Tracy Wharton

An Examination of Differential Association and Social Control Theory Family Systems and Delinquency

This study applies differential association and social control theories to juvenile delinquency. Using a path analysis model, relationships between family, self-image, and behavior are explored. Analyses suggest that positive self-image leads to decreased delinquency, and association with delinquent peers is the greatest predictor of delinquent behavior, regardless of race.

The Economic, Public Health, and Caregiver Burden of Late-life Depression

This article reviews the burden of late-life depression (LLD) from several perspectives, including costs of depression treatment and treatment of other comorbid psychiatric and medical conditions; the impact of LLD on job functioning, disability, and retirement; and how LLD influences others, such as family members and caregivers.

What Is Known About Dementia Care Recipient Violence and Aggression Against Caregivers

Aggression is a known behavior in dementia, but there is little in the literature about risk to home-based caregivers in situations where severe aggression is present. This article examines this issue with a focus on what is known and where further research is needed. Rates of severe aggression by dementia care recipients against caregivers are estimated at greater than 20%, and may be the strongest predictor of nursing home placement. Measures containing both assessment of behavior and objective measures of caregiver trauma are needed, along with interventions aimed at educating and protecting caregivers while respecting communicative properties of behavior.

Assessing health status differences between Veterans Affairs home-based primary care and state Medicaid Waiver Program clients.

OBJECTIVES Comprehensive health care for older adults is complex, involving multiple comorbidities and functional impairments of varying degrees and numbers. In response to this complexity and associated barriers to care, home-based care models have become prevalent. The home-based primary care (HBPC) model, based at a Michigan Department of Veterans Affairs Medical Center, and the Michigan Waiver Program (MWP) that includes home-based care are 2 of these. Although both models are formatted to address barriers to effective and efficient health care, there are differences in disease prevalence and functional performance between groups. The objective of this study was to explore the differences between the 2 groups, to shed some light on potential trends that could suggest areas for resource allocation by service providers. DESIGN Using a retrospective analysis of data collected using the interRAI-home care, we examined a cross-sectional representation of clients enrolled in HBPC and MWP in 2008. PARTICIPANTS The HBPC sample had 89 participants. The MWP database contained 9324 participants from across the State of Michigan and were weighted to be comparable to the HBPC population in sex and age, and to simulate the HBPC sample size. RESULTS Veterans were more independent in basic activities of daily living performance, but there was no difference in the rate of reported falls between the 2 groups. Veterans had more pain and a higher prevalence of coronary artery disease (z = 7.0; P < .001), Chronic obstructive pulmonary disease (z = 3.9; P < .001), and cancer (z = 8.5; P < .001). There was no statistically significant difference between the 2 groups in terms of the prevalence of geriatric syndromes. Scores on subscales of the interRAI-home care indicated a lower risk of serious health decline and adverse outcomes for MWP compared with HBPC clients (1.4 ± 1.1 vs 0.9 ± 0.1; z = 2.5; P = .012). Veterans receiving home-based care through the Veterans Affairs Medical Center were more burdened by chronic disease and had higher degrees of loneliness than their MWP counterparts- factors, which may increase their likelihood of hospitalizations. MWP participants had more cases of cerebrovascular accident (z = 2.1; P = .039), as well as a higher rate of diagnosed dementias (z = 2.7; P = .006). Though not different, stress among caregivers in both groups, and depression in clients of both groups were substantial. Overall, sleep, pain, coronary artery disease, chronic obstructive pulmonary disease, and cancer are significant issues for Veteran clients, and clients treated through MWP home-care in Michigan have higher than national average rates of dementias, diabetes, hypertension, and coronary artery disease. CONCLUSION With expanded home care models of service on the horizon, comparisons such as the one presented here could identify more efficient and effective service, with potential for improved client health outcomes.

Perceptions and Receptivity of Nonspousal Family Support A Mixed Methods Study of Psychological Distress Among Older, Church-Going African American Men

The purpose of this study was to explore the role of nonspousal family support on mental health among older, church-going African American men. The mixed methods objective was to employ a design that used existing qualitative and quantitative data to explore the interpretive context within which social and cultural experiences occur. Qualitative data (n = 21) were used to build a conceptual model that was tested using quantitative data (n = 401). Confirmatory factor analysis indicated an inverse association between nonspousal family support and distress. The comparative fit index, Tucker–Lewis fit index, and root mean square error of approximation indicated good model fit. This study offers unique methodological approaches to using existing, complementary data sources to understand the health of African American men.

