Building the capacity of older adults and community: findings from a developmental evaluation of United Way British Columbia's social prescribing programs for older adults. / Renforcer les capacités des aînés et de la collectivité : résultats d'une évaluation de l'élaboration des programmes de prescription sociale conçus par Centraide Colombie-Britannique à l'intention des aînés.

INTRODUCTION: Older adults with higher needs are ideal candidates for social prescribing interventions, given the complex and intersectoral nature of their needs. This article describes findings from a developmental evaluation of 19 social prescribing programs for older adults at risk of frailty. METHODS: An evaluation of the programs was conducted from 2020 to 2023. We used data from three components of the evaluation: (1) initial evaluation data collected in 2020 and 2021; (2) program profiles developed in 2022; and (3) co-creation sessions conducted in 2023. RESULTS: From startup until March 2023, the programs served a total of 2544 older adults. The community connectors identified factors at the individual, interpersonal, institutional, community and policy levels that contributed to the successful implementation and delivery of their programs (e.g. physician champions, communities of practice, strong pre-existing relationships with the health care system), as well as challenges (e.g. limited capacity of family physicians, lack of community resources). There was strong agreement among community connectors that successful social prescribing programs should include the following core elements: (1) making connections to needed community resources; (2) co-creation of a wellness plan with long-term clients or clients who require intensive supports; (3) ongoing follow-up and check-ins for clients with wellness plans; and (4) an assessment and triaging process for the prioritization of clients. CONCLUSION: To leverage the full potential of social prescribing interventions, it is essential that programs engage with a range of health and social care providers, that community connectors are skilled and well supported, and that adequate investments are made in the nonprofit and voluntary sector.

Integrating social prescribing in a Canadian regional health system to support healthy aging. / Intégration de la prescription sociale dans un système de santé régional canadien pour favoriser le vieillissement en santé.

INTRODUCTION: Social prescribing (SP) is a rapidly growing health and social model of care. The concept of social prescribing is based on well-known clinical practices such as community referrals, integrated health and social care, and navigator models. Although SP began in the United Kingdom's mental health and social care field, there are many examples of different models of SP foci and pathways. Here in Canada, SP is emerging at several provincial locations, with differences in its delivery reflecting the local context of people and places.

British Columbia (BC) has developed a province-wide social prescribing model supporting older adults through close partnerships between health care and community organizations. A regional health authority, Fraser Health, has a specific regional team focussing on integrating social prescribing into the health system through meaningful engagement and continuous co-creation with multisectoral partners, using strategies such as change management and Plan-Do-Study-Act cycles. Environmental and organizational support are big facilitators that have supported the continuation of the designated integration effort. Long-term funding and more partnerships between health care and community organizations will be critical to sustaining the social prescribing model in BC.

La Colombie-Britannique a élaboré un modèle de prescription sociale à l'échelle de la province pour soutenir les aînés grâce à des partenariats étroits entre les établissements de soins de santé et les organismes communautaires. Une régie régionale de santé, Fraser Health, a une équipe régionale spécialisée qui travaille à intégrer la prescription sociale au système de santé par des interactions significatives avec des partenaires multisectoriels et l'élaboration conjointe continue de programmes, au moyen de stratégies comme la gestion du changement et les cycles de planification, d'exécution, d'étude et d'action (de Plan-Do-Study-Act, soit Planification-Exécution-Étude-Action). Les ressources du milieu et le soutien des organismes sont des facteurs importants qui ont facilité la poursuite de ces travaux d'intégration. Un financement à long terme et une hausse des partenariats entre les établissements de soins de santé et les organismes communautaires seront essentiels à la pérennisation du modèle de prescription sociale en Colombie-Britannique.

Understanding and using experiences of social care to guide service improvements: translating a co-design approach from health to social care.

