Trust betrayal is a subjective feeling of a street‐level bureaucrat (SLB) that a client acted contrary to expectations, diminishing the former's belief in the latter's good intentions. How do SLBs ...experience a betrayal of trust by clients? How do such betrayals shape the future ways in which SLBs cope with clients? We investigate these questions empirically using semi‐structured, in‐depth interviews and focus groups with Israeli social service providers. The findings reveal four types of client trust betrayal: integrity‐based, previous impression‐based, legitimate behavior‐based, and category‐based. We identify five strategies SLBs employ to cope with clients following such betrayals. With specific clients who betrayed their trust, they adopt minimal, formal, and guarded behavior; they satisfy the client's demands; they sever the relationship with the client entirely. With future clients, they exhibit careful, less “naïve” behavior and adopt a boundary‐setting approach. The negative implications for public service delivery may be far‐reaching.
תקציר
בגידה באמון היא תחושה סובייקטיבית של בירוקרט ברמת הרחוב כי הלקוח פעל בניגוד לציפיותיו המוקדמות, דבר שהפחית את אמונת הראשון בכוונותיו הטובות של האחרון. כיצד בירוקרטים ברמת הרחוב חווים בגידה באמון מצד לקוחות? כיצד בגידות אלה מעצבות את דרכי ההתמודדות העתידיות שמאמצים בירוקרטים ברמת הרחוב עם לקוחות? אנו חוקרים שאלות אלה באופן אמפירי באמצעות ראיונות עומק חצי‐מובנים וקבוצות מיקוד עם ספקי שירותים חברתיים ישראליים. הממצאים חושפים ארבעה סוגים של בגידה באמון מצד לקוחות: בגידה מבוססת יושרה, בגידה מבוססת רושם קודם, בגידה בהתנהגות לגיטימית ובגידה מבוססת קטגוריה. אנו מזהים חמש אסטרטגיות שבירוקרטים ברמת הרחוב מאמצים בכדי להתמודד עם לקוחות בעקבות בגידות אלה. עם לקוחות ספציפיים שבגדו באמונם, הם מאמצים התנהגות מינימלית, רשמית ושמורה; הם מספקים את דרישות הלקוח; הם מנתקים את הקשר עם הלקוח לצמיתות. עם לקוחות עתידים הם מגלים התנהגות זהירה ופחות "נאיבית" ונוקטים בגישה של הצבת גבולות. ההשלכות השליליות של התופעה על אספקת השירות הציבורי עשויות להיות מרחיקות לכת.
Abstract
The aim of the study was to understand structural and socio-political barriers faced by social workers to providing services to Arab-Palestinian young women abused in childhood, considering ...their multiple marginalisation. The literature has addressed the structural barriers in terms of the written policy and the social services provided to the Arab-Palestinian minority. However, little is known about how these barriers affect the provision of services to Arab-Palestinian young women abused in childhood from the perspective of service providers. To address this gap, twenty-one social workers were interviewed in depth. The findings revealed two main themes: (i) structural discrimination and the socio-political context of Arab Palestinians in Israel; (ii) challenges and structural barriers at the level of social policy. Our findings shed light on the oppressive othering of Arab-Palestinian young women, who feel invisible vis- à-vis governmental organisations. Thus, social workers working in the field should examine the needs of the young women and work in collaboration with senior government officials to promote culture- and gender-adapted programmes.
Little is known about social workers who work with minorities living in conflict areas, such as Arab-Palestinian young women in Israel who were abused in childhood. They face various intensified barriers to providing services, which are related, amongst other things, to the majority–minority relationship. Our study aimed to clarify the barriers faced by social workers who provide services to these women. The findings show the social workers’ point of view regarding poverty, social exclusion and discrimination against Arabs in Israel. Their challenges include the lack of adapted services, inaccessibility of services, a policy that neglects dealing with risk situation by social workers and the young women’s perception of social workers as representatives of the establishment. Our conclusions show that social workers need to understand the cultural, social and political context in which Arab-Palestinian young women live in Israel. Moreover, policy makers need to provide a tailored response both to the young women and their social workers, such as contextual awareness training.
The Scottish oral health and psychosocial wellbeing programme, Smile4life, identified a scarce knowledge of the health and social services available for those going through homelessness or at risk of ...becoming homeless. The Public Bodies (Joint Working) (Scotland) Act 2014 aims to integrate health and social care in Scotland to meet the needs of vulnerable populations. The Reflexive Mapping Exercise aims to integrate care by providing a framework to map services that allows for analysis of the geographic distribution and types of support that has been offered. The reflexive component discusses joint strategies to integrate services, improve practices, and reduce unequal distribution that might marginalise individuals, limiting their access and engagement with services.
