Behavioral & Community Health
Permanent URI for this communityhttp://hdl.handle.net/1903/2271
Prior to January 24, 2011, this unit was named the Department of Public & Community Health.
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Item LGBTQ+ cultural-competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial(Wiley, 2023-08-25) Boekeloo, Bradley; Fish, Jessica; Turpin, Rodman; Aparicio, Elizabeth M.; Shin, Richard; Vigorito, Michael A.; Lare, Sean M.; McGraw, James S.; King-Marshall, EvelynLesbian, gay, bisexual, transgender, queer/questioning and other sexual and gender diverse (LGBTQ+) persons frequently lack access to mental health service organizations (MHOs) and therapists who are competent with LGBTQ+ clients. Existing continuing education programmes to better equip therapists to work with LGBTQ+ clients are often not widely accessible or skills focused, evaluated for effectiveness and inclusive of MHO administrators who can address the organizational climate needed for therapist effectiveness. A virtual, face-to-face, multi-level (administrators and therapists) and multi-strategy (technical assistance, workshop and clinical consultations) LGBTQ+ cultural competence training—the Sexual and Gender Diversity Learning Community (SGDLC)—was tested in a pilot randomized controlled trial. Ten organizations were randomly assigned to the intervention (SGDLC plus free online videos) or control (free online videos only) group. Pretest/posttest Organization LGBTQ+ Climate Surveys (n = 10 MHOs) and pretest/posttest Therapist LGBTQ+ Competence Self-Assessments (n = 48 therapists) were administered. Results showed that at pretest, average ratings across organization LGBTQ+ climate survey items were low; twice as many items improved on average in the intervention (10/18 items) than control (5/18 items) group organizations. At pretest, therapist average scores (range 0–1) were highest for knowledge (0.88), followed by affirmative attitudes (0.81), practice self-efficacy (0.81), affirmative practices (0.75) and commitment to continued learning (0.69). Pretest/posttest change scores were higher for the intervention relative to the control group regarding therapist self-reported affirmative attitudes (cumulative ordinal ratio [OR] = 3.29; 95% confidence interval [CI] = 1.73, 6.26), practice self-efficacy (OR = 5.28, 95% CI = 2.00, 13.93) and affirmative practices (OR = 3.12, 95% CI = 1.18, 8.25). Average therapist and administrator satisfaction scores were high for the SGDLC. These findings suggest the SGDLC training can affect organizational- and therapist-level changes that may benefit LGBTQ+ clients.Item Experiences of child welfare social workers in addressing substance use among maltreated young mothers to prevent child maltreatment(Wiley, 2023-02-24) Doig, Amara Channell; Jasczynski, Michelle; Phillips, Danielle R.; Robinson, Jennifer L.; Aden, Faduma; Huq, Maisha; Lee, Kaitlyn; Jones, Gary; Bernardi, Chloe; Aparicio, Elizabeth M.Substance use during the perinatal period and while parenting can pose a significant risk to children's safety and well-being. Mothers who have experienced child maltreatment are more likely to use substances than mothers without a history of maltreatment. This study explores how child welfare social workers experience supporting young, maltreated mothers struggling with substance use to prevent the intergenerational transmission of child maltreatment. Semi-structured in-depth interviews were conducted with four social workers working with young mothers with a history of maltreatment and substance use. Interpretative Phenomenological Analysis revealed two themes: (1) grappling with system challenges and (2) supporting strategies for disrupting intergenerational transmission of child maltreatment. The results highlight the need for systemic changes around support for social workers who work with young mothers who use substances and have a history of maltreatment, and substance use treatment and mental health programs themselves. Mothers need access to prenatal programs that are trauma-informed, non-judgemental and that support participants' basic needs and parenting skills.Item Brief Report: Perspectives of Foster Care Alumni on COVID-19 Vaccination: Key Findings and a Call to Action(2021-06) Shpiegel, Svetlana; Aparicio, Elizabeth M.The United States recently surpassed 32 million cases and 570 thousand deaths due to COVID-19. Vaccination of the general population is critical to ending the pandemic, and several highly effective vaccines have now received emergency FDA approval. Young adults are a key group to target for vaccination, as they may be asymptomatic carriers of COVID-19 and unknowingly spread the virus to others. However, recent research suggests that young adults have concerns about COVID-19 vaccination, particularly if they belong to racial and ethnic minority groups or other marginalized populations. Young people with foster care backgrounds are predominantly Black, Indigenous, and people of color (BIPOC), and their hesitancy toward COVID-19 vaccination may be exacerbated by public systems mistrust and ineffective messaging channels. To better understand vaccination attitudes among this population, we conducted focus groups and individual interviews with 23 young people ages 18 to 26 who had recently aged out of foster care. All young people in our sample were parents of young children; thus, their attitudes towards COVID-19 vaccination have relevance for their own as well as their children’s likelihood of getting vaccinated. As part of this project, participants described their attitudes towards COVID-19 vaccination and their reasoning for either accepting or declining a vaccine. Interview audio files were transcribed verbatim and rigorously analyzed using a structured approach to thematic analysis.