Background: Local authorities need to find new ways of collecting and using data on social care users' experiences to improve service design and quality. Here we draw on and adapt an approach used in the healthcare improvement field, accelerated experience-based co-design, to see if it can be translated to social care. We use loneliness support as our exemplar. Objectives: To understand how loneliness is understood and experienced by members of the public and characterised by social care and voluntary sector staff; to identify service improvements around loneliness support; to explore whether accelerated experience-based co-design is effective in social care; and to produce new resources for publication on Socialcaretalk.org. Design and methods: Discovery phase: in-depth interviews with a diverse sample of people in terms of demographic characteristics with experience of loneliness, and 20 social care and voluntary staff who provided loneliness support. Production of a catalyst film from the public interview data set. Co-design phase: exploring whether the accelerated experience-based co-design approach is effective in one local authority area via a series of three workshops to agree shared priorities for improving loneliness support (one workshop for staff, another for people with experience of local loneliness support, and a third, joint workshop), followed by 7-monthly meetings by two co-design groups to work on priority improvements. A process evaluation of the co-design phase was conducted using interviews, ethnographic observation, questionnaires and other written material. Results: Accelerated experience-based co-design demonstrated strong potential for use in social care. Diverse experiences of participants and fuzzy boundaries around social care compared to health care widened the scope of what could be considered a service improvement priority. Co-design groups focused on supporting people to return to pre-pandemic activities and developing a vulnerable passenger 'gold standard' award for taxi drivers. This work generated short-term 'wins' and longer-term legacies. Participants felt empowered by the process and prospect of change, and local lead organisations committed to take the work forward. Conclusions: Using an exemplar, loneliness support, that does not correspond to a single pathway allowed us to comprehensively explore the use of accelerated experience-based co-design, and we found it can be adapted for use in social care. We produced recommendations for the future use of the approach in social care which include identifying people or organisations who could have responsibility for implementing improvements, and allowing time for coalition-building, developing trusted relationships and understanding different perspectives. Limitations: COVID-19 temporarily affected the capacity of the local authority Project Lead to set up the intervention. Pandemic work pressures led to smaller numbers of participating staff and had a knock-on effect on recruitment. Staff turnover within Doncaster Council created further challenges. Future work: Exploring the approach using a single pathway, such as assessing eligibility for care and support, could add additional insights into its transferability to social care. Trial registration: This trial is registered as Current Controlled Trials ISRCTN98646409. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128616) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 27. See the NIHR Funding and Awards website for further award information.

Local councils need to find new ways of using people's experiences of social care to improve services. We explored whether a way of improving health services can improve social care services. 'Experience-based co-design' is a complicated name. It means working with people who use health or social care services to improve that service, and interviewing people as part of this process. Accelerated experience-based co-design uses existing interviews instead of new interviews. To see if the approach works in social care, we chose the topic of loneliness because many of us experience loneliness. We worked with Doncaster City Council because it has been focusing on loneliness. We interviewed 37 people across England and recorded what they said about loneliness. We made a film about their experiences that showed examples of good or poor care. We call these touch points. We held three workshops in Doncaster. Workshop 1 was with people who work in social care as paid workers or volunteers, and workshop 2 was with people who use social care services. In both workshops, people made a list of types of support that needed improvement. Both groups attended workshop 3, watched the film and decided what to focus on from the two lists. Two groups were set up to work on improving support for loneliness in Doncaster. Each group met seven times. One focused on taxi services, and the other group focused on supporting people to do activities they did before the pandemic. A researcher attended these meetings and talked with everyone involved to see how this approach worked. At the end, there was a celebration event. We found that loneliness is complicated. We found the approach to improving support does work in social care, but it needs some changes because social care is not like health care. We suggest ways the approach can be done differently.

The Resilience Hub approach for addressing mental health of health and social care workers during the COVID-19 pandemic: a mixed-methods evaluation.

