• An Exploratory Study of the Relationship Between Alienation and the Incidence of Financial Dependency

      Aronin, Geraldine; Mikulski, Barbara (1965-06)
      This study investigated the relationship between the degree of alienation and the incidence of financial dependency. The comparative groups were first time A.F.D.C. recipients and recidivists. The major hypothesis was that there is a relationship between the degree of alienation and the incidence of financial dependency. Our minor hypotheses were that there is a relationship between the degree of powerlessness, normlessness, social isolation and incidence of financial dependency. Depth of understanding was added to the study by measuring the recipient's degree of social anchorage and degree of crisis felt in applying for social assistance...
    • The relationship between child sexual abuse and self-concept in adult women: A community survey study

      Gibbons, John Joseph; Vassil, Thomas V. (1991)
      The relationship between Child Sexual Abuse (CSA) and Self-Concept was investigated using subjects from a community survey study conducted in Baltimore, Maryland. Regression and Step-wise regression analysis were employed to (1) identify CSA as a statistically significant predictor of self-concept, i.e. self-esteem and locus of control, (2) to control for extraneous variables, and (3) to rank order predictor variables in terms of their effect on the dependent variables. Several situational variables, i.e. variables inherent in the abuse event and a possible intervening variable, i.e. perceived social support were also controlled for. Statistically significant relationships were found between (1) CSA and self-esteem and locus of control, (2) CSA with intercourse and self-esteem and locus of control, and (3) Perceived Social Support and self-esteem and locus of control. Findings are discussed with implications for social work research, practice and policy.
    • A study of the association between social functioning and manic-depressive illness in family constellations with presumed genetic vulnerability for affective illness

      Scott, Alice Malone; Ephross, Paul H. (1991)
      This exploratory-descriptive study examines the association between social functioning and subclassifications of manic-depressive illness in family constellations with presumed genetic vulnerability for affective illness. The research question is: Are there differences in the social functioning of family members with bipolar I disorder, bipolar II disorder, and their biological relatives who are not affectively ill? A study sample of convenience was drawn from the Genetic Linkage Study of Affective illness conducted at the Johns Hopkins University School of Medicine. Twenty-one bipolar I's, 22 bipolar II's, and 20 unaffected participants were included. Instruments included interviewer administered scales (Hamilton Depression Rating Scale, Young Mania Rating Scale, and Health and Daily Living Assessment) and self administered scales (Social Adjustment Scale SR and Eysenck Personality Questionnaire). As hypothesized, findings reveal a statistically significant relationship between the diagnosis of bipolar illness and inadequate social functioning in the areas of close social relationships and overall social role adjustment. Both the bipolar I's and the bipolar II's had significantly fewer close relationships than their biological unaffected relatives. The two bipolar groups did not differ significantly from each other. When analyzed by Multiple Regression, personality as measured by the Eysenck Neuroticism Scale was found to be more highly predictive of overall social role adjustment than was the diagnosis of bipolar illness. Implications for social work and related practice in mental health settings and further research were drawn. Conceptual refinement of the global concepts social functioning within the interpersonal field and normality is greatly needed. Knowledge is lacking in the areas of nosology and the psychological and social environments which characterize individuals with subclassifications of bipolar illness. The impact of both ill and well intervals upon the family system needs to be explored.
    • An ecological approach to reducing child maltreatment

