Making the Connection Between Theories of Policy Change and Policy Practice: A New Conceptualization

Bryn Mawr College

Over the past few decades, powerful economic, political and cultural forces have restructured the welfare state and social work practice. In response, there have been calls in recent years for the re-politicisation of the social work profession. One of the main ways in which social work has been re-politicised is through the emphasis on social workers’ involvement in the policy arena, commonly referred to as ‘policy prac-tice’ in the literature. Although policy practice has recently received close attention in social work debates, it has remained relatively under-theorised. This article introduces social work scholars and practitioners to the theoretical work on policy change and elaborates its implications for how social workers can influence policy. Drawing on diverse literatures from the fields of political science and sociology, the article circum-scribes to four influential theories of policy change that provide support for informed action in the policy arena: neo-institutional theory, elite theory, resource mobilisation theory and interdependent power theory. Drawing on these theories, the article develops a conceptualisation of four different types of policy practice: institutional policy practice, elite policy practice, resource-based policy practice and radical policy practice.

Publication
British Journal of Social Work
Publication Year
2020

Structural and operational factors as determinant of meaningful community participation in sustainable disaster recovery programs: The case of Bangladesh

University of Washington

The debate around community participation in post-disaster sustainable recovery is largely neglected in both development discourse and literature on developing countries. However, the philosophy of build back better (BBB) in sustainable disaster recovery (SDR), with roots in the early 90s, is seeing a resurgence, as tracked by the United Nations Office of the Disaster Risk Reduction Sendai Framework of Action (2015–2030). Among the most disaster vulnerable countries globally, Bangladesh has shown remarkable progress in disaster preparedness, response policy, and planning, but the disaster recovery phase remains neglected in national policy and planning. This study aims, using quantitative analyses, to identify the factors that regulate community participation in disaster recovery in governmental and nongovernmental organization programs. This study also provides recommendations to strengthen the local and national strategies for bottom-up participation in a disaster recovery program for sustainability. Findings reveal 11 dominant factors that regulate community participation in sustainable disaster recovery programming (SDRP), and five factors that control decision making participation: disaster management system, leadership decentralization, community capacity building, community resources, and disaster experiences and vulnerability. In addition, the factors associated with the type of community participation fall variably along structural, operational, community, and participant domains. The study findings argue that to promote bottom-up participation, collaboration and integration between recovery programs are needed to improve existing policies or to adopt a new policy.

Publication
International Journal of Disaster Risk Reduction
Publication Year
2020

Why Are So Many Indigenous Peoples Dying and No One Is Paying Attention? Depressive Symptoms and “Loss of Loved Ones” as a Result and Driver of Health Disparities

Tulane University of New Orleans

Indigenous peoples have not only experienced a devastating rate of historical loss of lives, they are more likely to experience mortality disparities. The purpose of this article is to examine Indigenous women’s lived experiences of grief and loss in two Southeastern tribes and the relationship between depressive symptoms and recent loss of a loved one. Our exploratory sequential mixed-methods research was informed by the Indigenous based Framework of Historical Oppression, Resilience, and Transcendence (FHORT). We summarized key qualitative themes from ethnographic data from 287 female participants across the two tribes, collected through focus groups, family interviews, and individual interviews. We then quantitatively examined how these themes predicted depressive outcomes among 127 respondents. Specifically, we examined associations between depressive symptoms and components of historical oppression—historical loss, loss of lives, and the presence of PTSD symptoms—along with resilience and transcendence.

