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The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.

A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.

This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.

This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.

The purpose of this paper – the second of three – is to report the findings from a service user needs assessment in those who have contact with a local homelessness service in the North-West of England.

Data were collected using a semi-structured questionnaire that included a section exploring Adverse Childhood Experiences. Aggregated data from a total of 100 completed questionnaires were analysed to understand the nature and scope of those accessing the Homelessness and Vulnerable Adults Service (HVAS).

Homeless people accessing HVAS face a number of challenges, which reflect their upbringing and chaotic and complex lifestyles. Reports of multiple disadvantage, social isolation, physical and mental health problems were common among the cohort.

This was a small cohort study, and the authors accept that this may potentially limit the scope of the findings. Themes identified are, however, reflected in wider research and official data collection sources. Future research may seek to widen the data collection methods to offer a more representative cohort.

The provision of co-ordinated multi-agency support is essential to tackle health inequalities experienced by those who are homeless.

The complex issues often experienced by those who are homeless can further compound the impact of social exclusion on health and well-being. The reduction of statutory support and increased emphasis on self-reliance can further impact those people on the margins of society.

This study identifies how multiple deprivations and social isolation impacts upon health and well-being, further compounding a person’s ability and willingness to engage with services. It raises the question of the systems failure to respond effectively.

Needs change as people get older. Procuring resources to satisfy them can generate anguish and insecurities in consumers due to their financial situation. This study aims to analyze the relationship between age and financial stress among Mexican adults and estimate the age of their maximum financial stress.

This study is based on constructing a financial stress indicator using the confirmatory factor analysis and linear regression models with a quadratic term, employing data from the National Survey on Financial Inclusion 2021.

Results show that the relationship between age and financial stress follows a quadratic pattern, with a maximum level at age 56, which varies according to sex, marital status, number of dependents, education and regions. These findings interest financial product designers and policy developers who aim to improve consumers' well-being.

Longitudinal studies and indicators, such as financial fragility, are needed to facilitate refining models over time.

There is no evidence of studies that have addressed the age of maximum financial stress in Latin America. Doing so is relevant because identifying the stages in life when adults are most vulnerable to financial stress helps assess its causes more precisely, thus mitigating its adverse effects.

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process.

Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software.

This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process.

This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.

This paper aims to present commentary on adult safeguarding designated officers’ (nominated senior staff members in the Health Service Executive and its funded services) in Ireland readiness for online learning and their perception of the blended approach used in their training and considers the implications of this for practice.

In total, 233 designated officers were surveyed. A self-administered online survey comprising of two instruments was used. The questionnaire combines two previously validated tools measuring readiness for online learning and perceptions of blended learning. Minor modifications were made to account for local circumstance and language. Demographic questions relevant to the survey population were added. The response rate was 49%.

Designated officers regarded specified competencies for online learning as important to very important with highest importance placed in time management. Designated officers expressed they were confident to very confident in their ability to accomplish all competencies in online learning. The highest confidence was in the technical competencies. Designated officers are demonstrating high readiness for online learning. Designated officers reported positively on online contributions and on blended learning workload. The scores indicate positive perceptions of the blended learning experience. Responses to an open-ended question were largely positive with some suggestions for improvement made.

Findings have helped inform planning and development of the Health Service Executive’s adult safeguarding training for designated officers with changes made since this survey was undertaken.

To the best of the author’s knowledge, this is the first time a survey was undertaken of designated officers in Ireland with a view to improving safeguarding training. Recommendations for adaptions to the blended designated officer programme were proposed and subsequently accepted and implemented.

This study aims to investigate the relationships between the perceived neighborhood walkable environment (PNWE), neighborhood interaction (NI) and residents’ mental health, with a focus on examining differences among residents of different age groups.

Using an electronic survey questionnaire, data on PNWE, NI and mental health were collected from 1,159 residents across 205 communities in Shanghai, China. Our study utilized a structural equation modeling (SEM), employing the maximum likelihood estimation method. The structural equation model was fitted using the MPLUS software.

The mental health of young and middle-aged adults is generally poor, and they are at higher risk of depression than children and older adults. The effects of PNWE and NI on the mental health of residents varied among different age groups. As residents get older, their mental health is more affected by the PNWE. In addition, the influence of the PNWE on children and older adults’ mental health is direct and not mediated by NI. For young and middle-aged adults, the influence of the PNWE on their mental health needs to be mediated by NI.

This study marks the first examination of the relationship between PNWE, NI and mental health among different age groups of residents in China. The findings of this research can assist policymakers in gaining a deeper understanding of the underlying mechanisms by which PNWE affects mental health. Furthermore, it can contribute to the development of more targeted walkable environment designs aimed at enhancing mental health among various age groups.

This paper – the final paper of a series of three – aims to discuss the implications of the findings from a service user needs assessment of people experiencing homelessness in the Northwest of England. It will expand on the previous paper by offering a more detailed analysis and discussion of the identified key themes and issues. The service user needs assessment was completed as part of a review of local service provision in the Northwest of England against the backdrop of the COVID-19 pandemic.

