Trauma-informed interactions within a trauma-informed homeless service provider: Staff and client perspectives.

This study aims to provide practical insights for developing trauma-informed interaction strategies between service providers and participants in homeless service organizations (HSOs). Twelve providers and 17 participants were interviewed for a qualitative study on trauma-informed care (TIC) within an HSO. Thematic analysis revealed six themes regarding provider approaches to TIC interactions with participants: provide a sounding board, promote safety, foster understanding and respect, build relationships and trust, facilitate connection to services, and ensure flexibility in service provision. Participants noted three themes regarding their views of TIC interactions with providers: possess education and experience, build relationships and trust, and demonstrate supportive interpersonal styles. This study describes the application of TIC within an HSO, emphasizing the importance of supportive, positive interactions that promote understanding, respect, and trust. It highlights key factors in service provision. The findings expand our understanding of TIC implementation in HSOs and suggest areas for improvement.

Meta-analyses of teacher-delivered trauma-based and trauma-informed care interventions.

OBJECTIVE: Children impacted by adversity and trauma often experience psychological, emotional, behavioral, and academic difficulties. To address these concerns, there is a growing call for trauma-informed school systems to better support students with trauma histories. Teacher involvement in trauma-informed approaches is vital but understudied. METHOD: We conducted a meta-analytic review of the literature published between 1990 and 2019 to evaluate outcomes for teachers and students involved in teacher-delivered trauma interventions. Inclusion criteria specified peer-reviewed studies, dissertations, and nonacademic reports that used randomized controlled and nonrandomized pre-post intervention designs. RESULTS: We found 20 articles, of which, 12 were pre-post and eight were randomized designs. Seven articles specifically incorporated trauma-informed care (TIC), whereas the other 13 were traditional trauma-based mental health interventions. We conducted meta-analyses to assess student trauma symptom severity and teacher knowledge of trauma-informed practices. Results revealed that after participating in teacher-delivered trauma interventions, students reported significantly reduced trauma symptom severity postintervention and less severity of symptoms than students in the control conditions. There were no differences between trauma-based and TIC intervention student outcomes. Teachers exhibited greater knowledge acquisition after participating in TIC interventions. CONCLUSION: These findings suggest that trauma interventions, both with and without explicitly referencing TIC principles, are evidence-based in the context of teacher-facilitated school interventions. Additional research is needed to evaluate the organizational benefits of TIC, particularly to determine if the benefits of trauma-informed schools extend beyond students. We conclude with research, policy, and practice recommendations for transformative change to create trauma-informed schools. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Investigating the relationship between growing season quality and childbearing goals.

Agricultural production and household food security are hypothesized to play a critical role connecting climate change to downstream effects on women's health, especially in communities dependent on rainfed agriculture. Seasonal variability in agriculture strains food and income resources and makes it a challenging time for households to manage a pregnancy or afford a new child. Yet, there are few direct assessments of the role locally varying agricultural quality plays on women's health, especially reproductive health. In this paper we build on and integrate ideas from past studies focused on climate change and growing season quality in low-income countries with those on reproductive health to examine how variation in local seasonal agricultural quality relates to childbearing goals and family planning use in three countries in sub-Saharan Africa: Burkina Faso, Kenya, and Uganda. We use rich, spatially referenced data from the Performance Monitoring for Action (PMA) individual surveys with detailed information on childbearing preferences and family planning decisions. Building on recent advances in remote monitoring of seasonal agriculture, we construct multiple vegetation measures capturing different dimensions of growing season conditions across varying time frames. Results for the Kenya sample indicate that if the recent growing season is better a woman is more likely to want a child in the future. In Uganda, when the growing season conditions are better, women prefer to shorten the time until their next birth and are also more likely to discontinue using family planning. Additional analyses reveal the importance of education and birth spacing in moderating these findings. Overall, our findings suggest that, in some settings, women strategically respond to growing season conditions by adjusting fertility aspirations or family planning use. This study also highlights the importance of operationalizing agriculture in nuanced ways that align with women's lives to better understand how women are impacted by and respond to seasonal climate conditions.

Social support and networks among people experiencing chronic homelessness: A systematic review.