Publication
OMEGA-Journal of Death and Dying
Publication Year
2020

Effects of Mindfulness Meditation on Self-Transcendent States: Perceived Body Boundaries and Spatial Frames of Reference

University of Utah

Objectives: Mindfulness training is believed to encourage self-transcendent states, but little research has examined this hypothesis. This study examined the effects of mindfulness training on two phenomenological features of self-transcendence: (1) perceived body boundary dissolution and (2) allocentric spatial frame of reference. Methods: A sample of healthy, young adults (n = 45) were randomized to five sessions of mindfulness training or an active listening control condition. Results: Results indicated that mindfulness training decreased perceived body boundaries (F4,172 = 6.010, p < .001, η2 = .12) and encouraged more allocentric frames of reference (F4,168 = 2.586, p = .039, η2 = .06). The expected inverse relationship was observed between perceived body boundaries and allocentric frames of reference ((β = − .58, p = .001)), and path analysis revealed that the effect of mindfulness training on allocentric frames of reference was mediated by decreased perceived body boundaries (β = .24, se = .17, CI: 0.11 to 0.78). Conclusions: Taken together, study results suggest that mindfulness training alters practitioners’ experience of self, relaxing the boundaries of the self and extending the spatial frame of reference further beyond the physical body. Future studies are needed to explore the psychophysiological changes that co-occur with phenomenological reports of self-transcendence and the behavioral consequences following self-transcendent experiences.

Publication
Mindfulness
Publication Year
2020

Advances in the evaluation and management of cortical/cerebral visual impairment in children

University of Southern California

Cortical/cerebral visual impairment (CVI) is the most frequent cause of pediatric visual impairment in developed countries and is increasing in prevalence in developing nations. The most common underlying etiology is hypoxic-ischemic encephalopathy, particularly in premature children. Other causes include seizures, hydrocephalus, trauma, and infections. Because of neurologic comorbidities, children with CVI often present challenges in diagnosis and characterization of visual deficits. Caregiver questionnaires may aid in assessment of visual functioning, while newer types of neuroimaging, including functional neuroimaging and diffusion tensor magnetic resonance imaging, may provide further insights on structure-function relationships. Genetic testing may assist in identification of underlying genetic or metabolic syndromes. Although no standard therapy for pediatric CVI exists, advances in care of preterm children and those with hypoxic-ischemic encephalopathy may in future reduce the incidence of this disorder. In addition, various methods of visual stimulation and stem cells have been advocated as treatment for pediatric CVI. Future controlled trials using standardized methods of visual assessment are necessary to establish whether these interventions are superior to observation. Practitioners should work with families and teachers of children with CVI to optimize their environment for visual functioning. Comorbid ocular and systemic disorders, which are common, should be managed appropriately.

Publication
Survey of Ophthalmology
Publication Year
2020

Coping Behaviors Mediate Associations between Occupational Factors and Compassion Satisfaction among the Intimate Partner Violence and Sexual Assault Workforce

Washington University in St. Louis

The intimate partner violence (IPV) and sexual assault (SA) workforce faces significant occupational stressors yet little is known about positive occupational outcomes associated with this work. Therefore, this study analyzed factors associated with compassion satisfaction among the IPV/SA workforce in one southwestern U.S. state (n = 623). Drawing from the Resilience Portfolio Model (Grych et al. 2015), researchers examined the possible role of coping behaviors in mediating associations between compassion satisfaction and workplace resources / assets, perceived job security, and resilience. Analyses revealed partial mediation in the models that included workload, values, and resilience as independent variables, suggesting that these factors both influence workers’ coping behaviors and have an independent association with compassion satisfaction. Models investigating control, rewards, community, fairness, and perceived job security indicated significant total effects of the independent variables on compassion satisfaction. Overall, IPV/SA workers who engaged more frequently in a range of coping behaviors reported higher levels of compassion satisfaction. The findings point to implications for organizational and employee practice, including building in worktime for key individual coping behaviors, balancing workloads among staff members, and enhancing organizational level coping strategies, such as team supervision and team care planning.

