Philip Osteen

An Introduction to Using Multidimensional Item Response Theory to Assess Latent Factor Structures

This study provides an introduction to the use of multidimensional item response theory (MIRT) analysis for assessing latent factor structure, and compares this statistical technique to confirmatory factor analysis (CFA) in the evaluation of an original measure developed to assess students’ motivations for entering a social work community of practice. The Participation in a Social Work Community of Practice Scale (PSWCoP) was administered to 506 masters of social work students from 11 accredited graduate programs. The psychometric properties and latent factor structure of the scale are evaluated using MIRT and CFA techniques. Although designed as a 3-factor measure, analysis of model fit using both CFA and MIRT do not support this solution. Instead, analyses using both methods produce convergent results supporting a 4-factor solution. Discussion includes methodological implications for social work research, focusing on the extension of MIRT analysis to assessment of measurement invariance in differential item functioning, differential test functioning, and differential factor functioning.

Advancing Training to Identify, Intervene, and Follow Up with Individuals at Risk for Suicide Through Research

Research and training on suicide is critical given the fact that the majority of suicide deaths are preventable with accurate identification of risk and intervention by trained individuals. However, implementing and evaluating training is difficult because of the multiple factors involved, including, but not limited to, the heterogeneity of trainees, their diverse roles in suicide prevention, absence of clear guidelines for training content across settings, and limited methods for assessing outcomes. Here, three groups of trainees are discussed: community and professional gatekeepers and behavioral health providers. The roles each group plays in managing suicide risk and the training content it needs to be effective are addressed. A staged training approach is proposed, building on the core components of currently used suicide training: knowledge, attitudes, and skills/behaviors. Limitations of current assessment methods are identified and recommendations for alternative methods are provided. The article concludes with a discussion of next steps in moving the field forward, including overcoming challenges and identifying and engaging opportunities.

Stress and Quality of Life in Urban Caregivers of Children With Poorly Controlled Asthma: A Longitudinal Analysis

INTRODUCTION The intent of this analysis was to examine the longitudinal effects of risk and protective factors on quality of life (QOL) in caregivers of minority children with asthma. METHOD Caregivers (n = 300) reported on demographics, child asthma characteristics, daily asthma caregiving stress, general life stress, social support, and QOL. Latent growth curve modeling examined changes in QOL across 12 months as a function of stress, asthma control, and social support. RESULTS Caregivers were primarily the biological mother (92%), single (71%), unemployed (55%), and living in poverty. Children were African American (96%), Medicaid eligible (92%), and had poorly controlled asthma (93%). Lower QOL was associated with higher life stress, greater asthma caregiving stress, and lower asthma control over time. DISCUSSION Findings underscore the importance of assessing objective and subjective measures of asthma burden and daily life stress in clinical encounters with urban, low-income caregivers of children with poorly controlled asthma.

Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories

Objective: Examine associations of chronic health conditions on workplace productivity and accidents among US Department of Energy employees. Methods: The Health and Work Performance Questionnaire–Select was administered to a random sample of two Department of Energy national laboratory employees (46% response rate; N = 1854). Results: The majority (87.4%) reported having one or more chronic health conditions, with 43.4% reporting four or more conditions. A population-attributable risk proportions analysis suggests improvements of 4.5% in absenteeism, 5.1% in presenteeism, 8.9% in productivity, and 77% of accidents by reducing the number of conditions by one level. Depression was the only health condition associated with all four outcomes. Conclusions: Results suggest that chronic conditions in this workforce are prevalent and costly. Efforts to prevent or reduce condition comorbidity among employees with multiple conditions can significantly reduce costs and workplace accident rates.

Suicide Prevention in Social Work Education: How Prepared Are Social Work Students?

The prevalence of suicide suggests social workers will encounter clients at risk for suicide, but research shows social workers receive little to no training on suicide and suicide prevention and feel unprepared to work effectively with clients at risk. Baseline results from a randomized intervention study of the Question, Persuade, and Refer suicide prevention gatekeeper training with 73 advanced master’s of social work student interns show suicide knowledge was average, attitudes about suicide prevention were generally neutral, and use of suicide prevention practice skills was low. These results indicate an opportunity for enhancing student outcomes through training and inform social work education regarding necessary preparation for student interns and new graduates to identify and respond effectively to client suicide risk.

Family satisfaction, pain, and quality-of-life in emerging adults with spina bifida: a longitudinal analysis.

