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The concept of user participation is well accepted internationally. Nevertheless, studies show that both patients and health professionals find it challenging to maintain…
Abstract
Purpose
The concept of user participation is well accepted internationally. Nevertheless, studies show that both patients and health professionals find it challenging to maintain patient-centred ideals in the context of severe mental illness. The purpose of this paper is to explore how professionals deal with the ideals in light of patients’ right to participate in planning and decision making regarding milieu therapeutic measures and activities.
Design/methodology/approach
This is a qualitative study with an interactionist approach based on fieldwork at three district psychiatric centres in Norway during 2011-2012. The observations focused on patient-staff interaction in milieu therapeutic activities. Interviews were based on observed situations.
Findings
Adherence to treatment, rules and routines restricted patient autonomy. The professionals’ practical orientation towards routines overrode the ideals of patients’ rights. The staff regarded user participation primarily as participation in organised and mandatory activities. Refusal to comply was met with different sanctions, e.g. the prospect of being discharged.
Originality/value
Although user participation calls for patient-centred approaches, there is some debate about the challenges and premises for cooperation with persons suffering from severe mental conditions. This study adds insight into the everyday organisational context that facilitates or impedes user participation. It helps to explain why the user perspective can be overlooked, thus providing important information to both clinicians and policy makers who aim to fulfil the patient’s right to participate in planning and decision making regarding treatment and care.
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Iddrisu Yahaya, Krishna P. Pokharel, Abdul-Fatahi Alidu and Fred Amofa Yamoah
The purpose of this paper is to understand the impact of participation in sustainable agricultural intensification practices (SAIPs) on household food security status in…
Abstract
Purpose
The purpose of this paper is to understand the impact of participation in sustainable agricultural intensification practices (SAIPs) on household food security status in Northwestern Ghana.
Design/methodology/approach
The study utilised the Household Food Insecurity Access Scale (HFIAS) indicator for the measurement of food access data from 168 households in ten communities from the Northwestern region of Ghana for the analyses. Households were categorised into participating households (treatment) and non-participating households (control). The endogenous treatment effects model was employed to evaluate the impact of participation in SAIPs training on food insecurity access scale.
Findings
The results show that participation in SAIPs training lowers, on average, the household food insecurity access by 2.95 points, approximately an 11 per cent reduction in HFIAS score. Other significant factors found to influence household food insecurity access scale are age of household head, experience in farming, total acres owned by household, income level of the household and occupation of the head of the household.
Research limitations/implications
The training programme of participation in SAIPs has massive implications for food security, rural economy and farmers’ livelihoods. However, due to the unique conditions prevailing in Northwestern Ghana, the findings of this research are limited in terms of their generalisability. Future research direction in the area of SAIPs trainings and impact study replications in all qualifying rural food production areas in Ghana, which are susceptible to household food insecurity, will provide a national picture of the efficacy of SAIPs trainings on household food insecurity.
Practical implications
A proven means to decrease natural resource degradation, increase crops yields, and increase subsistence farmers’ income, and food security is an important intervention to resolve the seasonal food shortage, which last for five months in a typical year for agro-food-dependent farming communities in Northwestern Ghana.
Social implications
Ensuring household food security improvement and environmental sustainability will help improve living standards of food producers and reduce the adverse social challenges associated with food insecure communities such as health problems due to food deficiencies, social inequalities, environmental pollution and natural resource degradation in Northwestern Ghana.
Originality/value
The contribution of this paper is the novel thought and approach to examine the impact of the SAIPs trainings on household food security in Northwestern Ghana using the household food insecurity access scale indicator. The study also examined the factors that affect household food security using the endogenous treatment model, which also evaluates the impact of the training programme on the outcome variable.
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The aims of this paper are to measure the impacts of subsidy, work experience and training programmes on New Zealand male registered unemployed, and to examine the…
Abstract
Purpose
The aims of this paper are to measure the impacts of subsidy, work experience and training programmes on New Zealand male registered unemployed, and to examine the sensitivity of these estimates to the amount of time that participants are followed after an intervention.
Design/methodology/approach
The impact of an intervention on those who participate in an active labour market programme is the key question addressed in this paper. A New Zealand panel data set is used, which includes both intervention and individual characteristics of the unemployed. Both a potential outcomes and single nearest‐neighbour difference‐in‐differences matching approach are used to estimate the impact of participation.
