Koen Hermans

Bifurcated Commitment, Priorities, and Social Contagion: The Dynamics and Correlates of Volunteering within a University Student Population.

In spite of a progressive institutionalisation of community‐based learning into higher education, relatively little is known about the actual dynamics and correlates of volunteering by students. The study presented seeks a more in‐depth understanding of the spontaneous, extracurricular involvement within a university student population. Data are drawn from a postal survey of a representative sample of third‐year university students enrolled at a Flemish university (n = 744). In a first step, an exploration of the course and nature of students’ volunteer involvement is provided. In a second step, an explanatory model is constructed to predict the likelihood of belonging to the categories of volunteers, former volunteers or non‐volunteers. Firstly, it appears that a large group of students drop out of volunteering in transition to university, and that volunteering is rarely given priority in students’ agenda. Furthermore, a bifurcated pattern of involvement with a different pace inside and outside university is identified. Finally, extensive embedding in a volunteer environment as well as the discipline of study are major predictors of volunteering by students. Gender, church practice, being encouraged to volunteer and subjective study pressure produce subsidiary effects.

Street-Level Strategies of Child Welfare Social Workers in Flanders: The Use of Electronic Client Records in Practice

The use of information and communication technology (ICT) in child welfare services has increased significantly during the last decades, and so have the possibilities to process health data. Parton (2009) states that this evolution has led to a shift in the nature of social work itself: from ‘the social’ to ‘the informational’. It is claimed that social workers primarily are becoming information processors concerned with the gathering, sharing and monitoring of information, instead of being focused on the relational dimensions of their work. However, social workers have considerable discretion concerning the way they use ICT. In this paper, we investigate (i) the street-level strategies social workers develop regarding ICT and (ii) how these relate to a narrative social work approach. To illustrate this, an evaluation of Charlotte was conducted, a client registration system that is used by social workers in child welfare services in Flanders, Belgium. Based on fifteen interviews, we find that social workers develop various strategies regarding Charlotte to preserve a relational and narrative work approach. These strategies not only result in a gap between ICT policy and the execution of that policy in practice, but also decrease the extent to which accountability can be realised via registration data.

Towards a comprehensive research design for studying integrated care

Given that integrated care includes many different aspects, this paper seeks to design a comprehensive research approach and explains how this approach is applied in the CORTEXS research project on integrated care in the Flemish Community in Belgium. A systemic view on integrated care is translated into a multi-level, multi-disciplinary, multi-method and multi-stakeholder research design. A phased approach of taxonomy development and literature review, comparative case studies, social lab activities and valorisation initiatives is devised in order to link fundamental research with strategic valorisation of the research results. While this innovative comprehensiveness is seen as a major strength, it is acknowledged that the research design comes with certain risks that need to be tackled.

Building a working alliance between professionals and service users in family preservation. A multiple case study

In the margin of the ongoing experimental and quasi-experimental research projects on family preservation, some research projects focus on the process through which families accomplish change and acknowledge the importance of the working alliance. There is, however, little information about barriers and facilitators in building this working alliance. To fill this gap, we performed a multiple case study with a triangulation of ethnographical methods such as observation, in-depth interviews, case file analysis, and multistakeholder focus groups. We illustrate how, in a context of managerialism and transactional leadership, social workers find themselves in a continuous tension between complying with the expectations of their social organization and “tuning in” with the service users. This jeopardizes the working alliance between a social worker and a family. Consequences for research, practice, and policy regarding family preservation interventions are discussed.

Mechanisms of integrated care in Flanders: A bottom-up perspective

Background For some time now, integrated care has been put forward to create a more demand-driven, patient-centred and cost-effective care system. Various conceptual frameworks have been developed to shed light on the complex concept. However, they lack insight into the mechanisms driving integrated care in practice. The aim of this paper is to gain insight into how integrated care is realised in practice. Methods Six cooperation projects in Flanders were compared on five integration mechanisms. A content analysis of secondary sources on each of the cases and semi-structured interviews with representatives of these cases was conducted. The data were analysed using comparison tables. Results Six cases representing five cooperation models in the Flemish health and social care were analysed for the presence of integrated care mechanisms. Six of the 22 mechanisms are present in all case examples. Half of the identified mechanisms concern the integration of professionals. Integrated care in these Flemish cases refers mainly to organising a case meeting, appointing a case manager and dividing the tasks between care professionals. Integration of support is less developed. Conclusions The bottom-up approach to study the practical implementation of mechanisms is a fruitful approach, since it brings into light the complex realities and practicalities of the mechanisms of integration and how they are shaped by local actors in local contexts. The approach shows how Flemish and Belgian policy makers are struggling to scaling up these integration models, whilst at the same time responding to local conditions and needs.

Social differences in postponing a General Practitioner visit in Flanders, Belgium: which low‐income patients are most at risk?

One of the main goals of primary care is providing equitable health-care, meaning equal access, equal treatment and equal outcomes of healthcare for all in equal need. Some studies show that patients from lower socioeconomic groups visit a GP more often, while other studies show that they are more likely to postpone a visit to a GP. In this study, we want to explore within the social group of low-income patients living in Flanders, Belgium, which patients have a higher risk of postponing a visit to a GP. A face-to-face questionnaire was administered among 606 low-income users of Public Social Services. The questionnaire consisted of questions on socioeconomic and demographic characteristics, social networks, health and healthcare use. A multivariate logistic regression model was built to study the relationship between postponing or cancelling a GP visit which respondents thought they needed and variables on health, socio-demographic background. The multivariate regression indicates that depression, self-rated health and trust in the GP independently predict postponing a visit to a GP. Low-income people with a low trust in the GP, people with a poor self-rated health and people suffering from a severe depression are more likely to postpone or cancel a GP visit they thought they needed compared to other people on low incomes. This might indicate that the access to health-care for low-income people might be hindered by barriers which are not directly linked to the cost of the consultation.

Systems of Delivery of Health Care for Persons with Developmental Disabilities: The Case of Belgium

Belgium has an elaborate, but complicated and fragmented health and social care system that differs between regions. Looking at the system in the Dutch speaking community from a life course perspective, we see that many services are available, at low or no cost for the client, and developmental problems are often detected at a young age. However, the coordination between all services available is insufficient, and sometimes non-existent. Even though the number of services increased during the last decade, the waiting lists became longer. Also, people have difficulty finding their way in the system, which has a negative effect on accessibility. For adults with disabilities, the system of care is even more fragmented than for children, and the waiting lists are longer. Although it must be said that the government has made many efforts to ameliorate the situation, it still has not succeeded in overcoming these problems. Therefore, the Flemish government more and more opts for a demand-driven policy, in which the person in need of care receives a budget for care, instead of the organizations receiving subsidies directly from government.

Social work research as a practice of transparency

Social work research is inherently normative and as such the assumptions about social problems in social work research should be open to scrutiny and contestation. But although researchers often face tussles and huge contradictions, they rarely articulate them. In this article, we report on a small research project in which a collective of social work researchers in Flanders (the Dutch speaking part of Belgium) tried to think critically through some of the questions and complexities they were confronted with in social work research, more specifically in research on poverty. Our research aim implied that we tried to discuss the choices that were made during a diversity of research projects, including making explicit the grounds on which this happened. We learned that the choices made, although they seem to be very obvious ones, often remained implicit during the different research processes. We conclude that social work research requires that researchers attempt to realize a practice of transparency. The pursuit of such a practice of transparency refers to the importance of the creation of reflexive space in research communities to collectively embrace and discuss the complexities of social work research.