Publication
Journal of Family Violence
Publication Year
2020

Fatherhood and Racial/Ethnic Differences in the Progression of Romantic Relationships

Cornell University

This study examines the influence of fatherhood on the progression of men’s romantic relationships. High levels of relationship flux have resulted in a partner market increasingly characterized by the presence of children, but little is known about how children influence the progression of men’s romantic relationships. Children could reduce the likelihood of marriage and increase chances of cohabitation for single fathers in dating relationships, just as prior literature has found for single mothers. Given high levels of racial/ethnic assortative mating, and variation in the prevalence of single parenthood across racial/ethnic groups, the influence of prior children on men’s relationships may differ by race/ethnicity as well. The authors use data from adult male respondents of the 2002–2015 cycles of the National Survey of Family Growth aged 18–45 regarding the most recent sexual relationship (n = 9,255). Results of propensity score weighted event‐history analyses show that fathers in sexual relationships transition more often and more rapidly into cohabitation than do childfree men, but this pattern varies by race/ethnicity. Children from prior relationships have a strong influence on the progression of non‐Hispanic White men’s relationships, hastening cohabitation, and decreasing transitions to marriage, but prior children have little association with the progression of romantic relationships among Black or Hispanic men. Although fatherhood shapes the progression of men’s romantic relationships, the influence of fatherhood varies across racial/ethnic groups in the United States.

Publication
Journal of Marriage and Family
Publication Year
2020

Navigating a Minefield, Meta-Synthesis of Teen Mothers’ Breastfeeding Experience

Saint Louis University

Teen mothers have lower rates of breastfeeding duration and exclusivity than older mothers. A growing body of qualitative research on teen mothers’ experience helps to explain these disparities. Following a systematic search to identify relevant research, we synthesized the findings from 22 primary studies to conclude that teen mothers navigate a minefield that undermines their intention to breastfeed and their breastfeeding confidence and skill. This metaphorical minefield reflects competing norms for infant feeding and good mothering, as evident in mixed support from teens’ social networks; fragmented and stigmatizing healthcare; and spaces that are inhospitable to teen mothers and breastfeeding mothers in general. In recognition of this minefield, we urge clinicians to: respect teen mothers’ infant feeding decisions; develop collaborative relationships based on the principles of patient-centered and strength-based care; challenge stigmatizing healthcare practices; welcome teen mothers and their significant others to clinical settings; and press health systems to fully implement probreastfeeding policies. We also recommend further study to extend our knowledge about teen mothers’ breastfeeding experiences.

Publication
The American Journal of Maternal/Child Nursing
Publication Year
2020

Addressing the physician-scientist pipeline: Strategies to integrate research into clinical training programs

University of North Carolina at Chapel Hill

Introduction Physician-scientists are critical members of the biomedical workforce. Thecombination of rigorous scientific training and clinical skills uniquely positions them tobridge clinical needs with investigational pursuits by identifying important clinical questionsthat drive basic discoveries and translating those into therapeutics that improve patientoutcomes. The impact of physician-scientists on biomedical science has been profound.Indeed, the recipients of the 2019 Nobel Prize in Physiology or Medicine, William Kaelin Jr.,Gregg Semenza, and Peter Ratcliffe, are all physician-scientists. Furthermore, physician-scientists have been well represented as Nobel laureates (including Frederick Banting, CarlCori, Earl Sutherland, Alfred Gilman, Michael Brown, Joseph Goldstein, Bernardo Houssay,Edwin Krebs, Peter Agre, Harold Varmus, Robert Lefkowitz, Brian Kobilka, and RalphSteinman, to name a few). Yet, as the need for novel therapies has grown, the number ofphysician-scientists has declined (1). The reasons for this decline are numerous, includinglength and cost of clinical training, declining funding opportunities, reduced visibility ofphysician-scientist role models, and compensation disparities between academic andprivate practice careers. Residency, fellowship training, and entry into faculty — importantentry points for budding physician-scientists and a period of continuity for those who wish tobuild on their earlier research experiences — are critical junctures where attrition occursalong the physician-scientist training timeline (2–5).

Publication
Journal of Clinical Investigation
Publication Year
2020

Young transgender women survivors of intimate partner violence: A latent class analysis of protective processes

University of Chicago

None available.

