Diane B. Mitschke

Uncovering Health and Wellness Needs of Recently Resettled Karen Refugees from Burma

Often, newly resettled refugees continue to face obstacles to acculturation long after initial resettlement. Findings from interviews with Karen refugees from Burma suggest that recently resettled refugees experience major obstacles in locating and accessing employment and health care due to language and transportation barriers. Interviewees expressed a need for assistance in learning English and help with transportation, job skills, and financial planning. Results of this needs assessment indicate that many of the basic needs of refugees are not being met following the initial relocation period, and significant efforts are needed to achieve social justice for this vulnerable population.

Cancer in the family: Review of the psychosocial perspectives of patients and family members

ABSTRACT As advances in cancer care have led to more treatment options and longer survival for cancer patients, a focus on quality of life for patients and their families has gained importance. This review provides a discussion of stress and coping theory, documents the relevance of this topic area for social work practice, and illuminates the results of a literature review by emphasizing the perspective from which research was collected within the family system. Recognizing the impact of cancer on the lives of patients, their partners, children, and the family as a whole is an essential factor in providing appropriate and adequate psychosocial services to families facing cancer.

Improving Social Work Students' Understanding of Health and Social Justice Knowledge through the Implementation of Service Learning at a Free Community Health Clinic

Service learning is a teaching strategy that involves engaging in a mutually beneficial partnership between a community and students in the classroom. Social work education and service learning share core values of service and social justice and, when unified, can offer students unique opportunities to engage in meaningful application of knowledge and skills in a real-world setting. This article provides an exemplar describing the unique student learning outcomes that resulted from a service learning partnership between graduate-level social work students in a diversity course and a community health clinic serving Latino immigrants and Burmese refugees.

Implementation of a collaborative care model for the treatment of depression and anxiety in a community health center: results from a qualitative case study.

Background The collaborative care model is a systematic approach to the treatment of depression and anxiety in primary care settings that involves the integration of care managers and consultant psychiatrists, with primary care physician oversight, to more proactively manage mental disorders as chronic diseases, rather than treating acute symptoms. While collaborative care has been shown to be more effective than usual primary care in improving depression outcomes in a number of studies, less is known about the factors that support the translation of this evidence-based intervention to real-world program implementation. The purpose of this case study was to examine the implementation of a collaborative care model in a community based primary care clinic that primarily serves a low-income, uninsured Latino population, in order to better understand the interdisciplinary relationships and the specific elements that might facilitate broader implementation. Methods An embedded single-case study design was chosen in order to thoroughly examine the components of one of several programs within a single organization. The main unit of analysis was semi-structured interviews that were conducted with seven clinical and administrative staff members. A grounded theory approach was used to analyze the interviews. Line-by-line initial coding resulted in over 150 initial codes, which were clustered together to rebuild the data into preliminary categories and then divided into four final categories, or main themes. Results Four unique themes about how the implementation of a collaborative care model worked in this setting emerged from the interviews: organizational change, communication, processes and outcomes of the program, and barriers to implementation. Each main theme had a number of subthemes that provided a detailed description of the implementation process and how it was unique in this setting. Conclusion The results indicated that adequate training and preparation, acceptance and support from key personnel, communication barriers, tools for systematic follow-up and measurement, and organizational stability can significantly impact successful implementation. Further research is necessary to understand how organizational challenges may affect outcomes for patients.

What Leads Non-U.S.-Born Latinos to Access Mental Health Care?

Latinos underutilize mental health care services. Of those who do, about 70% do not return after the initial visit. This studys purposes were: (1) to identify factors that led non-U.S.-born Latinos to utilize services from a nonprofit clinic in Texas and (2) to assess whether acculturation played a role in accessing mental health care. Data were collected over a 10-week period using an interview schedule and the Bidimensional Acculturation Scale for Latinos. Results indicate acculturation does not play a significant role in access, but patient knowledge of mental health care issues does. Specifically, the main barriers to access were: (1) lack of knowledge that there was a mental health issue; and (2) lack of knowledge of where to go for mental health services.

Using Drama to Prevent Teen Smoking: Development, Implementation, and Evaluation of Crossroads in Hawai`i

The use of drama as a preventive education measure has demonstrated success in various health promotion venues and offers promise in promoting positive youth attitudes and behavior change related to tobacco use. Especially important is a need to implement culturally relevant methods to reach youth. This article describes the development and implementation of a tobacco prevention drama for Asian and Pacific Islander youth. The resulting play, Crossroads, features a soap opera-style drama interspersed with humorous vignettes and multimedia effects and incorporates cultural cues, mannerisms, dress, and values consistent with Asian and Pacific Islander youth culture. Evaluation data indicate that the drama has an effect on audience knowledge, attitudes, and intended behavior, including a change in future intent to smoke cigarettes and the ability of audience members to develop connections with the characters in the play and apply concepts that are presented in the play to their own lives.

Enhancing Learning and Learner Satisfaction Through the Use of WebCT in Social Work Education

Emerging technology has produced changes in the ways that social workers learn, practice, and interact. As communication and educational innovations have increasingly involved the use of ever-improving technologies for social work practice, so too has social work education evolved to incorporate these advances in the classroom setting. This article describes and evaluates various aspects of one particular type of web-based learning environment, WebCT, and its incorporation into five face-to-face foundation courses in a bachelors and masters level social work program. The authors utilized an online survey to assess frequency of access of the web-based course management system and perceptions of the features. Results of this online survey assessing student use and perception of hybrid courses are shared along with implications and recommendations.

Coping with prostate cancer in Asian-American, Native Hawaiian, and Caucasian families.

Prostate cancer is the most commonly diagnosed invasive cancer among men in the United States. In order to explore the coping experience of men and their families facing prostate cancer, a qualitative analysis of written responses to open-ended questions related to roles during the illness experience, closeness of relationships, and coping strategies was conducted with a sample of 100 Caucasian, Asian, and Native Hawaiian participants. Results indicate that family members and friends are essential to coping with the effects of the disease, and also that spouses, children, and friends fulfill unique and important roles in facing the illness experience.

Listening to refugees: How traditional mental health interventions may miss the mark

Understanding the dynamics of mental health of recently resettled refugees is an essential component of any comprehensive resettlement program, yet establishing the components of a successful and acceptable mental health intervention is an elusive task. Semi-structured interviews were conducted with 30 resettled refugees from five countries who had received treatment for depression, post-traumatic stress symptoms, or anxiety. Themes generated from the interviews emphasized the need for strong group-based social support as well as a focus on practical needs such as acquiring and maintaining employment, language and literacy training, and access to care.

Exploring dating practices and acceptability of a dating violence program with Karen youth

ABSTRACT Teen dating violence (TDV) negatively impacts the health of youth in the United States and internationally, but we know little about dating violence among resettled refugee adolescents in the United States. We conducted a focus group with six Karen refugee youth to learn about dating practices and determine acceptability of a TDV prevention program curriculum, as a first step in addressing TDV in this community. Five themes emerged from the youth’s discussion related to: (1) gender roles, (2) dating practices, (3) healthy vs. unhealthy relationships, (4) acceptability of a TDV prevention program, and (5) acculturation. Findings indicate that gender roles and parents play important roles in youth’s views on dating practices. Youth shared the importance of communication in healthy relationships. Results indicated that Karen youth will likely participate in a TDV prevention program but acculturation may influence participants’ level of sharing. Future research is needed to examine the effects of a prevention program with this population.