      Mann, Linda Neunlist; Goldmeier, John (1991)
      This study was conducted to determine the effect of a parent training program on maltreating parents. The program was a brief intervention, based on the ecological model of child maltreatment, using both group and class sessions and was designed to provide parenting information and knowledge. The expectation was that at the end of the twelve-week program, the parents would increase in the parenting knowledge and skills, thereby increasing their parenting abilities and decreasing the likelihood that they would abuse or neglect their children. The study used three objective instruments in an attempt to measure changes in the parents' child abuse potential, levels of depression, and appraisal of social support. More than half of the subjects dropped out of the program prior to completion and a large number of the participants did not provide valid information on the three objective measures. However, in spite of these problems, the data analysis indicated that there were significant differences between the subjects' pre- and post-test scores, suggesting that participation in the parent training program had a positive benefit for a majority of the participants. The study findings indicate that, following the intervention, the parents had reduced levels of depression, reduced levels of child abuse potential, and increased appraisals of social support. In addition, there were significant differences between the participants who completed the program and those who dropped out and between the participants who provided valid information on the measures and those who provided invalid information. The study findings can be useful for social workers who are involved in planning and designing programs for maltreating parents and the findings suggest that parent training programs can be a beneficial intervention in efforts to reduce child maltreatment.
    • Factors contributing to maternal protectiveness following the disclosure of intrafamilial child sexual abuse: A documentary study based on reports of Child Protective Service workers

      Heriot, Jessica K.; Ephross, Paul H. (1991)
      This study investigate maternal protectiveness following the disclosure of intrafamilial child sexual abuse. Two questions were posed: (1) What proportion of mothers act in a protective way following the disclosure of child sexual abuse, and (2) What factors are associated with maternal non protection? Maternal protectiveness was operationalized in two ways: (1) The mother takes action to physically separate herself and her abused child from the perpetrator, and (2) she feels and acts supportively toward her sexually abused child. The study investigated fourteen factors thought to be associated with maternal non protectiveness. They were grouped in three categories: individual maternal factors, child characteristics, and factors pertaining to the mother's relationship to the perpetrator. The study also investigated the relationship between maternal belief and maternal protectiveness. The study population was drawn from substantiated cases of child sexual abuse reported to Baltimore City and County Sexual Abuse Intake Units, Division of Child Protective Services. The sample consisted of 118 mothers whose children were abused by a family member or the mother's partner with whom the mother and the child were living when the abuse was reported to Child Protective Services. At the close of the intake period, data was collected on maternal protectiveness via a questionnaire given to intake workers. The majority of mothers took action to separate themselves and their children from the perpetrator (56.8%). Two-thirds of the mothers were supportive of their sexually abused children. Fifty-two percent of the mothers both separated from the perpetrator and were supportive of their children. Mothers whose feelings toward the perpetrator were warm and accepting were more likely to be non protective than mothers whose feelings were hostile and rejecting. Mothers of seriously abused children were more likely to be non protective than mothers of less seriously abused children. In addition, mothers who abused drug and/or alcohol and mothers of children abused by a husband or boyfriend were at risk for non protection. Finally, mothers of older children were less likely to be protective than mothers of younger children.
    • The effect of the provision of inhome services on the elderly person's informal support network

      McFarland, Margaret Lauren; Gelfand, Donald E. (1991)
      This study examined the effect that the provision of formal services had on the informal support network as it related to the care of the elderly. Interviews were conducted with 107 persons over the age of sixty, who lived alone and who were scheduled to start receiving at least two services from a home health agency. The survey instrument included data on the types and frequency of tasks provided by each member of the informal support network, the level of functioning of the elderly person, and the relationship with the primary caregiver. A follow up interview was conducted two months later to determine if there were any changes in time spent by the informal support network in providing instrumental tasks, affective tasks, or those tasks needing specialized skills. This research also studied whether changes in the affective relationship between the elderly person and the informal support system occurred after formal services were provided. It was found that the informal support system decreased the amount of time spent on instrumental tasks or those tasks that did not necessitate emotional involvement. A decrease in time was also found for those tasks requiring specialized skills and affective tasks requiring emotional involvement. The decrease in the provision of affective tasks or the strength of the informal support network did not change the affective relationship between the primary caregiver and the elderly person. Studying the impact that the provision of formal services has on the informal support network allows us the opportunity to determine how the two systems can work together to more effectively meet the needs of the growing number of elderly. Policy planners who are concerned about the substitution effect of formal services need to plan for a balanced and effective mix of care for the elderly person, where the caregiver is given support and respite, and the costs for long term care are controlled.
    • An evaluation of an intervention implemented to cause improved adjustment of prisoners

