This study describes the implementation of three evidence-based treatments addressing traumatic stress symptoms within a wraparound foster care program in Illinois. Child–Parent Psychotherapy (CPP), ...Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) were implemented with a racially diverse sample of youth ages 3–18 at six agencies. Culturally sensitive adaptations were made to treatment approaches to improve client retention and outcomes. Data analyses revealed no racial differences in retention in the program and no differences in outcomes between minority youth exposed to the intervention and other participants. All three evidence-based treatments were effective in reducing symptoms and improving functioning among minority youth. Implementation issues, including challenges and culturally competent accommodations, are discussed.
Since the outbreak of COVID-19, billions of people have gone into lockdown, facing pandemic related challenges that engender weight gain, especially in the obese. We report the results of an online ...survey, conducted during Israel's first quarantine, of 279 adults treated in hospital-based obesity clinics with counseling, medications, surgery, endoscopic procedures, or any combination of these for weight loss. In this study, we assessed the association between changes in dietary and lifestyle habits and body weight, and the benefits of receiving weight management care remotely through telemedicine during lockdown. Compared to patients not receiving obesity care via telemedicine, patients receiving this care were more likely to lose weight (OR, 2.79;
= 0.042) and also to increase participation in exercise (OR, 2.4;
= 0.022). While 40% of respondents reported consuming more sweet or salty processed snacks and 33% reported less vegetables and fruits, 65% reported more homemade foods. At the same time, 40% of respondents reported a reduction in exercise and 52% reported a decline in mood. Alterations in these eating patterns, as well as in exercise habits and mood, were significantly associated with weight changes. This study highlights that lockdown affects health behaviors associated with weight change, and advocates for the use of telemedicine to provide ongoing obesity care during future quarantines in order to promote weight loss and prevent weight gain.
In the Old Northwest from 1830 to 1870, a bold set of activists battled slavery and racial prejudice. This book is about their expansive efforts to eradicate southern slavery and its local influence ...in the contentious milieu of four new states carved out of the Northwest Territory: Illinois, Indiana, Michigan, and Ohio. While the Northwest Ordinance outlawed slavery in the region in 1787, in reality both it and racism continued to exert strong influence in the Old Northwest, as seen in the race-based limitations of civil liberties there. Indeed, these states comprised the central battleground over race and rights in antebellum America, in a time when race's social meaning was deeply infused into all aspects of Americans' lives, and when people struggled to establish political consensus. Antislavery and anti-prejudice activists from a range of institutional bases crossed racial lines as they battled to expand African American rights in this region. Whether they were antislavery lecturers, journalists, or African American leaders of the Black Convention Movement, women or men, they formed associations, wrote publicly to denounce their local racial climate, and gave controversial lectures. In the process, they discovered that they had to fight for their own right to advocate for others. This bracing new history by Dana Elizabeth Weiner is thus not only a history of activism, but also a history of how Old Northwest reformers understood the law and shaped new conceptions of justice and civil liberties. The newest addition to the Mellon-sponsored Early American Places Series, Race and Rights will be a much-welcomed contribution to the study of race and social activism in nineteenth-century America.
Abstract Out-of-home placement decision-making in child welfare is founded on the best interest of the child in the least restrictive setting. After a child is removed from home, however, little is ...known about the mechanism of placement decision-making. This study aims to systematically examine the patterns of out-of-home placement decisions made in a state's child welfare system by comparing two models of placement decision-making: a multidisciplinary team decision-making model and a clinically based decision support algorithm. Based on records of 7816 placement decisions representing 6096 children over a 4-year period, hierarchical log-linear modeling characterized concordance or agreement, and discordance or disagreement when comparing the two models and accounting for age-appropriate placement options. Children aged below 16 had an overall concordance rate of 55.7%, most apparent in the least restrictive (20.4%) and the most restrictive placement (18.4%). Older youth showed greater discordant distributions (62.9%). Log-linear analysis confirmed the overall robustness of concordance (odd ratios ORs range: 2.9–442.0), though discordance was most evident from small deviations from the decision support algorithm, such as one-level under-placement in group home ( OR = 5.3) and one-level over-placement in residential treatment center ( OR = 4.8). Concordance should be further explored using child-level clinical and placement stability outcomes. Discordance might be explained by dynamic factors such as availability of placements, caregiver preferences, or policy changes and could be justified by positive child-level outcomes. Empirical placement decision-making is critical to a child's journey in child welfare and should be continuously improved to effect positive child welfare outcomes.
