Abstract
Social Services Professionals’ Views of Barriers to Supporting Homeless Non-Custodial Fathers: A Qualitative Inquiry
Tiana N. Rogers, PhD, MA, MA1 and Charles R. Rogers, PhD, MPH, MS, CHES2
(1)University of Utah - Sorenson Impact, Salt Lake City, UT, (2)University of Utah School of Medicine, Salt Lake City, UT
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The population of homeless fathers in the U.S. continues to increase despite an increase in father-specific programming. Research on how to minimize risk factors and barriers to service for non-custodial fathers is limited compared with research on non-custodial mothers. The purpose of this theory-driven, qualitative inquiry was to investigate barriers to service for homeless non-custodial fathers from the perspective of social service professionals who work directly assist men with finding homes while meeting the demands of fatherhood. The sample included seven administrators and 12 direct service professionals engaged with fathers transitioning from homelessness. Multiple cycle coding was employed to capture emerging themes that revealed how emotional, relational, and systemic factors impact work with homeless non-custodial fathers. Findings from this study inform social change by indicating a clear need for empathy, relationship building, and collaboration between service providers and policy makers in order to create effective approaches for supporting fathers and bridge the gap between social work-focused research and practice.
Administration, management, leadership Diversity and culture Provision of health care to the public Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Neighborhood structure, processes, and spatial variation in the rate of child welfare investigation in Baltimore City
Stacey Williams, PhD MPH, Carlos Castillo-Salgado, MD, DrPH, JD and Philip Leaf, PhD
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
With growing support for place-based interventions to promote health and well-being, evidence from a population-based perspective is needed to inform child welfare efforts to prevent abuse and neglect. The current study extends the application of small-area ecological research methods from spatial epidemiology to study neighborhood context and the rate of child welfare contact. Using data from 2010-2012, we analyzed global and local spatial variation in the age-adjusted rate of child welfare contact per 1,000 child-years across neighborhoods in Baltimore City (n=55). Evidence for neighborhood context was drawn from the American Community Survey and through observational assessments using the Neighborhood Inventory for Environmental Typology. Through bivariate analysis and negative binomial regression, we examined the association between neighborhood structure (i.e., disadvantage), processes (i.e., drugs and alcohol, violence), and variation in the rate of investigation. The rate of investigation in neighborhoods with high disadvantage was 3 times the rate in neighborhoods with low disadvantage. Both the drug and alcohol index and the violence index were strongly correlated with the rate of child welfare investigation (rho = 0.55 and 0.65, respectively). After adjusting for neighborhood disadvantage, a high score on the violence index was associated with a rate of child welfare investigation 1.7 times the rate in areas with medium or low scores. To reduce the rate of investigation, child welfare may benefit from further coordination with other public agencies using place-based efforts to provide child development and violence prevention programs in urban areas.
Planning of health education strategies, interventions, and programs Public health administration or related administration Public health or related public policy Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
A longitudinal analysis of the effect of multi-generational households on obesity in Hispanic adolescents: A study of moderation by immigrant status and family structure
HaeNim Lee
Case Western Reserve University, Cleveland, OH
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Hispanic adolescents in the United States are more likely than other ethnic groups to live with grandparents with cultural norms of multi-generational livings. This study examines (a) whether living in multi-generational households is associated with body mass index (BMI) trajectories as Hispanic adolescents age into emerging adulthood, (b) to what extent the association between living in multi-generational households and BMI trajectories can be explained by immigrant status and family structure.
Methods: The data comes from the National Longitudinal Study of Adolescent and Adult Health Wave 1(1994-1995)-Wave 3 (2001-2002). The analytic sample consists of 1,659 Hispanic adolescents who belonged to in single and two- parent households with and without a grandparent present. Growth curve models were used to evaluate the trajectory for changes in BMI.
Results: For the first model, the results showed that Hispanic adolescents living in multi-generational households had significantly slower BMI increases than those not living in multi-generational households (b= -0.12, p<0.05). When the models were then stratified by immigrant status and family structure, results showed that living in multi-generational households had significantly slower BMI increases than those not living in multi-generational households among immigrant families (b= -0.15, p<0.05) or two-parent families (b= -0.15, p<0.05). However, the associations were not found among non-immigrant or single-parent families.
Conclusions: These results suggest that living in multi-generational households may play an important role in reducing long-term obesity risk particularly among Hispanic adolescents in immigrant or two-parent families.
Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Environmental health sciences Public health or related organizational policy, standards, or other guidelines Public health or related public policy Public health or related research
Abstract
Factors Influencing Youth Behavioral Health: Adverse Childhood Experiences, Level of Rurality, and Poverty
Pat Conway, PhD1, Sarah Olimb, MSW1, Jennifer Uhrich, MPA2 and Heidi Favet, BA3
(1)Essentia Institute of Rural Health, Duluth, MN, (2)Well Being Development, Ely, MN, (3)Essentia Health Ely Clinic, Ely, MN
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Adverse childhood experiences (ACEs) and poverty have been found to increase behavioral health challenges in adolescence. On the other hand, support from parents, other adults, and peers may prevent or reduce challenges. Understanding which factors influence rural youth’s behavioral health outcomes provides guidance for successful program development. This presentation answers the research question, Which risk factors and supports influence rural youth behavioral health. This secondary analysis of existing data examined students’ perceptions, using results of the 2016 Minnesota Student Survey (MSS); 1,650 5th, 8th, 9th, and 11th grade students in rural, Northern Minnesota completed the MSS. Thirty-six percent received free or reduced-price school lunch, a proxy measure for income. The Minnesota Department of Education administers the MSS every three years; variables include social support and health-related items similar to the YRBS. Youth with a higher number of ACEs and low income reported higher rates of mental health issues such as self-harm and substance use than other students. Students who reported higher levels of parent support and inclusion in decisions at home were less likely to report these challenges. The data revealed challenges facing rural communities including adverse childhood experiences, limited access to behavioral health care, and poverty. For instance, rates of depression were higher for students who experienced at least one ACE. Youth in this rural region experienced a higher rate of ACEs than state-wide (52% vs 35%). Results are now being used to develop programs designed to better serve higher risk youth and reduce barriers to access to care.
Assessment of individual and community needs for health education Epidemiology Planning of health education strategies, interventions, and programs Program planning Provision of health care to the public Social and behavioral sciences
Abstract
Drug Overdose and Child Maltreatment: Variation across the Urban/Rural Divide
Rebecca Orsi, PhD1, Paula Yuma-Guerrero, PhD, MPH1, Kristen Sergi, RN2 and Audrey Shillington, PhD, MSW, MPE3
(1)Colorado State University, Fort Collins, CO, (2)Colorado School of Public Health at Colorado State University, Fort Collins, CO, (3)Colorado State University, Ft. Collins, CO
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Introduction.
Substance abuse and poverty predict child maltreatment, but have not been extensively studied using population-level data. Given the epidemic of opioid overdose in the US, it is imperative to understand how a community’s serious substance abuse contributes to child maltreatment. The purpose of this study was to examine changes in county maltreatment rates, predicted by drug overdose death rates and moderated by rural status.
Methods.
We conducted a national study of all US counties (n=2,963). We used zero-inflated negative binomial modeling to estimate the impact of drug overdose death rates on child maltreatment report rates. We examined whether these risks are moderated by rurality. Our measures were compiled from five sources, including the US Census, CDC, USDA, RWJF County Health Rankings and the National Child Abuse and Neglect Data System.
Results.
Drug overdose death rates positively predicted maltreatment rates [χ2(1)=16.03 , p<.0001]. Compared to urban counties, the increase in maltreatment reports with increasing overdose deaths is stronger in non-metro rural counties (χ2(1)=3.31, p=.069) and strongest in non-metro suburban counties (χ2(1)=8.60, p=.003). Median family income [χ2(1)=331.18 , p<.0001] negatively predicted maltreatment rates, while % children in single-parent households [χ2(1)=28.61, p<.0001], violent crime [χ2(1)=32.47 , p<.0001] and % white population [χ2(1)=137.04 , p<0001] positively predicted maltreatment.
Conclusions.
Consistent with family-level research, counties challenged by substance use and poverty also experience greater maltreatment report rates. This relationship varies, with non-metro counties demonstrating a stronger relationship. Future research should explore how access to health care and social support services may mediate the relationship.
Epidemiology Public health or related research Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Childhood sexual abuse and current suicidal ideation among adolescents: Problem-focused and emotion-focused coping skills
Yoewon Yoon, MSW and Julie A. Cederbaum, PhD, MSW, MPH
University of Southern California, Los Angeles, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Suicidal ideation is a warning indicator of more serious suicidal behavior. While there is an extant research base on the relationship between suicidal ideation and sexual abuse history, little is known about protective factors that might buffer suicidality. Adolescents’ intrinsic qualities of coping skills are known to enable successful adaptation after adversity. The present study sought to examine whether adolescents with history of childhood sexual abuse are at heightened risk for suicidal ideation. In addition, we examined the impact of problem-focused and emotion-focused coping skills as protective against suicidal ideation.
Methods: Data analyzed is from 307 youth (age 16 or 18) from San Diego and Seattle at Wave 7 of the Longitudinal Studies of Child Abuse and Neglect study. Among youth, 17.6% reported suicidal ideation. We used multivariate stepwise logistic regression models to predict the association between sexual abuse, coping skills, and suicidal ideation, controlling for other predictors of suicidality.
Results: Adolescents with sexually abuse histories were 3.38 times more likely to report suicidal ideation compared to those with no sexual abuse. Emotion-focused coping was a buffer for suicidal ideation; adolescents reporting greater emotion-focused coping skills were .80 times less likely to report suicidal ideation.
Conclusion: Our findings indicate that emotion-focused coping skills work to reduce reported suicidal ideation. This has implications for early intervention efforts. Building youth assets through promotion of positive youth development may serve as an important buffer to reduce negative outcomes in youth who have experienced sexual abuse.