      Pugh, David N.; Varghese, Raju (1991)
      This dissertation is an evaluation of an intervention implemented to improve the adjustment of prisoners. The intervention, known as Decisions, is a structured educational model. It rests upon the assumption that criminals are poor problem-solvers and view themselves as victims of forces over which they have little or no control. Decisions attempts to cause enhanced prisoner adjustment by first causing improvement in problem-solving ability and a shift toward the internal dimension of personal control of prisoners. The literature review revealed three studies directly related to the underlying assumptions of Decisions. None of the studies lend any support to those assumptions. However, the literature does indicate that problem-solving ability and locus of control are related to prisoner adjustment. The literature reviewed also shows that the locus of control of prisoners is subject to at least short-term change via an intervention like Decisions. It was hypothesized that the experimental group would score significantly better on problem-solving scores and significantly more internal on locus of control scores at posttest and follow up. It was also hypothesized that the experimental group would score significantly better in adjustment at follow up. The analysis revealed a significant initial group difference on pretest locus of control scores, and on the scores of one adjustment scale. Attrition resulted in additional group differences on age and education. All analyses showed nonsignificant results. There were no significant differences between groups on posttest and follow up locus of control and problem-solving scores, nor on follow up prison adjustment scores. Only the variable age accounted for any significant variance of prison adjustment. Several interpretations of the results are offered. The first is that outcome is the cause of significant group differences both present at pretest and resulting from a high mortality rate. The second is that skewed distributions of two measures made it difficult for any change in the desired direction to be detected. A third and more plausible interpretation is that the intervention rests upon a weak theory. That is, neither the literature nor the data generated in this study support the assumption that prisoners are poor problem-solvers and externals. (Abstract shortened with permission of author.)
    • The effect of student-field instructor similarity on their respective perceptions of the field practicum in social work education

      Polinger, Eileen Joan; Ephross, Paul H. (1991)
      This study examined the effect of graduate social work student/field instructor similarity on their respective perceptions of the field practicum experience in social work education. This was done by surveying the students and field instructors in three Master of Social Work programs, pairing student responses with those of their own field instructor, and studying the results for congruency and significance. Similarity was conceptualized as one person or thing being like another, the sharing of some but not all characteristics, as having a general likeness, as closely resembling and as nearly corresponding. Perceptions were conceptualized as the ways people understand and view their surroundings--the ways people identity, comprehend, and grasp the meanings of things. The independent variable was similarity/dissimilarity between student and field instructor and the dependent variable was the congruency of their respective perception of field practicum elements. Similarity of student and field instructor was measured by socio-demographic factors, the Kolb Learning Style Inventory, and the Myers-Briggs Type Indicator. Congruence of perception was measured by means of questions on practice factors, a Q Sort, and a group of open ended evaluative questions. One hundred thirteen pairs (226 returns) constituted the analyzable data. There was indeed similarity in the perceptions of students and field instructors. Year of placement status was found to be related to perception of practicum elements. The premise that personality similarity and teaching/learning style preference similarity are related to similarity in the perception of practicum elements was neither supported nor refuted. Certain selected socio-demographic similarities were found to be related to perception of practicum elements and certain selected socio-demographic similarities were found to be related to positive perception of practicum elements. Areas of similarity that emerged as significant included age, religion, years of experience in social work, teaching/learning style. Year of placement status, gender, race, ethnicity, and area of specialization. Implications of study findings are discussed as they relate to current literature and to learning and role theories. Implications for future research and social work education are identified as are the limitations of the study.
    • Hospital social workers and AIDS patients: Stressors, potency, burnout and physical symptoms