The reflexive mapping framework aims to maximise participation and development through co-designed participatory research, involving an advisory group composed of key stakeholders and individuals with lived experience. Policy makers and practitioners working in the homelessness sector collaborated to gather, review, and update the data collected about services through online searches, telephone calls, institutional visits, and event consultations. An analysis of the current service provision was made to identify deficits and areas to improve.
The mapping is a visual and descriptive publication that includes services from different areas of support and their referral pathways. The completed mappings and reflexive exercises have shown a scarcity of services allocated to the most deprived areas of Scotland, with the majority of services seeking to address crisis periods with little aim at prevention, early intervention, and sustainability.
The mapping process identified the need to take a prophylactic approach and create a more equitable distribution of services. The Reflexive Mapping Exercise helps to provide a framework that promotes communication and integration of health and social care services among practitioners and vulnerable services users. A reflexive approach helps to plan the strategic delivery of homeless services in Scotland with the service user at the forefront of care. The limitations surrounding the dynamic nature of service provision changes have been identified and are planned to be addressed through the formation of an online interactive resource.
This work was supported by Scottish Government (grant number 121.80.4497).
Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to ...adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the acute health crises of falls, delirium and immobility. A more proactive, integrated, person-centred and community-based response to frailty is required. The British Geriatrics Society Fit for Frailty guideline is consensus best practice guidance for the management of frailty in community and outpatient settings.
The BGS recommends that all encounters between health and social care staff and older people in community and outpatient settings should include an assessment for frailty. A gait speed <0.8m/s; a timed-up-and-go test >10s; and a score of ≥3 on the PRISMA 7 questionnaire can indicate frailty. The common clinical presentations of frailty (falls, delirium, sudden immobility) can also be used to indicate the possible presence of frailty.
The BGS recommends an holistic medical review based on the principles of comprehensive geriatric assessment (CGA) for all older people identified with frailty. This will: diagnose medical illnesses to optimise treatment; apply evidence-based medication review checklists (e.g. STOPP/START criteria); include discussion with older people and carers to define the impact of illness; work with the older person to create an individualised care and support plan.
The BGS does not recommend population screening for frailty using currently available instruments.
Accompanying the success of the radical right and right-wing populist movements, right-wing alternative online media have recently gained prominence and, to some extent, influence on public discourse ...and elections. The existing scholarship so far focuses primarily on the role of content and social media distribution and pays little attention to the audiences of right-wing alternative media, especially at a cross-national level and in the European context. The present paper addresses this gap by exploring the characteristics of the audiences of right-wing alternative online media. Based on a secondary data analysis of the 2019 Reuters Digital News Survey, this article presents a cross-national analysis of right-wing alternative media use in Northern and Central Europe. The results indicate a comparatively high prevalence of right-wing alternative online media in Sweden, whereas in Germany, Austria, and Finland, these news websites seem to be far less popular. With regard to audience characteristics, the strongest predictors of right-wing alternative online media use are political interest and a critical stance towards immigration, accompanied by a skeptical assessment of news quality, in general, and distrust, especially in public service broadcasting media. Additionally, the use of social media as a primary news source increases the likelihood of right-wing alternative news consumption. This corroborates the high relevance of social media platforms as distributors and multipliers of right-wing alternative news content. The findings suggest that right-wing alternative online media should not be underestimated as a peripheral phenomenon, but rather have to be considered influential factors for center-right to radical right-leaning politics and audiences in public discourse, with a high mobilizing and polarizing potential.
•Decentralized health service delivery is associated with increased production of preventive healthcare services for women.•The primary mechanism for this is increased monitoring of health workers by ...intermediary organizations under the reform.•Decentralization also insulated the Regional Health Authority from political fallout from key local actors.•This allowed it to assert its influence and pressure for improved service delivery through the intermediary organizations.
Governments in many less developed countries have decentralized their social support systems over the last several decades. However, despite enthusiasm for these reforms, evidence remains limited and mixed as to whether they improve the delivery of basic social services. I take advantage of an unexpected pause in reform implementation in Honduras due to the country’s 2009 coup to investigate the effects of decentralization on local health services. Drawing on administrative data, an original survey of health workers, and qualitative interviews, my analysis shows that decentralization is credibly associated with increases in preventive care for women and that improved accountability and greater resilience to shocks are important mechanisms for this change. Moreover, my analysis highlights how regional organizations use decentralization to assert their own influence and deflect negative political consequences while pressuring for improvements in service delivery. These findings shed light both on the possibilities for improving local social services through governance reform and how national-level reforms can be leveraged by powerful actors at lower rungs of the governmental hierarchy.
