scholarly journals Cross Cultural Workers for women and families from migrant and refugee backgrounds: a mixed-methods study of service providers perceptions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helen J. Rogers ◽  
Lily Hogan ◽  
Dominiek Coates ◽  
Caroline S. E. Homer ◽  
Amanda Henry
Keyword(s):  
Culturally Responsive ◽  
Service Providers ◽  
Perinatal Outcomes ◽  
Cross Cultural ◽  
Mixed Methods Study ◽  
Model Of Care ◽  
Community Based ◽  
Cultural Workers ◽  
Barriers To Access ◽  
Community Based Services

Abstract Background Women from migrant and refugee backgrounds who live in high-income countries are at increased risk of adverse perinatal outcomes, including mental health issues, preterm birth and maternal and infant mortality. There is a need to implement and evaluate models of care to meet their specific needs in order to improve health outcomes, their experiences of care, and overcome barriers to access. In Sydney, Australia, a unique model of care was implemented to support women and families from migrant and refugee backgrounds to access health and community-based services through the continuum of pregnancy to the early parenting period. This model of care is known as the Cross Cultural Workers (CCWs) in Maternity and Child and Family Health Service (the CCW Service). The aim of this study was to explore the perceptions of service providers regarding the CCW Service and identify recommendations for improvement. Methods A mixed-methods study was conducted consisting of surveys and face to face semi-structured interviews. Service providers were recruited from hospital-based maternity and community-based services. Survey data were analysed descriptively. Interviews were analysed using qualitative content analysis. Results Sixty-nine service providers completed surveys and 19 were interviewed. The CCW Service was highly regarded by service providers who perceived it to be critical in improving care for women from migrant and refugee backgrounds. The overarching theme from the interviews was the ability of the CCW Service to act as a ‘bridge to health’ through the provision of culturally responsive care. There were three main categories; supporting access to health and community-based services, improving the healthcare experience, and organisational factors, including part-time hours, capacity, heavy workloads and confusion/lack of clarity regarding the CCW role, which affected CCWs’ capacity to optimally support service providers in providing culturally responsive care. These limitations meant CCWs were not able to meet demand, and fully operationalise the model. Conclusion Service providers perceived the CCW model to be a culturally responsive model of care tailored to the needs of women and families from migrant and refugee backgrounds, that reduces barriers to access, and has the potential to improve perinatal outcomes, and women's experience and satisfaction with care.

scholarly journals Cross Cultural Workers for Women and Families From Migrant and Refugee Backgrounds: A Mixed-Methods Study of Service Providers Perceptions

2021 ◽  
Author(s):  
Helen J Rogers ◽  
Lily Hogan ◽  
Dominiek Coates ◽  
Caroline SE Homer ◽  
Amanda Henry
Keyword(s):  
Culturally Responsive ◽  
Service Providers ◽  
Perinatal Outcomes ◽  
Cross Cultural ◽  
Mixed Methods Study ◽  
Model Of Care ◽  
Community Based ◽  
Cultural Workers ◽  
Barriers To Access ◽  
Community Based Services

Abstract BackgroundWomen from migrant and refugee backgrounds who live in high-income countries are at increased risk of adverse perinatal outcomes, including mental health issues, preterm birth and maternal and infant mortality. There is a need to implement and evaluate models of care to meet their specific needs in order to improve health outcomes, their experiences of care, and overcome barriers to access. In Sydney, Australia, a unique model of care was implemented to support women and families from migrant and refugee backgrounds to access health and community-based services through the continuum of pregnancy to the early parenting period. This model of care is known as the Cross Cultural Workers (CCWs) in Maternity and Child and Family Health Service (the CCW Service). The aim of this study was to explore the perceptions of service providers regarding the CCW Service and identify recommendations for improvement.MethodsA mixed-methods study was conducted consisting of surveys and face to face semi-structured interviews. Service providers were recruited from hospital-based maternity and community-based services. Survey data were analysed descriptively. Interviews were analysed using qualitative content analysis. ResultsSixty-nine service providers completed surveys and 19 were interviewed. The CCW Service was highly regarded by service providers who perceived it to be critical in improving care for women from migrant and refugee backgrounds. The overarching theme from the interviews was the ability of the CCW Service to act as a ‘bridge to health’. There were three main categories; supporting access to health and community-based services, improving the healthcare experience, and organisational factors affecting CCW Service provision. A limitation of the CCW Service was the part-time hours of the CCWs, reducing their ability to meet demand, build service provider capacity to provide culturally responsive care and fully operationalise the model. Conclusion Service providers perceived the CCW model to be a culturally responsive model of care tailored to the needs of women and families from migrant and refugee backgrounds, that reduces barriers to access, has the potential to improve perinatal outcomes, and women's experience and satisfaction with care.