      Egan, Marcia; Oktay, Julianne S. (1991)
      This study examined a model of stress and cognitive appraisal as it applies to burnout in hospital social workers providing services to AIDS patients. The research was done in response to reports of the stresses on healthcare workers presented by the AIDS epidemic, and to calls in the burnout literature to examine coping responses in specific practice areas. Questionnaires were mailed to social workers in hospitals of over 350 beds in the ten states with the highest incidence of AIDS. The sample was comprised of 128 social workers who had provided services to 10 or more AIDS patients within the previous six months. The questionnaire measured background variables (demographic variables, work and practice characteristics), independent variables (stressors of practice with AIDS patients, potency and how difficult the social workers found their practice with AIDS patients) and dependent variables (burnout and physical symptoms). The research was guided by the theories of Lazarus, Maslach and Ben Sira. Univariate, bivariate and multivariate analyses were used to test hypothesized relationships between the dependent and independent variables. Background variables were used as controls. The analyses supported the hypotheses that stressors of practice with AIDS patients and difficulty in practice were correlated, and that potency interacts with stressors as they relate to difficulty. That is, in persons with high potency, the relationship between stressors and difficulty is lower than is the case in persons with low potency. The three measures of burnout were related to difficulty. Potency also had a strong direct effect on burnout and physical symptoms. The results suggest that potency is an important factor in burnout, and should be studied further. If substantiated in further research, the results imply that employers and educators need to develop strategies to increase the sense of mastery, self-confidence and faith in societal justness (potency) if they hope to decrease burnout in social workers who practice with AIDS patients.
    • A comparison of verbal interaction and help-giving activities in leaderless self-help support groups and professionally-led support groups

      Haran, Judith F.; Ephross, Paul H. (1992)
      This study compared professionally-led support groups and leaderless self-help support groups to examine whether the presence or absence of a leader in the group made a difference in verbal interaction and member-to-member helping behaviors. This study utilized a comparative design and paired ten professionally-led groups with ten leaderless groups. Through the use of audio-tapes, group process was examined for differences in verbal interaction using the Hill Interaction Matrix. Members's perceptions of helping behaviors occurring in group meetings were measured with the Helping Processes Questionnaire. Members of the leaderless groups focused more on common interest topics while members of the professionally-led groups concentrated on personal topics, indicating that members may feel more comfortable sharing personal information in the presence of a trained leader, or that leaders more strongly encouraged the sharing of personal material. Members of the professionally-led groups did not focus on the group as a whole and avoided discussion of group tasks, processes, or intergroup relationships. The professionally-led groups had more risk-taking interactions, indicating that members felt comfortable enough to share their situations and confront other members. Within both types of groups, the most frequently occurring help-giving activities were behavioral prescription, normalization, encouragement of sharing and explanation. The least frequently occurring activities were requesting feedback, punishment, and extinction. Members of leaderless groups gave significantly higher ratings for encouragement of sharing, self-disclosure, establishment of group goals, assertion of group norms and mutual affirmation. According to the findings, professional leadership did not make a major difference in the verbal interactions and helping activities occurring in parent support groups. The findings also demonstrate the need for additional content about group dynamics and small group theory in social work education.
    • Selected factors affecting utilization of social services by women clients of two domestic violence shelters

      Horner, Douglas Charles; Belcher, John R. (1992)
      Utilizing a model based on ecological theory and feminism, the major research question for this study was: What factors in the experience of women victims of couple violence who request assistance from shelters are associated with the use of shelter services? The dependent variable for this research, the use of shelter services, was measured by two constructs; the length of shelter stay and the use of referrals by clients for additional services. The use of referrals was operationalized constructing a ratio of the number of referrals completed by a client and the number of referrals provided. Two primary independent variables were identified for analysis; clients' perception of social support and clients' identification with feminist/egalitarian values for couple relationships.;Six control variables were employed to test if spurious relationships existed between variables or offer alternative explanations to relationships suggested. These are frequency and intensity of abuse, length of the couple relationship, age of the victim, educational incompatibility of the partners, employment status of the victim, and risk of abuse to womens' children by the partner. A fourth variable set, type of referral provided, was employed to test what additional explanation of variance in the dependent variable constructs may be determined.;Interviews were completed with women clients of two domestic violence shelters (50 women from each shelter) yielding a total sample of 100. The statistical analysis was accomplished using a linear hierarchical multiple regression model. The results obtained for the completion ratio dependent variable indicated that 42% of the variance was explained at a statistically significant level for the total model. Four variables significant in the model included perceived social support, age of the clients, perceived risk to children, and referrals for protective services. No statistical relationships were found concerning total days of shelter stay. Social workers in shelter settings should evaluate further the importance of these and other variables, during the intake phase for sheltering, to have information concerning clients' potential utilization of services within the shelter and from the social service community. This information may assist service planning and funding.
    • The effect of negative self-referential mood and depression upon creative processes related to change in psychotherapy

