Use Of Welfare Services Research Articles

Developmental trajectories of challenging behaviors reported retrospectively by Japanese parents of adult children with intellectual disabilities

Introduction: Individuals with intellectual disabilities (ID) are at heightened risk of behavioral problems. Methods: This study investigated differences in the severity of challenging behaviors (CBs) among individuals with IDs at varying life stages. Data were collected from parents’ retrospective interviews. Surveys were completed by 47 parents whose child with IDs was 19 years or older and had made use of welfare services for individuals who exhibit CBs. Results: The final study sample consisted of 28 parents. Findings showed that (a) parents gave the lowest total scores for severity of CBs for their adult children when at the pre-school stage compared to other stages (elementary school, junior high school, high school, and post-high school), (b) differences between life stages appear to depend on the type of CB, and (c) the most common CB recorded for children between 0 and 2 years old was extreme hyperactivity, followed by severe sleep disturbances. Conclusions: The results of the study show that domain ratings for stereotypic/restricted behaviors, sleep disturbance problems, feeding problems, and problems with elimination often remain stable throughout the life stages. Moreover, parents frequently reported that CBs often occurred in children aged 0–2 years.

Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden

BackgroundUnderstanding the mechanisms of implementation of public health interventions in community settings is a key aspect of programme assessments. To determine core components and establish a programme theory are important tools to improve functioning and support dissemination of programme models to new locations. An extended early childhood home visiting intervention has been developed on-site in a socioeconomically disadvantaged area of Sweden since 2013 with the aim of reducing persisting health inequities in the population. This study aimed at investigating the core programme components and how the intervention was perceived to contribute towards health equity from early childhood.MethodsQualitative framework method was applied in a document analysis and subsequent semi-structured interviews with 15 key actors involved in the programme.ResultsThe intervention was found to be constituted of five core components centred around the situation-based, parental strengthening work method delivered by a qualified team of child health care nurse and social worker. The programme theory foresaw positive effects on child and parental health, responsive parenting practices, families’ use of welfare services according to need and increased integration and participation in society. The principles of Proportionate Universalism were recognised in the programme theory and the intervention was perceived as an important contribution to creating conditions for improved health equity for the families. Still, barriers to health equity were identified on the structural level which limit the potential impact of the programme.ConclusionsThe core components of the Extended home visiting programme in Rinkeby correspond well to those of similar evidence-based home visiting interventions. Combining focus on early childhood development and responsive parenting with promoting access to the universal welfare services and integration into society are considered important steppingstones towards health equity. However, a favourable macro-political environment is required in the endeavour to balance the structural determinants’ influence on health inequities. Improved availability and accessibility to welfare services that respond to the needs of the families regarding housing, education and employment are priorities.Trial registrationThe study was retrospectively registered on 11/08/2016 in the ISRCTN registry (ISRCTN11832097).

918Building the evidence base for australia’s veteran population

Abstract Background There is a wealth of existing research on Australia’s veteran population. However, much of the existing research seeks to answer questions on specific issues, veterans of specific conflicts, or of veterans who use the Department of Veterans’ Affairs services, with little to no information beyond these specific populations. Methods Several large administrative datasets including the Pharmaceutical Benefits Schedule (PBS), Causes of Death and Specialist Homelessness Services were linked with Defence information to enable analysis of veterans’ information against a range of topics, such as cause of death, health service and homelessness service use. Comparisons were made between the Australian Population as a whole and the veteran population. Results Results show some similarities and some differences between the veteran population and the whole Australian population. Results are disaggregated between those who are currently serving, in the reserves and ex-serving as well as by service type and other variables. Conclusions These results have helped to improve what is known about the broader veteran community. They provide important context for policy makers to understand how best to service the veteran community that was previously unknown, and help identify areas for more detailed research and exploration. Key messages Data linkage provides an important opportunity to understand the specific health and welfare needs of veterans who are otherwise difficult to identify in large administrative datasets. Comparison of veterans’ health and welfare service use with the broader Australian population provides important information for policy makers.

The impact of long-term workers' compensation benefit cessation on welfare and health service use: protocol for a longitudinal controlled data linkage study.

