ABSTRACT
With growing recognition of the adverse health impacts of unmet social needs, Medicaid managed care organizations (MMCOs) are increasingly focusing on addressing the social needs of Medicaid enrollees as part of a holistic approach to care. Information and knowledge sharing among MMCOs pertaining to lessons learned and promising practices from their social determinants of health (SDOH) targeted efforts can help identify successful practical approaches for navigating common challenges, developing robust SDOH programming, and effectively delivering whole-person care. Using data from interviews with 28 representatives of 8 national and regional MMCOs, this qualitative study describes the perspectives of MMCO representatives on the lessons learned and emerging promising practices from addressing SDOH among their Medicaid enrollees. Participants discussed the importance of member and community-centeredness, structured programming, and delivery system realignment in the effective delivery of whole person care. Ten lessons learned and emerging promising practices are discussed. Findings from this study suggest that success in addressing the social needs of Medicaid beneficiaries may be achieved through adaptive, data-driven, member- and community-centric efforts by MMCOs, facilitated by system-level changes that formally integrate social services within health care. Lessons learned and promising practices can serve as a foundation for identifying and evaluating best practices and guidelines for effective MMCOs' SDOH-related programming.
Subject(s)
Managed Care Programs , Medicaid , Delivery of Health Care , Humans , Social Determinants of Health , Social Work , United StatesABSTRACT
Resumen Este artículo aborda, desde la perspectiva de juventud, un panorama de la situación de las juventudes en América Latina y el Caribe a partir de indicadores socioeconómicos y demográficos globales y regionales. Provee un análisis interseccional de las opresiones y desafíos que enfrentan las personas jóvenes para alcanzar su pleno desarrollo dentro de un entramado de relaciones de poder, desigualdad, exclusión, discriminación y violencia. Con base en evidencias, destaca intervenciones eficaces y promisorias que orienten la inversión en juventud mediante políticas públicas, presupuestos y programas a escala, como medidas redistributivas del poder y los recursos que contribuyan al disfrute de sus derechos humanos, la autonomía, emancipación y agencia para participar en asuntos públicos que les afectan.
Abstract This article approaches, from a youth perspective, an overview of the situation of youth in Latin America and the Caribbean based on global and regional socio-economic and demographic indicators. It provides an intersectional analysis of the oppressions and challenges that young people face to achieve their full potential within a complex structure of power relations, inequality, exclusion, discrimination and violence. Based on the evidence, it highlights effective and promising interventions for guiding investment in youth through public policies, budgets and programmes at scale, as measures for redistributing power and resources that contribute to the fulfilment of their human rights, autonomy, emancipation and agency to participate in public affairs that affect them.
Subject(s)
Humans , Adolescent , Violence , Human Rights , Public Policy , Caribbean Region , Latin AmericaABSTRACT
BACKGROUND: Multiple culturally-oriented programs, services, and frameworks have emerged in recent decades to support the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander (Aboriginal) people in Australia. Although there are some common elements, principles, and methods, few attempts have been made to integrate them into a set of guidelines for policy and practice settings. This review aims to identify key practices adopted by programs and services that align with the principles of the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples' Mental Health and Social and Emotional Wellbeing 2017-2023. METHODS: A comprehensive review of electronic databases and organisational websites was conducted to retrieve studies of relevance. Twenty-seven publications were included in the review. Next, we identified promising practices through a collaborative review process. We then used the principles articulated in the above-mentioned framework as the basis to complete a framework analysis. This enabled us to explore the alignment between current scholarship about SEWB programs and services with respect to the principles of the framework. RESULTS: We found there was a strong alignment, with selected principles being effectively incorporated into most SEWB program and service delivery contexts. However, only one study incorporated all nine principles, using them as conceptual framework. Additionally, 'capacity building', 'individual skill development', and 'development of maladaptive coping mechanisms' were identified as common factors in SEWB program planning and delivery for Aboriginal people. CONCLUSION: We argue the selective application of nationally agreed principles in SEWB programs and services, alongside a paucity of scholarship relating to promising practices in young people-oriented SEWB programs and services, are two areas that need the urgent attention of commissioners and service providers tasked with funding, planning, and implementing SEWB programs and services for Aboriginal people. Embedding robust participatory action research and evaluation approaches into the design of such services and programs will help to build the necessary evidence-base to achieve improved SEWB health outcomes among Aboriginal people, particularly young people with severe and complex mental health needs.
