Exploring the Subjective Caregiving Experience Among Chinese, Korean, and Southeast Asian Communities

Although the Asian American community is one of the fastest growing racial groups in the US, members of this group continue to be underserved and understudied, especially when it comes to the needs of family caregivers. Therefore, through a national initiative to understand the lived experiences of diverse family and friend caregivers, survey data was collected from a variety of Asian American ethnic subgroups including Chinese (n=148), Korean (n=131), and Southeast Asian (i.e., Vietnamese, Hmong, Cambodian, Laotian; n=161). Surveys were distributed in-person and online, and also offered in the translated native languages of the abovementioned groups. Caregivers had to be 18 years and older and providing care to a person aged 55 and older who needed assistance because of ongoing health problems or disabilities. For the overall sample of Asian American caregivers (n=440), participants were on average 51.68 years of age (SD=15.98), identified as female (n=336), were not born in the US (n=348), lived with the care receiver (n=247), and reported less than $10,000 in income per year (n=199). As guided by the Stress Process Model and through a series of ANOVA tests, when compared on all major outcomes, Southeast Asian caregivers significantly reported: 1) more difficulty with care related tasks (e.g., financial/legal decisions), 2) a stronger cultural commitment to caregiving, 3) higher work strain, and 4) more depressive symptomology. Discussion will focus on opportunities for professionals to meet the needs of Asian American caregivers through the use of available trainings and programs aimed to support diverse caregivers.

Enhancing Early Engagement (E3) in mental health services training for children’s advocacy center’s victim advocates: feasibility protocol for a randomized controlled trial

Background Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative. Methods The feasibility study protocol is to develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training embeds key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs were randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program and differential impact and costs by level of training will be examined. Discussion The overarching goal of this project is to test the feasibility of training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child, and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods hybrid type II effectiveness-implementation and cost-effectiveness trial of family navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols. Trial registration NCT04221633 Date and version identifier March 25, 2021; Vers. 1.0 (original); September 11, 2021; Vers 2.0 (revision); October 29, 2021; Vers. 3.0 (revision)

Insurance Fraud in Korea, Its Seriousness, and Policy Implications

Several characteristics of insurance fraud including its chronic nature justifies the need for identifying feasible proposals which can be expected to bring about significant impacts. Recent statistics show that insurance fraud is now consistently on the increase. However, insurance fraud is highly fragmented and each offence is not significant enough to elicit active interest among the public or interventions from the police. Three problems have been identified and diagnosed. These were a lack of awareness, an absence of a national leadership and also limited attention directed to insurance fraud by the investigating authorities. Based on these, three recommendations have been suggested. (1) Embarking on and developing a national initiative by central government, (2) Taking a dynamic concentration approach to send deterrent threats to potential fraudsters, and (3) Using big data technologies to detect clandestine activities by organised groups.

Learning from Lean: a quality improvement project using a Lean-based improvement approach to improve discharge for patients with frailty in an acute care hospital

A Lean-based improvement approach was used to complete a quality improvement project (QIP) focused on improving speed and quality of discharge of frail patients on two wards at a large teaching hospital in the UK. This was part of a national initiative to embed continuous improvement within the trust. The aim of the QIP was to improve the proportion of prenoon discharges to 33% of total patients discharged from the ward each day. An ‘improvement practice process’ followed, which included seven discrete workshops that took the QIP through four distinct phases—understand, design, deliver and sustain. Several improvement methods and tools were used, including value stream mapping and plan–do–study–act (PDSA) cycles. Ten PDSA cycles were implemented across the clinical areas, including improved planning and data collection of discharge, improved communication between nursing and medical staff, and earlier referrals to community hospitals for discharge. Improved performance was identified through the outcome metric prenoon discharges on both wards, with the average increasing from 8% to 24% on ward X and from 9% to 19% on ward Y, with no other significant change seen in other measures. Pettigrew et al’s context–content–process change model was used to structure the learning from the QIP, which included the impact of varying ward contexts, the format of conducting improvement with staff, the importance of organisational support, the need for qualitative measures, agreeing to an apposite aim and the power of involving service users. The original aim of 33% prenoon discharges was not achieved, yet there was clear learning from completing the QIP which could contribute to ongoing improvement work. This identified that the Lean-based improvement approach used was effective to some degree for improving discharge processes. Further focus is required on collecting qualitative data to identify the impact on staff, especially related to behaviour and culture change.

Assessing Competencies Using Scenario-Based Learning in Cybersecurity

Recent years have seen a disconnect between much-needed real-world skills and knowledge imparted to cybersecurity graduates by higher education institutions. As employers are shifting their focus to skills and competencies when hiring fresh graduates, higher education institutions are facing a call to action to design curricula that impart relevant knowledge, skills, and competencies to their graduates, and to devise effective means to assess them. Some institutions have successfully engaged with industry partners in creating apprenticeship programs and work-based learning for their students. However, not all educational institutions have similar capabilities and resources. A trend in engineering, computer science, and information technology programs across the United States is to design project-based or scenario-based curricula that impart relevant knowledge, skills, and competencies. At our institution, we have taken an innovative approach in designing our cybersecurity courses using scenario-based learning and assessing knowledge, skills, and competencies using scenario-guiding questions. We have used the National Initiative for Cybersecurity Education (NICE) Cybersecurity Workforce Framework and the Office of Personnel Management (OPM) Hiring Cybersecurity Workforce report for skills, knowledge, and competency mapping. This paper highlights our approach, presenting its overall design and two example mappings.