Background: Resilience Hubs provide mental health screening, facilitation of access and direct provision of psychosocial support for health and social care keyworkers in England affected by the coronavirus disease 2019 pandemic. Aim: To explore implementation of the Hubs, including characteristics of staff using the services, support accessed, costing data and a range of stakeholder perspectives on the barriers and enablers to Hub use and implementation of staff well-being support within the context of the pandemic. Design: Mixed-methods evaluation. Setting: Four Resilience Hubs. Methods: Findings were integrated via mixed-method case studies, including: analyses of Hub mental health screening (N = 1973); follow-up questionnaire data (N = 299) on service use and health status of Hub clients; economic information provided by the Hubs; 63 interviews with Hub staff, wider stakeholders, Hub clients and keyworkers who did not use the Hubs. Results: Findings were consistent across Hubs and workstreams. Most Hub clients were NHS staff. Under-represented groups included men, keyworkers from minority ethnic communities, care homes and emergency services staff. Clients reported comorbid mental health needs across multiple domains (anxiety; depression; post-traumatic stress; alcohol use; functioning). Their health status was lower than population norms and relevant pre-pandemic data. Several factors predicted higher needs, but having pre-pandemic emotional well-being concerns was one of the most robust predictors of higher need. Sixty per cent of participants who completed follow-up questionnaires reported receiving mental health support since Hub screening, most of which was directly or indirectly due to Hub support. High levels of satisfaction were reported. As in many services, staffing was the central component of Hub cost. Hubs were predominantly staffed by senior clinicians; this staffing model was consistent with the generally severe difficulties experienced by clients and the need for systemic/team-based working. Costs associated with health and social care use for Hub clients were low, which may be due to barriers to accessing support in general. Enablers to accessing Hubs included: a clear understanding of the Hubs, how to self-refer, and managerial support. Barriers included confusion between Hubs and other support; unhelpful beliefs about job roles, unsupportive managers, negative workplace cultures and difficulties caused by systemic issues. Some keyworkers highlighted a perceived need for further diversity and cultural competency training to improve reach to under-represented communities. Other barriers for these groups included prior negative experiences of services, structural inequalities and stigma. Some wider stakeholders had concerns around growing waiting times for Hub-provided therapy, and insufficient data on Hub usage and outcomes. Feedback was otherwise very positive. Limitations: Main limitations included lack of comparative and pre-pandemic/baseline data, small numbers from under-represented groups limiting fine-grained analysis, and participant self-selection. Conclusions: Findings highlighted the value of the Hub model of outreach, screening, support navigation and provision of direct support during the coronavirus disease 2019 pandemic, and as a potential model to respond to future crises. The research provided recommendations to improve Hub promotion, equality/diversity/inclusion access issues, management of specialist resources and collection of relevant data on Hub outcomes and activities. Broader recommendations for the primary prevention of mental health difficulties across the health and care system are made, as individual support offers should be an adjunct to, not a replacement for, resolutions to systemic challenges. Research recommendations are made to conduct more robust evaluations of the clinical and cost-effectiveness of the Hubs, using larger data sets and comparative data. Study registration: This study is registered as researchregistry6303. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132269) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 29. See the NIHR Funding and Awards website for further award information.

Many health and social care staff struggled with mental health difficulties during the coronavirus disease 2019 pandemic. The study evaluated new National Health Service services ('Resilience Hubs') that were set up to help these keyworkers. We worked with four Hubs to: (1) look at who accessed the Hubs and what difficulties they had; (2) ask Hub 'clients' which support they used, and how helpful they found the Hubs; (3) look at what resources are needed to run the Hubs, to understand their 'value for money'; (4) interview people who worked with or used the Hubs (e.g. Hub staff, Hub clients, but also keyworkers who did not use the Hubs) to have their feedback. We used this information to make recommendations for the Hubs and the organisations that work with them. We found that Hub clients were mainly National Health Service staff. Many had several mental health difficulties, including anxiety, depression and post-traumatic stress disorder. Few men, staff from minority ethnic communities, care home workers and emergency service staff used the Hubs. People were generally happy with the support they had from the Hubs; clients who completed a follow-up questionnaire rated the helpfulness of support provided by Hubs as 92 out of 100 on average. Staffing was the main cost, as Hubs were mainly staffed by experienced clinicians. Things that made it easier for people to use the Hubs were clear understandings of Hub support and how to access it, and the support of their managers/employers. Some keyworkers from minority ethnic communities wanted greater diversity in the Hub teams. Some had concerns around waiting times and about not knowing enough about how well these services worked. Feedback was otherwise very positive. Our recommendations included how to: better promote the Hubs; improve inclusion of and support for individuals from minority groups; get better data on how well and for whom they work; and for employers to pay more attention to the mental health and well-being of keyworkers beyond the coronavirus disease 2019 pandemic.

