Is TANF Truly Accessible and Helpful? Victims’ Experiences With Domestic Violence Screening Under the Family Violence Option
This study explores the experiences of domestic violence victims with their Temporary Assistance for Needy Families (TANF) applications and the subsequent assessment processes in the state of Georgia, focusing on the conditions related to their disclosure of abuse and their postdisclosure experiences. This study interviewed five victims of domestic violence, four local victim advocates, and three nationally recognized experts regarding domestic violence screening in TANF programs using semistructured interviews. Data were analyzed using grounded theory techniques. The findings showed that the participants perceived TANF application and assessment processes as (i) inaccessible and (ii) unhelpful, lacking special considerations for domestic violence victims. Conditions related to victims’ disclosure of abuse included (i) safety concerns, (ii) working relationships between local victim support agencies and TANF offices, (iii) a safe environment to disclose abuse, and (iv) advocacy. After disclosing their domestic violence history to their TANF caseworkers, the victims reported experiencing (i) a lack of continued assessment and support related to domestic violence and (ii) a compulsion to make final decisions regarding continuing or discontinuing their TANF applications. The current study contributes to the field of social work by providing a better understanding of how and to what extent victims of domestic violence are actually supported within the TANF system and by yielding practice and policy implications for effectively assisting the victims of domestic violence within the TANF system.
Visualizing Perceived Enablers of and Barriers to Healthy Eating by Youth in Rural El Salvador
Objective: To explore the perceived environmental enablers for and barriers to healthy eating among rural Salvadoran youth. Methods: A photovoice activity was implemented at a grade school located in a rural region of northeastern El Salvador. Results: Nine female and 8 male youth aged 8–12 years participated. A total of 116 photos were generated for thematic analysis. Photos and descriptions from youth revealed an overall theme of ambiguity in healthy eating across multiple environments. This theme of ambiguity was interwoven throughout 2 subthemes: (1) links between food and health, and (2) the juxtaposition of globalized foodscapes and natural resources. Conclusions and Implications: Photos and descriptions from youth illustrated the murky distinctions between healthful and less healthful foods embedded within daily encounters across multiple environments. To further an understanding of factors that promote or hinder healthy eating in youth, future research might incorporate methods that capture the ways in which youth conceptualize healthy eating, as well as their contributions to healthy eating.
On the fringes: How youth experiencing homelessness conceptualize social and economic inequality–A Photovoice study
This study used Photovoice methods with young adults experiencing homelessness to collaboratively identify issues that are of greatest importance in an open‐ended, exploratory, and inductive manner. Participants selected two concepts to focus their inquiry: freedom and prosperity. Within these concepts, participants discussed nature as a source of inspiration, a desire to better themselves and to change their situations, and passion for contributing to social change by exposing economic inequality and raising awareness about homelessness. These findings demonstrate that young people are keenly aware of the structural and macro‐level factors that have contributed to their risks of social exclusion and marginalization.
Towards a Biopsychosocial Psychiatry
Objective: Constructing a meaningful biopsychosocial model for the mental health field has been extremely elusive. Identifying the linkages between the biological, psychological and social domains has been especially daunting. There has been important progress in clarifying general correlations of certain social factors related to the mental health of individuals and in developing training programs to recognize these social factors. However, efforts have usually focused on broad correlations and there have been serious deficiencies in developing methods for understanding and dealing with the specific processes happening at the psychological and social interface. For this reason, it would be important to be able to do such things as for example have a means to clarify the processes that connect the individual’s mental health and its specific interactions with his or her social class. In this report we suggest two approaches that can contribute to solving this problem. Methods: We will describe approaches from the fields of anthropology and microhistory that link the specific experiences of the individual and the nature of the social context in which he or she finds him/herself. Results: Careful application of certain anthropological and history study methods that “take seriously” the specific interactions between the environmental situation and the individual can provide approaches to improved understanding of the relevant variables and the causal links between “psycho” and “social” in the biopsychosocial model. Conclusions: Teaching and applying these principles in treatment and research can contribute to a more effective model of biopsychosocial interactions in the mental health field.