Findings
The key findings are that work experience programmes are the most effective in the short‐term. Training programmes are the least effective. Programmes are more effective for the long‐term unemployed than for short‐term unemployed. The results are sensitive to the point of time examined in the post‐intervention period, with short‐term benefits disappearing completely three years after the intervention.
Originality/value
This paper examines the relative effect of active labour market programmes in New Zealand using a consistent evaluation framework. The sensitivity of the results to different time periods, and matching estimator specifications are examined.
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Alina Morawska and Matthew Sanders
Despite the importance of increasing engagement and minimising attrition and drop‐out in parenting interventions, there is a paucity of empirical evidence examining…
Abstract
Despite the importance of increasing engagement and minimising attrition and drop‐out in parenting interventions, there is a paucity of empirical evidence examining factors related to engagement and participation. The range of factors examined in relation to engagement is generally limited in scope and variety, focusing on variables of convenience rather than utilising a theoretically‐driven approach.The aim of this article is to review the factors related to parental engagement with interventions and to describe strategies and implications for improving engagement with parenting interventions. Several policy and practice implications are identified: (1) Poor parental engagement may threaten or compromise the capacity of parenting programmes to deliver valued outcomes. Viable engagement strategies need to be a core part of prevention and early intervention parenting programmes; (2) Agencies delivering parenting services need a proactive engagement strategy, which includes strategies to prevent drop‐out, as well as strategies to actively respond to parental disengagement; (3) Research is needed to test the efficacy and robustness of different engagement enhancement strategies. Empirical tests are needed to test the effectiveness of different engagement strategies in order to ensure that the most efficient, cost‐effective and efficacious approach is used in order to engage parents. Investment of research effort to improve parental engagement is likely to have a high yield in terms of programme efficiency, utility and cost effectiveness. We conclude that research examining how to improve engagement and decrease non‐completion is needed to strengthen the population level value of parenting programmes as preventive interventions.
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Albert M. Kopak, Steven L. Proctor and Norman G. Hoffmann
Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which…
Abstract
Purpose
Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which indicators have the greatest impact on treatment outcomes. The purpose of this paper is to determine which clinical indicators influenced the likelihood of rearrest among male drug-involved offenders.
Design/methodology/approach
This prospective longitudinal study examined indicators of 12-month post-treatment rearrest for male criminal justice-involved substance use treatment patients. Multinomial logistic regression results drawn from a sample of 1,531 adult male patients who were mandated to substance use treatment indicated that there were different factors related to the likelihood of one as well as multiple post-treatment arrests.
Findings
Demographic risk factors, such as age and unemployment, were associated with significant increases in the probability of experiencing an arrest within 12-months of treatment discharge. Substance use relapse was also a significant indicator of the likelihood of rearrest and contributed to an increase in the odds of one post-treatment rearrest as well as multiple rearrests. A drug dependence diagnosis, relative to a diagnosis for alcohol dependence, was associated with an increased likelihood of rearrest. Participation in outpatient treatment was associated with a lower likelihood of rearrest.
Practical implications
These findings emphasize the need for treatment providers to concentrate heavily on demographic risk reduction to minimize the chance that male patients are rearrested after treatment. Relapse prevention, on the other hand, is critical in the effort to minimize the number of post-treatment rearrests in this population.
Originality/value
The results from this study provide evidence to empirically support the refinement of substance treatment programs for male patients involved in the criminal justice system.
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Stacy Lee Burns and Mark Peyrot
Purpose – This study tracks the legal control of the problem of substance abuse.Methodology/Approach – The chapter explores the “natural history” of the evolution of the…
Abstract
Purpose – This study tracks the legal control of the problem of substance abuse.
Methodology/Approach – The chapter explores the “natural history” of the evolution of the social construction of drug use and our collective response to it. Over the past 100 years, our understanding of drug use/abuse and the system for handling drug problems have gone through a series of changes. In the past 20 years or so, provision of treatment for drug offenders within the criminal justice system has rapidly expanded. California's recently enacted Proposition 36 (Prop 36) initiates for the first time on a mass basis the court-supervised drug treatment that began a decade earlier on a much smaller scale with the original drug courts. This chapter compares the Prop 36 program for diverting nonviolent drug offenders into court-supervised treatment with the original drug courts.
Findings – The research shows how court-supervised drug treatment has evolved from a personalized care program in the original drug courts to a mass processing operation under Prop 36. The research finds that the social problem solution of offering treatment to more drug defendants created its own unanticipated consequences and problems, including significant standardization in the operations of the court and a dilution of many useful features that defined the early drug courts.