BackgroundIn 2012, the Australian state of New South Wales passed legislation that reformed its workers’ compensation system. Section 39 introduced a five-year limit on income replacement, with the first affected group having their benefits cease in December 2017. There is limited evidence on how this will affect their healthcare service use and where they will go for financial support.MethodsMultiple data sources will be linked: administrate workers’ compensation claims data from the State Insurance Regulatory Authority (SIRA), universal health insurance data from the Medical Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), state hospital and emergency department data, and social welfare data from the Department of Social Services’ Data Over Multiple Individual Occurrences (DOMINO). An estimated 4,125 injured workers had their benefits cease due to Section 39. These will form the exposure group who will be compared to 1) a similar group of workers’ compensation claimants who have had at least two years of compensated time off work but whose benefits did not cease due to Section 39; and 2) a community comparison group drawn from state hospital and emergency department records.An accredited third party will link the data, which will be accessible only via secure virtual machine. Initial analyses will compare the prevalence and incidence of service use across groups in both the year before and year after benefit cessation; the community control will be assigned the median benefit cessation date in lieu of an actual date. To estimate the impact of benefit cessation due to Section 39, we will conduct time series analysis of the prevalence and incidence of service use.DiscussionThis study will provide much-needed evidence on the consequences of long-term benefit cessation, particularly on subsequent healthcare and welfare service use.

Applying Big Data Analysis to Discuss the Elderly Social Welfare Service Use Condition and the Relevant Factors

The advance of medical technology and the change in living environment gradually prolong the life expectancy of humans to constantly increase the elderly population in the world. Relevant demands and problems derived from aging are therefore getting emphasized. To cope with the elderly needs, the government sequentially promotes welfare service. Nevertheless, it is still discovered that the welfare service use rate of the elderly is rather low, not achieving the estimated demand. Aiming at the elderly in Guilin, the data in this study are collected and analyzed from social welfare related open information platforms and the analyses and research, publications, or database of government agencies. The relevant data are integrated, analyzed, discussed, and applied to understand the effects of indicators and further activate the utilization of data. The research results show remarkable correlations between redisposing factors and service use condition, enabling factors and service use condition, and demand factors and service use condition. According to the results, suggestions are proposed, expecting to comprehensively understand the elderly social welfare service use conditions and identify the factors in the elderly service use so as to examine the match of the elderly welfare service with the elderly needs to develop the maximal function of social welfare service.

접근성이 비도시지역 장애인의 복지관 이용에 미치는 영향

접근성이 비도시지역 장애인의 복지관 이용에 미치는 영향

The Effect of Health Conditions, Welfare Service Use, and Family and Social Support among the Korean Disabled on Their Life Qualities

The Effect of Health Conditions, Welfare Service Use, and Family and Social Support among the Korean Disabled on Their Life Qualities

Factors Which affect the use Intention of the Social Welfare Service of the Disabled: Focused on the Disabled of Chungcheongbuk-do Province

Objectives: This study was conducted for the disabled to activate the use of the disabled welfare facilities of the disabled and ultimately encourage them to use the disabled welfare facilities positively by examining the factors which affect the use intention of the social welfare service in using it. Methods/Statistical Analysis: As a survey study of correlation, this study was conducted from June 1, 2014 to Oct 30, 2014, and the subjects were 74 disabled people who lived in C city. The collected data was processed by real number, percentage, average and standard deviation, t-test and ANOVA, and post-hoc with scheffe's test, Pearson Correlation, and regression analysis using SPSS Program 20.0. Findings: This study result, Trouble in using transportation had the most influence on the use intention of the social welfare service, where explanatory power was 95%. Improvements/Applications: It is considered that to improve the use intention of the social welfare service of the disabled, it is considered that by grasping the perception level of health state, health counseling must be done customized for the individual, and that by expanding the experience of the social welfare service use of the disabled through provision of information on it, it is possible to expand the use intention.