The objectives of this systematic review were to synthesize available information on social support and social networks among individuals experiencing chronic homelessness, examine the measurement of social support, the impact of social support on outcomes, and the impact of interventions on social support. The authors searched Academic Search Complete, PsycArticles, Pubmed, PsycINFO, ScienceDirect, Cinahl, and ProQuest for English-language empirical articles published between 1998 and 2019. Studies were included if they sampled single and unaccompanied adults experiencing chronic homelessness and examined the impact of social support and/or social networks. The search yielded 29 studies. Results were synthesized according to research questions and patterns of findings that emerged from included studies. Wide variability in the measurement of social support was found across studies. Nearly all studies found changes in social support associated with housing interventions. A substantial evidence base indicated intervention effects on social support are largely positive. Review findings suggest individuals with substance use disorders may require additional social functioning support once housed. Indigenous people may require tailored interventions to center their cultural values and facilitate existing community strengths. Overall, the results from this review suggest social support plays a key role in the housing experiences and outcomes of individuals experiencing chronic homelessness. Future studies should include qualitative and mixed methods work as these methods revealed important insights about social support. More evidence is needed to inform the development of specific interventions targeting social support to facilitate community integration of formerly homeless individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Designing a Pest and Disease Outbreak Warning System for Farmers, Agronomists and Agricultural Input Distributors in East Africa.

Early warnings of the risks of pest and disease outbreaks are becoming more urgent, with substantial increases in threats to agriculture from invasive pests. With geospatial data improvements in quality and timeliness, models and analytical systems can be used to estimate potential areas at high risk of yield impacts. The development of decision support systems requires an understanding of what information is needed, when it is needed, and at what resolution and accuracy. Here, we report on a professional review conducted with 53 professional agronomists, retailers, distributors, and growers in East Africa working with the Syngenta Foundation for Sustainable Agriculture. The results showed that respondents reported fall armyworm, stemborers and aphids as being among the most common pests, and that crop diversification was a key strategy to reduce their impact. Chemical and cultural controls were the most common strategies for fall armyworm (FAW) control, and biological control was the least known and least used method. Of the cultural control methods, monitoring and scouting, early planting, and crop rotation with non-host crops were most used. Although pests reduced production, only 55% of respondents were familiar with early warning tools, showing the need for predictive systems that can improve farmer response.

Conflict and Climate Factors and the Risk of Child Acute Malnutrition Among Children Aged 24-59 Months: A Comparative Analysis of Kenya, Nigeria, and Uganda.

Acute malnutrition affects a sizeable number of young children around the world, with serious repercussions for mortality and morbidity. Among the top priorities in addressing this problem are to anticipate which children tend to be susceptible and where and when crises of high prevalence rates would be likely to arise. In this article, we highlight the potential role of conflict and climate conditions as risk factors for acute malnutrition, while also assessing other vulnerabilities at the individual- and household-levels. Existing research reflects these features selectively, whereas we incorporate all the features into the same study. The empirical analysis relies on integration of health, conflict, and environmental data at multiple scales of observation to focuses on how local conflict and climate factors relate to an individual child's health. The centerpiece of the analysis is data from the Demographic and Health Surveys conducted in several different cross-sectional waves covering 2003-2016 in Kenya, Nigeria, and Uganda. The results obtained from multi-level statistical models indicate that in Kenya and Nigeria, conflict is associated with lower weight-for-height scores among children, even after accounting for individual-level and climate factors. In Nigeria and Kenya, conflict lagged 1-3 months and occurring within the growing season tends to reduce WHZ scores. In Uganda, however, weight-for-height scores are primarily associated with individual-level and household-level conditions and demonstrate little association with conflict or climate factors. The findings are valuable to guide humanitarian policymakers and practitioners in effective and efficient targeting of attention, interventions, and resources that lessen burdens of acute malnutrition in countries prone to conflict and climate shocks.

Sustainable food systems and nutrition in the 21st century: a report from the 22nd annual Harvard Nutrition Obesity Symposium.

Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition, and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world can come together at the UN Food Systems Summit in late 2021 and make strong and binding commitments toward food system transformation. The NIH-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition held their 22nd annual Harvard Nutrition Obesity Symposium entitled "Global Food Systems and Sustainable Nutrition in the 21st Century" in June 2021. This article presents a synthesis of this symposium and highlights the importance of food systems to addressing the burden of malnutrition and noncommunicable diseases, climate change, and the related economic and social inequities. Transformation of food systems is possible, and the nutrition and health communities have a significant role to play in this transformative process.

Identifying a typology of homelessness based on self-sufficiency: Implications for rapid re-housing interventions.

Limited research exists on the characteristics of individuals experiencing homelessness who achieve positive housing outcomes in rapid re-housing (RRH) interventions. We aimed to identify a typology of homelessness based on Self-Sufficiency Matrix (SSM) domains and examine its relation to sociodemographic characteristics and housing placement through RRH. Homeless Management Information System data, including sociodemographics, SSM domains, and housing outcomes, were obtained for 261 Homelessness Prevention and Rapid Re-housing Program participants in Indianapolis, Indiana, from 2009 to 2012. Latent class analysis (LCA) and latent class regression (LCR) were used to identify subgroups and predict associations between the identified typology and sociodemographic variables and housing placement outcome, respectively. LCA revealed three classes based on SSM domains: "High Self-Sufficiency," "Low Socioeconomic Self-Sufficiency," and "Low Psychosocial Self-Sufficiency." LCR revealed that race significantly predicted class membership such that Black individuals had a significantly higher probability of being in the High Self-Sufficiency class than the other two classes. Latent class membership significantly predicted immediate housing placement. The Low Psychosocial Self-Sufficiency group was the least likely to exit RRH to a permanent housing placement compared to the two other subgroups. Results affirm that individuals with greater psychosocial self-sufficiency have better housing outcomes through RRH than those with more complex support needs. Future research is needed to understand factors influencing differential self-sufficiency, as measured by the SSM, among Black and White individuals.

Considering climate and conflict conditions together to improve interventions that prevent child acute malnutrition.

Despite early warning signs about threats to food security, humanitarian interventions often lag behind these warning signs. Climate and conflict conditions are among the most important factors preceding food system failures and malnutrition crises around the world. Research shows how conflict and climate conditions can upend functional food and economic systems, but this research does not address the severe health impacts of these conditions on infants and young children. Translating quantitative research findings into humanitarian interventions requires geographical detail, resulting in location-specific alerts of risks of food insecurity. We describe how the use of readily available, spatially referenced quantitative data can support targeted interventions for nutrition resiliency. Effective humanitarian programmes for targeted nutrition interventions require real-time datasets on food security drivers and models that can provide actionable guidance to mitigate negative impacts of conflict and climate conditions on the people most susceptible to food insecurity. Although treatment of acute malnutrition is important, treating existing malnutrition is not enough. Instead, action to prevent acute malnutrition should be taken to minimise suffering and to maximise wellbeing, particularly in contexts prone to worsening climate and conflict conditions.

Neighborhood Socioeconomic Resources and Crime-Related Psychosocial Hazards, Stroke Risk, and Cognition in Older Adults.

Living in neighborhoods with lower incomes, lower education/occupational levels, and/or higher crime increases one's risk of developing chronic health problems including cardiovascular disease risk factors and stroke. These cardiovascular health problems are known to contribute to cognitive decline and dementia. The purpose of this study was to determine the association of neighborhood socioeconomic resources and crime-related psychosocial hazards on stroke risk and cognition, hypothesizing that cardiovascular health would mediate any relationship between the neighborhood-level environment and cognition. The study evaluated 121 non-demented Chicago-area adults (~67 years; 40% non-Latino White) for cardiovascular health problems using the Framingham Stroke Risk Profile 10-year risk of stroke (FSRP-10). The cognitive domains that were tested included memory, executive functioning, and attention/information processing. Neighborhood socioeconomic resources were quantified at the census tract level (income, education, and occupation); crime-related psychosocial hazards were quantified at the point level. Structural equation modeling (SEM) did not show that the FSRP-10 mediated the relationship between neighborhood characteristics and domain-specific cognition. The SEM results did suggest that higher crime rates were associated with a higher FSRP-10 (ß(105) = 2.38, p = 0.03) and that higher FSRP-10 is associated with reduced attention/information processing performance (ß(105) = -0.04, p = 0.02) after accounting for neighborhood socioeconomic resources. Clinicians may wish to query not only individual but also neighborhood-level health when considering cognition.