Co-producing and co-assessing a new service solution for enhancing health and social care integration: a participatory research protocol.

BACKGROUND: This paper describes a study protocol for co-producing and co-assessing a new sustainable and scalable service solution that enhances health and social integration by involving providers and volunteers delivering services for elderly people in the province of Cremona (Italy), where the elderly population will reach 27% in 2023. METHODS: This upcoming study involves mixed-method participatory research and is structured in three study phases and related objectives. First, it will co-produce a new, accessible and sustainable service solution using an iterative design and management method, Plan-Do-Check-Act by involving professionals and volunteers of a heterogeneous group of health, social and third sector organizations located in the city of Cremona (Italy). Second, the study protocol will co-assess the outcomes of the new service solution using a mixed-method approach for measuring the outcomes on: professionals and volunteers (micro level) and their health, social and third sector organizations (meso level). Third, this study will co-investigate the scalability of the new solution promoting health and social integration in other similar urban areas of the Province of Cremona via the Intervention Scalability Assessment Tool (macro level). The data will be collected through the analysis of official documents, websites, policies and participatory workshops. DISCUSSION: This protocol proposes an innovative intervention, a novel participatory approach, and an unexplored scalability assessment tool in the context of health and social care integration. This study aims to support professionals from health and social care service providers and volunteers from third-sector organizations to collaborate and integrate each other's resources. In doing so, the participatory approach will facilitate the co-creation of an effective response to the need of health and social integration, and the development of trustful relationships between health and social care service providers. Moreover, the adoption of Plan-Do-Check-Act and Intervention Scalability Assessment Tool will ensure the quality, scalability and sustainability of the new service solution in other settings.

Promoting positive youth development in rural communities: Integrating social work, psychology, and education.

Considering the peculiar socio-cultural background and developmental obstacles encountered by rural youth in China, the study examines the necessity of adopting an integrated strategy that brings together social work, psychology, and education to promote positive youth development. This research intends to fill the gap by explaining the impact of these factors on community engagement and youth development in China. Targeted programs were also suggested according to the needs of rural youth in China. The respondents of the study comprised 350 young people, whose age ranged from 15 to 24 years, living in different rural areas of the country. The structured questionnaire was designed to collect the data using a convenience sampling technique. Structural Equation Modeling (SEM) was applied as the analysis tool using IBM SPSS AMOS software. The results show that social work and education have a significant impact on community engagement and positive youth development. The findings also reveal that psychology positively influences community engagement. Community engagement was seen to mediate the relationships between social work, psychology, education, and positive youth development. The policymakers and practitioners can fully use the interrelationships between social work, psychology, and education to create a more comprehensive approach that considers the specific characteristics of rural youth in China. Additionally, highlighting community engagement as a mediator also explores the opportunity for bottom-up initiatives and community efforts to instigate favorable youth outcomes in the countryside.

Difficult Conversations: A Collaborative Interprofessional Simulation for Social Work, Athletic Training and Physician Assistant Programs.

Students graduating from professional healthcare programs are expected to demonstrate competence in their area of study to enter the workforce and immediately start working with people. High expectations and a fast-paced environment are typical aspects of these professional positions and often result in higher rates of burnout, compassion fatigue, and lack of empathy, leading to an overall decrease in patient satisfaction. As a result, patients who face difficult situations may often feel as though their needs are not being addressed. The purpose of this study was to examine the effectiveness of a shared educational module and simulated patient encounters on improving student confidence and competence engaging in difficult conversations with patients regarding intimate partner violence, substance abuse, and suicidal ideation. Students in the social work (n=14), athletic training (n=7), and physician assistant degree programs (n=20) participated in a collective learning module focusing on patient-centered care (PCC) skills required for having difficult conversations with patients. After students completed the shared learning module and prior to the simulated experience, students were given the Inter-professional Teams in Difficult Conversations Self-Assessment survey, a self-assessment tool measuring level of competence in engaging in difficult conversations. Students were then assigned to one of three rooms at random and varied in topic from intimate partner violence, substance abuse, or suicidal ideation. After the simulation, students completed the Inter-professional Teams in Difficult Conversations Self-Assessment survey again. Standardized patients (SP) also completed the Patient-Professional Interaction Questionnaire (PPIQ) immediately after the simulated experience. As hypothesized, students self-reported very high confidence in their ability to engage in difficult conversations using PCC, but SPs reported feeling little empathy or understanding of their situation from the students. Findings from this research demonstrate the disconnect in transfer of knowledge from understanding what PCC skills are to implementing them during difficult conversations.