Methodological and Ethical Considerations in Research With Immigrant and Refugee Survivors of Intimate Partner Violence
To promote safe and positive health outcomes by utilizing culturally relevant evidence-based interventions for immigrant and refugee women survivors of intimate partner violence, their active participation in research is critical. With 43.6 million immigrants and refugees living in the United States, there is a need for research studies to eliminate health disparities in these populations. However, barriers to recruiting and retaining these populations in research prevent the provision of quality and culturally informed services to meet their needs. The aim of this article is to discuss the recruitment and retention strategies employed and analyze the methodological and ethical challenges in the context of the weWomen Study. The use of a multifaceted approach informed by best practices maximized recruitment efforts and active participation that generated high numbers of immigrant and refugee women participants. The study also substantiated the need for more community-based participatory approaches to engage community members in the development of culturally appropriate approaches that instill a sense of ownership over the research process. Active research participation of immigrant and refugee survivors will help investigators understand their unique needs and facilitate the implementation of targeted evidence-based interventions.
When Disney came to Broadway: Assessing the impact of corporatization in an art world
This article explores the commercial and creative impact of diversified corporations on artistic production. Drawing on original data from 70 seasons of Broadway musical theater, I examine the relationship between measures of corporate involvement in theater production and measures of content innovation and success. Contrary to my hypotheses, I find that musicals produced by diversified corporations are not systematically less innovative than musicals produced solely by non-corporate producers, as levels of innovation vary across measures. However, average levels of innovation on Broadway have declined over time due, in part, to the growing number of diversified-corporate musicals in the market. With respect to success, I observe two systematic trends. First, relative to non-corporate musicals, diversified-corporate musicals achieved equivalent to exceptional success as they were establishing themselves in Broadway’s theater market. Second, the relative success of diversified-corporate musicals declined as their prevalence in Broadway’s theater market grew. Together, these findings highlight the non-trivial ways in which an artistic market can change when corporate involvement in artistic production grows.
“Officers Are Doing the Best They Can”: Concerns Around Law Enforcement and Social Service Collaboration in Service Provision to Sex Workers
Frontline service providers are often tasked with providing services to criminalized populations, including individuals involved in the sex trade. These providers have been working to transform services to this population, proposing what they believe to be socially just responses in helping individuals in the sex trade transition from “criminals” to a “victims.” While frontline service providers have been advocating for trauma-informed and compassionate responses to working with individuals involved in the sex trade, they regularly temper this work with collaboration with law enforcement, propagating carceral (punishment-oriented) logics in order to “protect” vulnerable clients. This qualitative study, completed in a Midwestern U.S. state, used interviews with 30 frontline service providers who work with individuals in the sex trade to understand service providers’ perceptions around their work with this population, and how this shapes collaborations with law enforcement. Findings reveal that as most frontline service providers assume that individual trauma and drug use are present in the sex trade, these individual characteristics have legitimated paternalistic service responses provided in collaboration with law enforcement. However, a minority of frontline service providers denounce these collaborations as harmful to their clients, revealing that responses to law enforcement are not homogenous across service providers. I conclude by discussing what these law enforcement–social service collaborations mean for the social work profession and provide a discussion of alternative methods to work with individuals in the sex trade.
Measuring the Psychological Impacts of Prison-Based Dog Training Programs and In-Prison Outcomes for Inmates
As interest grows in programs that improve prison inmates’ behavior and psychosocial well-being, any such interventions must be rigorously examined and their underlying mechanisms for change must be understood. This pilot study examined the use of prison-based dog training programs across Washington State Department of Corrections facilities for their impacts on inmates’ infraction rates. The study also compared levels of empathy, self-efficacy, and anxiety between program participants and nonparticipants. Findings indicated that prison dog program participants’ infraction rates improved and that participants had lower levels of anxiety than nonparticipants.