Publication
Psychology of Sexual Orientation and Gender Diversity 
Publication Year
2020

COVID-19 cases and testing in 53 prison systems

Cornell University

COVID-19 has entered United States prison systems at alarming rates. Disparities in social and structural determinants of health disproportionately affect those experiencing incarceration, making them more vulnerable to COVID-19. Additionally, prisons are sites of congregate living, making it impossible to practice social distancing, and most prisons have relied only on incremental measures to reduce risk and spread of COVID-19. To more fully understand the impact that COVID-19 is having on incarcerated populations, it is critical to have systematic data on testing, test positivity, cases, and case fatality. Using data from the COVID Prison Project, we present data on 53 prison systems COVID-19 testing, test positivity, case, and case fatality by state and compare these data with each state’s general population. We do this for the early stages of the pandemic, utilizing data through July 15, 2020. Many states are not reporting full information on COVID testing with some also not reporting on case fatality. Among those reporting data, there is a wide variation between testing, test positivity, and case rates within prison systems and as compared to the general population. However, when more tests are deployed more cases are identified with the majority of state prisons having higher case rates than their general population. These findings underscore the need for the implementation and study of COVID-19 mitigation and surveillance strategies to flatten the COVID-19 curve in prisons across the country. We call for future research to build on these data from the COVID Prison Project to protect the health of our nations’ often forgotten residents.

Publication
Health & Justice
Publication Year
2020

Working Conditions Supporting Person-Centered Care of Persons Living with Dementia in Long-Term Care Homes

University of Western Ontario

The COVID-19 pandemic has underscored the importance of person-centered dementia care and working conditions that support such care in long-term care (LTC) home settings. Personal support workers (PSWs), known also as certified nursing assistants, provide the most direct formal care for persons living with dementia. However, little is known about the working conditions that enable person-centered care. Accordingly, the purpose of this study was to examine the working conditions and the impact of those conditions on PSWs in LTC homes. PSWs (N=39) employed at one of five LTC homes in southwestern Ontario, Canada participated in a series of one-hour focus groups before, during, and after Be-EPIC, a person-centred communication training program for formal caregivers of persons living with dementia. Using an interpretive description investigative framework, textual data from focus group conversation transcripts were open-coded into categories. Overarching themes were interpreted inductively. Study credibility was enhanced through investigator triangulation. Three themes emerged related to working conditions of PSWs: dementia care is complex, lack of trained staff to provide person-centered dementia care, and residents’ families are not situated in the residents’ care circle. Four themes emerged related to the impact of current working conditions of PSWs: occupational burnout, poor resident care, frustrated and disengaged families, and PSWs leave their role. The findings offer opportunities for employers to ameliorate working conditions to support person-centered care. We conclude with specific workplace recommendations that respond to the complexity of dementia care and the associated occupational stresses PSWs experience in the current LTC environment.

Publication
Innovation in Aging
Publication Year
2020

Parental buffering in the context of poverty: positive parenting behaviors differentiate young children’s stress reactivity profiles

Colorado State University

Experiencing poverty increases vulnerability for dysregulated hypothalamic–pituitary–adrenal (HPA) axis functioning and compromises long-term health. Positive parenting buffers children from HPA axis reactivity, yet this has primarily been documented among families not experiencing poverty. We tested the theorized power of positive parenting in 124 parent–child dyads recruited from Early Head Start ( M age = 25.21 months) by examining child cortisol trajectories using five samples collected across a standardized stress paradigm. Piecewise latent growth models revealed that positive parenting buffered children’s stress responses when controlling for time of day, last stress task completed, and demographics. Positive parenting also interacted with income such that positive parenting was especially protective for cortisol reactivity in families experiencing greater poverty. Findings suggest that positive parenting behaviors are important for protecting children in families experiencing low income from heightened or prolonged physiologic stress reactivity to an acute stressor.

Publication
Development and Psychopathology
Publication Year
2020

Opportunity beckons: a case for community practice within the classroom

University of Georgia

Current trends point toward the marginalization of community practice in the field of social work and social work education. Since community practice education is heavily informed by trends in the field, the opportunity for educational expansion is immediate and great. This moment necessitates a move toward methods of community practice education that emphasize practitioner skill development in theory, creativity, collaboration, understanding, and investment. In an attempt to address the need for community-practice education, the authors present a challenging and innovative assignment for graduate students that encouraged university/community partnerships through experiential community experiences.

