Search results

In Spring 2015, Texas experienced record-breaking floods, causing deaths, injuries, and widespread property and infrastructure damage. However, little is known about those who encountered access barriers to disaster support in Texas. The purpose of this paper is to examine the unmet disaster-related needs from 2-1-1 calls during evacuation, flooding, and early recovery phases.

The 2-1-1 Texas Information and Referral Network’s caller database was used to identify real time, non-emergency, unmet disaster-related caller needs longitudinally. The two-month study period included a baseline week before flashflood (05/01/2015) into early recovery (06/30/2015). Caller unmet needs were categorized and graphed by type daily throughout the study period.

Of the 4,880 disaster-related 2-1-1 calls from Texas’ 254 counties, 1,183 callers needed housing help, compared to 442 utilities, 409 food and 109 medically related assistance. Total calls quickly peaked at 405 calls/day during Memorial Day weekend when Greater Houston flooded. Despite total calls decreasing gradually during recovery, they remained four times higher than baseline. Unmet needs varied by type, especially during early recovery. Housing, food, and medical unmet needs surged when Houston flooded. Although medical calls were lowest volume than other basic needs, demand for medical assistance had a higher threshold throughout early recovery.

Examination of unmet needs over disaster phases identified longitudinal patterns of demand and effectiveness of disaster management efforts.

Using real-time 2-1-1 data to monitor types of unmet demand is valuable to tailor timely and effective disaster support, reduce access barriers, and allocate disaster support services and supplies to the vulnerable communities.

In South Africa, the majority of the population struggles to access care and support for mental health challenges. Drawing on challenges faced by asylum seekers and refugees in the urban margins of Johannesburg, this paper aims to explore the relationship between migration and mental health through a lens of heightened vulnerability, precarious urban spaces and unmet basic needs.

Remote interviews were conducted with respondents working in the mental health-care sector (public and private) and with migrant communities in Johannesburg. Respondents were identified via purposive sampling and interviews were conducted in English. Key findings were identified using thematic analysis.

Effective responses to asylum seekers and refugees facing mental health challenges are based on an understanding of context, of crisis and of the need to meet basic needs such as paying rent, finding employment and providing for families. These “daily stressors” not only compound “extreme traumatisation” but are a form of trauma in and of itself.

This paper shows how alternative responses determined by an understanding of context, of crisis and of the need to meet basic needs provide critical and potentially far-reaching interventions. Locating trauma in the unmet needs, precarious urban spaces and marginalisation opens up space to further question the ways that migration and mental health shape and reshape one another.

This study examined access to and quality of supports for families of adolescents with disabilities.

An online survey was completed by family members of transition-aged young adults who had participated in parent training sessions on topics related to transitions to adulthood. Survey responses came from all 50 states, the District of Columbia, and 4 U.S. territories.

More than one-third of families reported unmet information needs related to areas such as employment, housing, preparing for adult relationships, and preparing others to support the family members with disabilities. Families of younger transition-aged youth, youth with Autism Spectrum Disorder or other disabilities, and families with lower household incomes reported more unmet needs. The overall quality of services families reported receiving was 2.19 on a 4-point scale of 1 to 4. Parents reported needing more information and quality of supports related to the transition of youth from school to adulthood.

Given the scope of unmet needs, ongoing collaboration between schools, agencies, organizations, and other entities that serve families is critical. While schools play a key role in supporting the transition process, other organizations also have a role.

The results from this survey demonstrate that the need for support is not limited to youth with disabilities, but that family members also have information and support needs related to their roles as caregivers in the transition process.

This survey provides information about unmet needs and current services from a national sample that includes often underserved populations and includes sufficient numbers of respondents to allow comparisons between families, based on the type of disability their family member had.

Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse treatment provision among individuals of varying socioeconomic and racial/ethnic backgrounds. This study investigates that achievement by analyzing the relationship between community socioeconomic and racial/ethnic disadvantage and organizational provision of substance abuse treatment, treatment need and utilization across United States counties, 2000, 2002 and 2003. Results confirm equity in service provision in poorer communities and those with higher concentrations of African Americans. Significant disparities remain, however, in communities with higher concentrations of Hispanics, youth and female-headed households. Limitations and implications for future studies of health care provision are discussed.

The overall objective of this research was to elucidate the ecosystem of women’s health social enterprises (WHSEs) based in the United States. The Aim I was to conduct a secondary data analysis of a random national sample of non-profit WHSEs based in the United States regarding their characteristics and areas of intervention. Aim II was to conduct a qualitative assessment of a sample of WHSEs based in the United States regarding their perspectives on the ecosystem of WHSEs. Aim I utilized the GuideStar database and assessed enterprise size, geographic location, financial distress, health intervention area, and health activity category using descriptive statistics, statistical tests, and multivariable regression analysis via SPSS. Aim II utilized in-depth interviewing and grounded theory analysis via MAXQDA 2018 to identify novel themes and core categories while using an established framework for mapping social enterprise ecosystems as a scaffold.