ObjectiveThis study uses the Life Course Model for Spina Bifida (SB) to advance knowledge of factors associated with change in quality-of-life (QOL) among emerging adults with SB. DesignForty-eight participants (mean [SD], 22.04 [2.16] yrs) completed self-report questionnaires at two time points, 15 mos apart. Four QOL domains (physical health, psychological, social relationships, and environment) were measured using the World Health Organization QOL–BREF version. SB clinical data were collected via chart reviews. Paired t tests and reliable change indices evaluated group- and individual-level QOL change, respectively. Multiple regression analyses tested the contributions of the Life Course variables in explaining change in QOL over time. ResultsNo significant group-level differences in the QOL domains were found between time 1 and time 2, but there was substantial individual variation in QOL over time. SB severity was related to a decline only in psychological QOL (B = −0.68, P = 0.02). Increased pain was associated with reduced physical health (B = −0.29, P = 0.049) and psychological (B = −0.29, P = 0.03) QOL at time 2, whereas greater family satisfaction was related to improved QOL in several domains. ConclusionsClinicians should be aware of the negative impact of pain and the protective influence of family satisfaction on QOL in emerging adults with SB.

Evaluation of a Continuing Education Training on Client Financial Capability

The researchers conducted an evaluation study assessing outcomes among 37 social workers who completed a continuing education course on financial capability and working with clients. Key constructs assessed included participants’ attitudes about financial capability, self-efficacy to provide services, organizational barriers, and basic financial knowledge. Social work participants reported that financial problems among their clients were almost unanimous as a reason for seeking services. Organizational barriers, such as lack of time and access to staff with financial knowledge, prevented social workers from providing client financial services. At follow-up, social workers reported improved personal financial knowledge and behaviors. Suggestions for future research and improving social work continuing education and integrating financial capability into the social work curriculum in academic settings are suggested.

Proximate Outcomes of Service-Learning Among Family Studies Undergraduates

Attitudes in academics, career, civic responsibility, and empowerment were reported before and after 143 undergraduate Family Studies students completed a service- learning project. Results suggested improved academic and career post-test scores. Civic responsibility and empowerment improved but not significantly. Open-ended responses suggested three additional outcomes: group work, leadership, and empathy. Implications for academic programs focused on engaging students in service-learning projects working with or on behalf of families are discussed.

Psychosocial Assessment by Hospice Social Workers: A Content Review of Instruments From a National Sample

CONTEXT Hospice social workers are charged with completing a psychosocial assessment for every new enrollee. This assessment is part of the patients comprehensive assessment and serves to inform the plan of care and key quality indicators. OBJECTIVES To review the content of hospice social work assessments because little is known about what assessment topics are included or overlooked. METHODS Using a cluster random sample from all 50 states, we contacted hospice agencies and requested a blank copy of the social work assessment completed at intake. We then systematically reviewed the content of these assessments to determine which domains were included and which were omitted. A total of 105 hospice agencies participated (response rate 42%). Among the assessments provided, 76 (72%) were unique assessments. RESULTS Participating hospices were largely freestanding (65%), nonprofit (60%), and either medium (39%) or small (37%) in terms of average daily census. Over 60% of the sample, assessments included content on the following: financial resources; family structure; coping resources; bereavement risk; past losses; caregiver depression; religiosity/spirituality; patient anxiety, patient depression; and advance directives. However, most assessments did not include items evaluating the following: patient physical/functional status; preferences for treatment/care; awareness of diagnosis, prognosis, or disease progression; communication and literacy issues; changes in relationship intimacy/sexuality; and cultural values, beliefs, and customs. CONCLUSION Hospice social workers should consider modifying their assessment practices to include a comprehensive array of assessment topics pertinent to patients and families. An accurate, comprehensive assessment that contributes to a holistic, interdisciplinary approach will likely lead to better clinical outcomes.

Predicting Changes in Behavioral Health Professionals’ Clinical Practice Skills for Recognizing and Responding to Suicide Risk

Objective: Behavioral health professionals who have primary contact with people at risk for suicide play a critical role in suicide prevention. Previous studies suggest that training helps professionals build clinical practice skills to identify and assess suicide risk, but only limited research is available regarding which factors influence changes in clinical practice skills. This study aims to identify those factors, as measured by written responses to 3 vignettes, over time. Social cognitive theory is used as the conceptual framework to develop models of changes in clinical practice skills. Method: Secondary data (n = 314) from the Recognizing and Responding to Suicide Risk (RRSR) training are analyzed using multilevel modeling analyses. Results: Model 1 shows higher levels of self-efficacy and more positive attitudes toward suicide prevention significantly predict improvement in clinical practice skills over time. Model 2 shows other significant predictors of changes in behavioral health professionals’ clinical practice skills include self-efficacy, gender, age, and educational degree. Conclusions: Findings from the analyses suggest those designing trainings or interventions intended to increase professionals’ skills in suicide prevention should account for individual characteristics, differing levels of self-efficacy, and variability in attitudes toward suicide prevention among behavioral health professionals.