Publication
Journal of Community Practice
Publication Year
2020

Social work and the state: Perspectives and practice

Bryn Mawr College

The state has been central to social work throughout the profession’s history. Despite its theoretical and political significance, the mainstream of the social work field has long disregarded the state as an object of inquiry. The scant attention given to the state within social work is especially puzzling given a resurgence of interest in the state within the social sciences over the past few decades. To redress this imbalance, this article explores six influential theories of the state and discusses their implications for social work practice and policy. These theories suggest we conceive of the state as: a liberal and caring guardian; a tool for class dominance; a means of social control; a political practice; an institutional structure; and a cultural construct. Drawing on diverse literatures, the article advances the understanding of social work that takes seriously the problem of the state.

Publication
Social Policy & Administration
Publication Year
2020

Cardiovascular Health among U.S. Indigenous Peoples: A Holistic and Sex-Specific Systematic Review

Tulane University of New Orleans

The purpose of this systematic review is to examine mental, sociocultural, behavioral, and physical risk and protective factors related to cardiovascular disease (CVD) and related outcomes among U.S. Indigenous peoples. A total of 51 articles met the inclusion criteria of research focusing factors for CVD among U.S. Indigenous peoples (Mental n = 15; Sociocultural, n = 17; Behavioral/Physical, n = 19). This review reveals clear risks for CVD, which tended to be elevated for females. Mental health problems (depression, anxiety, PTSD/trauma, alcohol, and other drug (AOD) abuse) were clearly associated with CVD, along with enculturation, social support, and the social environment – including discrimination and trauma. Poor diet and obesity, diabetes, hypertension, cholesterol were behavioral or physical factors. Overall, identified research was limited and in beginning stages, lacking more information on etiology of the interconnections across sex and the mental, sociocultural, and behavioral determinants of CVD.

Publication
Journal of Evidence-Based Social Work
Publication Year
2020

Assessment of Pediatric Optic Neuritis Visual Acuity Outcomes at 6 Months

University of Southern California

Importance: Optic neuritis (ON) in children is uncommon. There are limited prospective data for visual acuity (VA) outcomes, associated diseases, and neuroimaging findings. Prospective data from a large sample would be useful for counseling families on treatment decisions and prognosis. Objective: To prospectively study children with a first episode of ON, describe VA after 6 months, and ascertain the network’s (Pediatric Eye Disease Investigator Group and Neuro-Ophthalmology Research Disease Investigator Consortium) ability to enroll pediatric patients with ON prospectively. Design, setting, and participants: This nonrandomized cohort study was conducted from September 20, 2016, to July 20, 2018, at 23 sites in the United States and Canada in pediatric ophthalmology or neuro-ophthalmology clinics. A total of 44 children (aged 3-15 years) presented with a first episode of ON (visual loss, pain on eye movements, or both) within 2 weeks of symptom onset and at least 1 of the following in the affected eye: a distance high-contrast VA (HCVA) deficit of at least 0.2 logMAR below age-based norms, diminished color vision, abnormal visual field, or optic disc swelling. Exclusion criteria included preexisting ocular abnormalities or a previous episode of ON. Main outcomes and measures: Primary outcomes were monocular HCVA and low-contrast VA at 6 months. Secondary outcomes were neuroimaging, associated diagnoses, and antibodies for neuromyelitis optica and myelin oligodendrocyte glycoprotein. Results: A total of 44 children (mean age [SD], 10.2 [3.5] years; 26 boys [59%]; 23 White individuals [52%]; 54 eyes) were enrolled in the study. Sixteen patients (36%) had bilateral ON. Magnetic resonance imaging revealed white matter lesions in 23 children (52%). Of these children, 8 had myelin oligodendrocyte glycoprotein-associated demyelination (18%), 7 had acute disseminated encephalomyelitis (16%), 5 had multiple sclerosis (11%), and 3 had neuromyelitis optica (7%). The baseline mean HCVA was 0.95 logMAR (20/200), which improved by a mean 0.76 logMAR (95% CI, 0.54-0.99; range, -0.70 to 1.80) to 0.12 logMAR (20/25) at 6 months. The baseline mean distance low-contrast VA was 1.49 logMAR (20/640) and improved by a mean 0.72 logMAR (95% CI, 0.54-0.89; range, -0.20 to 1.50) to 0.73 logMAR (20/100) at 6 months. Baseline HCVA was worse in younger participants (aged <10 years) with associated neurologic autoimmune diagnoses, white matter lesions, and in those of non-White race and non-Hispanic ethnicity. The data did not suggest a statistically significant association between baseline factors and improvement in HCVA. Conclusions and relevance: The study network did not reach its targeted enrollment of 100 pediatric patients with ON over 2 years. This indicates that future treatment trials may need to use different inclusion criteria or plan a longer enrollment period to account for the rarity of the disease. Despite poor VA at presentation, most children had marked improvement by 6 months. Associated neurologic autoimmune diagnoses were common. These findings can be used to counsel families about the disease.