Enhancing provider knowledge and patient screening for palliative care needs in chronic multimorbid patients receiving home-based primary care.

This article describes a pilot model to increase palliative care (PC) knowledge and collaboration among providers and to systematically identify chronic multimorbid home care patients who would benefit from focused discussion of potential PC needs. Thirty health care providers from a home-based primary care team attended interdisciplinary trainings. The Palliative Performance Scale (PPS) tool was used to trigger discussions of potential palliative needs at team rounds for patients who scored below a cutoff point on the tool. Palliative Performance Scale implementation added little burden on nurses and triggered a discussion in 51 flagged patients. The tool successfully identified 75% of patients who died or were discharged. Screening was systematic and consistent and resulted in targeted discussions about PC needs without generating additional burden on our PC consult service. This model shows promise for enhancing collaborative patient care and access to PC.

Older, Church-Going African Americans’ Attitudes and Expectations About Formal Depression Care

This phenomenological study involved focus groups with church-affiliated, African American women and men (N = 50; ages 50 and older) in southeast Michigan to determine their attitudes and expectations around formal mental health care. Data analysis employed a constant comparative approach and yielded themes related to formal mental health care, along with delineating concerns about defining depression, health, and well-being. Health and well-being were defined as inclusive of physical and spiritual aspects of self. Churches have a central role in how formal mental health care is viewed by their attendees, with prayer being an important aspect of this care. Provider expectations included privacy and confidentiality; respect for autonomy and need for information, having providers who discuss treatment options; and issues related to environmental cleanliness, comfort, and accessibility. Implications include providing effective, culturally tailored formal depression care that acknowledges and integrates faith for this group.

Rigor, Transparency, and Reporting Social Science Research: Why Guidelines Don’t Have to Kill Your Story

Dissemination of research is the most challenging aspect of building the evidence base. Despite peer review, evidence suggests that a substantial proportion of papers leave out details that are necessary to judge bias, consider replication, or initiate meta-analyses and systematic reviews. Reporting guidelines were created to ensure minimally adequate reporting of research and have become increasingly popular since the 1990s. There are over 200 guidelines for authors to assist in reporting a range of study methodologies. Although guidelines are freely available, they are underutilized and there is criticism regarding assumptions about methodologies targeted by guidelines. As journal editors lean into endorsements, social work authors may benefit from considering guidelines appropriate for their work. This article explores pros and cons of guideline use by authors and journals and presents some suggestions for the field of social work, including assessment of whether profession-specific reporting guidelines are needed, and cautions regarding limitations.

Adapting an Interprofessional Training Model for Social Work Field Placements: An Answer for Better Mental Health Care Outreach for Older Adults in Primary Care.

ABSTRACTProfessional shortages of geriatrically trained social workers pose a barrier to mental health care for older adults. Integrating graduate social work interns into primary care settings may...

Professional quality of life of Florida emergency dispatchers

Purpose The purpose of this paper is to determine a baseline level of the Professional Quality of Life (ProQOL 5) in emergency dispatchers in the state of Florida, as well as to examine the how it is associated with psychological resilience, perceived coworker support, different types of debriefing, and perceived organizational support. Design/methodology/approach This was done through a cross-sectional administration of surveys to emergency telecommunicators and dispatchers in the state of Florida. Findings In total, 186 surveys were completed by active emergency dispatch personnel across the state of Florida. The study found that psychological resilience, education, and perceived organizational support were statistically related to professional quality of life in Florida Dispatchers. Research limitations/implications There are limitations due to the nature of cross-sectional survey design and due to the sample size. There are also possible issues with the accuracy of self-reported survey answers. The lack of participation from all agencies also hinders generalizability. Practical implications This study serves as a reference point for a very under studied emergency service population. There are also implications that psychological resilience development in dispatch personnel would assist in multiple aspects of their professional quality of life. Originality/value This is the first study to use the ProQOL 5 on dispatch personnel in Florida. It also displays statistical relationships between factors which dispatch agencies could use to increase employee job satisfaction and potentially reduce turnover.