일반 독거노인과 저소득 독거노인간의 주관적 건강에 미치는 영향요인 차이: 서울시 일개 지역을 중심으로

Objectives: As the size of elderly population living alone grows, socioeconomic diversity has also increased. This study examined if social risk factors of poor self-rated health were distinguishable between the low income elderly and their non-low income counterparts both living alone. Methods: The '2006 Elderly Health Interview Survey' conducted by D-gu in Seoul was utilized. We divided the elderly living alone into two groups depending on their economic status: low income and non-low income. Employing logistic regression, we analyzed the associations of poor self-rated health with socio-demographic factors, health-related factors, social support, the relations with children, social activities, welfare service use, and the perception of neighborhood safety. Results: Proportion of rating one's own health being poor was different between two populations. Social support was important for the self-rated health of the non-low income elderly, while welfare service use, the perception of neighborhood safety, and the relations with children were noticeable for the low income elderly. Conclusions: To better understand the health need of elderly population living alone, their heterogeneity in socioeconomic characteristics should be taken into account.

WITHDRAWN: Home-based support for disadvantaged adult mothers.

Babies born to socio-economically disadvantaged mothers are at higher risk of a range of problems in infancy. Home visiting programs are thought to improve outcomes, both for mothers and children, largely through advice and support. To assess the effectiveness of home visiting programmes for women who have recently given birth and who are socially or economically disadvantaged. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 3, 2006); MEDLINE (1966 to March 2006); EMBASE (1980 to 2006 week 12); CINAHL (1982 to March week 4 2006); PsycINFO (1872 to March week 4 2006); ASSIA (1987 to March 2006); LILACS (1982 to March 2006); and Sociological Abstracts(1963 to March 2006). We searched grey literature using ZETOC (1993 to March 2006); Dissertation Abstracts International (late 1960s to 2006); and SIGLE (1980 to March 2006). We also undertook communication with published authors about ongoing or unpublished research. Included studies were randomised controlled trials investigating the efficacy of home visiting directed at disadvantaged adult mothers. Two reviewers (EC and JP or CB) independently assessed titles and abstracts identified in the search for eligibility. Data were extracted and entered into RevMan (EC, JP and CB), synthesised and presented in both written and graphical form (forest plots). Outcomes included in this review were established at the protocol stage by an international steering group. The review does not report on all outcomes reported in included studies. We included 11 studies with 4751 participants in this review. Data show no statistically significant differences for those receiving home visiting, either for maternal outcomes (maternal depression, anxiety, the stress associated with parenting, parenting skills, child abuse risk or potential or breastfeeding) or child outcomes (preventive health care visits, psychosocial health, language development, behaviour problems or accidental injuries. Evidence about uptake of immunisations is mixed, and the data on child maltreatment difficult to interpret. This review suggests that for disadvantaged adult women and their children, there is currently no evidence to support the adoption of home visiting as a means of improving maternal psychosocial health, parenting or outcomes for children. For reasons discussed in the review, this does not amount to a conclusion that home visiting programmes are ineffective, but indicates a need to think carefully about the problems that home visiting might influence, and improvements in the conduct of outcome studies in this area.

Making informed choices in social care: the importance of accessible information

The current policy trend is to encourage greater choice in the use of welfare services. To make informed choices, people need information. The process of finding and using information has costs for individuals in terms of effort, time and material resources. These costs are different for different people and impact on their use of information in different ways. Thus, the accessibility of information is important in ensuring those people who need to make choices can do so in an informed way. This paper discusses the importance of information in making informed choices about social support by drawing on the findings of a scoping review of government research and development activity on the accessibility of information about adult social care services. The scoping review was carried out in spring 2006. Details of recent, current and planned projects were obtained through discussions with staff in government departments, government agencies and other related organisations identified using a snowballing technique. Forty-two contacts were made. Eleven research and 36 development projects were identified that aimed to investigate or improve the accessibility of information about social care services. A limited literature search was undertaken on information needs in areas not already under investigation by government. Eighteen articles were identified. Information and helpline staff from six voluntary organisations gave their views on the accessibility of information about social care services. Our findings show that there is no government-related or other recent research evidence on the specific information access needs for some user groups and services, for example, people from ethnic minority groups. For other user groups, such as people with chaotic lifestyles, there is evidence on information needs but no current or planned development projects to address these needs. The implications for the costs of finding and processing information to aid informed choices are discussed.