Practical implications – “Farming out” drug defendants to probation and treatment makes case-processing and treatment potentially less effective therapeutically. The chapter raises questions about how social control can extend its domain without “breaking the bank” and what the consequences are for how social problems are handled.
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Yaara Zisman-Ilani, Emma Kaminskiy and Pedro Serrano Aguilar
Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences…
Abstract
Purpose
Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences and concerns in a deliberative process with the health care provider. Many existing instruments assess the antecedents, process, or the outcomes of SDM. The purpose of this paper is to identify the SDM-related measures applied in a mental health context.
Design/methodology/approach
The authors performed a systematic review in several electronic databases from 1990 to October 2016. Studies that assessed quantitatively one or more constructs related to SDM (antecedents, process, and outcomes) in the field of mental health were included.
Findings
The authors included 87 studies that applied 48 measures on distinct SDM constructs. A large majority of them have been developed in the field of physical diseases and adapted or directly applied in the mental health context. The most evaluated construct is the SDM process in consultation, mainly by patients’ self-report but also by external observer measures, followed by the patients’ preferences for involvement in decision making. The most applied instrument was the Autonomy Preference Index, followed by the Observing Patient Involvement in Decision Making (OPTION) and the Control Preferences Scale (CPS). The psychometric validation in mental health samples of the instruments identified is scarce.
Research limitations/implications
The bibliographic search is comprehensive, but could not be completely exhaustive. Effort should be invested in the development of new SDM for mental health tools that will reflect the complexity and specific features of mental health care.
Originality/value
The authors highlight several limitations and challenges for the measurement of SDM in mental health care.
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Chi Meng Chu, Michael Daffern, Stuart D.M. Thomas and Jia Ying Lim
Gang affiliation is strongly associated with youth crime. Although gang prevention, intervention and suppression programmes have been used to reduce affiliation and manage…
Abstract
Purpose
Gang affiliation is strongly associated with youth crime. Although gang prevention, intervention and suppression programmes have been used to reduce affiliation and manage youth gang‐related activities, the effectiveness of these approaches is questionable. Further, comprehensive programmes supporting disengagement from gangs that also address the actual criminal behaviours of gang‐affiliated youth are rare. Arguably, these are necessary if the goal of intervention is to reduce criminal behaviour and support disengagement from gangs. This paper aims to address these issues.
Design/methodology/approach
This study sought to elucidate the criminogenic needs of gang‐ and nongang‐affiliated youth offenders (n=165) using two commonly used risk/need assessment instruments, the structured assessment of violence risk in youth (SAVRY) and the youth level of service/case management inventory (YLS/CMI).
Findings
The results revealed that gang‐ and nongang‐affiliated youth offenders had similar criminogenic need profiles except for one difference on an item measuring peer delinquency.
Practical implications
Gang‐affiliated youth offenders have comparable criminogenic needs to other youth offenders. These needs require intervention if a reduction in crime is desired, and since gang‐affiliated youth offenders are more likely to re‐offend than those that are nongang‐affiliated, these results also suggest that there may be additional needs, beyond those assessed by the SAVRY and YLS/CMI, which should be investigated and considered in rehabilitation programmes.
Originality/value
Few studies have directly compared the risk and needs profiles between gang‐ and nongang‐affiliated youth offenders using standardised risk assessment measures; this study may be relevant to professionals working in the juvenile justice and offender rehabilitation arenas.
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Asmita Patel, Rachel Calam and Angela Latham
The research sought to assess perceived barriers to enrolment in parenting programmes by different ethnic groups in a deprived inner‐city community. In study one, parents…
Abstract
The research sought to assess perceived barriers to enrolment in parenting programmes by different ethnic groups in a deprived inner‐city community. In study one, parents of children attending pre‐school services targeted with outreach strategies were assessed using a Barriers Checklist to identify factors influencing uptake. In study two, a larger sample completed the checklist and SDQ (Strengths and Difficulties Questionnaire) to test associations between intention and parent‐rated behavioural difficulties. Study one found no significant differences in individual perceived barriers or levels of behavioural difficulty between ethnic groups. In study two, Pakistani, Asian British and African families showed the highest levels of interest in attending groups, and White British and Black British the lowest. There was no significant correlation between interest and behavioural difficulties. Higher parent education was associated with interest. The research shows that barriers to attendance are diverse, and finding further ways of enhancing the uptake of community‐based group programmes across different ethnic groups would be valuable.
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