Aim I findings suggest that WHSE activity is more predominant in the south region of the United States but not geographically concentrated around cities previously identified as social enterprise hubs. WHSEs take a comprehensive approach to women’s health, often simultaneously focusing on multiple areas of health interventions. Although most WHSEs demonstrate a risk for financial distress, very few exhibited severe risk. Risk for financial distress was not significantly associated with any of the measured enterprise characteristics. Aim II generated four core categories of findings that describe the ecosystem of WHSE: (1) comprehensive, community-based, and culturally adaptive care; (2) interdependent innovation in systems, finances, and communication; (3) interdisciplinary, cross-enterprise collaboration; and (4) women’s health as the foundation for family and population health. These findings are consistent with the three-failures theory for non-profit organizations, particularly that WHSEs address government failure by focusing on the unmet women’s health needs of the underserved populations (in contrast to the supply of services supported by the median voter) and address the market failure of over exclusion through strategies such as cross-subsidization and price discrimination. While WHSEs operate with levels of financial risk and are subject to the voluntary sector failure of philanthropic insufficiency, the data also show that they act to remediate other threats of voluntary failure.

Aim I findings highlight the importance of understanding financial performance of WHSEs. Also, lack of significant associations between our assessed enterprise characteristics and their financial risk suggests need for additional research to identify factors that influence financial performance of WHSE. Aim II findings show that WHSEs are currently engaged in complex care coordination and comprehensive biopsychosocial care for women and their families, suggesting that these enterprises may serve as a model for improving women’s health and health care. The community-oriented and interdisciplinary nature of WHSE as highlighted by our study may also serve as a unique approach for research and education purposes. Additional research on the ecosystem of WHSE is needed in order to better inform generalizability of our findings and to elucidate how WHSE interventions may be integrated into policies and practices to improve women’s health.

Drawing on sensemaking and emotion regulation research, the purpose of this paper is to reconceptualize core contributor withdrawal (CCW) in the context of online peer-production communities (OPPCs). To explain the underlying mechanisms that make core contributors withdraw from these communities, the authors propose a process theory of contributor withdrawal called the core contributor withdrawal theory (CCWT).

To support CCWT, a typology of unmet expectations of online communities is presented, which uncovers the cognitive and emotional processing involved. To illustrate the efficacy of CCWT, a case study of the English version of Wikipedia is provided as a representative OPPC.

CCWT identifies sensemaking and emotion regulation concerning contributors’ unmet expectations as causes of CCW from OPPCs, which first lead to declined expectations, burnout and psychological withdrawal and thereby to behavioral withdrawal.

CCWT clearly identifies how and why important participation transitions, such as from core contributor to less active contributor or non-contributor, take place. By adopting process theories, CCWT provides a nuanced explanation of the cognitive and affective events that take place before core contributors withdraw from OPPCs.

CCWT highlights the challenge of online communities shifting from recruiting new contributors to preventing loss of existing contributors in the maturity stage. Additionally, by identifying the underlying cognitive and affective processes that core contributors experience in response to unexpected events, communities can develop safeguards to prevent or correct cognitions and emotions that lead to withdrawal.

CCWT provides a theoretical framework that accounts for the negative cognitions and affects that lead to core contributors’ withdrawal from online communities. It furthers the understanding of what motivates contributing to and what leads to withdrawal from OPPC.

This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa.

The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis.

Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working.

Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working.

Children’s mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources.

Under the Illinois Library System Act, the head librarians of the University of Illinois, Southern Illinois University, Chicago Public, and Illinois State Libraries, with the Chairman, Illinois State Library Advisory Committee, serve as the Research and Reference Center Committee. The R & R Committee's first duty in encouraging and in making available adequate library research and reference facilities for the residents of Illinois is “to develop long range acquisition policies to strengthen the existing collections and to avoid unnecessary duplication.” To this end, a subcommittee, broadly representative of the Illinois library community, was appointed late in 1975 with specific charge to identify unmet needs of the Illinois library and information network and to make recommendations to identify or to develop collections to meet these needs. The Subcommittee's report, accepted by the parent committee in February, 1977, follows. The R & R Committee directed that the report be distributed widely to library systems and to other appropriate groups in the state and that their consideration and response be aggressively sought, supported, and encouraged before the casting and adoption of the plan, the determination of priorities, and the implementation of the grand design. This plan is now before the Illinois library community for preview, with the anticipation that it will provoke the thought, reaction, and action vitally necessary to make it a vehicle for the continuance of the state's record of dynamic library development.

The purpose of this study was to assess the self-perceived need, seeking and use of dental care and its main determinants in Kurdistan province, Iran.

A total of 1,056 adults in Kurdistan province were included in this cross-sectional study. Multistage sampling approach was used to select the samples. Data on sociodemographic characteristics, economic status, self-perceived need, seeking and use of dental care were collected using a self-administrated questionnaire. Multivariate logistic regression model was used to assess factors affecting the use of dental care. In addition, socioeconomic inequality relating to dental care needs and use of dental care were examined using concentration curve and concentration index.

In this study, unmet dental care need was 62.7%. There was a perceived need for dental care among 13.7% (n = 145) of the participants in the past month, with only 39.3% (n = 57) seeking the care. The most important reasons for unmet dental care need were “Could not afford the cost” and “Insurance did not cover the costs.” Multivariate logistic regression showed that supplementary insurance status and household economic status were identified as main determinants affecting dental care-seeking behavior. The result of concentration index revealed that seeking dental care was more concentrated among the rich, whereas the perceived dental care need is more prevalent among the poor.

This study demonstrated that the prevalence of unmet dental care needs is high in the study setting. Also, financial barrier was identified as the main determinant of unmet dental care needs.