Rereporting of child maltreatment: Does participation in other public sector services moderate the likelihood of a second maltreatment report?

Objective This study uses administrative data to track the first rereports of maltreatment in a low-income, urban child welfare population ( n = 4957) while controlling for other public service involvement. Service system involvement is explored across the following sectors: Child Welfare, Income Maintenance, Special Education, Juvenile Court, and various forms of Medicaid-reimbursed medical or mental health care. This study builds knowledge by adding the services dimension to an ecological framework for analyses and by following recurrence for a longer period of time than prior investigations (7.5 years). Method We model the rereporting of a child for maltreatment as a function of child, caregiver, service, and neighborhood characteristics using data from birth records, child welfare, income maintenance, Medicaid, adult corrections, juvenile court, special education, law enforcement, and census sources. Bivariate and multivariate analyses are presented, the latter using Cox regression with a robust sandwich covariance matrix estimate to account for the intracluster dependence within tracts. Results Key results across bivariate and multivariate analyses included a lower rate of rereporting among children with parents who were high school graduates and/or permanently exited from the first spell on AFDC ( p < .0001); and for children in families that received less intensive in-home services compared to those not receiving services, receiving intensive in-home, or foster care services ( p < .0001). Higher rates of rereporting were found for children with Medicaid mental health/substance abuse treatment records ( p < .0001) and special education eligibility for emotional disturbance ( p < .005). Conclusions Caretaker characteristics and nonchild welfare service use patterns had a strong association with the likelihood of a child being rereported to the child welfare agency and should be more heavily attended to by child welfare workers. High rates of service sector overlap suggest that interagency ties and cooperation should be strengthened. The lower risk associated with less intensive in-home services compared to unserved cases may indicate underidentification of in-home service eligibility following a first report of maltreatment.

Are church and state substitutes? Evidence from the 1996 welfare reform

Churches provide community services similar to those provided by the government, but there has been no convincing analysis of the extent to which church activity can substitute for government activity. To address this important issue, this paper uses a new panel data set of Presbyterian Church (USA) congregations to regress both church-member donations and a church's community spending on a number of variables, including government welfare expenditures. A provision of the 1996 welfare law that decreased the availability and use of welfare services by non-citizens serves as an instrument to identify the causal effect of government spending on church activity. The results show that church activities substitute for government activities. Extrapolating the findings to all denominations, the estimated “crowd-out” effect lies between 20 and 38 cents on the dollar. The results are subjected to a number of robustness tests.

Intimate Partner Violence and Use of Welfare Services Among California Women

Intimate Partner Violence and Use of Welfare Services Among California Women

A Prospective Analysis of the Relationship Between Reported Child Maltreatment and Special Education Eligibility Among Poor Children

This study presents data from the first large-scale longitudinal study to track the involvement of children reported for maltreatment in both the special education and child welfare systems. A range of state and local administrative databases were combined and cross-sector service histories were established for 7,940 children who had received Aid to Families With Dependent Children between 1993 and 1994. The authors address the following questions: (a) Is maltreatment associated with entry into special education after controlling for other factors? (b) among maltreated children, does maltreatment type or child welfare service use predict special education eligibility? and (c) what is the relationship between maltreatment type and type of educational disability? Results indicate that child maltreatment system involvement generally predates special education entry and is predictive of entry even after controlling for other factors. A range of other associations between factors such as child and maternal characteristics, services received, maltreatment type, and special education classification are detailed.

Making sense of symptom checklists: a latent class approach to the first 9 years of the British Household Panel Survey.

