scholarly journals Intersecting systemic and personal barriers to accessing social services: qualitative interviews in northern California

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilary Placzek ◽  
Stephanie Cruz ◽  
Michelle Chapdelaine ◽  
Mary Carl ◽  
Sara Levin ◽  
...  
Keyword(s):  
Social Services ◽  
Social Issues ◽  
Safety Net ◽  
Social Needs ◽  
Qualitative Assessment ◽  
Community Resources ◽  
Northern California ◽  
Care Clinic ◽  
Social Risks ◽  
Patient Reported

Abstract Background Addressing social risks in the clinical setting can increase patient confidence in the availability of community resources and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts. It is not well understood what barriers patients face when trying to connect to community resources that help address social risks. This paper aims to describe patient-reported barriers to accessing and using social needs-related resources to which they are referred by a program embedded in a safety net primary care clinic. Methods This is a qualitative assessment of patient-reported barriers to accessing and using social needs assistance programs. We conducted over 100 in-depth interviews with individuals in Northern California who participated in a navigation and referral program to help address their social needs and describe a unique framework for understanding how policies and systems intersect with an individual’s personal life circumstances. Results Individuals described two distinct domains of barriers: 1) systems-level barriers that were linked to the inequitable distribution of and access to resources, and 2) personal-level barriers that focused on unique limitations experienced by each patient and impacted the way that they accessed services in their communities. While these barriers often overlapped or manifested in similar outcomes, this distinction was key because the systems barriers were not things that individuals could control or overcome through their own initiative or by increasing individual capacity. Conclusions Respondents describe intersecting systemic and personal barriers that compound patients’ challenges to getting their social needs met; this includes both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. These results speak to the need for structural changes to improve adequacy, availability, and accessibility of social needs resources. These findings highlight the need for advocacy to address systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues, and investment in incentives to strengthen relationships between health care settings and social service agencies.

scholarly journals Intersecting Systemic and Personal Barriers to Accessing Social Services: Qualitative Interviews in Northern California

2021 ◽  
Author(s):  
Hilary Placzek ◽  
Stephanie Cruz ◽  
Michelle Chapdelaine ◽  
Mary Carl ◽  
Sara Levin ◽  
...  
Keyword(s):  
Social Services ◽  
Life Histories ◽  
Structural Changes ◽  
Social Issues ◽  
Social Needs ◽  
Qualitative Assessment ◽  
Community Resources ◽  
Northern California ◽  
Social Risks ◽  
Patient Reported

Abstract Background. Addressing social risks in the clinical setting can increase patient confidence in the availability of community resources and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts. It is not well understood what barriers patients face when trying to connect to community resources that help address social risks.Methods. This is a qualitative assessment of patient-reported barriers to accessing and using social needs assistance programs. We conducted over 100 in-depth interviews with individuals in Northern California who participated in a navigation and referral program to help address their social needs and describe a unique framework for understanding how policies and systems intersect with an individual's personal life circumstances.Results. Individuals described two distinct domains of barriers: 1) systems-level barriers that were linked to the inequitable distribution of and access to resources, and 2) personal-level barriers that focused on unique limitations experienced by each patient and impacted the way that they accessed services in their communities. While these barriers often overlapped or manifested in similar outcomes, this distinction was key because the systems barriers were not things that individuals could control or overcome through their own initiative or by increasing individual capacity.Conclusions. Respondents describe intersecting systemic and personal barriers that compound patients’ challenges to getting their social needs met; this includes both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. These results speak to the need for structural changes to improve adequacy, availability, and accessibility of social needs resources. These findings highlight the need for advocacy to address systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues, and investment in incentives to strengthen relationships between health care settings and social service agencies.

scholarly journals DYNAMICS OF DEVELOPMENT OF CIVIL SOCIETY AND THE NON-PROFIT SECTOR IN THE THREE SIBERIAN REGIONS (BASED ON EXPERT EVALUATIONS)

2020 ◽  
Vol 3 (3) ◽  
pp. 13-34
Author(s):  
Daria A. Omelchenko ◽  
Svetlana G. Maximova ◽  
Oksana E. Noyanzina
Keyword(s):  
Civil Society ◽  
Social Services ◽  
Social Issues ◽  
Federal District ◽  
Social Needs ◽  
Actual State ◽  
Novosibirsk Oblast ◽  
Non Profit ◽  
Border Regions ◽  
The Republic

