Arati Maleku

Culturally Competent Health Care from the Immigrant Lens: A Qualitative Interpretive Meta-Synthesis (QIMS)

Immigrant groups comprise a large segment of ethnic minorities in the United States. Although the literature is rich with strategies to deliver culturally and linguistically appropriate services to eliminate health inequities, studies addressing cultural competence from the immigrants perspective are limited. Further research is needed to build knowledge of the predictors and needs of this population, and to influence health care policy and practice. Using qualitative interpretive meta-synthesis, this study describes the lived experience of immigrants accessing health care to understand the essence of cultural competence in health care through their lens. Findings provide insight on expanding the definition of culturally competent health care beyond language, behaviors, attitudes, and policies.

Maternal Mortality and Female Literacy Rates in Developing Countries during 1970–2000: A Latent Growth Curve Analysis

Background. The gross longitudinal relationship between female literacy and maternal mortality ratios has not been adequately investigated even though the knowledge of the relationship is crucial for designing maternal mortality reduction programs through female literacy campaigns and improvements. The objective of the study was to examine the dynamic relationship between female literacy and mortality ratios. A longitudinal study design spanning three decades, 1970–2000, was used. Country level data on 143 nations belonging to six geographical regions for the duration 1970–2000 were secured from websites hosted by global agencies such as World Bank and the United Nations were utilized. Maternal mortality ratios (1970–2000) ranged from 147 to 271 across the six regions. The longitudinal relationship between female literacy rates and maternal mortality ratios was examined using a latent growth curve approach. The study found that rates of change in female literacy and maternal mortality ratios are negatively related. Steady rates of increase in female literacy were associated with declining maternal mortality ratios as well. We find that female literacy programs are of immense value in reducing maternal mortality ratios given their ability to yield sustained reductions in mortality levels in developing countries.

Impact of applied suicide intervention skills training on resilience and suicide risk in army reserve units

Suicide is a concern in the armed forces both because of the increased risk due to the high prevalence of mental health issues and its ripple effect. Increasing protective factors against suicide then, becomes crucial in reducing military suicide. This study used a pre/post quasi-experimental design to investigate 2 hypotheses over a 4-month intervention period. The sample was drawn from Army Reserve platoons that have received Applied Suicide Intervention Skills Training (N = 131). Age significantly positively correlated with pretest resilience scores, whereas pretest suicidality scores were not significantly correlated with any predictors. Posttest hopelessness scores decreased over the intervention period. Administrative records documented that the high training group had fewer reported suicide attempts and reports of suicidal ideation than the low training group. Results provided preliminary evidence that this peer model may change relevant variables related to suicidality and support the need for direct investigation on efficacy of such primary prevention programs on resilience and target suicide risk factors and whether they are ameliorated by peer model interventions. Results may also add to resilience theory development regarding applicability of the resilience construct in populations with less defined conditions of cumulative trauma or adversity.

Women, war, and reproductive health in developing countries

ABSTRACT Globally, millions of people are affected by war and conflicts every year. However, women have increasingly suffered the greatest harm by war in more different ways than men. We conceptualize a reproductive rights approach toward examining the effects of war on women’s reproductive health in developing countries. Given the rising concerns of exclusion to adequately address women’s rights, sexual and gender-based violence, and post-conflict accountability, we specifically focus on the limitations of the Minimum Initial Service Package, a UN-sponsored reproductive health service program in conflict zones while offering a broad reproductive rights-based conceptual lens for examining reproductive health care services in war-torn areas. In addition, we discuss the roles social workers may play at both micro and macro levels in war-torn areas to bring about both short term and long term gains in women’s reproductive health.

Pathways to age-friendly communities in diverse urban neighborhoods: Do social capital and social cohesion matter?

ABSTRACT Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.

Adolescent Issues in India: Toward a Rights-Based Approach

Youth policies, laws, and programs have attempted to respond to the demographic fact that the population of India is very young. Social science literature in India is rich with descriptions of demographic and cultural characteristics of youth while also providing extensive analysis of youth policies and programs. One drawback of current literature on youth in India involves the poor focus on adolescents as a significant demographic component of the youth population. This chapter provides a brief discussion of selected social problems confronting the adolescents in India today alongside with current governmental efforts in terms of laws, policies, and programs to prevent and assuage the undesirable consequences of social problems. It is argued that the difference between social problems and programs and policies intended to solve those social problems is a number of intrinsic flaws. They appear to be haphazard and ill conceived. Policies lack a broad conceptualization of adolescents as a group and their health needs. In this regard, it is argued that a rights-based approach toward building capacities among adolescents today enjoys widespread appeal, especially when dealing with vulnerable groups such adolescents. In addition, we argue that a Bourdiean perspective provides a rich theoretical stance to locate adolescents as a client group in need of capacity building.

Antenatal Care in Nepal: A Socioecological Perspective

Globally, millions of women die during pregnancy and childbirth due to preventable causes. In Nepal, although significant improvements have been made in the availability of routine antenatal care (ANC), the need for effective initiatives still persists. Using the 2011 Nepal Demographic and Health Survey data, we examine the relationship between ecological and socioeconomic variations on the effect of ANC services between three distinct ecological zones in Nepal. We make a case for the consideration of socioecological niches in designing effective policies and programs to achieve positive maternal health outcomes. Most importantly, we demonstrate how sociocultural perspective can be one alternative for examining the cultural and contextual effects on womens health, contributing to the methodological literature on womens health. Since geography and culture are components of human ecology and form the larger socioecological system, we highlight the importance of these contextual effects on womens health in general, and the conditions under which women from diverse backgrounds may experience similar health issues.

Training MSSW Students for Military Social Work Practice and Doctoral Students in Military Resilience Research

The demand for social workers with military-related practice and research experience exceeds the current supply. To advance military social work education, we developed an interlevel master’s of science in social work (MSSW) field practicum and doctoral research practicum that provides military social work field experiences and contributes to doctoral education on military intervention research. Tasked with the primary responsibility of teaching complex resilience concepts to youth participants, the project challenges MSSW students to develop deep knowledge of the material. Assigned the role of project manager of an ongoing intervention study and responsible for performing multiple hands-on research tasks, the project promotes doctoral student research proficiency. Feedback from students suggests that the project supports learning outcomes and enhances motivation to engage in present and future intervention research.

International Non-Governmental Organizations in Latin America and Social Capital: An Empirical Case Study

International Non-Governmental Organizations (INGOs) in developing countries promote interests of the poor, provide social services, and stimulate community engagement. The exponential growth of INGOs during the last four decades was accompanied by major financial scandals and corruption charges leading to an increase in research on the impact of INGOs on community well-being in developing countries. Due to sparse empirical studies that evaluate the role and functions of INGOs, the question of the impact of INGOs on community well-being has remained largely rhetorical. Our study attempts to provide preliminary evidence on the impact of socio-economic programs carried out by an International Governmental Organization (INGO), Adventist Development and Relief Agency (ADRA), in four Latin American countries. Results from the quasi-experimental study suggest that communities with ADRA programs have a higher level of social capital than communities without them. While the results reported here may not be generalized to all INGOs, our study is unique in providing a valuable empirical approach toward examining the role of INGOs in developing countries.