scholarly journals All Is Good, but Not Really: Daily Reports of Satisfaction With Home- and Community-Based Services

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-640
Author(s):  
Jyoti Savla ◽  
Karen Roberto ◽  
Aubrey Knight ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
...  
Keyword(s):  
Service Use ◽  
Service Providers ◽  
Theory And Practice ◽  
Community Based ◽  
Daily Diaries ◽  
Rural Caregivers ◽  
Service Expectations ◽  
Extensive Body ◽  
Barriers To Health ◽  
Community Based Services

Abstract An extensive body of literature documents correlates of and barriers to health service use, yet much less is known about satisfaction with home- and community-based services for persons with dementia (PwD). Daily diary data from 122 rural caregivers (CG) of PwD (814 daily diaries) were used to assess everyday service use experiences. At the last diary interview, CG identified areas where service use expectations were and were not being met. CGs reported problems with services used on fewer than 5% of study days (e.g., service provider was delayed because of car trouble). In contrast, 82% of CG identified areas where service expectations were not being met. Their most common concerns were lack of control over service availability and lack of adequate training among service providers. Recommendations for alternative ways for capturing service use satisfaction will be offered, and implications for theory and practice will be discussed.

scholarly journals Dedicated community-based services for adults with personality disorder: Delphi study

2008 ◽  
Vol 193 (4) ◽  
pp. 342-343 ◽  
Author(s):  
Mike J. Crawford ◽  
Katy Price ◽  
Deborah Rutter ◽  
Paul Moran ◽  
Peter Tyrer ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Delphi Study ◽  
Service Providers ◽  
Community Outreach ◽  
Community Based ◽  
Delivery Of Care ◽  
Violent Offending ◽  
History Of ◽  
Community Based Services

SummaryDedicated community-based services have been recommended for people with personality disorder, but little is known about how such services should be configured. We conducted a Delphi survey to assess opinions about this. A panel of expert authors, service providers and service users agreed on only 21 (39%) of 54 statements on the organisation and delivery of care. Consensus was not reached on important issues such as working with people with a history of violent offending, the role of community outreach and the use of compulsory treatment. Further work needs to be undertaken before the optimal organisation of dedicated personality disorder services can be agreed.

scholarly journals Community-based rehabilitation workers’ perspectives of wheelchair provision in Uganda: A qualitative study

2019 ◽  
Vol 8 ◽  
Author(s):  
Nikola Seymour ◽  
Martha Geiger ◽  
Elsje Scheffler
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Service Providers ◽  
Community Based ◽  
Wheelchair Users ◽  
Transfer Of Skills ◽  
Services Delivery ◽  
Barriers To Access ◽  
Community Based Rehabilitation ◽  
Field Notes

Background: The challenges of wheelchair provision and use in less resourced settings are the focus of global efforts to enhance wheelchair service delivery. The shortage of professional wheelchair service providers in these settings necessitates the collaboration of multiple stakeholders, including community-based rehabilitation (CBR) workers, whose role needs to be further understood.Objectives: The aim of this study was to determine what CBR workers in three areas of Uganda perceived as (1) the challenges with wheelchair provision and use, (2) the factors contributing to these challenges, (3) the role they themselves can potentially play and (4) what facilitators they need to achieve this.Method: This qualitative study in the transformative paradigm comprised focus group discussions to gather perceptions from 21 CBR workers in three areas of Uganda, each with an operational wheelchair service, participant observations and field notes. Thematic analysis of data was implemented.Results: Community-based rehabilitation workers’ perceptions of challenges were similar while perceived causes of challenges differed as influenced by location, historical and current wheelchair availability and the CBR workers’ roles. Their main responsibilities included assistance in overcoming barriers to access the service, transfer of skills and knowledge related to wheelchairs, follow-up of users for wheelchair-related problem-solving, and user and community empowerment.Conclusion: Community-based rehabilitation workers can contribute in various ways to wheelchair service delivery and inclusion of wheelchair users; however, their capabilities are not consistently applied. Considering the diversity of contextual challenges, CBR workers’ range of responsive approaches, knowledge of networks and ability to work in the community make their input valuable. However, to optimise their contribution, specific planning for their training and financial needs and effective engagement in the wheelchair services delivery system are essential.

scholarly journals Reaching Urban Poor Hypertensive Patients

2016 ◽  
Vol 8 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Jim Sanders ◽  
Clare E. Guse
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Urban Poor ◽  
Models Of Care ◽  
Blood Pressure Goal ◽  
Fee For Service ◽  
Model Of Care ◽  
Community Based ◽  
Chronic Disease Care ◽  
Barriers To Access