Community-based participatory design for research that impacts the lives of transgender and/or gender-diverse autistic and/or neurodiverse people
Objective: Research addressing the co-occurrence of autism (and/or neurodiversity) and gender-diversity (A/ND-GD) has been conducted largely without the perspectives and voices of the A/ND-GD community. Including A/ND-GD community advocates as research partners may be a critical next step for advancing research initiatives on the co-occurrence given the apparent complexity and alterity of the A/ND-GD experience. Method: Consistent with the community-based participatory research (CBPR) model we propose herein, our authorship team includes a partnership between clinician researchers and diverse A/ND-GD community collaborators. Multiple facets of the A/ND-GD lived experience are examined, including through narratives provided by our A/ND-GD community partners. Results: Based on our experience conducting A/ND-GD-related research and our lived experience as A/ND-GD self-advocates, we highlight challenges in this line of research, including risks of conducting studies without the involvement of the A/ND-GD community. And given that many A/ND-GD youth present with gender-related urgency during the teen years, we provide a developmental framework for how CBPR-informed methods may enrich our understanding of the care needs of these young people and provide context for the apparent heterogeneity in their gender needs and trajectories over time. Conclusions: Integrating CBPR methodologies in A/ND-GD research initiatives has the potential to optimize the relevance of the research questions asked and the interpretation and contextualization of study findings.
Personality-based posttraumatic stress disorder subtypes in young adults
The symptom presentation of posttraumatic stress disorder (PTSD) varies widely between individuals, which can complicate both diagnosis and treatment. Personality may help to explain this variability, and personality-based subtypes of PTSD (externalizing, internalizing, and simple; Miller, Greif, & Smith, 2003) have been identified for this purpose. Yet, empirical tests of these subtypes have been limited, focusing largely on older samples with combat trauma or other homogenous trauma types. Our study examined PTSD subtypes in two samples of young adults with heterogeneous trauma exposure using cluster analyses. We tested for subtype-based heterogeneity in traumatic response (i.e., PTSD symptomatology). Results revealed that, across the two samples, externalizing (low conscientiousness and moderate neuroticism), internalizing (low extraversion and moderate neuroticism), and simple (low neuroticism) personality-based subtypes emerged, consistent with the existing literature. Subtype-based differences in PTSD symptom severity also were observed, with the simple subtype generally exhibiting less severe PTSD symptomatology than internalizing and externalizing subtypes. However, the subtypes did not differ in terms in number or type (interpersonal vs. noninterpersonal) of traumatic experiences. Findings support PTSD subtypes and their relevance for posttraumatic response, particularly PTSD severity, in young adults with a variety of trauma types.
Nutrition provider confidence in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study
The multi-sector, multi-level Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study resulted in improvements in obesity risk factors among children age 2–4 years enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC). The goal of this study was to examine whether the MA-CORD intervention increased WIC provider confidence in their ability to identify childhood obesity and obesity-related behaviors. As part of the MA-CORD intervention conducted from 2012 to 2015, we implemented WIC practice changes focused on childhood obesity prevention within two Massachusetts communities. We examined changes in provider confidence to assess childhood obesity risk factors and practice frequency among WIC practices located in MA-CORD intervention communities over a 3-year period, compared to non-intervention sites. We measured provider confidence on a continuous scale using questions previously developed to assess provider and parent confidence to make weight-related behavior change (range 0 to 24). There were 205 providers at baseline and 165 at follow-up. WIC providers at intervention sites reported greater confidence in their ability to identify childhood obesity and obesity-related behaviors compared to the usual care sites (β = 1.01, standard error = 0.13). These findings persisted after adjusting for provider gender, years in practice, highest education level, and WIC position. Conclusions The MA-CORD intervention was associated with increased WIC provider confidence to assess children’s obesity risk. Interventions that increase confidence in assessing obesity-related behaviors may have salutary effects within WIC programs that serve low-income families.
Lived experiences of chronic cognitive and mood symptoms among community-dwelling adults following stroke: a mixed-methods analysis
Few studies have explored the lived experiences of chronic cognitive and mood symptoms following stroke using a racially/ethnically diverse sample. Therefore, we aimed to explore the perceptions of chronic post-stroke cognition and mood symptoms and goals among a racially/ethnically diverse sample of community-dwelling adults aging with stroke. This qualitative study using mixed-methods analysis included semi-structured interviews regarding perceived post-stroke cognitive and mood symptoms among community-dwelling stroke survivors at least one-year post stroke. Transcripts were subjected to thematic content analysis, and differences in theme usage patterns by age, gender, race/ethnicity, and post-acute rehabilitation setting were assessed using an inferential clustering technique. The majority of participants (93%) reported cognition-related themes, including language and communication, memory, thinking abilities, comprehension, visual-spatial processing, and cognitive assessments and training. Nearly half of participants mentioned mood-related themes, including depression, aggression and anger, mood fluctuations, anxiety, and psychological services and medication. Nearly half reported an unmet need for cognition or mood-related treatment. Inferential clustering analysis revealed that older participants reported a different pattern of cognitive and mood symptoms than those aged younger than 65 (p = 0.02). Older adults were more likely to describe post-stroke language/communication changes, while younger adults described post-stroke mood changes. Stroke survivors experienced cognitive and mood-related symptoms beyond one-year post stroke, which has implications for long-term assessment and management. Incorporation of continued symptom monitoring into existing community-based services is needed to address chronic cognitive and mood symptoms affecting the quality of life of persons with stroke.