Home Together: A Multi-Level Community-Based Health Promotion Program Supporting Families Experiencing Homelessness.

Home Together (HT) is a multi-level multi-component health promotion program, co-led by academic and non-profit partners in Arkansas that sought (1) to improve access to and family acceptance of social services and health care among women experiencing homelessness who have a diagnosed mental health condition and a child younger than six years and (2) to increase service provider capacity to engage with this population. A socioecological perspective was used to detail program components and lessons learned. Home Together enrolled 345 women representing unduplicated families. Of these, 214 completed six-month reassessments and 111 completed discharge assessments. Representative of the area and population served, most self-identified as belonging to racial minorities (87.0%), being younger than 35 years (80.1%), experiencing violence (76%), and being heterosexual (82%). Pre-post testing indicated positive changes for HT families, including improvements in mental health, health care access, and housing. Yet, even the most coordinated comprehensive programs are no substitute for policy-level changes that help families reach stability.

How Attitudes Toward Evidence-Based Practice Impacts Burnout: A Sequential Mediation Model.

PURPOSE: With the rapid development of China's social work sector, the increasing job pressures, and risks of professional burnout among social workers have become more prevalent. This study examined the relationship between Chinese social workers' attitudes toward evidence-based practice (EBP) and burnout, exploring the mediating mechanisms of evidence-based knowledge (EBK) and service quality perception (SQP). MATERIALS AND METHODS: We applied PROCESS 4.2 macro in SPSS to analyze the data from 5,931 social workers, testing the sequential mediation effects of EBK and SQP between their attitudes toward EBP and burnout. RESULTS: The findings revealed: (1) Attitudes toward EBP had significant indirect positive effects on burnout; (2) EBK partially mediated the relationship between EBP attitude and burnout; (3) SQP partially mediated the relationship between attitudes toward EBP and burnout; (4) Attitudes toward EBP had a sequential mediated effect on burnout through EBK and SQP. DISCUSSION: The findings emphasize the need to implement targeted interventions and training programs to foster positive attitudes toward EBP, promote continuous professional development, and provide access to EBP resources. Moreover, nurturing EBK and SQP could help alleviate burnout by improving social workers' ability to address client issues and enhance their sense of confidence and accomplishment. CONCLUSION: This study fills a research gap by providing empirical evidence on the negative correlation between Chinese social workers' attitudes toward EBP and burnout, while demonstrating the mediating roles of EBK and SQP.

A mixed method study exploring similarities and differences in general and social services-specific barriers to treatment-seeking among individuals with a problematic use of alcohol, cannabis, or gambling.

INTRODUCTION: The treatment gap for addictive disorders is one of the largest in health care. Several studies have investigated barriers to treatment for different addictive disorders, but very few studies conducted have explored whether the barriers differ depending on substance or behavior or if they are common among all addictive disorders. In Sweden, addiction care is provided both by the healthcare and social services, where the latter is common, but also less popular. To our knowledge, there are no studies exploring whether the barriers are different depending on where the treatment is given. AIM: The aim was to thoroughly explore both which general and social services-specific barriers to treatment that are common, which barriers that differs, and how the barriers are described among individuals with a problematic use of alcohol, cannabis and/or gambling. METHOD: A mixed method convergent parallel design was conducted. For the quantitative measures, surveys including the validated Barriers to Treatment Inventory as well as questions regarding barriers in the Swedish multi-provider landscape, were collected from individuals with a problematic use of alcohol (n = 207), cannabis (n = 51), and gambling (n = 37). In parallel, 17 semi-structured interviews from the same population were conducted and analyzed with thematic analysis. Thereafter, the quantitative and qualitative data was compared, contrasted, and at last, interpreted. RESULTS: The quantitative data showed that the largest general barriers in all groups were privacy concern and poor availability, and the largest barriers for seeking help from the social services was stigma, unawareness of what is offered, and fear of consequences for all groups. The qualitative data resulted in five general barriers: stigma, ambivalence, accessibility, fear of consequences, and lack of knowledge about addiction and its' treatments, and three barriers specifically towards social services: social services reputation, fear of meeting acquaintances, and lack of knowledge. The themes were developed from data from all groups, but different aspects of the themes were mentioned by different groups. CONCLUSION: There are details and aspects that differentiates both the general and social service-specific barriers to treatment between individuals with a problematic use of alcohol, cannabis, and gambling, but in large they perceive similar barriers.

