Suchergebnisse

The increasing ethnic diversity of the UK has been mirrored by growing public awareness of multicultural issues, alongside developments in academic and government thinking. This paper explores the contested meanings around ethnic identity/ies in community settings, drawing on semi-structured interviews with staff from Children's Centres and allied agencies conducted for a research project that examined the relationship between identity and the participation of parents/carers in services in northeast England. The research found that respondents were unclear about, especially, white ethnic identities, and commonly referred to other social categorizations, such as age, nationality, and circumstances such as mobility, when discussing service users. While in some cases this may have reflected legitimate attempts to resist overethnicizing non-ethnic phenomena, such constructions coexisted with assumptions about ethnic difference and how it might translate into service needs. These findings raise important considerations for policy and practice.

As mental health care transitions from facility-based care to community-based services, methods to classify patients in terms of their expected health care resource use are an essential tool to balance the health care needs and equitable allocation of health care resources. This study performed a scoping review to summarize the nature, extent, and range of research on case-mix classifications used to predict mental health care resource use in community settings. This study identified 17 eligible studies with 32 case-mix classification systems published since the 1980s. Most of these studies came from the USA Veterans Affairs and Medicare systems, and the most recent studies came from Australia. There were a wide variety of choices of input variables and measures of resource use. However, much of the variance in observed resource use was not accounted for by these case-mix systems. The research activity specific to case-mix classification for community mental health care was modest. More consideration should be given to the appropriateness of the input variables, resource use measure, and evaluation of predictive performance. Future research should take advantage of testing case-mix systems developed in other settings for community mental health care settings, if possible.

Recent UK policy changes have generated renewed public and academic interest in the contexts and purposes for work with young people. Emphasis on youth inclusion and participation as components of policy discourse associated with citizenship and community cohesion contrasts with other more regulatory trends in youth policy, while moves towards integrating local services have increased dependence on community providers. The paper draws on empirical study of community organisations working with young people to consider how recent transitions have been reflected in the experiences of community 'partners' and activities with young people. Do the greater emphases on community level involvement and young people's participation mark a shift towards more responsive, better integrated services? Research to date suggests significant gaps between how policy‐makers promote inclusive services and perceptions of delivery at local level. Despite professional initiatives to create new spaces for young people to participate, dominant institutional cultures and contractually led service targets present barriers to involving disengaged young people, undermining alternative models of working. The paper argues the need for a better appreciation of the complexity and challenges of work with young people at community level, together with greater openness to diversity and risk.

AbstractA framework for the evaluation of health and human service programs in community settings is proposed and used to critique how well the chapters in this volume advance community‐based program evaluation.

With co-existence of under-nutrition and obesity among its people, malnutrition afflicts India like a double-edged sword. The search for solutions has often pointed at 'Nutrition Communication' as a tool in alleviating malnutrition. This study, through three case studies in India, attempts to critically examine how various organizations engaged in nutrition communication perceive, develop and implement communicative processes. These case studies typically combined data collection methods like information gathering and interviews. We realize nutrition communication programmes are top-down, expert-driven and are often denied planning, evaluation or budgets. We argue that factors such as the organization's knowledge of the nutrition problem(s), perceptions of the key communicators, their motivation levels and personal biases also affect the design and implementation of nutrition communication programmes.

The effects of self-scheduling plus training to implement weekly schedules on the frequency, diversity, and novelty of self-directed leisure activities by three adults with moderate developmental disabilities living in the community were examined in this study. Self-scheduling consisted of the adults choosing desired leisure/recreational activities via picture cards, and then placing the cards in a sequenced activity book for each day of the week. Training for schedule implementation consisted of a daily prompt to look at the picture schedule plus a nightly review of engaged activities. All participants learned to independently self-schedule their leisure activity as a result of training and maintained their performance on probes conducted between 8 weeks and 6 months after training. Self-scheduling and training schedule implementation resulted in substantial increases in the weekly frequency and diversity of self-directed leisure activity, as well as increases in the cumulative novelty of activity. These results were also maintained long term. This study emphasizes the importance of incorporating choice and self-management in leisure education for persons with severe and moderate intellectual disabilities.