Stressors of Rape Crisis Work From the Perspectives of Advocates With and Without Sexual Assault Victimization History.

Rape crisis centers largely rely on volunteers for delivering emergency room advocacy to survivors of sexual assault. Volunteer advocates bear witness to trauma as part of their role, such as when listening to details of sexual assault. This exposure may negatively affect advocates long term, which may lead to secondary traumatic stress and vicarious traumatization, and possibly reduce their ability to provide quality services and remain in their role. In addition, some advocates may be survivors of sexual assault themselves. Survivors may differentially experience the toll of advocacy work. The present qualitative study sought to identify stressors that advocates face within their role, aspects of stressors unique to survivors who advocate, and the effects of stressors on advocates. Semistructured interviews were conducted with 18 current volunteer advocates, 11 of whom identified as survivors, from three rape crisis centers. Findings demonstrated stressors associated with self-evaluation; rules or expectations of the role (including the crisis nature of the role); witnessing lack of client support; helplessness around sexual assault as a systems issue; identifying with the client; witnessing the physical and emotional impact on clients; and being reminded of their own assault. Results also revealed how these stressors and advocacy overall influenced advocates. Unique aspects of stressors to survivors arose in the way advocates experienced the stressors. In addition, survivors exclusively described being reminded of past trauma within advocacy work. Findings have implications for supporting advocate well-being by better understanding the stressors that may lead to negative outcomes and informing individual coping, training, and overall organizational support of advocates. Such measures may ensure retention of volunteers and maintain quality advocacy services.

Domestic migration and mobile phones: A qualitative case study focused on recent migrants to Ouagadougou, Burkina Faso.

Migration has long been used as a strategy for livelihood diversification in rural, subsistence communities. Yet in order for migration to effectively serve as a livelihood diversification strategy, it should meet certain conditions: migration should ease financial burdens, should confer access to economically valuable resources and information, and should broaden social networks. Using qualitative data gathered in 25 interviews with rural migrants to Ouagadougou, Burkina Faso, we examine how mobile phone technology has impacted migration as a livelihood diversification strategy. Our results show that while mobile phones facilitate migration, the advantages conferred may benefit migrants at the expense of the home communities. Mobile phones alleviate financial constraints, enable access to broader networks, and facilitate informational and resource support among migrants. Our results show limited evidence of migrants using mobile phone technology to provide resources or information to the home community. Our results highlight the need to reconsider the ways in which migration can be used as a livelihood diversification strategy in light of changing communication technologies to promote the economic success of both migrants and their home communities.

Attempting Randomized Housing First Research in a Community Context: Reflections on Failure.

The Housing First (HF) model of permanent supportive housing for individuals experiencing chronic homelessness has a strong evidence base that has largely been driven by researchers in the field of community psychology in partnership with community-based organizations. However, important gaps in the HF literature remain. Implementing rigorous research designs to further the evidence for HF requires immense resources to fund both the housing intervention and the research activities. In the absence of such resources, university-community partnerships may be established to integrate research within business-as-usual services and utilize existing housing units. This first person account presents a "post-mortem" exploration of an attempt to conduct a randomized trial of scattered-site and single-site approaches to HF within a community context from the perspectives of multiple stakeholders involved in the endeavor. Despite strengths of the research collaborative, the project did not come to completion due to a series of both insurmountable and avoidable barriers. Yet, the experience illuminated several potential challenges researchers and housing providers conducting work in this area may encounter, such as ever-changing homeless service system policies that may impact research and organizational procedures. Lessons learned and recommendations for preventing or overcoming systems-level barriers and potential challenges within the university-community partnership are described.

Mapping the effects of drought on child stunting.