Enabling spaces for (varied) co-existence.

For people in homelessness, access to social services may appear difficult and alienating, which often contributes to poor health and a risk of accelerated marginalization. Historically, day centres for people in homelessness have been characterized by an emphasis on providing refuge and momentary restitution, accommodating urgent basic needs. In this article, we present a case study of the design of a new day centre in Denmark that aspires to move beyond the historical place-for-being. Rather, the new day centre is to be a place-for-being-and-becoming, focusing on bridging the varied needs of people in homelessness with easy access to social services at the day centre. This article explores the creation of new behaviour settings along with the challenges and considerations in designing enabling spaces for people in societally marginalized positions, concurrently offering and supporting a sense of inclusion, the possibility to develop one's agency and experience of lived citizenship. This article is part of the theme issue 'People, places, things, and communities: expanding behaviour settings theory in the twenty-first century'.

Professional perspectives on facilitators and barriers for high quality provision of health, education and social care services to disabled children in England during the COVID-19 pandemic: a qualitative study.

OBJECTIVES: To understand how health, education and social care services for disabled children changed during the COVID-19 pandemic, what did or did not work well and what the impacts of service changes were on both professionals and families. DESIGN: Qualitative study using semistructured interviews. SETTING: Telephone and video call interviews and focus groups with professionals working in one of five local authority areas in England. PARTICIPANTS: 78 health, education and social care professionals working with children in one of five local authority areas in England. RESULTS: There was a significant disruption to services and reduced contact with families during the early stages of the pandemic; nevertheless, professionals were able to reflect on innovative ways they interacted with and sought to support and maintain health, education and social care provision to disabled children and their families. As waitlists have substantially increased, this and the longevity of the pandemic were perceived to have had negative consequences for staff health and well-being, the health and psychosocial outcomes of children and young people, and their parent carers. CONCLUSIONS: Key learning from this study for service recovery and planning for future emergencies is the need to be able to identify disabled children, classify their level of need and risk, assess the impact of loss of services and maintain clear communication across services to meet the needs of disabled children. Finally, services need to work collaboratively with families to develop child-centred care to strengthen resilience during service disruption.

The All Together Group: Co-Designing a Toolkit of Approaches and Resources for End-of-Life Care Planning With People With Intellectual Disabilities in Social Care Settings.

INTRODUCTION: Support staff within social care settings have expressed a need for resources to facilitate end-of-life care planning with people with intellectual disabilities. This study aimed to co-design a preliminary toolkit of end-of-life care planning approaches and resources that can be implemented in adult social care services for people with intellectual disabilities. METHODS: An adapted Experience-Based Co-Design process was applied to develop a toolkit for end-of-life care planning with people with intellectual disabilities. A co-design group (the 'All Together Group') met six times from January to October 2023. The group comprised nine people with intellectual disabilities (including four researchers with intellectual disabilities, who also co-facilitated the workshops), five family members, five intellectual disability support staff, two intellectual disability service managers, and five healthcare professionals. RESULTS: The All Together Group tested resources for and approaches to end-of-life care planning with people with intellectual disabilities, based on findings from a scoping review and a focus group study. Easy-read end-of-life care planning forms were deemed overwhelming and complicated, whilst visual and creative approaches were welcomed. Three new visual resources to support illness planning and funeral planning with people with intellectual disabilities were developed: (i) 'When I'm ill' thinking cards; (ii) 'Let's Talk About Funerals' conversation-starter pictures; and (iii) 'My funeral' planning cards. These three resources, alongside three positively evaluated existing resources, were included in a new toolkit for end-of-life care planning with people with intellectual disabilities. CONCLUSION: Through an iterative, flexible, inclusive, and comprehensive co-design process, a toolkit of three newly developed and three existing resources was created to facilitate support staff in doing end-of-life care planning with people with intellectual disabilities. Following a trialling process with support staff, the final toolkit was made freely available online. PATIENT OR PUBLIC CONTRIBUTION: The research team included four researchers with intellectual disabilities (A.C., D.J., L.J., and R.K.-B). Researchers with intellectual disability have been part of every step of the research process; from study design to data collection and analysis to dissemination of study findings.Intellectual disability service provider representatives (M.W., N.P., and S.S.) were part of the co-design group as well. Two of these representatives were also co-applicants in the overall project (N.P. and S.S.). The co-design group included people with intellectual disabilities, families, intellectual disability support staff and health and social care professionals. The study was supported by a Research Advisory Group comprising a variety of stakeholders, including people with intellectual disabilities families, intellectual disability researchers, representatives from intellectual disability organisations, and policymakers.