      Blundo, Robert George; Altstein, Howard (1992)
      The present study uses the creative processing of information as a means of understanding the cognitive processes involved in therapeutic change during a depressive episode. The focus was on the consequences of cognitive content and moods on the enhancement or inhibition of the creative processing of information. It was hypothesized that the negative self-referential cognitive content associated with depression would inhibit the processing of information creatively. The first Study looked at the effect of induced negative and positive self-referential content and mood, negative and positive content and mood related to viewing the circumstances of others, and the effect of high and low arousal. Female student volunteers (105) were randomly assigned to one of these seven inductions and then completed the Remote Associates Test. The findings did not show a significant difference between these conditions. A Pearson correlation demonstrated a marginal relationship between subjects who reported their moods as negative and lower creative performance. To determine if naturally occurring negative self-referential thoughts would inhibit creativity, a second group of subjects were assigned to either the dysphoric or nondysphoric group based on their initial Beck Depression Inventory scores. To determine if this hypothesized inhibiting negative content could be reversed, one half of both the dysphoric and nondysphoric subjects were assigned to a positive self-referential induction prior to completing the creative task. A third group of subjects who had scored dysphoric during the initial screening were found to have scored nondysphoric when they completed the creativity task. No significant differences were found between the three groups. Contrasts demonstrated that those subjects in the third group undergoing affect-repair and who had received the positive induction performed significantly better than group members who had not received the positive induction. This suggests that interventions that enhance or help initiate affect-repair could benefit depressed individuals. Limitations suggest that the concept of creativity may be too general a description of more specific cognitive processes that are biasing in their effect. Change might best be considered the process of overcoming these biases. Future research might consider how this takes place.
    • Child sexual abuse and the subsequent adolescent sexual, family planning, and fertility patterns of low-income women

      Castle-Young, Brenda G.; Crymes, Joseph T. (1992)
      This study compares the adolescent sexual behaviors, fertility patterns and family planning behaviors of low socioeconomic, single parent women who reported a history of child sexual abuse (N = 38) with those who did not (N = 437). All questions on sexual behaviors, family planning behaviors, and fertility patterns were taken verbatim from the National Survey of Family Growth Cycle 3, (1981) from the National Center on Health Statistics. The data for this study was gathered in a survey conducted from September 1984 to June 1985. This secondary analysis of 475 cases began with a simple bivariate analysis of CSA related to each of the hypothesized outcomes. Subsequently, for each hypothesized outcome a regression analysis was conducted which included child sexual abuse (CSA) and the control variables race, age at time of interview, years of school achieved, and parenting support. The findings revealed that women who reported CSA had their first intercourse at an earlier age, had more sexual partners, had less committed relationships, had a greater number of live births, and were less likely to have had an abortion than women who reported CSA. However, there was inadequate support for the hypotheses which predicted differences between the two groups on age at first live birth, contraception patterns, opinion of responsibility for contraception, or percent of unwanted live births. Additionally, several of the situational factors had impact on some of these behavioral outcomes. Increased frequency of CSA increased the number of sexual partners, decreased the use of contraception, and increased the percent of unwanted live births. As the severity of CSA increased, the age at first intercourse was younger. The earlier age that CSA began and the greater the number of perpetrators, the greater the number of sexual partners that were reported. The greater the number of perpetrators, the less likely a CSA victim was to use contraceptives between first intercourse and first pregnancy. If the perpetrator was a family member, opinion of self-responsibility for contraception decreased. These consequences of CSA likely lead to decreased life chances and serious health problems.
    • Pathological gambling behavior and self-concept theory: An investigation of the validity of the addictive personality syndrome (APS)