Preventive healthcare-seeking behavior among poor older adults in Mexico: the impact of Seguro Popular, 2000-2012
The objective of this study was to determine the effect of Seguro Popular (SP) on preventive care utilization among low-income SP beneficiaries and uninsured elders in Mexico.
A Puzzle of Racial Attitudes: A Measurement Analysis of Racial Attitudes and Policy Indicators
In the 1970s and 1980s, researchers argued that a new dimension of racial prejudice, termed “symbolic racism” and later “racial resentment,” emerged among white Americans as their endorsement of traditional prejudice declined. Recently, Carmines, Sniderman, and Easter have challenged this conceptualization. Relying on American National Election Surveys data, they argue that racial resentment and the attitudes about racial policy that it presumably explains are part of the same latent construct (labeled racial policy attitudes). This conclusion undermines theories that racial prejudice among white Americans is a primary determinant of their continued opposition to racial policies. We replicate their analyses and test an alternative model using five additional samples. We find that an alternative model that specifies racial resentment as distinct from racial policy attitudes was a better fit to the data, and additionally, we find preliminary evidence that it is inappropriate to consider racial policy attitudes as a single dimension using traditional indicators.
The Effectiveness of Psychoeducation and Brief Treatments in the Aftermath of Sexual Assault
Recent estimates indicate that roughly 20% of US adult women and 1.7% of men report being raped during their lifetime and an estimated 1.6% of women report being raped in the previous 12 months (Breiding et al., Surveillance Summaries, 63:1–18, 2014b). Sexual assault victimization is associated with higher rates of revictimization, interpersonal difficulties, and social stigma. Survivors of sexual assault are also at an increased risk of abusing alcohol and drugs, even among those who did not abuse substances prior to the assault (Kilpatrick et al., Journal of Consulting and Clinical Psychology 65:834, 1997a). As such, there is an impetus to develop brief and evidence-based interventions that target the unique constellation of challenges faced by sexual assault victims. The aim of this chapter is to examine the available support for brief treatments and psychoeducational interventions in the aftermath of trauma and discuss limitations and future directions for research.
Toward an Experimental Therapeutics Approach in Human Services Research
Over the past decade, the experimental therapeutics approach has gained currency as an organizing framework for research in mental health. However, examples of this approach outside of person-directed therapeutic and preventive interventions have been relatively uncommon. This article describes an experimental therapeutics approach to mental health and human services research that considers the role of social and ecological determinants in a person’s recovery from mental disorder. To illustrate this approach, this article decomposes an employment intervention to show three of its components and identifies the targets for two components: social relationships and health insurance. These targets can be engaged by provider-, community-, or policy-level interventions. Such applications of an experimental therapeutics approach to research on mental health services can enhance the rigor of studies and thereby contribute to the well-being of persons living with mental disorders in the United States.
Innovations in child welfare interventions for caregivers with substance use disorders and their children
Families who enter the Child Welfare System (CWS) as a result of a caregiver’s substance use fare worse at every stage from investigation to removal to reunification (Marsh, Smith, & Bruni, 2011). Intervening with caregivers with Substance Use Disorders (SUDs) and their children poses unique challenges related to the structure and focus of the current CWS. Research demonstrates that caregivers with SUDs are at a greater risk for maladaptive parenting practices, including patterns of insecure attachment and difficulties with attunement and responsiveness (Suchman, Paulo, DeCoste, & Mayes, 2006). Caregivers with SUDs have also often experienced early adversity and trauma. However, traditional addiction services generally offer limited opportunities to focus on parenting or trauma, and traditional parenting programs rarely address the special needs of parents with SUDs. This article details four innovative interventions that integrate trauma-informed addiction treatments with parenting for families involved in the child welfare system. Common mechanisms for change across programs are identified as critical components for intervention. This work suggests the need for a paradigm shift in how cases involving caregivers with substance use disorders are approached in the child welfare system.