Social Needs Screening Via Electronic Tablet in Pediatric Primary Care.

OBJECTIVES: (1) Assess whether health-related social needs (HRSN)/caregiver mental health concerns (CMHC) disclosure rates differ when screening questions are administered on paper versus electronic tablet. (2) Evaluate whether changes in need identification alters referral rates to social work and our medical-legal partnership (MLP). METHODS: We conducted a retrospective review of HRSN/CMHC screening in publicly insured patients 0-18 years presenting for well-child visits in three primary care practices. Our primary outcome was HRSN/CMHC disclosure rate, comparing the proportion of positive HRSN/CMHC screens during the 11 months before and after screening modality change. Generalized estimating equations and interrupted time series (ITS) were used to assess changes over time. Mediation analyses assessed the indirect effect of HRSN/CMHC disclosure during the electronic screening period on changes in referrals to social work/MLP. RESULTS: A total of 16,151 patients had paper-based HRSN/CMHC screens; 13,019 patients had electronic screens. Overall, 11% of paper-based screens identified ≥1 need, compared to 26% of electronic screens (p<0.001). All three practices saw an increase in disclosure rate after transition from paper to electronic screening (odds ratio [OR] range 1.54 to 4.24). Using ITS, two of three practices had significantly increased odds of need disclosure with electronic screens compared to paper (OR 3.0, 95% confidence interval [CI] 2.5, 3.6; and OR 1.7, 95%CI 1.2, 2.4). Increased HRSN/CMHC disclosure rates from transitioning to electronic screening mediated increased referrals to social work/MLP. CONCLUSIONS: Electronic screening was associated with an increased HRSN/CMHC disclosure rate compared to paper, which led to increased referrals to social work/MLP.

Enhancing Evidence-Based Practice in Rural Social Work: Applying the Theory of Planned Behavior to Identify Key Determinants.

PURPOSE: This study explores the application and extent of utilization of Evidence-Based Practice (EBP) among rural social workers, identifying key factors such as attitudes, social pressures, and perceived barriers that influence its use. METHODS: Utilizing the Theory of Planned Behavior as a framework, this research involved a comprehensive survey targeting rural social workers. The survey assessed their attitudes toward EBP, the social pressures, and the barriers in implementing EBP. Data from 91 participants were analyzed using multiple regression to determine how these factors impact EBP utilization. RESULTS: The analysis indicated that while attitudes toward EBP did not significantly affect its use, perceived ease of use, social pressures, and practical barriers were significant predictors. Interestingly, the data showed that external factors like organizational support and resource availability played a larger role than personal attitudes in the adoption of EBP. The regression model successfully explained 39% of the variance in EBP usage among rural social workers. DISCUSSION: The findings underscore the importance of external over internal factors in the adoption of EBP within rural settings. The study suggests that improving access to EBP resources and enhancing organizational support could facilitate more effective use of EBP among rural social workers. CONCLUSION: Effective implementation of EBP in rural areas necessitates addressing both perceived and actual barriers. Developing strategies to enhance resource availability and organizational support is recommended to boost EBP adoption, ultimately aiming to improve service outcomes and client well-being.