      Hudak, Clark Joseph, Jr.; Varghese, Raju (1992)
      This study investigated the relationship between the self-concept and the Addictive Personality Syndrome (APS) among a sample of pathological gamblers. Seventy-five respondents met the sampling criteria and were drawn from various Gamblers Anonymous chapters in the Baltimore/Washington/Northern Virginia metropolitan areas, and two professional treatment programs--the National Center for Pathological Gambling and the Washington Center for Pathological Gambling. Self-esteem and self-concept stability were predicted to be causally related to the dependent variable dissociation. The Rosenberg Self-Esteem Scale, the New York State Stability of Self Scale, and the Jacobs Dissociation Scale were used to measure self-esteem, self-concept stability, and dissociation respectively. Data were also collected for sociodemographic variables and those for family and gambling backgrounds. The measuring instrument consisted of a 45-item questionnaire which was self-administered in about thirty minutes. The findings lend support to four of the five research hypotheses. Using ordinary least squares linear regressions, statistical analyses tentatively revealed a negative causal relationship between dissociation and self-concept stability. Contrary to prediction was that self-esteem was not found related to dissociation. A leptokurtic univariate distribution skewed toward low self-esteem appeared to account for this latter finding. As predicted, self-esteem and self-concept stability were found unrelated. Further comparative analyses revealed higher levels of self-concept stability among dissociators than non-dissociators. There were no differences between these groups on self-esteem scores. In a follow-up survey of a subset of the study's sample self-concept principles were further explicated. Thus hypotheses four and five were tentatively supported which predicted manifestations of the desired and presenting selves during gambling activity. The findings support the notion that self-concept principles can better explain components of the Addictive Personality Syndrome, and relevance of the tested variables have implications for social work theory, practice, education, and research.
    • Analysis of factors affecting sterilization rates for Puerto Rican women living in the Bronx, New York

      Greenberg, Karen Elfman; Palley, Howard A. (1992)
      The aim of the study was to explain the high incidence of sterilization using a sample of 2033 Puerto Rican women, ages 15-49 years collected by Fordham University between May 1985 to December 1986. The study examined three objectives: (1) to determine the differing rates of sterilization among Puerto Rican women born on the island, the mainland, and for those who migrate back and forth, (2) to investigate the sterilization behavior of Puerto Rican women in their context and determine to what degree the behavior is a result of socioeconomic and life event variables, and (3) to understand the various implications of sterilization behavior of women. Three hypotheses were tested for the first objective. The data indicated that island women had a higher rate of sterilization than mainland Puerto Rican, that mainland Puerto Rican women had a higher rate of sterilization than their white non-hispanic women counterparts and that van y ven women had the lowest sterilization rate. Two models were developed to explore the second objective and multivariate regression techniques were used to test the predictive power of the Model I socioeconomic variables while Model II used life event variables. In Model I, only income was found to be a good predictor of sterilization. All three Model II variables, number of children, age at first marriage and age at first birth proved to be good predictors of sterilization. For the third objective a qualitative instrument using 24 questions served as the cornerstone for 10 interviews with social work practitioners to compare practical experience and explore ethnic dilemmas in social work. Data extrapolated from the replies of the practitioners reinforced the findings for income in Model I and all Model II variables. The data demonstrated that insularity and machismo are at the core of Puerto Rican culture. Insularity has been fostered in the face of economic hardships while machismo is a lifestyle that does not allow Puerto Rican women to go beyond their traditional roles. These issues are crucial to understanding the pattern of fertility behavior for Puerto Rican women. The results from the comparison of sterilization rates, Model I and II variables and the interviews suggest that low income Puerto Rican women in the Bronx, New York remain insular and choose sterilization as the traditional method of Puerto Rican birth control.
    • A study of factors that contribute to the discrepancy between the high number of women receiving college education and the low number of women participating in the labor force in the Kingdom of Saudi Arabia.

