• Alternative Response in Child Welfare: A Mixed Methods Study of Caseworker Decision Making

      Shipe, Stacey LeAnn; Harrington, Donna (2017)
      A family's entrance into the child welfare system begins once a report meets a jurisdiction's definition for child maltreatment. Alternative response (AR), a legislatively mandated policy in Maryland, is an approach to child protective services (CPS) where caseworkers are required to provide a family-centered, strengths-based approach as opposed to making a final determination of abuse/neglect. Once a family begins their trajectory into the child welfare system they are reliant on caseworkers to make the best decisions for them, but these decisions are influenced by multiple factors. This mixed-methods study examined caseworker decision making and the influence child, family, and organizational factors had on recurrence. The quantitative phase of this study used administrative data for 2,871 families from three jurisdictions in the state of Maryland. Using child and caregiver characteristics that are predictive of recurrence, differences were examined between families who received a traditional response (TR) versus an AR. These same characteristics were used to predict which families would receive a subsequent investigation, and among those, what predicted a substantiated recurrence. In the qualitative phase, AR caseworkers participated in focus groups where they were asked about the findings from the quantitative portion of the study as well as other organizational factors that influenced their overall decision making for families. County level differences were found among the TR and AR families for child and caregiver race, maltreatment allegation, Medicaid receipt, and re-investigation. These differences held when the counties were examined individually. The number of children, child gender, and Medicaid receipt predicted a subsequent investigation. Child age, maltreatment allegation, Medicaid receipt, previous investigative finding/response, and county predicted a substantiated recurrence. The findings from the focus groups revealed challenges specific to agency mandates and that caseworkers rarely differentiated their approach between a TR and AR. The results suggest that additional research is needed to fully understand the influence of case factors and organizational context and its impact on family outcomes. Also needed is additional training for caseworkers to fully understand the purpose of AR as well as the processes that place families on an AR track.
    • Development and Implementation of an Audiovisual Informed Consent Delivery System for Non-surgical Root Canal Therapy

      Aguilar, Lauren; Macek, Mark D. (2018)
      The aims of this mixed-methods study were (1) to explore patients' preferences towards informed consent for endodontic procedures, (2) to use focus group feedback to develop short audiovisual presentations, and (3) to determine whether the audiovisual format lead to a different level of understanding than traditional consent. First was a focus group to assess patient expectations and attitudes towards consent for non-surgical root canal therapy (NSRCT). Second was developing two short audiovisual presentations. Finally a clinical trial tested the videos with 50 patients at the University of Maryland School of Dentistry. A questionnaire was used to assess patient preferences, comprehension, and recall of the consent and analyzed. There were no significant differences between groups in terms of recall, comprehension, understanding, or attitudes. Nonetheless, the data collected may be useful to restructure informed consent procedures for NSRCT and set a precedent for innovative consenting procedures.
    • Social Workers and Disproportionate Minority Contact: A Mixed Methods Study

      Afkinich, Jenny Lee; Bright, Charlotte Lyn (2020)
      Disproportionate minority contact (DMC) is the disproportionate representation of racial minority youth at all levels of the juvenile justice system. DMC is evident in rates of initial arrests, referrals to court, delinquency findings/ adjudications, out-of-home placements, and transfers to adult criminal court. Race remains a significant predictor of legal outcomes for youth even when factors such as prior legal history and current charge severity are considered despite White and minority youth reporting similar levels of offending. This mixed methods study examined the relationship between community social workers employed by the South Carolina Department of Juvenile Justice (SC DJJ) in the agency’s county offices and DMC. Administrative data from SC DJJ was utilized to determine the extent of DMC in the state, to compare legal outcomes (i.e., receiving confinement dispositions and being waived to adult court) for youth in counties with community social workers to youth in counties that do not employ community social workers, and to compare the legal outcomes for youth in counties with community social workers over time. The results indicate that DMC continues to exist in South Carolina when measured via relative rate indices. Overall, there was little evidence that employing community social workers is sufficient to reduce DMC at the disposition or waiver stage. Qualitative interviews with nine of the 11 community social workers were used to identify and understand the mechanisms, barriers, and facilitators for reducing DMC. The findings suggest multiple nuanced ways the social workers can play a role in reducing DMC. The social workers identified two stages in the juvenile justice process in which they can and have had an impact on increasing equity: (1) out-of-home placement decisions for youth on probation or parole and (2) determining probation requirements. The social workers described a need for hiring additional social workers. They also believe they could train police officers and school officials about alternatives to making a referral to SC DJJ to reduce inequitable decisions at the front-end of the juvenile justice system. Implications for the study include an expanded role for community social workers and new ways to examine DMC quantitatively.
    • Volunteer Guardians in the Community: A Mixed Methods Exploration of a Complex Volunteer Task

      Jones, Andrea L.; Oktay, Julianne S. (2013)
      Demographic trends indicate a significant increase in the number of adults over 65, especially those 85 and older (Federal Interagency Forum on Aging-Related Statistics, 2010). Community services may be reduced or eliminated due to fiscal constraints (NGA, 2010). Recruiting and retaining volunteers to act as legal guardians (VGs) for incapacitated older adults may be essential in meeting increased community service demand for guardians. This mixed method study built upon prior research to include themes of qualitative semi-structured interviews and quantitative results from the Volunteer Functions Inventory (VFI; Clary et al., 1998; Clary, Snyder, & Stutkas, 1996) with VGs from a mid-Atlantic not-for-profit guardianship agency. Quantitative data suggest VG motivations score higher than the comparison sample on subscales measuring factors, such as Values (humanitarian, altruistic reasons), and lower than comparison sample on the Career, Enhancement, and Protective factor subscales. Qualitative data were collected using a semi-structured interview guide and analyzed using the Generic Inductive Qualitative Method (Hood, 2007). Interviews conducted with 12 volunteer guardians indicated themes related to why VGs chose this task, such as `helping the unbefriended (Values factor),' `giving back/paying forward,' and `learning to help.' Themes illustrative of how the guardians performed this volunteer task included `how they with conflict,' `need for a good match (client to volunteer),' and `asking for help.' In addition, findings seem to indicate that volunteers with human service training employed a more directive case management style. Volunteers without human service training provided more collaborative, functionary guardian services. Qualitative interview data were also collected from six board and agency staff and indicated a difference in perception between administration and VGs related to the `need for a good match,' as well as `recruitment' methods. Implications for practice include the need to provide more support and assistance to volunteers without human service training, understanding the need for guardian-client matches that would be more compatible with the guardian type, as well as a need for improved, specific recruiting methods. Implications for future research include the development of a model to recruit and train volunteer guardians that could be replicated by social service, faith-based, and other not-for-profit agencies.