Semi-structured questionnaires were administered and used by health-care professionals to collect data from individuals accessing the Homeless and Vulnerable Adults Service (HVAS) in Bolton. The questionnaires included a section exploring Adverse Childhood Experiences. Data from 100 completed questionnaires were analysed to better understand the needs of those accessing the HVAS.

Multiple deprivations including extensive health and social care needs were identified within the cohort. Meeting these complex needs was challenging for both service users and service providers. This paper will explore key themes identified by the needs assessment and draw upon further comments from those who participated in the data-gathering process. The paper discusses the practicalities of responding to the complex needs of those with lived experience of homelessness. It highlights how a coordinated partnership approach, using an integrated service delivery model can be both cost-effective and responsive to the needs of those often on the margins of our society.

Data collection during the COVID-19 pandemic presented a number of challenges. The collection period had to be extended whilst patient care was prioritised. Quantitative methods were used, however, this limited the opportunity for service user involvement and feedback. Future research could use qualitative methods to address this balance and use a more inclusive approach.

This study illustrates that the needs of the homeless population are broad and varied. Although the population themselves have developed different responses to their situations, their needs can only be fully met by a co-ordinated, multi-agency, partnership response. An integrated service model can help identify, understand, and meet the needs of the whole population and individuals within it to improve healthcare for a vulnerable population.

This study highlighted new and important findings around the resilience of the homeless population and the significance of building protective factors to help combat the multiplicity of social isolation with both physical and mental health problems.

The discussion provides an opportunity to reflect on established views in relation to the nature and scope of homelessness. The paper describes a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 pandemic. Recommendations for service improvements will include highlighting established good practices including embedding a more inclusive/participatory approach.

This research was conducted as part of a PhD study. The purpose of this paper is to explore the factors taken into consideration when multi-agency practitioners were considering financial harm in the context of adult protection and how this influenced their decision-making processes.

An adapted q sort methodology initially established the areas of financial harm considered to have additional factors, which led to complexity in adult protection decision making. These factors were further explored in individual interviews or focus groups.

The data identified that the decision-making process varied between thorough analysis, rationality and heuristics with evidence of cue recognition, factor weighting and causal thinking. This highlighted the relevance of Kahneman’s (2011) dual processing model in social work practice. Errors that occurred through an over reliance on System 1 thinking can be identified and rectified through the use of System 2 thinking and strengthen social work decision-making.

This paper considers the practice of multi-agency adult protection work in relation to financial harm and identifies the influences on decisions.

Loneliness and social isolation are risk factors for morbidity and mortality and a growing health concern. Peer support is an intervention that has shown efficacy in the wider health-care arena. However, little is known about its effectiveness when working with adults and adolescents experiencing these issues. The purpose of this study is to conduct a scoping review on loneliness and social isolation in adult and youth populations.

A preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews was conducted. Five databases, Web of Science, Academic Search Complete, Embase, PsycINFO and Scopus were searched for peer-reviewed literature published in English from inception to 2023.

The search yielded 2,402 articles of which (N = 12) met the inclusion criteria for this review. Peer support interventions for loneliness and social isolation are a relatively new topic of interest for academics. However, it is apparent that loneliness and social isolation cut across populations experiencing various health and social issues. More experiential research is needed to evidence the effectiveness of peer support in these areas with both adults and adolescents. Emerging areas of interest include the use of technology to deliver interventions and the use of technology to facilitate peer support implementation with populations difficult to reach.

Peer support may be a promising social intervention to help those experiencing loneliness and social isolation associated with a range of health conditions. However, further research needs to be undertaken in this emerging area of practice.

Loneliness and social isolation are of increasing concern. To the best of the authors’ knowledge, this is the first scoping review conducted in this area

The design of buildings is crucial to functionality and safety for senior citizens. People often refrain from talking about old age and its related support; however, it is inevitable. The paper aims to highlight the essentials of a home design that considers the aged citizens in Nigeria.

A qualitative research technique is used in the study. A closed-ended questionnaire and an interview were used to gather information on the requirements for aging-in-place basics in home design from middle-aged and elderly households.

Findings from the study revealed that a majority of the respondents considered old age as a phase of life to prioritize in home design. Lighting, furniture and fixtures and electrical installations are variously perceived by the respondents as aging-in-place essentials.

The study has far-reaching consequences for the built environment, particularly for homeowners. It is related to the third sustainable development goal (SDG), which seeks to secure the health and well-being of people of all ages.

The study's uniqueness and usefulness are highlighted in the gaps between present house design culture and the reality of senior citizen occupants' dwellings, as well as the appropriateness to satisfy changing demands associated with old age. It would encourage homes to develop the culture and duty of providing a sustainable home that is accessible to everybody and provides emotional and physical safety for the elderly.