      Samergandi, Rogayah Shokrallh A.; Oktay, Julianne S. (1992)
      The basic research question was why Saudi women are not working despite their educations and the government's need for their services (Saudi Arabia is the largest importer of foreign labor in the Arab world). With the recession period in the 1980s it became apparent that there was a pressing need for educated women to use their educational degrees appropriately and to contribute to the work force, thus meeting the women's increased personal needs and the government's need for labor. The research focused on the changes in modern Saudi women's roles and the ensuing problems. Empirical examination based on the concepts of modernization (particularly Riggs's prismatic theory), cultural lag, and status inconsistency theories framed the research. The research also examined Muslim women's roles and attempted to explain how in highly traditional societies, such as Saudi Arabia, religious and cultural norms suppress certain aspects of the modernization process by enforcing the role of women. Qualitative methods were used to conduct in-depth interviews with sixty-nine professional Saudi women (workers and nonworkers) in the city of (L) in the Kingdom of Saudi Arabia. The study examined factors such as professional work opportunities; motivational factors for seeking a college education and for choosing not to work outside the home; and professional employment; social restraints; degree of family support; religious, modernization, and individual factors. Findings indicated that the importance of motherhood and wife roles, women's motivations for college educations for goals other than careers, lack of economic need before the recession in the 1980s, absence of employment opportunities (women's jobs were saturated), limited fields of education available for women (education, social work, and recently, medicine), and religious restraints were the most important factors that influenced women not to work outside their homes. Implications for practice include a need for increased services to assist women in balancing the demands of their roles. To solve transportation and childcare problems for working women, car pooling and childcare centers should be provided. Employment services, should be created such as job banks as well as full-time and part-time job sharing.
    • Older women: An analysis of the influences of race, health status, and social network involvement on use of community services

      Soniat, Barbara Ann; Oktay, Julianne S. (1992)
      This study examined the effect of race, health status, socioeconomic status and social network involvement on use of community services by elderly women. The data for the study were extracted from the 1984 Supplement on Aging, a national survey of older Americans. The sub-sample used in this study consisted of 6578 Black and White women age sixty-five and older. The Andersen behavioral model of service utilization was used to examine the predictive values of predisposing, enabling and need variables for determining use of community services. Logistic regression analysis was used to examine the individual and combined effects of demographic, individual and sociocultural factors on use of community services by older women. A key issue addressed by this research was utilization of community services by elderly Black women. When race and use of social and support services were examined without controls, there were no significant racial differences in use of social services. However, Black women were more likely to use support services. In logistic regression analyses that controlled for the influences of the other study variables, Black women were more likely to use social services, but race did not have any additional explanatory value for predicting use of support services. When the Andersen model was applied separately to the two groups, the results revealed that the predictive factors operated differently. For example, Black women's use of social services declined with age. Age had an opposite effect for White women, with service utilization increasing with age. The study indicates that strategies for targeting services to diverse racial groups need to consider both within and between group differences in utilization behaviors.
    • Social drift among primary alcohol abusers