Subject(s)
Health Services, Indigenous , Mental Health , Adolescent , Australia , Emotions , Humans , Native Hawaiian or Other Pacific IslanderABSTRACT
There is merit in understanding how recreation-oriented programs for adults living with mental illness address barriers to participation and how programming is structured to create safe and inclusive environments, resulting in programming that amplifies the benefits of recreation for mental well-being. Following an environmental scan of programs targeting adults living with mental illness in Canada, ten coordinators in community mental health settings were interviewed. Four themes were constructed to reflect characteristics deemed to be 'promising practices' related to recreation-oriented programming: (a) barriers and solutions to individual participation, (b) characteristics of welcoming and supportive environments,
Subject(s)
Attitude of Health Personnel , Community Mental Health Services/methods , Health Knowledge, Attitudes, Practice , Mental Disorders/psychology , Mental Disorders/rehabilitation , Recreation , Canada , Health Services Accessibility , Humans , Interviews as Topic , Leadership , Recreation/psychology , Social Support , Socioeconomic FactorsABSTRACT
INTRODUCTION: In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. METHODS: The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. RESULTS: The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. CONCLUSION: While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.
INTRODUCTION: Dans le domaine de la promotion de la santé et de la prévention des maladies chroniques, tant les pratiques exemplaires que les pratiques prometteuses peuvent fournir des renseignements cruciaux sur les interventions qui améliorent les résultats sur la santé des individus et des collectivités, notamment leur mode d'action et les raisons de leur efficacité dans différents contextes. MÉTHODOLOGIE: Nous avons établi des critères de définition des pratiques prometteuses sur la base des critères de l'Agence de la santé publique du Canada (ASPC) pour les pratiques exemplaires. Nous avons modifié et mis à l'épreuve (en trois phases) ces critères en nous servant d'interventions décrites dans des publications. Nous avons résolu les questions et les difficultés d'ordre théorique et méthodologique grâce à des consultations et des discussions approfondies avec un groupe de travail. RÉSULTATS: L'équipe a établi un ensemble de critères relatifs aux pratiques prometteuses qui diffèrent sur six plans des critères relatifs aux pratiques exemplaires. CONCLUSION: Bien que plusieurs difficultés complexes se soient présentées pendant l'élaboration des critères, des discussions et des débats exhaustifs nous ont permis de les surmonter. Les critères de sélection du Portail canadien des pratiques exemplaires permettent de repérer les pratiques exemplaires et prometteuses dans les domaines de la santé publique, de la promotion de la santé et de la prévention des maladies chroniques, voire éventuellement dans d'autres domaines.
Subject(s)
Chronic Disease/prevention & control , Health Promotion/standards , Preventive Health Services/standards , Program Evaluation/standards , Benchmarking , Canada , Health Promotion/methods , Humans , Internet , Practice Guidelines as Topic/standards , Preventive Health Services/methodsABSTRACT
As the importance of afterschool hours for youth development is widely acknowledged, afterschool settings have recently received increasing attention as an important venue for youth interventions. A range of intervention programs have been in place, generally aiming at positive youth development through enhancing the quality of programs. A growing need has thus arisen for reliable and valid measures of afterschool quality. This study examined the extent to which the two observational tools, i.e., Caregiver Interaction Scales (CIS) and Promising Practices Rating Scales (PPRS), could serve as reliable and valid tools for assessing the various dimensions of afterschool setting quality. The study shows the potential promise of the instruments, on the one hand, and suggests future directions for improvement of measurement design and development of the field, on the other hand. In particular, our findings suggest the importance of addressing the effect of day-to-day fluctuations in observed afterschool quality.