As climate change continues, it is expected to have increasingly adverse impacts on child nutrition outcomes, and these impacts will be moderated by a variety of governmental, economic, infrastructural, and environmental factors. To date, attempts to map the vulnerability of food systems to climate change and drought have focused on mapping these factors but have not incorporated observations of historic climate shocks and nutrition outcomes. We significantly improve on these approaches by using over 580,000 observations of children from 53 countries to examine how precipitation extremes since 1990 have affected nutrition outcomes. We show that precipitation extremes and drought in particular are associated with worse child nutrition. We further show that the effects of drought on child undernutrition are mitigated or amplified by a variety of factors that affect both the adaptive capacity and sensitivity of local food systems with respect to shocks. Finally, we estimate a model drawing on historical observations of drought, geographic conditions, and nutrition outcomes to make a global map of where child stunting would be expected to increase under drought based on current conditions. As climate change makes drought more commonplace and more severe, these results will aid policymakers by highlighting which areas are most vulnerable as well as which factors contribute the most to creating resilient food systems.

Intention to Read to Newborns Following a Brief Reading Promotion Intervention among Low-Income Pregnant Women.

INTRODUCTION: Reading to children can increase word knowledge and success in school. The American Academy of Pediatrics recommends beginning reading at birth. However, children from low-income families are exposed to less words, including reading exposure, than children from high-income families. METHODS: Pregnant women attending a community prenatal education program targeted at high-risk and low-income populations were recruited into this study. Participants completed a pre-survey, engaged with a brief educational intervention, then completed a matched post-survey. Surveys assessed perceived benefits, intended behaviors, and self-efficacy regarding reading to their child. RESULTS: Of 61 eligible participants, 54 (89%) completed the study. Participants reported being Black (33%), White (30%), Hispanic (28%), and other race (9%). Average gestational age at enrollment was 27 weeks (range 13 to 38 weeks). The average age of respondents was 26 years (SD = 7.2); 46% reported being pregnant for the first time. Following the intervention, no change in knowledge regarding benefits of reading was observed, however, baseline knowledge was high (58% - 94%). At post-test, significantly more women reported it was important to start reading to their child at birth (83% vs 56%; p < 0.001) and that they planned to start reading to their child at birth (70% vs 50%; p = 0.001). CONCLUSIONS: A brief educational intervention showed promise in increasing pregnant women's intentions to read to their children and should be considered in conjunction with other reading promotion programs. Follow-up to assess actual reading behavior is needed.

Psychometric properties of the self-sufficiency matrix among homeless and vulnerably housed individuals and families.

Homeless service systems have been implementing assessment tools to inform service provision for individuals and families. Although a variety of assessments are available, their psychometric evidence base is limited. The self-sufficiency matrix (SSM) is one assessment that demonstrates promising reliability and validity. However, the SSM's factor structure has been inconsistent across studies. This study explored the factor structure of the SSM, using exploratory factor analysis and confirmatory factor analysis in a sample of individuals (N = 427) and families ( N = 428) at risk of or experiencing homelessness. Data were derived from a midwestern city's Homeless Management Information System and included all participants from the Homelessness Prevention and Rapid Re-Housing Program. Results suggest the SSM is multidimensional and the factor structure differs across individuals and families. Additionally, the SSM demonstrates measurement invariance across racial and gender groups. Further development and testing of the SSM is necessary to better serve individuals experiencing homelessness.

Trauma Intervention in Sub-Saharan African Children: A Systematic Literature Review.

Sub-Saharan Africa is a part of the world that is highly affected by a large number of atrocities, causing a myriad of financial, physical health, and mental health consequences. Yet, unfortunately, according to the World Health Organization (WHO), this is also the part of the world that is least served by mental health services. In response, the WHO has created mandates to increase mental health resources and capacity in all countries. Researchers have taken on the work of introducing and adapting treatments in various sub-Saharan African countries with an aim to create sustainable, evidence-based treatment in a part of the world with high need. The current qualitative systematic review of the literature examines 20 articles that report on research conducted in sub-Saharan African countries with children who have suffered different types of traumas. This review answers questions concerning the types of treatments used, the people administering the treatments, the measures they take to adapt these treatments, and the types of outcomes that are seen. Overall, the majority of treatments being used are shown to be effective with the associated populations.

Predictors of employment outcomes in a comprehensive service program for individuals experiencing chronic homelessness.

