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Effects of preventive home visits on older people's use and costs of health care services: a systematic review
- Authors:
- LIMMATTA H., et al
- Journal article citation:
- European Geriatric Medicine, 7(6), 2016, pp.571-580.
- Publisher:
- Elsevier
Introduction: The aim of this study was to systematically review the evidence from randomized controlled trials (RCT) concerning effectiveness of preventive home visit (PHV) programs on older people's use and costs of health and social services. We also evaluated resultant costs-changes achieved with intervention in older people's functioning, quality-of-life (QOL) or mortality. Materials and methods: A systematic review of published RCTs reporting use and/or costs on PHVs on multimorbid older people was performed. The characteristics and methodological quality of studies were assessed. Results: Of the 3219 articles screened, 19 met the inclusion criteria. The methodological quality of the trials was principally moderate (n = 5) or good (n = 10). Of the studies, 12 evaluated the overall costs of health and social services. None of these studies was able to show significant differences in total costs between intervention and control groups. Six studies suggested that PHVs may decrease nursing home admissions and/or hospital days. Seven studies showed some favourable effect on physical functioning, QOL, or mortality, without increasing the total health care costs. Conclusions: Of the high number of studies investigating efficacy of PHVs on older people, only a few studies explore economic effects. PHVs do not provide overall savings to health care costs, but some interventions might offer some cost-neutral positive effects on functioning, QOL and/or mortality. More studies are needed to clarify the effective aspects of the programs and cost-effectiveness of the PHVs. (Edited publisher abstract)
Post-investigation service need and utilization among families at risk of maltreatment
- Authors:
- SIMON James David, BROOKS Devon
- Journal article citation:
- Children and Youth Services Review, 69, 2016, pp.223-232.
- Publisher:
- Elsevier
This study examined the relationship between different areas of family need and the utilization of home-based, post-investigation services (HBPS) following a child protective services (CPS) investigation. The sample consisted of 2598 families with children who remained at home after an initial CPS investigation between July 2006 and April 2011. Family need was measured in three areas (concrete, clinical, and educational) using the Family Assessment Form (FAF), and families received one or more of the following HBPS: case management, concrete, educational, and clinical services. Pearson chi-square analyses were utilized to identify significant areas of needs to be included in a final multivariate logistic regression for each HBPS while controlling for demographic characteristics. Numerous areas of family need were associated with receipt of services intended to address those needs. Specifically, concrete need related to financial conditions was met with concrete services, educational need related to child development (an indicator of parenting need) was met with educational services, and clinical need related to interactions between caregivers (a potential indicator of domestic violence) was met with clinical services. In contrast, caregivers with concrete need related to living conditions were less likely to receive both educational and clinical services. Findings from the study highlight that matching concrete needs to related services is relatively straightforward but that the match between educational and clinical needs to respective services is more complex. The study discusses the complexities of matching different areas of need and HBPS following a CPS investigation and the importance of "bridging services" to engage families at risk of maltreatment in additional prevention services. (Edited publisher abstract)
The role of gender, sexuality and context upon help-seeking for intimate partner violence: a synthesis of data across five studies
- Authors:
- MORGAN Karen, et al
- Journal article citation:
- Aggression and Violent Behavior, 31, 2016, pp.136-146.
- Publisher:
- Elsevier
Programmes of research which combine related studies are commonplace, including in the field of Intimate Partner Violence (IPV). Whereas the systematic synthesis of published qualitative data is now well established, the synthesis of qualitative data that make up a programme of work is rare. A Programme of Research on Violence in Diverse Domestic Environments (PROVIDE) is a UK NIHR funded programme. The five studies associated with PROVIDE are sited in general practice, sexual health clinics, mental health services and 3rd sector IPV agencies. Synthesising the data from across the studies offered an opportunity to highlight variations in help-seeking strategies according to gender and sexual orientation and identify variations in help-seeking across different contexts. The approach to the synthesis was meta-ethnography. The synthesis identified 23 2nd order constructs in relation to helpseeking. Findings show gender and sexuality influences how help-seeking in different contexts is viewed. Disclosure of IPV to mental health services was rare. Women favour help-seeking from primary care which is familiar and where they are known, whilst gay men favour help-seeking from GUM clinics where there is a taken for granted acknowledgement of sexual identity. These differences suggest an intersectional approach to providing support services for IPV is needed. (Publisher abstract)
Women's employment and domestic violence: a review of the literature
- Author:
- SHOWALTER Kathryn
- Journal article citation:
- Aggression and Violent Behavior, 31, 2016, pp.37-47.
