Substance Use Screening, Brief Intervention, and Referral to Treatment in Urban Settings: Barriers and Facilitators to Implementation With Minoritized Youth.

BACKGROUND: Substance use in minoritized youth is associated with negative long-term health and life outcomes. The present study explores perspectives of school stakeholders at urban minority-serving schools regarding integration of an evidence-based intervention, screening, brief intervention, and referral to treatment (SBIRT) into existing school prevention models. METHODS: Twenty-two participants were interviewed using the Consolidated Framework for Implementation Research to identify barriers and facilitators to SBIRT implementation. Qualitative data were transcribed, coded, and analyzed. RESULTS: Four major themes related to barriers to SBIRT implementation included: lack of training, unclear role expectations, student confidentiality, and punitive school climates. The 3 major facilitators included: the feasibility of the intervention, its fit within multi-tiered systems of support, and the districts increasing collaboration with community mental health providers. These major themes along with other minor themes are discussed. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: SBIRT implementation within low-income, minority-serving schools may reduce substance use disparities among minoritized youth, improving health and life outcomes. Recommendations addressed training, school climate, and student engagement, highlighting a collaborative and supportive approach involving all stakeholders. CONCLUSIONS: While SBIRT implementation has barriers and facilitators, overall, school staff were optimistic about implementation. In light of these findings, additional research should embed SBIRT in these settings.

Palliative and hospice social workers' moral distress during the COVID-19 pandemic.

OBJECTIVES: Moral distress is associated with adverse outcomes contributing to health-care professionals' worsened mental and physical well-being. Medical social workers have been frontline care providers throughout the COVID-19 pandemic, and those specializing in palliative and hospice care have been particularly affected by the overwhelming numbers of those seriously ill and dying. The main objectives of this study were (1) to assess palliative and hospice social workers' experiences of moral distress during COVID-19 and (2) to identify and describe participants' most morally distressing scenarios. METHODS: Using a mixed-methods approach, participants completed an online survey consisting of the Moral Distress Thermometer (MDT) and open-ended text responses. RESULTS: A total of 120 social work participants responded to the study, and the majority of participants (81.4%) had experienced moral distress with an average MDT score of 6.16. COVID-19 restrictions emerged as the main source of moral distress, and an overlap between the clinical and system levels was observed. Primary sources of moral distress were grounded in strict visitation policies and system-level standards that impacted best practices and personal obligations in navigating both work responsibilities and safety. SIGNIFICANCE: In the first year of the COVID-19 pandemic, palliative and hospice social work participants indicated high levels of moral distress. Qualitative findings from this study promote awareness of the kinds of distressing situations palliative and hospice social workers may experience. This knowledge can have education, practice, and policy implications and supports the need for research to explore this aspect of professional social work.

A comparison of child abuse and neglect encounters before and after school closings due to SARS-Cov-2.

BACKGROUND: Risk factors for child abuse and neglect and commonly used reporting mechanisms were highly affected by SARS-Cov-2 pandemic; yet, little is known about the effects of SARS-Cov-2 on rates of child abuse and neglect. OBJECTIVE: To compare overall rates, demographics, types of abuse and acuity of child abuse and neglect encounters seen at one university health system for the 6 months before and after school closings due to the SARS-Cov-2 pandemic. PARTICIPANTS AND SETTING: Data was extracted from a database of billed ICD10 codes for child abuse and neglect including sexual abuse codes. There were 579 encounters for patients <18 years of age and 476 unique patients. METHODS: In addition to ICD10 code and pre/post school closing, each encounter was identified to be inpatient, outpatient and/or emergency department. Demographic data such as age, gender, ethnicity, and race were extracted. Incident rate ratios in addition to descriptive statistics, Mann-Whitney U test, two-sample t-test, or the chi-square test of association were used in the analysis. RESULTS: No significant differences were identified for total rates of child abuse and neglect encounters (p = .08), physical abuse (p = .91) nor child maltreatment (p = .86) codes or in the age (p = .46), gender (p = .58), and race/ethnicity (p = .15) of patient encounters pre- versus post-school closings. The sexual abuse incidence and inpatient encounters increased by 85% (IRR = 1.85, p < .0001; IRR = 1.85, p = .004, respectively). CONCLUSIONS: Our findings provide a unique contribution to the existing literature in that we identified a significant increase in the incidence of sexual abuse and higher patient acuity as evidenced by higher rates of inpatient encounters after school closing due to SARS-Cov-2.