Contemporary Russian social policy is marked by intensive development of state-public partnership as an important instrument for identifying and responding to social issues, improving quality of social services, protecting rights and freedoms of the Russian citizens. Shouldering some of the state functions on the provision of social services, organization of socially significant events and activities, NPOs are often more efficient and effective, they react faster on social needs and provide population with opportunities to participate in resolution of their problems and change their lives for the better way. The analysis of dynamic characteristics of civil society, fulfilled by the authors on the base of expert evaluations in the three border regions of the Siberian federal district (the Altai region, the Novosibirsk oblast, the Republic of Altai, n = 180), allowed to reveal their structure and relationships with peculiarities of the functioning and interaction with other NPOs and governmental bodies at different levels. Our findings suggest that processes in civil society are strongly interconnected, and that the assessment of their actual state and dynamics is very subjective, affected by professional experience and peculiarities of expert organization.

scholarly journals Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Matthew W. Kreuter ◽  
Tess Thompson ◽  
Amy McQueen ◽  
Rachel Garg
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Determinants Of Health ◽  
Social Services ◽  
Social Determinants ◽  
Safety Net ◽  
Social Needs ◽  
Determinants Of Health ◽  
Health Improvement ◽  
Health Care Settings

There has been an explosion of interest in addressing social needs in health care settings. Some efforts, such as screening patients for social needs and connecting them to needed social services, are already in widespread practice. These and other major investments from the health care sector hint at the potential for new multisector collaborations to address social determinants of health and individual social needs. This article discusses the rapidly growing body of research describing the links between social needs and health and the impact of social needs interventions on health improvement, utilization, and costs. We also identify gaps in the knowledge base and implementation challenges to be overcome. We conclude that complementary partnerships among the health care, public health, and social services sectors can build on current momentum to strengthen social safety net policies, modernize social services, and reshape resource allocation to address social determinants of health. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Inter-Sectoral Cooperation for the Implementation of Social Policy in Rural Areas. Proposal of Research Tool

2018 ◽  
pp. 149-161
Author(s):  
Katarzyna Zajda ◽  
Sławomir Pasikowski
Keyword(s):  
Social Policy ◽  
Social Services ◽  
Rural Areas ◽  
Social Issues ◽  
Public Institutions ◽  
Social Needs ◽  
Research Tool ◽  
Effective Implementation ◽  
Rural Municipalities ◽  
Three Factor

The cooperation of local public institutions with non-governmental organisations and citizens can increase chances for the effective implementation of social policy, understood as a set of activities on behalf of satisfying social needs and resolving social issues. The aim of this article is to present a tool that would enable us to determine the level of cooperation between entities in the scope of co-creation and co-production of social services that satisfy the needs of residents of rural municipalities (gmina). The article contains an overview of analyses conducted in 2018 on a sample of public institutions responsible for satisfying social needs and resolving social issues representative of rural municipalities. In light of these analyses the scale is a three-factor construct and includes the following factors: 1. Seeking entities for cooperation and cooperating with them, 2. Including residents of municipalities in undertakings on their own behalf, 3. Evaluation of cooperation and working towards future cooperation.

scholarly journals Interest in Clinic-Based Financial Services among Low-Income Prenatal Patients and its Association with Health-Related Social Risk Factors

2021 ◽  
Vol 12 ◽  
pp. 215013272110244
Author(s):  
Patrick Y. Liu ◽  
Orly Bell ◽  
Olivia Wu ◽  
Monique Holguin ◽  
Christina Lozano ◽  
...  
Keyword(s):  
Low Income ◽  
Financial Services ◽  
Financial Stress ◽  
Well Being ◽  
Safety Net ◽  
Social Needs ◽  
Childhood Development ◽  
Social Risk ◽  
Prenatal Health ◽  
Social Risks

Background Poverty and financial stress affect prenatal health and well-being as well as early childhood development. This study sought to examine interest in clinic-based financial services to address financial stress in low-income, Medicaid-enrolled prenatal patients and its relationship with self-reported social risks. Methods We conducted a cross-sectional study of patients at a large safety-net prenatal clinic. Participants completed a written survey on interest in linkage to financial services, poverty-related financial stress, difficulty affording social needs, and interest in services to address material hardships. We compared interest in financial and social needs services by level of financial stress using multivariate regression. Results Respondents (N = 108) were entirely Medicaid-enrolled, with a majority identifying as Hispanic/Latinx (57%) or Black/African American (20%). Sixty-four percent indicated interest in connection to any of the financial services surveyed. Interest was highest in employment (52%), savings and budgeting (49%), job training/adult education (49%), and financial counseling (48%) services. Individuals with high financial stress, compared to those with low financial stress, expressed a higher level of interest in financial services (aRR = 1.61 [95% CI 1.12-2.39]). Interest in financial services was associated with difficulty affording social needs (aRR = 2.24 [95% CI 1.33-4.43]) and interest in services addressing social needs (aRR = 1.45 [95% CI 1.13-1.92]). Conclusion In this study of low-income, Medicaid-insured prenatal patients, there was a high degree of interest in clinic-based financial services. Integrating financial services into prenatal health care appears to be an approach that low-income patients would be interested in to directly address poverty and financial stress.