Publication
JAMA Ophthalmology
Publication Year
2020

Measurement of Economic Abuse Among Women Not Seeking Social or Support Services and Dwelling in the Community

Washington University in St. Louis

Scholars have defined economic abuse (EA) as tactics used by abusive partners to undermine the self-sufficiency and economic self-efficacy of survivors of intimate partner violence (IPV). However, no measures of EA have been tested in non-IPV-service seeking samples. The current study assesses the psychometric properties of the Scale of Economic Abuse (SEA)-12 (Postmus, Plummer, & Stylianou, 2016) in a nonservice seeking sample of adult females attending community college. A quantitative web-based survey was administered to a simple random sample of female community college students (n = 435). Analyses included confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). CFA indicated a poor fit for the three-factor model of the SEA-12 in this sample. The results of the EFA found a single factor model retaining four items (the Scale of Economic Abuse-Short, or SEAS). Women are experiencing EA outside of IPV service-seeking populations, and that tactics of economic control seem to be central to EA in this sample.

Publication
Violence and Victims
Publication Year
2020

Disrupting hegemony in social work doctoral education and research: Using autoethnography to uncover possibilities for radical transformation

Fordham University

Social work has enhanced its profile in the United States by adopting a particular dialect of scientific inquiry wherein positivism and evidence-based practice are considered gold standards of social work research and practice. This ideological shift permeates doctoral education and research training, as well as social work more broadly. Little attention, however, is paid to the pedagogical approaches used to train doctoral students into a “science of social work,” and we know even less about critical methodologies in doctoral education. This collaborative autoethnography weaves together the personal narratives of three doctoral students and one early career faculty member navigating an academic context within a large public university in the United States. We employ a participatory and intersectional approach to analyze narrative data in terms of how our identities interact with the structures relevant to where we study and work. Three themes emerged from our collaborative analysis: becoming disillusioned by disciplinary shortcoming; confronting dissonance with radical solidarity; and making change on the inside using perspectives from the outside. We argue throughout that critical reflexivity is a tool to document, resist, and transform hegemonic discourse that narrowly defines what it means to embody social work research, practice, and education.

Publication
Qualitative Social Work
Publication Year
2020

Consideration of Heterogeneity in a Meta-analysis of Latino Sexual Health Interventions

University of Chicago

Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted infections, and HIV, persistent sexual and reproductive health (SRH) disparities that represent a national public health concern. Despite progress nationally, Latina adolescents continue to exhibit above-average teenage pregnancy, birth, and repeat birth rates.1 Particularly concerning are the 17% increase in reportable sexually transmitted infections among 10- to 19-year-old Latino adolescents since 2014 and the 6% rise in new HIV diagnoses among 13- to 19-year-old Latino adolescents between 2016 and 2017 alone.2–4 Given these statistics, research is needed to strengthen the evidence on programs to reduce Latino adolescent SRH disparities.

Publication
Pediatrics
Publication Year
2020