Supporting collegiate foster youth and alumni: A mixed-method planning approach for higher education.

Despite the proliferation, of on-campus academic support programs for foster youth and alumni (e.g., those formerly in foster care), few conceptual frameworks for developing these programs exist. This study employed Group Concept Mapping (GCM) methodology to delineate a conceptual framework, from the perspective of foster youth and alumni (N = 51), for the development of on-campus support initiatives. GCM is an integrated mixed-method research method that uses non-metric multidimensional scaling and hierarchical cluster analyses, to analyze qualitative data (e.g., statement form) collected during brainstorming sessions. This research was guided by two separate queries: (1) How do foster youth/alumni conceptualize support programs to support foster youth/alumni through to degree completion; and, (2) Is there a difference in priority areas of this conceptualization between current college students, and those who have dropped out of college within the last 18 months? Analyses revealed that participants conceptualized on-campus support programs via an eight-cluster solution, including Campus Awareness, Advocacy, Data Tracking, Pre-College Supports, Fostering Family Connections, Academic Financing, Campus Life, and Peer/Mentor Supports clusters. Additionally, analyses revealed significant priority ratings between areas of this conceptualization. In terms of Importance to academic success, current students rated statements in the Academic Financing and Peer/Mentor Supports clusters significantly lower than did non-students. For Feasibility, current students viewed statements in the Data Tracking, Campus Life, and Peer/Mentor Supports clusters as significantly more feasible than non-students. Pragmatic implications derived from these findings include fostering inclusive campus environments for foster youth/alumni and advocacy undertakings by institutions, on behalf of this population.

Planning a mentorship initiative for foster parents: Does gender matter?

Despite the use of mentoring programs in fields such as business, career training, and youth development, little is known about how mentoring can be used to train and support new foster parents. This paper describes how Concept Mapping was used with current foster parents to develop a conceptual framework suitable to plan a foster parent mentor program. A secondary aim of this study was to explore priority differences in the conceptualization by self-reported gender (foster mothers vs. foster fathers). Participant data was collected via three qualitative brainstorming sessions, and analyzed using non-metric multidimensional scaling and hierarchical cluster analysis. Findings indicate that foster parents participating in this study conceptualized effective mentor programs via a seven cluster solution. Study results also showed no significant differences in cluster ratings by gender. Implications for practice and program planning are identified, as well as areas for future research.

Perspectives of parents on making decisions about the care and treatment of a child with cancer: a review of literature.

This review focuses on parental decision making regarding the care and treatment of children with cancer. Articles were abstracted from the following sources: Ovid Databases (Cochrane Database of Systematic Reviews, Database of Abstracts of Review of Effects, Medline, and Social Work Abstracts) and EBSCOhost (Academic Search Premier and Academic Search Complete) using smart text. The criteria for the search were publications between 2005 and 2012 and publication in peer-review journals. The descriptors used were parents of children with cancer, decision making, decisions about childhood cancer, and parents. The search yielded 59 references, but after duplicates, as well as dated and irrelevant articles were removed, 17 articles were identified that focused specifically on the decisions parents make regarding the care and treatment of children with cancer. Coders agreed that the child's quality of life/well-being, parental hope/expectations, support/supportive care, communication, and information were important themes in considering the decisions parents made regarding the care and treatment of children with cancer. These themes provide insight into the needs of parents in making decisions about the care and treatment of children with cancer.

Utilizing screening, brief intervention, and referral to treatment: teaching assessment of substance abuse.

Although social workers regularly encounter clients with substance use problems, social work education rarely addresses addictions with any depth. This pilot study explored the use of screening, brief intervention, and referral to treatment (SBIRT) with 74 social work students. Students completed SBIRT training with pre- and post-questionnaires that assessed attitudes, knowledge, and skills concerning substance misuse. Statistically significant differences were demonstrated with students reporting more confidence in their ability to successfully assess for alcohol misuse and subsequently intervene.