- Publisher:
- Elsevier
A steady and accessible financial outlet is central to living an abuse free life for women who experience domestic violence. In this systematic review of the literature, the relationship between domestic violence and employment instability as a result of workplace disruptions used by abusive men to sabotage their partner's employment efforts is explored. A total of 20 quantitative studies of adult women were selected that measured employment and domestic violence. A quarter of the studies included measured mental health problems, revealing correlations and mediation effects between domestic violence and employment stability. Every study selected found workplace disruptions among women experiencing domestic violence. On-the-job harassment was found in four of the studies reviewed with two studies finding corresponding decline in productivity and performance. Losing paid work time is also a serious cause of employment instability as workplace time reductions workplace time reductions were found in approximately half of the studies reviewed. Job loss or unemployment as a result of domestic violence was found in seven of the studies reviewed. To prevent employment instability, employers can restructure policy and procedures of Employee Assistance Programs (EAPs) and policymakers can further support and expand Family Violence Options for welfare-recipients experiencing domestic violence. (Publisher abstract)
Making ‘what works’ work: a meta-analytic study of the effect of treatment integrity on outcomes of evidence-based interventions for juveniles with antisocial behavior
- Authors:
- GOENSE Pauline Brigitta, et al
- Journal article citation:
- Aggression and Violent Behavior, 31, 2016, pp.106-115.
- Publisher:
- Elsevier
This study meta-analytically examined the effect of treatment integrity on client outcomes of evidence-based interventions for juveniles with antisocial behaviour. A total of 17 studies, from which 91 effect sizes could be retrieved, were included in the present 3-level meta-analysis. All included studies, to a certain level, adequately implemented procedures to establish, assess, evaluate and report the level of treatment integrity. A moderator analysis revealed that a medium-to-large effect of evidence-based interventions was found when the level of treatment integrity was high, whereas no significant effect was found when integrity was low. Treatment integrity was significantly associated with effect size even when adjusted for other significant moderators, indicating the specific contribution of high levels of treatment integrity to positive client outcomes. This implies that delivering interventions with high treatment integrity to youth with antisocial behavior is vital. (Edited publisher abstract)
The path to economic independence among survivors of intimate partner violence: a critical review of the literature and courses for action
- Authors:
- PELED Einat, KRINGEL Karni
- Journal article citation:
- Aggression and Violent Behavior, 31, 2016, pp.127-135.
- Publisher:
- Elsevier
Public policy encourages women, including survivors of intimate partner violence (IPV), to develop economic independence. However, a critical review of the literature in this field reveals that IPV survivors face unique obstacles in doing so: active and violent intervention by the perpetrator; damage to the survivor's health due to prolonged subjection to violence; and structural obstacles. A background of gendered violence, low socioeconomic status, and belonging to a marginalised ethnic or racial group, may further intersect with the direct and indirect influences of that violence, resulting in even greater obstacles to the development of economic independence. The article concludes with a discussion of how existing intervention programs for developing economic independence among survivors of IPV meet those obstacles, and a framework for intervention in this domain. (Edited publisher abstract)
Culturally specific interventions for female survivors of gender-based violence
- Authors:
- O'BRIEN Jennifer E., MACY Rebecca J.
- Journal article citation:
- Aggression and Violent Behavior, 31, 2016, pp.48-60.
- Publisher:
- Elsevier
Women who experience gender-based violence (GBV) often experience negative psychological symptoms such as anxiety and depression. Culture is associated with the perpetration of GBV and its associated mental health consequences. To date, most evidence-supported interventions to address the psychological consequences of GBV have been developed and evaluated for dominant-culture populations within the United States. To better serve the global population of female GBV survivors, and to aid service providers working with diverse populations, the authors conducted a comprehensive, systematic review of the literature to explore the availability of culturally specific GBV interventions and the level of evidence supporting these interventions. The review included 15 articles, which, based on content analysis, were grouped in 6 methodological categories. Findings reveal varying stages of intervention development and evaluation rigor. Moreover, the review identifies challenges in transnational intervention delivery and evaluation. The authors offer recommendations for research and practice. (Edited publisher abstract)
Factors associated with re-entry to out-of-home care among children in England
- Authors:
- McGRATH-LONE Louise, et al
- Journal article citation:
- Child Abuse and Neglect, 63, 2016, pp.73-83.