The effective delivery of wraparound depends upon the availability of a wide range of community-based services. This study seeks to determine the impact of proximity to resources on the effectiveness ...of a wraparound program for stabilizing foster care placements among a sample of youth. We present a methodology for deriving proximity scores for individual clients using Geographic Information Systems technology, and incorporate this score into a model for predicting placement disruption among youth in foster care receiving services within a wraparound model aimed at preventing placement disruptions. Cox Regression is used to predict length of time until placement disruption using clinical, demographic, and service proximity measures. Risk of placement disruption is predicted by trauma experiences, risk behaviors, and age, and is reduced by the presence of child strengths and proximity to resources. The impact of proximity to resources on placement disruption varies by land use type, suggesting that proximity exerts a greater impact on youth in rural and suburban areas than in urban areas where wraparound service delivery models may be able to overcome distance and other barriers. Implications for the implementation of wraparound programs as well as service system planning are discussed.
The effectiveness of mental health care services is severely limited when young people run away from residential treatment. This study describes the development of a decision support model for ...predicting discharge due to running away on the basis of individual characteristics. Subjects include 667 wards of a large Midwestern state between the ages of 7 and 20 who were placed in residential treatment and discharged during 2007. A model combining eight predictors-namely School Attendance, History of Running/Runaway Ideation, and linear as well as quadratic terms for Age, Substance Abuse and Delinquency-demonstrated good internal validity and moderate predictive power for discharge due to elopement. Results of this study can support mental health care workers in identifying potential recipients of interventions that reduce the likelihood of premature exits from residential care among young people.
Abstract
Behaviours can be adaptively correlated with each other and with other aspects of phenotype. We investigated behaviour across foraging, mating, and risk contexts in females of the poeciliid ...fish, Girardinus metallicus. We quantified relationships between these behaviours and aggression signals, body size, and reproductive output. Behaviours describing aggression and boldness, some of which were repeatable, were correlated in females. Aggression was signalled by the darkening of a black spot on the extended dorsal fin or by fin flaring. Spot darkening occurred during intra- and intersexual interactions and was positively correlated with interfemale aggression and negatively correlated with the time females spent following males, suggesting that it is an honest indicator of motivational state. In contrast, fin flaring was directed only at females and occurred more frequently in the foraging context. Larger females had fewer offspring and received fewer courtship displays, possibly because they were more aggressive to males. In contrast to studies of males, we found a negative relationship between rank order of boldness and aggression, consistent with either a trade-off or with selection favouring the negative relationship. Our results highlight the importance of studying females in model systems to uncover novel patterns and potentially meaningful departures from what is typically seen in males.
As state and local jurisdictions in the United States prepare to implement the provisions of the 2018 Family First Preventive Services Act (FFPSA), they are faced with the large-scale challenge of ...making effective linkages between geographically dispersed clients and local preventive services. This pilot study applies a conceptual framework (Proctor et al., 2011) to describe implementation of a scalable, mobile community resource referral tool for use by child and family welfare caseworkers serving intact families with allegations of abuse or neglect. The study also demonstrates how data generated by use of the resource referral technology can be applied to visualize the geographic distribution of resource needs in relation to availability. Caseworkers from one urban agency were trained and given access to the mobile referral tool for a three-month observation period. Implementation data were obtained using mixed methods, including self-administered surveys, semi-structured focus group interviews with caseworkers, and metadata generated by the referral technology. Appropriateness, acceptability and feasibility outcomes were assessed. Findings establish that a mobile referral technology can be implemented with minimal training into caseworker workflows, and identify challenges that can be addressed in future iterations and implementations to reduce redundancy and prevent interruption in referral communication. Additionally, the use of mobile referral technology improved the ability of child welfare professionals to document referrals, and can provide child welfare systems with geographical information about need that will be essential for refining the preventive service continuum. Overall, the functionality of the tool and the data it generates will be important for optimizing resource referrals for preventive case management of child welfare-involved families.
•This study tests the feasibility of implementing a mobile resource referral technology among child welfare preventive caseworkers.•Implementation of mobile resource referral technology is feasible.•Challenges include integration/compatibility with existing technology and attitudes about digital vs. written documentation.•Geographic data on service need and accessibility can inform adjustments to the child welfare preventive service array.
After children enter the child welfare system, subsequent out-of-home placement decisions and their impact on children’s well-being are complex and under-researched. This study examined two placement ...decision-making models: a multidisciplinary team approach, and a decision support algorithm using a standardized assessment. Based on 3,911 placement records in the Illinois child welfare system over 4 years, concordant (agreement) and discordant (disagreement) decisions between the two models were compared. Concordant decisions consistently predicted improvement in children’s well-being regardless of placement type. Discordant decisions showed greater variability. In general, placing children in settings less restrictive than the algorithm suggested (“under-placing”) was associated with less severe baseline functioning but also less improvement over time than placing children according to the algorithm. “Over-placing” children in settings more restrictive than the algorithm recommended was associated with more severe baseline functioning but fewer significant results in rate of improvement than predicted by concordant decisions. The importance of placement decision-making on policy, restrictiveness of placement, and delivery of treatments and services in child welfare are discussed.
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