A post-conflict environment may be more conducive to achieving a transformational agenda through the layering of these incremental transformative dynamics. Implementing a transitional justice ...mechanism, like a reparations program, may be one such incremental, though significant, marker, but it will not singly create the transformation ultimately sought. This framing of transformative dynamics attempts to mitigate the placement of unrealistic expectations on transitional justice mechanisms in the larger goal of transforming social order. Here, Kawahara highlights applicable theory, beginning with a brief discussion of transitional justice and arguing instead for a transformative dynamics framework. She uses Robert Cox's binary theoretical approaches to world order as an illustration. She introduces reparations as one transitional justice mechanism and explains how the purpose of reparations--specifically reparations under Roy Brooks' Atonement Model--fundamentally limits what it can achieve, noting that reparations cannot and should not be expected to fill gaps in development programs or social services. She addresses how reparations, development programs, and social services may be wrongly viewed as synonymous but can be complementary.
This collection of essays had its origins in a one-day workshop held in August 2015 at The Australian National University. Jointly convened by Dr John Butcher (ANZSOG) and Professor David Gilchrist ...(Curtin Not-for-profit Initiative) the purpose of the workshop was to bring together academic researchers, policy practitioners and thought leaders to address a variety of emerging issues facing policymakers, public sector commissioners, not-for-profit providers of publicly funded services, and businesses interested in opportunities for social investment. The workshop itself generated a great deal of interest and a ‘baker’s dozen’ of contributors challenged and engaged a full house. The level of enthusiasm shown by the audience for the subject matter was such that the decision to curate the presentations in the form of a book was never in doubt. The editors trust that this volume will vindicate that decision. At one time the state exercised a near monopoly in the delivery of social programs. Today, almost every important public problem is a three sector problem and yet we have little idea of what a high-performing three sector production system looks like. It is the editors’ hope that this volume will provide a foundation for some answers to these important public policy questions.
Co-opetition in the business world refers to a situation in which competing private firms find it mutually beneficial to cooperate under specific conditions in an effort to jointly finance certain ...activities for a common purpose that benefits each firm.1 In our view, encouraging health insurers to apply this business approach to community health, where it is generally unfamiliar, may be a key to tackling social determinants of health (SDOH).It is well understood that social services, quality housing, food, and other services are important SDOH. These upstream factors are typically addressed by various communitybased organizations (CBOs), including nonprofit social service organizations and local government agencies, whose effectiveness in improving health hinges on how well CBOs and health insurers coordinate referrals, services, funding, and data. Effective coordination requires a smoothly functioning and adequately financed health and social service ecosystem infrastructure built on local trust among CBOs and between CBOs and clients, as well as managerial competence to track referrals and outcomes. Infrastructure encompasses both information exchanges (e.g., Unite Us, Healthify, findhelp, CIE San Diego)2 and network curators (e.g., community health clinics, Area Agencies on Aging) facilitating contracting and outcome reporting.Less well understood is the reality that both social services and the ecosystem's infrastructure have properties resembling public goods. This means that an investor's competitors and multiple downstream stakeholders can benefit from services and infrastructure without contributing to their cost and cannot easily be prevented from benefiting from others' investments.3 This "free rider" problem discourages investors and helps explain the relative lack of investment in SDOH services and infrastructure in comparison with health care delivery systems; organizations are reluctant to invest if their competitors also benefit.
Telehealth has gained substantial attention during the COVID-19 pandemic, and reimbursement policies in health care settings have increased access to remote modes of care delivery. Telehealth has the ...potential to mitigate care concerns for people living with dementia and their family caregivers. There is a paucity of knowledge on the performance of telehealth services and user experiences, especially among caregiving dyads during the pandemic.
This study aims to describe the implementation, effectiveness, user experience, and barriers to accessing and using telehealth services for people living with dementia and their caregivers during the COVID-19 pandemic.
Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, we searched 7 databases (PubMed, PsycINFO, AgeLine, CINAHL, Social Services Abstracts, Web of Science, and Scopus) and a web-based search engine (Google Scholar). The inclusion criteria for peer-reviewed English publications from March 2020 to August 2022 consisted of studies related to telehealth services for people living with dementia and their family caregivers and studies conducted during the COVID-19 pandemic.
A total of 24 articles (10 quantitative and 14 qualitative studies) from 10 different countries were included. The major findings of the reviewed articles were extracted and organized into the following 4 themes: study design characteristics-strategies were adopted to improve the accessibility and experience of people living with dementia-caregiver dyads; efficacy outcomes of telehealth services-robust evidence is lacking on the comparative effectiveness of in-person services; perceived experiences of people living with dementia and caregivers-most reviewed studies reported positive experiences of using telehealth services and perceived personal and social benefits from their participants; and barriers to accessing and using telehealth services-several barriers related to individuals, infrastructure, and telehealth environments were identified.
Although evidence of its effectiveness is still limited, telehealth is widely accepted as a viable alternative to in-person care for high-risk groups, such as people living with dementia and their caregivers. Future research should include expanding digital access for those with limited resources and low technology literacy, adopting randomized controlled trial designs to establish the comparative effectiveness of different modes of service delivery, and increasing the sample diversity.
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