- Publisher:
- Elsevier
Exiting and re-entering out-of-home care (OHC) is considered a disruption to permanence which may have long-lasting, negative consequences for children due to a lack of stability and continuity. Each year approximately one-third of children in OHC in England exit, but information is lacking on rates of re-entries and associated factors. Using national administrative data, the authors calculated rates of re-entry among children exiting OHC from 2007 to 2012, identified key child and care factors associated with re-entry using Cox proportional hazards modelling, and developed a simple probability calculator to estimate which groups of children are most likely to re-enter OHC within three months. Between 2007 and 2012 re-entries to OHC in England decreased (from 23.3% to 14.4% within one year of exit, p < 0.001), possibly due to concurrent changes in the way children exited OHC. Overall, more than one-third of children exiting OHC in 2008 re-entered within five years (35.3%, N = 4076), but rates of re-entry varied by child and care characteristics including age, ethnicity, mode of exit, and placement stability. Based on these associated factors, the authros developed a calculator that can estimate the likelihood of rapid re-entry to OHC for a group of children and could be used by social care practitioners or service planners. The findings provide insight into which groups of children are most likely to re-enter OHC, who may benefit from additional support or ongoing monitoring. (Edited publisher abstract)
Exploring children’s perspectives of engagement with their carers using factor analysis
- Authors:
- WITHINGTON Tania, et al
- Journal article citation:
- Child Abuse and Neglect, 63, 2016, pp.41-50.
- Publisher:
- Elsevier
Positive engagement between a child and carer in out-of-home care is understood to have long-term benefits for children who have experienced abuse or neglect. This study analysed data from the ‘Views of Children and Young People in Foster Care 2009′ survey of 937 children in out-of-home care in Queensland, Australia, to identify factors that supported or hindered engagement between a child and carer. Exploratory and confirmatory factor analysis and structural regression were used. Findings suggest that children’s engagement with their carer is influenced by a range of internal and external factors including child characteristics, the care experience, contact with biological parents, and placement trajectory. Child engagement is important because it is central to positive outcomes such as placement stability in out-of-home care. Implications for policy and practice include the need for a structural response that supports building and maintaining positive child-carer relationships. (Publisher abstract)
Organic vs. functional neurological disorders: the role of childhood psychological trauma
- Authors:
- KARATZIAS Thanos, et al
- Journal article citation:
- Child Abuse and Neglect, 63, 2016, pp.1-6.
- Publisher:
- Elsevier
Although the relationship between psychological trauma and medically unexplained symptoms (MUS) is well established, this relationship is less well understood in people with medically unexplained neurological symptoms. In the present study, the authors set out to compare people with functional neurological disorders, and organic neurological disorders, in terms of childhood and adulthood traumatic events, traumatic stress, emotional dysregulation and symptoms of depression and anxiety. It is hypothesised that those with functional neurological disorders would be more likely to report childhood and adulthood traumatic life events, traumatic symptomatology, emotional dysregulation and symptoms of anxiety and depression, compared to those with organic neurological disorders. Sample consisted of a consecutive series of people with functional neurological disorders and with organic neurological disorders (n = 82) recruited from a hospital in Scotland. Participants completed measures of life events, traumatic stress, emotional regulation, anxiety and depression. The two groups were found to significantly differ in relation to all measures, with the MUS group being more likely to report childhood and adulthood life events, more severe emotional dysregulation, traumatic stress and symptoms of anxiety and stress. Logistic regression analysis revealed that exposure to childhood traumatic life events, specifically childhood sexual abuse, and childhood physical neglect, were the only factors which were significantly associated with membership of the medically unexplained neurological symptoms group. Although further research is required to confirm the authors' findings, their results suggest that identifying and addressing the impact of childhood trauma, may alleviate distress and aid recovery from functional neurological disorders. (Edited publisher abstract)