scholarly journals Associations Between Patients’ Unmet Social Needs and Self-Reported Health Confidence at One Primary Care Clinic

2020 ◽  
Vol 11 ◽  
pp. 215013272092132
Author(s):  
Heather Bleacher ◽  
Aimee English ◽  
William Leblanc ◽  
L. Miriam Dickinson
Keyword(s):  
Self Efficacy ◽  
Primary Care Clinic ◽  
Patient Activation ◽  
Social Needs ◽  
Wilcoxon Test ◽  
Efficacy Evaluation ◽  
Improvement Project ◽  
Care Clinic ◽  
Patient Reported ◽  
Reported Health

Social determinants of health affect a person’s health at least as much as their interactions with the healthcare system. Increased patient activation and self-efficacy are associated with decreased cost and improved quality. Patient-reported health confidence has been proposed as a more easily measured proxy for self-efficacy. Evaluation of the association between unmet social needs and health confidence is limited. Our objective was to identify and address our patients’ unmet social needs and assess health confidence levels. From November 2017 through July 2018 we screened 2018 patients of an urban academic family medicine residency practice for unmet social needs, measured their health confidence, and made referrals to community resources if desired. Patients reporting the presence of any social need reported lower health confidence scores on average than those with no needs (8.49 vs 9.30, median 9 vs 10, Wilcoxon test P < .001). Low health confidence scores (<7) were strongly associated with number of needs ( P < .001) after adjusting for age, gender, race, ethnicity, payer, and visit type (1 vs 0 needs, odds ratio [OR] = 2.566, 95% CI 1.546-4.259; 2 or more vs 0 needs, OR = 6.201, 95% CI 4.022-9.561). Results of this quality improvement project suggest that patients with unmet social needs may have decreased perceived ability to manage health problems. Further study is needed to determine if this finding is generalizable, and if interventions addressing unmet social needs can increase health confidence.

scholarly journals Health and social impacts of California wildfires and the deficiencies in current recovery resources: An exploratory qualitative study of systems-level issues

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248617
Author(s):  
Annie Rosenthal ◽  
Eric Stover ◽  
Rohini J. Haar
Keyword(s):  
Social Services ◽  
Service Providers ◽  
Social Issues ◽  
Community Support ◽  
Well Being ◽  
Social Needs ◽  
Insurance Companies ◽  
Ripple Effect ◽  
Recovery Resources ◽  
Post Disaster

Background Wildfires in California have become more deadly and destructive in recent years, and four of the ten most destructive fires occurred in 2017 and 2018. Through interviews with service providers, this article explores how these recent wildfires have impacted surrounding communities and the role various recovery resources have played in responding to the short- and long-term health and social needs of survivors. Methods Using a purposive sampling methodology, we interviewed 21 health and social service personnel who assisted in wildfire recovery efforts in California in 2017 and 2018. The study participants worked or volunteered in medical facilities, social services agencies and philanthropy/nonprofit organizations located in communities affected by wildfires. Participants were asked about three common, overarching themes that fire-impacted communities navigate post-disaster: health issues, social issues, and response and recovery resources. Inductive coding was used to identify common subthemes. Results The two most frequently discussed social issues during interviews were housing and employment access. Mental and emotional well-being and access to health resources were identified as being the most challenging health concerns that survivors face post-disaster. Participants also identified the following private and public recovery resources that survivors use to attempt to restabilize following the fire: community support, county agencies, the Federal Emergency Management Agency (FEMA,) insurance companies and philanthropic organizations. However, participants noted that the cumulative impacts of these efforts still leave many of their patients and clients without the resources needed to restabilize emotionally, financially and physically. Finally, participants spoke about the community-wide, downstream impacts of wildfires, noting that “survivors” are not only those whose health is immediately compromised by the disaster. Conclusion Given the worsening wildfire seasons in California, we must increase our understanding of both the scope of the health and social issues that survivors navigate following a disaster, as well as the effectiveness and sustainability of recovery resources available to survivors. We must also understand the “ripple effect” that wildfires have on surrounding communalities, impacting housing access, social services, and health care access. More research and support, especially during the current COVID-19 pandemic, is urgently needed to improve our ability to support the health and social needs of wildfire survivors in the future.