Other professions or practice related to public health Public health or related education Public health or related research Social and behavioral sciences
Abstract
Family Transition Coach Model: The role of mixed income housing in establishing health equity
Nikki Patterson-Russel, MSW and Schanea Ward, BSW
Richmond City Health District, Richmond, VA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Problem Statement:
Richmond City has a complex history of racial and socioeconomic status segregation. The legacy of this segregation can be seen in the modern-day concentration of low-income and public housing communities. One community, Creighton Court, is in the process of transitioning residents to mixed-income housing to reconcile the intentional segregation in Richmond's past. Transitioning into a mixed-income community comes with a lot of new experiences for public housing residents.
Process:
Addressing the social determinants of health is the solution to moving communities towards health equity. Richmond's public housing communities are experiencing change as the system moves towards mixed-income housing. Residents often experience economic hardship, fear, violence, underemployment, substance abuse, and inequality that persist even after housing improves. To address this, Richmond City Health District employs Family Transition Coaches to provide case management and counseling services to support residents. Through a combination of on-site, affordable, and culturally relevant clinical and case management services, Richmond City Health District strives to improve the health of public housing communities and empower residents in moving towards self-sufficiency.
Impact:
The FTCs have become a staple in the Creighton Court community. During a housing summit held by the Office of Community Wealth Building, a city agency aimed at reducing poverty, many of the residents and service providers identified the FTCs as playing an impactful role in the transition of residents to mixed-income housing. Currently, FTCs serve 80 households; additional funding has been secured to expand the FTC model to serve more households.
Social and behavioral sciences
Abstract
Understanding the Interconnectedness of Behavioral Health Risks Experienced by Mother’s and Food Insecurity
Tracey Barnett, PhD, LMSW1 and D. Crystal Coles, PhD, LSCSW2
(1)University of Arkansas, Fayetteville, AR, (2)University of Kansas, Lawrence, KS
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Purpose:
Mothers who experience elevated psychosocial risk factors face challenges related to their mental, physical, and emotional health. This coupled with being food insecure can add another layer of challenges when to ensuring well-being of their children. Often, women’s health and food insecurity are studied independently, despite its interrelationship. This study employed a secondary data analysis of the Fragile Families and Child Well-Being Study (Year 2015) to explore the associations among psychosocial risk factors and food insecurity.
Methods:
An adapted version of the Institute for Health and Recovery’s Behavioral Health Risk Screen (BHRS), PHQ-9, Edinburgh Postnatal Depression Scale (EPDS), and additional anxiety questions were used to examine depression, substance use and smoking usage of biological mothers and their experiences with food insecurity within the 2015 Fragile Families study (N=257).
Findings:
Behavioral health risks: emotional health (r=.195, p<.002), smoking (r=.148, p<.018), and interpersonal violence (r=.137, p<.002) were significantly correlated with food insecurity. Findings from the multiple regression indicated that food insecurity (dependent variable), when regressed on emotional health, smoking, and interpersonal violence, R2adj = 0.054, are statistically significant (F5, 251 = 3.93, p < 0.02). With other variables held constant, food insecurity was positively related to smoking, interpersonal violence, and emotional heath.
Implications:
Findings indicate robust evidence for policies and public health interventions to target food insecure women with elevated risk of psychosocial stressors, by holistically encompassing and addressing behavioral health and lifestyle factors while revealing environmental, structural and social determinants of health which impact equity of care.
Public health or related research Social and behavioral sciences
Abstract
Minority stress and health: Implications for cisgender and gender non-conforming sexual minority youth accessing crisis services
Ankur Srivastava, MPhil, MSW, Joshua Rusow, MSW, Harmony Rhoades, PhD and Jeremy Goldbach, Ph.D.., LMSW
University of Southern California, Los Angeles, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Introduction: Behavioral health disparities exist for gender and sexual minority youth when compared to their cisgender heterosexual peers. Minority stress theory has been widely used to explain the health disparities found among both sexual minority and gender minority youth; however, minority stress research is often limited by lumping these groups together or ignoring gender minority identity. Furthermore, research suggests that increasing number of sexual minority youth are identifying with gender non-conforming (GNC) identities. Methods: This study examined minority stress and behavioral health outcomes among cis-gender and GNC sexual minority adolescents who contacted a nationwide LGBTQ crisis services provider. Results: 29% of sexual minority youth identified with GNC identities (e.g., transgender, nonbinary, genderqueer). GNC youth reported higher odds of lifetime suicide attempt (OR=2.33) and greater likelihood of endorsing a future suicide attempt as likely (OR=2.26), after accounting for age, race, burdensomeness and thwarted-belongingness, as compared to non-GNC youth. Lifetime sexual minority stress was a significant predictor to mental health disorders in the sample. In addition, GNC sexual minority youth reported more symptoms of mental health disorders (PTSD and depression) after accounting for lifetime minority stress experiences and sexual orientation. Conclusions: Sexual minority youth in our sample presented a range of gender identities. GNC sexual minority youth reported more suicidality and symptoms of mental health disorders that their peers. Crisis services organizations working to reduce suicidality among LGBTQ youth may want to be sensitive to the additional stressors and comorbid behavioral health disparities associated with multiple minority experiences.
Assessment of individual and community needs for health education Diversity and culture Public health or related research Social and behavioral sciences