This study examined predictors of employment service referral and employment outcomes among individuals experiencing chronic homelessness participating in a comprehensive service program emphasizing housing placement and economic independence. The sample included all participants enrolled in the program. Participants self-determined whether to be referred for employment services. Outcomes included (a) whether participants were referred for employment services offered by the program (N = 275); and (b) whether employment was attained among the subsample of participants referred for employment services (N = 135). Logistic regression analyses for the 2 outcomes were conducted. Predictors included demographics and health indicators collected via self-report during program intake. Participants who were younger and racial/ethnic minorities were more likely to seek referrals than those who were older and White/European American. Individuals who were unemployed due to disability were less likely to seek referrals than those who were unemployed but seeking employment. Participants with better reported health and who were unemployed but seeking employment were more likely to attain employment than those with poor health or were unemployed for another reason (e.g., retired, disabled). Findings from this study have implications for employment services implemented in the context of homeless service programs. Future developments in employment services for people who are chronically homeless should include an array of employment services varying in intensity based on need. Other issues to be addressed to facilitate employment and its impact include addressing stigma and increasing earning potential. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Permanent Housing Placement and Reentry to Services Among Family Recipients of Homelessness Prevention and Rapid Re-Housing Program (HPRP) Assistance.

The Homelessness Prevention and Rapid Re-Housing Program (HPRP) provided individuals and families who were either at-risk or currently experiencing homelessness with time-limited financial and housing support services. Evaluations of HPRP showed a high rate of family placement into permanent housing. However, little research has explored immediate and longitudinal outcomes for families enrolled in HPRP. Using Homeless Management Information System data from Indianapolis, Indiana, we examined demographic and program-related predictors of families entering permanent housing and their risk of reentry into homeless services following HPRP participation. The sample included 511 families who enrolled in the program from 2009 to 2012, with an average follow-up period of 4.5 years. We conducted analyses separately for Homelessness Prevention (HP) recipients (n = 357) and Rapid Re-Housing (RRH) recipients (n = 154). Results revealed that HP families were more likely to enter permanent housing if they: included adults who were older in age, were enrolled longer in the program, were provided rental arrear services and utility payments, and did not receive legal services. RRH families receiving rental assistance services had significantly greater odds of entering permanent housing. Among permanently housed families, at least one family member in 10.9% of HP recipients and 18.8% of RRH recipients reentered homeless services. HP families with younger children and one veteran family member were at increased risk of reentry to homelessness services. RRH recipients who did not receive moving cost services and had more children were at greater risk of reentry. Study findings suggest a need for future research on HP and RRH interventions that identify unique service needs among families who are experiencing housing instability or homelessness.

Uncertainties of potentials and recent changes in global yields of major crops resulting from census- and satellite-based yield datasets at multiple resolutions.

Global agriculture is under pressure to meet increasing demand for food and agricultural products. There are several global assessments of crop yields, but we know little about the uncertainties of their key findings, as the assessments are driven by the single best yield dataset available when each assessment was conducted. Recently, two different spatially explicit, global, historical yield datasets, one based on agricultural census and the other largely based on satellite remote sensing, became available. Using these datasets, we compare the similarities and differences in global yield gaps, trend patterns, growth rates and changes in year-to-year variability. We analyzed maize, rice, wheat and soybean for the period of 1981 to 2008 at four resolutions (0.083°, 0.5°, 1.0° and 2.0°). Although estimates varied by dataset and resolution, the global mean annual growth rates of 1.7-1.8%, 1.5-1.7%, 1.1-1.3% and 1.4-1.6% for maize, rice, wheat and soybean, respectively, are not on track to double crop production by 2050. Potential production increases that can be attributed to closing yield gaps estimated from the satellite-based dataset are almost twice those estimated from the census-based dataset. Detected yield variability changes in rice and wheat are sensitive to the choice of dataset and resolution, but they are relatively robust for maize and soybean. Estimates of yield gaps and variability changes are more uncertain than those of yield trend patterns and growth rates. These tendencies are consistent across crops. Efforts to reduce uncertainties are required to gain a better understanding of historical change and crop production potential to better inform agricultural policies and investments.