scholarly journals Adding a Seat at the Table: A Case Study of the Provider's Perspective on Integrating Community Health Workers at Provider Practices in California

2021 ◽  
Vol 9 ◽  
Author(s):  
Courtney A. Paulson ◽  
Eva M. Durazo ◽  
Leigh D. Purry ◽  
Arianne E. Covington ◽  
Bruce Alan Bob ◽  
...  
Keyword(s):  
Best Practices ◽  
Community Health ◽  
Social Services ◽  
Social Needs ◽  
Care Team ◽  
Community Resources ◽  
Office Staff ◽  
Provider Practices ◽  
Blue Shield

Blue Shield of California's Community Health Advocate Program was created to support whole person-health needs by helping individuals of all socio-economic statuses navigate and access community resources, social services, and medical systems. Blue Shield's Health Reimagined team is partnering with medical providers, community resources centers, and community partners to provide intensive person-centered and technology-enabled care to patients, ensuring social needs are met while promoting health equity. A key aspect of the Health Reimagined initiative embeds Community Health Advocates (CHAs) within physician practices serving patients using a payor-agnostic approach, by which Blue Shield aims to increase access to social services and community resources, improve health outcomes, reduce medical costs, and improve overall patient experience. The purpose of this case study is to understand the provider's perspective of embedding a CHA into the care team and the resulting impact on the practice and patients. Blue Shield also sought to identify best practices and barriers of a CHA program within primary and specialty care practices. As part of an ongoing two-year mixed-methods impact evaluation (2019–2021), 10 semi-structured interviews were conducted with a total of 18 providers and office staff at five primary care and specialty practices where CHAs have been embedded. We also conducted two focus groups with the same five CHAs at different points in time. Several themes emerged from the provider, office staff, and CHA interviews. Provider practices found great value in adding a CHA to their care team as the CHA brings flexibility and continuity to patient care. They also found that having access to a CHA with shared life experiences of the communities they served is a key component to the program's success. Providers and staff reported a new understanding of the social determinants of health that impacts a patient's wellbeing with the embedding of a CHA in the care team. Overall, practitioners expressed high satisfaction with the CHA program. During the COVID-19 pandemic, CHAs have been critically important in care, as social needs have increased, and resources have shifted. The CHA program is constantly adapting to address challenges faced by all stakeholders and applying new knowledge to ensure best practices are implemented within the CHA program.

Udział kobiet w działalności prawotwórczej Senatu II Rzeczypospolitej

2016 ◽  
Vol 14 (2) ◽  
pp. 207-218 ◽  
Author(s):  
Paweł Fiktus
Keyword(s):  
World War I ◽  
Social Services ◽  
Social Issues ◽  
Political Life ◽  
Alcoholic Beverages ◽  
Second Republic ◽  
National Minorities ◽  
Participation Of Women ◽  
The Government ◽  
Political Groups

At the end of World War I, in many European countries women won the active and passive right to vote. Poland was one of the first countries, where women were allowed to participate in political life. Already at the time of establishing the Legislative Sejm (1919) the first women-MPs took their seats in Parliament. Similarly, the situation presented itself in the case of the Senate. During its first session (1922) women participated in the works of the upper chamber. The purpose of this paper is to present the participation of women in the legislative work of the Senate in various terms of office. The participation of women in the legislative work of Parliament was characterized by their involvement in issues concerning education or social services, while avoiding participation in the legislative work or that dealing with political matters. The situation presented itself differently as regards women’s involvement in the work of the Senate. A good example here was the activity of Dorota Kałuszyńska, who – during the work on the so called April Constitution of 1935 – not only participated in it very actively, but also ruthlessly attacked the then ruling camp. Another very interesting episode related to activities of women in the Senate was an informal covenant during the work on the bill to limit the sale, administration and consumption of alcoholic beverages. Belonging to different political groups: the said D. Kłuszyńska as a representative of the Polish Socialist Party, Helena Kisielewska from the Bloc of National Minorities and Hanna Hubicka of BBWR [the Nonpartisan Bloc for Cooperation with the Government] unanimously criticized the regulations in force, which – in their opinion – did not fulfill their role when it came to anti-alcohol protection. The participation of women as far as their number was concerned was indeed small, but the Senate (like Parliament) of the Second Republic functioned in the period when women had just begun their activity on the legislative forum. Undoubtedly, it was a very interesting period, in which women had the benefit in the form of gaining their parliamentary experience. For example, it gave rise to subsequent activities of Dorota Kłuszyńska, who actively participated in the legislative works of the Sejm in the years 1947–1952, dealing with social issues or family.

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