      Tovar, Daniel David; Belcher, John R. (1992)
      Research relevant to the pathways of becoming homeless (social drift) are few, particularly those that pertain to primary alcohol abusers. The author explored the plight of these individuals within the context of an urban city substance abuse treatment center located within the Johns Hopkins Medical System. By using a qualitative research design, the testimonies from the subjects developed the central themes through a sequence of interviews. In addition, the ongoing analysis of data and the emerging hypotheses were continually reconstructed by a constant comparative method involving the review of case files, revising observations, and the negotiation of the emerging themes with the subjects. The data was also continually tested for its trustworthiness using a set of systematic procedures. Findings that emerged indicated that there were five prevalent clusters of life events and factors that led to social drift of the respondents. They were in the categories of predispositional factors, the lack of intervention during the formative years, the life-cycle and progression of the alcohol and subsequent poly-drug abuse itself, non-productive and refuge-seeking related behaviors and by the clients' own inability to successfully negotiate with the social support systems and treatment chances even when made available to them.
    • Independent living among community-based elderly: The impact of social support and sense of coherence

      Lewis, Judith Salter; Hegar, Rebecca L. (1993)
      This research began with an interest in enhancement of independent functioning among community based elderly. As the population ages, increasing numbers of older people, though not in need of institutional care, may need a variety of supports to maintain independence. Housing residents and administrators are faced with complex challenges as problems related to advanced aging occur, and independent functioning is threatened. In the interest of careful planning to maintain the best person-environment fit, and maintain maximum independence, systematic research can build knowledge that contributes to meeting these goals. This research involved assessing the factors of social support and sense of coherence as they relate to independent living ability among a group of 128 elderly residents of a metropolitan senior housing complex. Cross-sectional data were gathered using a pre-coded questionnaire in individual in-person interviews with a nonprobability sample of consenting residents. Independent living ability was measured by ADL and IADL scales from the OARS multidimensional assessment questionnaire. Social support was measured using the Norbeck Social Support Questionnaire (Norbeck, et al., 1983), and Antonovsky's Sense of Coherence Questionnaire (1979) was used to measure sense of coherence. Data were analyzed using multiple regression. Hypotheses predicted relationships between each of the independent variables (social support and sense of coherence) and independent living ability after controlling for five demographic variables (age, education, income, number of living children, length of time at the complex). Findings did not support the predicted models. Since substantive knowledge lends some credibility to the connection between social support, sense of coherence, and well-being among the elderly, explanations for study findings are attributed to design and methodological factors. Low reliability of the dependent measure for this study may be explained by limited sample variability in ADL/IADL tasks. Random sampling and the use of a more varied sample is advisable in replication of this study.
    • Health care utilization by children entering foster care: Factors associated with provider-initiated health referral and referral completion

      Risley-Curtiss, Christina; Combs-Orme, Terri (1993)
      Because of the events that precipitate entry into foster care, of social characteristics, and of the trauma associated with placement, foster children represent one of America's most vulnerable groups in terms of their health needs. Unfortunately, prior research has demonstrated that the probability of the health needs of these children being met is poor. Additionally, the Maryland Department of Human Resources has been sued for, among other things, failure to provide adequate health care to foster children. The resulting consent decree requires that children entering foster care receive a health assessment within five days of entry and a more comprehensive assessment after 30 days. The primary purpose of this study was to determine the ability of selected factors to explain (1) provider-initiated health referrals, and (2) the completion of those referrals for a cohort of children entering foster care in Baltimore. Multivariate analyses techniques were used with data from nonprobability samples of 1910 children entering care (#1) and 262 children in care for at least 30 days (#2). Consistent with previous studies, this study found that the sample children had multiple health problems. More than 70% of the children had 2 or more problems and 98.4% had at least one referral for additional services. Moreover, the children continue to have unmet health needs with only 45% of non-routine referrals completed during the study period. Age, race, sexual abuse, number of mental health problems, number of physical health problems and sexual activity explained 39% of the variance in number of referrals while age and completion time explained 9% of the variance in referral completion. Age was the best predictor of both number of referrals and referral completion. Age and number of mental health problems predicted type of referral (dental, medical or mental health). This study demonstrates that despite a lawsuit and new health project, foster children are still not getting their health needs met. It is critical that child welfare personnel recognize the need for comprehensive health care for foster children. More research in health care utilization by foster children is needed; this study demonstrates the applicability of the Aday/Andersen model of health utilization and multivariate analysis techniques to that study.