practice reviews

PurposeThe purpose of this study is to read across 20 adult practice reviews (APRs) undertaken in Wales to identify cross-cutting themes.Design/methodology/approachThe method was for each APR to be read and independently coded by four researchers from differing disciplines of criminology, law and social work.FindingsFive overarching themes were identified of (safeguarding, capacity and duty to report; commissioning and inspection; transitions; voice of vulnerable people and family and carers. In addition, quality and good practice are reflected onResearch limitations/implicationsA further study capturing more APRs since the implementation of the Social Services and Well-being Act (2014) should be undertaken to help review changes in practice since the new legislation was introduced. Future research into APRs should adopt a similar multi-disciplinary approach.Practical implicationsThe study identified the benefit of adopting a single unified assessment tool.Originality/valueThis is only the second study of its type undertaking a multi-disciplinary perspective of APRs.

“I definitely cannot afford to be feeling poorly if there’s no need to be”: a qualitative evaluation of antiviral uptake following suspected occupational exposure to avian influenza

BackgroundGrowing numbers of people have been potentially exposed to avian influenza (AI), as the United Kingdom has managed the largest and most sustained series outbreaks in recent years. Antiviral medication is recommended for exposed individuals for chemoprophylaxis to reduce the severity of illness and the likelihood of secondary transmission. However, some individuals have been hesitant or declined antivirals. In this study, we aimed to identify the factors affecting the uptake of and adherence to antiviral medication.MethodsWe interviewed 14 individuals occupationally exposed to avian influenza and conducted focus groups with 15 public health professionals involved in advising and arranging antivirals. The data were analysed thematically based on COM-B factors (capability, opportunity, motivation).ResultsAlthough participants saw avian influenza as a severe disease, most did not consider themselves susceptible to it because they felt safe in personal protective equipment and knew that bird-to-human transmission was rare. The biggest barrier to uptake and adherence was experiencing side effects, especially if these disrupted day-to-day life or work. Participants who took antivirals followed medical advice in a novel situation, had health conditions or vulnerable family members they wanted to protect. As responding to an outbreak was exhausting, easy access to antivirals for those at most risk was considered important for improving uptake.ConclusionsThe factors affecting antiviral uptake were multifaceted. Public health interventions should prioritise those at most risk and address multiple components of behaviour, such as advising how to manage side effects, addressing concerns about long-term usage and providing convenient access to antivirals for those at most risk.

Improving the well-being of families of children with Autism Spectrum Disorder (ASD) in Internally Displaced People (IDP) camps in South East and North Central Nigeria

The well-being of families of children with Autism Spectrum Disorder (ASD) in Internally Displaced People (IDP) camps in South East and North Central Nigeria is an area of increasing concern. The study utilized descriptive survey design, and the target population consisted of 80 parents and caregivers from camps in Anambra, Enugu, Imo, Benue, Kogi, and Nasarawa. A simple random sampling method was used for participant selection. Data were collected through a structured, validated questionnaire, with reliability confirmed via a Cronbach’s Alpha coefficient of 0.76. Descriptive and inferential statistics, including ANOVA, were used for data analysis. The findings highlight significant healthcare issues, such as a lack of specialists, inaccessible diagnostic services, and scarce medication. In education, challenges include the absence of tailored curricula, inadequate facilities, and exclusion from learning activities. Additionally, the study identifies key strategies to address these issues, including the provision of specialized caregiver training, the establishment of therapy centers, financial support, community awareness campaigns, and peer support groups. The study concludes that addressing these challenges requires comprehensive and coordinated efforts involving government, NGOs, and local communities to improve the overall well-being of these vulnerable families. The results provide valuable insights for policy development and program implementation in humanitarian settings, ensuring better support and inclusion for children with ASD.

Bono de Desarrollo Humano en el Bienestar Económico de los Beneficiarios de las Zonas Urbanas de Machala

This study examines the Human Development Bond and its impact on the well-being of beneficiaries in Machala, Ecuador, assessing its effectiveness in combating poverty and improving the quality of life of vulnerable families. The program, aimed at reducing social inequality and promoting economic inclusion, primarily targets female-led households. Employing a quantitative approach, the research was conducted through surveys of bond recipients, focusing on the program's operation and management.The results highlight Machala's complex socioeconomic context, characterized by high levels of poverty and economic dependence. Only 23% of respondents own their homes, reflecting the economic fragility of beneficiaries. Women constitute the majority of recipients, shedding light on both their empowerment and the structural inequalities they face. While the Human Development Bond provides temporary relief, the study reveals that it has fallen short of its goals to significantly reduce poverty and improve long-term well-being. These findings underscore the need for reforms and complementary strategies to address the structural roots of poverty and enhance the program's future impact.