In health inequalities research there is a growing impetus to examine the development of inequalities in health over time. However, many of the sources of longitudinal data in Britain are not designed specifically for health research. Typically, health status is assessed by self-reported problems and the use of symptom checklists. The British Household Panel Survey (BHPS) is an annual survey of approximately 5500 private households containing 9000 men and women, which began in 1991. Each year, the BHPS contains a checklist of 13 health problems and symptoms. The findings presented here are based on adult participants aged 16 years and over in 1991. Using eight waves of data from the BHPS, we use latent class analysis (LCA) to model latent health status from a set of observed binary variables. Individuals are assigned to a latent health class on the basis of LCA estimated probabilities of class membership given their response patterns and the estimated unconditional class frequencies. The predictive value of latent health class membership is assessed for self-reported health status and functioning, health and welfare service use, and mortality 1 year later. The LCA supported a suitable four-class model of health status representing good health, psychosomatic health problems, physical health problems and comorbid health problems. Members of the good latent health class were predicted to have better self-reported health and functioning, less health and welfare service use, and lower risk of mortality 1 year later than members of the three problem health classes. Those with comorbid health problems were predicted to have particularly poor outcomes. A latent class approach to modelling self-reported health problems and symptoms has allowed for both quantitative and qualitative dimensions of health status to be captured. This may motivate better informed models of health by users of general population surveys.

Percentage of elderly and the use of welfare services at city welfare offices in Japan

Japan's population is aging rapidly. As in other developed countries, the establishment of a system of care for the elderly, especially for those suffering from dementia, has become an urgent issue. As the role of welfare offices, which is to directly serve the people, has become increasingly important, the need to assess their use in terms of demographic factors has risen. With respect to demographic factors, this study analyses the use of the welfare services by the demented elderly at city welfare offices in Japan from 1987 to 1989.In December 1991, questionnaires were mailed to 670 city welfare offices nationwide, excluding those located in designated large cities and special wards in Tokyo. Four-hundred and thirty-seven (65.2%) of the offices responded.Offices located in areas with a relatively high percentage of elderly reported giving fewer counselling sessions and reported fewer people registered for or utilizing domiciliary welfare services than offices in areas with a relatively low percentage of elderly. The differences between the two areas in the total amount of counselling, counselling cases at the welfare office, and respite-care for 1989 and day-care service registration were significant. The Pearson's correlation coefficients for the percentage of elderly and these activities all showed negative values, except for home-help utilization in 1987 and 1989.Welfare offices in which the number of activities increased significantly over the 3 years examined in this study were more common in the areas where a committee for communication between medical and welfare sectors (hereinafter “liaison-committee”) existed. Discriminant analysis suggests a correlation between the existence of a liaison-committee and the following variables: the percentage of the elderly living alone, the number of home-helpers per elderly, the capacity of day-care service per elderly and the number of surgeries per elderly.From the results, it is apparent that the welfare offices in areas with a high elderly percentage tended to have less activity. Today, municipalities with a high percentage of elderly in its population are particularly required to draw up plans for their health and welfare. The establishment of a network like a liaison-committee will enable the municipalities to achieve their goals.

The effect of immigrants on natives' incomes through the use of capital

This paper deals with questions about the effects of immigrants on three types of capital: the private capital immigrants work with, the public (government) capital that immigrant workers use, and the public capital used for services by immigrants. Private capital dilution is unimportant. The overall effect is an addition to the incomes of natives of a sum equal to perhaps 1% or 2% of the incomes of the immigrants for some number of years, small enough to ignore in this context. In the government sector, workers can be assumed to obtain all the returns to capital, and about 8% of immigrants work in this sector. Therefore, for productive capital taken altogether, we estimate that immigrants capture the returns from only 8% of the capital they work with, the government capital; the result is a loss of perhaps 2% of an immigrant family's income for one year, which is considerably smaller (being for only one year) than the above-mentioned gain to natives through the private capital that immigrants work with. The cost to natives of equipping an immigrant family with ‘demographic capital’ — schools, hospitals, and local roads — turns out to be much more important. This quantity depends upon the cost of such equipment, the proportion financed by bonds, the average length of life of the capital, and the average life of the bonds. We develop an estimating equation, and calculate that the cost to natives in 1975 dollars is $4172, about a fifth of a year's income for an average family. This is not insignificant in magnitude. But this amount — together with the effect through productive capital dilution discussed in the first part of the paper — is considerably smaller than the benefits of immigrants to natives through their relatively low use of welfare services and their relatively high contribution of taxes.