Background: There is a significant disparity in hypertensive treatment rates between those with and without health insurance. If left untreated, hypertension leads to significant morbidity and mortality. The uninsured face numerous barriers to access chronic disease care. We developed the Community-based Chronic Disease Management (CCDM) clinics specifically for the uninsured with hypertension utilizing nurse-led teams, community-based locations, and evidence-based clinical protocols. All services, including laboratory and medications, are provided on-site and free of charge. Methods: In order to ascertain if the CCDM model of care was as effective as traditional models of care in achieving blood pressure goals, we compared CCDM clinics’ hypertensive care outcomes with 2 traditional fee-for-service physician-led clinics. All the clinics are located near one another in poor urban neighborhoods of Milwaukee, Wisconsin. Results: Patients seen at the CCDM clinics and at 1 of the 2 traditional clinics showed a statistically significant improvement in reaching blood pressure goal at 6 months ( P < .001 and P < .05, respectively). Logistic regression analysis found no difference in attaining blood pressure goal at 6 months for either of the 2 fee-for-service clinics when compared with the CCDM clinics. Conclusion: The CCDM model of care is at least as effective in controlling hypertension as more traditional fee-for-service models caring for the same population. The CCDM model of care to treat hypertension may offer another approach for engaging the urban poor in chronic disease care.

Marketisation of women’s organisations in the criminal justice sector

2020 ◽  
pp. 203-220
Author(s):  
Vickie Cooper ◽  
Maureen Mansfield
Keyword(s):  
Criminal Justice ◽  
Service Providers ◽  
The Political ◽  
Community Based ◽  
Political Values ◽  
Reform Programme ◽  
System P ◽  
Specialist Services ◽  
Community Based Services ◽  
Roll Out

This chapter explores the gendered impacts of the austerity-driven probation reforms, which include the dismantling of community-based services for economically marginalised women and the alarming 131% rise in women recalled to custody. Blame for these deleterious effects has been apportioned to the privatisation of Probation Trusts in England and Wales and the subsequent dominance of ‘Community Rehabilitation Companies’ – where, in practice, larger, cheaper service providers are pushing out smaller, specialist services. Whilst we don’t disagree with this narrative, we argue that the neo-liberal tropes of the gender responsive reform programme – that preceded the privatisation of Probation Trusts – is an important policy context for understanding the contractual inequalities that we are seeing unfold today. The roll out of the gender responsive reform programme marked a key moment in the landscape of women’s voluntary sector as it encouraged them to compete with other voluntary services and prove ‘better value’ for money. This form of marketisation, we argue, has resulted in women’s services attenuating or, at best, compromising the political values and ethics that previously underpinned their ‘specialist’ approach to working with women in the criminal justice system.

Older People with Learning Difficulties Leaving Institutional Care—A Case of Double Jeopardy

1996 ◽  
Vol 16 (2) ◽  
pp. 125-150 ◽  
Author(s):  
Alan Walker ◽  
Carol Walker ◽  
Tony Ryan
Keyword(s):  
Older People ◽  
Old Age ◽  
Service Providers ◽  
Institutional Care ◽  
Learning Difficulties ◽  
Field Research ◽  
Community Based ◽  
Official Definitions ◽  
The Impact ◽  
Community Based Services

AbstractPeople with learning difficulties are now surviving into old age and more and more of them are being resettled from long-stay hospitals. The main purpose of this article is to examine some of the key barriers facing, and dilemmas involved in, the provision of community-based services to this newly emerging user group. The findings of some recent field research on older people with learning difficulties who have been resettled into the community are used to illustrate the challenges facing service providers. Particular reference is made to the impact of age discrimination and traditional differences between service specialisms. The article shows that both official definitions of need in old age and the aspirations of the service responses to those needs have been artificially constructed in very narrow terms, especially when compared with the principled approach to service provision for younger people with learning difficulties. In conclusion, therefore, it is argued that the principles underpinning services for people with learning difficulties, such as normalisation, should be applied to older people as well.

Service Provider Perspectives Regarding Knowledge Sharing Activities in Community-Based Services

2020 ◽  
Vol 39 (2) ◽  
pp. 25-39
Author(s):  
Casey Fulford ◽  
Virginie Cobigo
Keyword(s):  
Service Providers ◽  
Service Organizations ◽  
Practical Implementation ◽  
Knowledge Mobilization ◽  
Community Based ◽  
Distributed Information ◽  
Social Service Organizations ◽  
Provider Perspectives ◽  
Adults With Intellectual Disabilities ◽  
Community Based Services

Evaluation of knowledge mobilization (KM) activities in community-based mental health and social service organizations is needed. Our objective was to understand how service providers want to access and share knowledge, in order to improve KM practices to better support adults with intellectual disabilities. We distributed information about five strategies for supporting friendships; this included strategy descriptions, outcomes of strategy evaluations, and practical implementation considerations. We distributed information through a conference presentation, online presentations, and online modules. Service providers completed questionnaires and phone interviews. We present findings on their perspectives regarding the format and content of the material, which can inform future KM efforts.

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