Healing policies for Black boys and young men in St. Louis (Race and Opportunity Lab Brief Report No. 2)
Black boys and men in the St. Louis region face punitive local, state, and federal policies that de- crease their quality of life and limit their potential to give back to society. System-level changes that reshape the contexts in which the 60,000 Black boys and young men in St. Louis heal, grow, and thrive are necessary to help them reach their full potential. Such changes would benefit St. Louis by increasing this population’s workforce readiness and decreasing the likelihood of its involve- ment in the criminal justice system. Dr. Sean Joe of the Race and Opportunity Lab’s HomeGrown STL project recommends a shift away from puni- tive legislation toward generation and implemen- tation of healing policies. Healing policies are reg-, ulatory and legislative interventions and reforms specifically designed to improve the well-being of Black boys and young men.
Prevalence and correlates of nonmedical use of prescription drugs (NMUPD) among Young adults experiencing homelessness in seven cities across the United States
Background: Nonmedical use of prescription drugs (NMUPD) is an urgent public health concern facing the United States. Young adults experiencing homelessness (YEH) are at increased risk of NMUPD; however, community estimates of NMUPD among YEH are sparse. This current study sought to understand patterns and correlates of NMUPD in a geographically heterogeneous sample of YEH recruited from seven cities across the United States. Methods: From June 2016 to July 2017, 1,426 YEH (aged 18–26) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information on substance use, mental health, trauma, and sexual-risk behaviors. Multivariable logistic regression was utilized to assess demographic, psychological, and behavioral correlates of self-reported past-month NMUPD and NMUPD types (i.e., prescription stimulant, sedative, and opioids). Results: Approximately 20% of participants reported past-month NMUPD. Almost 9% reported misusing prescription opioids, 8.7% misused prescription sedatives, and 6% misused prescription stimulants. Multivariable logistic regressions revealed unmet mental health needs were associated with sedative and stimulant misuse but not opioid misuse. Having suicidal thoughts was associated with opioid misuse but not sedative or stimulant misuse. Although no geographical differences emerged for stimulant and sedative misuse, youth from Denver, Phoenix, and San Jose were more likely to engage in opioid misuse relative to youth in Los Angeles. Conclusions: These findings indicate that interventions designed to address NMUPD need to be multifaceted, designed to address other risk behaviors correlated with NMUPD, and target unmet mental health needs.
American Indian women cancer survivors’ coping with depressive symptoms
Depressive symptoms have been identified as a primary predictor of quality of life among cancer patients. Depression and cancer are co-occurring and disproportionately elevated for American Indian and Alaska Native (AI/AN) women. The purpose of this article is to examine American Indian (AI) women cancer survivors’ coping mechanisms for depressive symptoms. The methodology included a qualitative descriptive approach with conventional content analysis to examine the coping strategies of AI women cancer survivors associated with depressive symptoms. The interview guide was semi-structured and developed in collaboration with a community advisory board (CAB). Data-derived qualitative analysis was used to generate codes inductively from the data. A sample of 43 AI women cancer survivors (n = 14 cervical cancer, n = 14 breast cancer, and n = 15 other cancers) from the Northern Plains region, in the state of South Dakota were interviewed. Data were collected from June 2014 to February 2015. Qualitative content analysis was used for data analysis, which allowed themes to emerge inductively from the data. Analysis revealed 430 preliminary codes. After de-briefing, validation, and discussion among coauthors, these were then sorted into 67 codes. Member checks with all available participants were conducted to minimize misinterpretation. Findings: A total of 26 participants (62%) indicated they had feelings of depression since their cancer diagnosis. Women coped with depressive feelings by (a) participating in faith traditions; (b) seeking creative and positive outlets; (c) martialing family and social support; and (d) keeping busy with other life activities. Interpretation: AI women experienced depressive symptoms following a cancer diagnosis and used a variety of positive coping mechanisms to create personal meaning. AI women may need unique support following a cancer diagnosis, and interventions should incorporate AI beliefs and traditions, such as storytelling and talking with family and community members.