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1 – 10 of 464George Okello Candiya Bongomin, Pierre Yourougou, Rebecca Balinda and Joseph Baleke Yiga Lubega
Currently, consumers of financial products and services have become more vulnerable to predatory financial institutions, especially in the aftermath of Covid-19 pandemic…
Abstract
Purpose
Currently, consumers of financial products and services have become more vulnerable to predatory financial institutions, especially in the aftermath of Covid-19 pandemic. Therefore, financial consumers like the persons with disabilities (PWDs) should be equipped with knowledge and skills to help them to evaluate complex financial products on offer in financial markets, especially in developing countries to avoid being victims of fraudulent lending. The purpose of this study is to establish whether customized financial literacy mediates the relationship between financial consumer protection and financial inclusion of PWDs’ owned MSMEs in rural Uganda post Covid-19 pandemic.
Design/methodology/approach
SmartPLS 4.0 was used to construct the measurement and structural equation models to test whether customized financial literacy significantly mediates the relationship between financial consumer protection and financial inclusion of PWDs’ owned MSMEs in rural Uganda post Covid-19 pandemic.
Findings
The results revealed a partial mediating effect of customized financial literacy in the relationship between financial consumer protection and financial inclusion of PWDs’ owned MSMEs in rural Uganda post Covid-19 pandemic. Conducting customized financial literacy increases financial consumer protection by 12 percentage points to promote financial inclusion of PWDs’ owned MSMEs in rural Uganda post Covid-19 pandemic.
Research limitations/implications
This study focused only on customized financial literacy and financial consumer protection to promote universal financial inclusion of PWDs’ owned MSMEs post Covid-19 pandemic. Future studies may use data collected from other vulnerable groups amongst the unbanked population in developing countries, Uganda inclusive. In addition, this study also collected only quantitative data from the selected population. Further studies can be conducted using key informant interviews and focused group discussion to get the perceptions of the PWDs on being protected from exploitation by unscrupulous financial institutions.
Practical implications
The findings from this study can help policymakers in developing countries like Uganda to revise the existing consumer protection law to include strong clauses on protection of people with special needs like the PWDs. The law must ensure that they are not exploited by financial institutions because of their conditions. The law ought to make sure that the PWDs are educated about their rights in the financial market place and all information on financial products offered by financial institutions should be simplified and interpreted to them before they make consumption decisions.
Originality/value
To the best of the authors’ knowledge, the present study is amongst the first few studies to provide a meticulous and unique discourse on the ever increasing role of financial literacy combined with consumer protection to reduce consumption risks within the financial markets, especially in developing countries in the aftermath of global pandemic shocks. This study uses the social learning theory, theory of reasoned action and theory of planned behaviour to elucidate how customized financial literacy can enhance consumer protection to increase financial inclusion of groups with special needs like the PWDs who have become more susceptible to exploitation by unscrupulous financial institutions in under-developed financial markets, especially in post Covid-19 pandemic.
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Robert J. Kane, Jordan M. Hyatt and Matthew J. Teti
The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models…
Abstract
Purpose
The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models, introducing the concept of “untethered” co-response.
Design/methodology/approach
This paper conducts a review of literature to trace the evolution of police responses to individuals with serious mental illness (SMI) and vulnerable populations. It categorizes four generations of police approaches—zero-policing, over-policing, crisis intervention and co-response—and introduces a fifth generation, the “untethered” co-response model exemplified by Project SCOPE in Philadelphia.
Findings
The review identifies historical patterns of police response to SMI individuals, emphasizing the challenges and consequences associated with over-policing. It outlines the evolution from crisis intervention teams to co-response models and introduces Project SCOPE as an innovative “untethered” co-response approach.
Research limitations/implications
The research acknowledges the challenges in evaluating the effectiveness of crisis intervention teams and co-response models due to variations in implementation and limited standardized models. It emphasizes the need for more rigorous research, including randomized controlled trials, to substantiate claims about the effectiveness of these models.
Practical implications
The paper suggests that the “untethered” co-response model, exemplified by Project SCOPE, has the potential to positively impact criminal justice and social service outcomes for vulnerable populations. It encourages ongoing policy and evaluative research to inform evidence-based practice and mitigate collateral harms associated with policing responses.
Social implications
Given the rising interactions between police and individuals with mental health issues, exacerbated by the COVID-19 pandemic, the paper highlights the urgency for innovative, non-policing-driven responses to vulnerable persons.
Originality/value
The paper contributes to the literature by proposing a fifth generation of police response to vulnerable persons, the “untethered” co-response model and presenting Project SCOPE as a practical example.
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Barney G. Pacheco and Marvin H. Pacheco
The global impact of the COVID-19 pandemic has been well documented, but there is still limited insight into the complex interaction of factors that determine its longer-term…
Abstract
Purpose
The global impact of the COVID-19 pandemic has been well documented, but there is still limited insight into the complex interaction of factors that determine its longer-term effects on the most vulnerable sectors of society. The current study therefore develops an integrated conceptual framework to investigate how consumers' fear of mortality and the perceived risk of severe illness associated with COVID-19 act as critical determinants of consumer food choices and perceived well-being.
Design/methodology/approach
An online survey was utilized to collect data from a sample of 407 adult, low-income consumers across Trinidad and Tobago. The PROCESS macro was used to empirically test the hypothesized relationships in a moderated mediation model.
Findings
The results confirm that an increase in the perceived risk of severe illness has a significant negative effect on the consumption of healthy foods and perceived well-being. Moreover, consumers' choice of healthy foods mediates the negative relationship between consumers' perceived risk of severe COVID-19 illness and subjective well-being. Finally, the negative relationship between perceived risk of illness and healthy food choice weakens as an individual's fear of pandemic-related mortality increases.
Originality/value
This research integrates multiple related theoretical constructs to provide a more nuanced understanding of the lingering impact that risk perceptions and fear have on consumer food choices and associated well-being among a vulnerable Caribbean population. The changes identified have important implications for researchers interested in consumer food preferences as well as policymakers seeking to promote a healthy lifestyle among individuals coping with psychologically stressful circumstances.
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Ryan J. Chan, Shiran Isaacksz, Brian Low, Cecile Raymond, Lori Seeton and Christopher T. Chan
Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples…
Abstract
Purpose
Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.
Design/methodology/approach
In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.
Findings
We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.
Practical implications
Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.
Originality/value
There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.
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Angela Woods, Rebecca Lace, Joanne Dickinson and Ben Hughes
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
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.
Social implications
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.
Originality/value
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.
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Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…
Abstract
Purpose
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.
Design/methodology/approach
This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).
Findings
Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.
Originality/value
This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.
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Nicholas Fancher, Bibek Saha, Kurtis Young, Austin Corpuz, Shirley Cheng, Angelique Fontaine, Teresa Schiff-Elfalan and Jill Omori
In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular…
Abstract
Purpose
In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.
Design/methodology/approach
A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.
Findings
Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.
Originality/value
To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.
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Misun Lee, Ralph S. Brower and Daniel L. Fay
This paper analyzes how a national social enterprise policy encourages the social missions of social enterprises and uncovers the relationships between social enterprise…
Abstract
Purpose
This paper analyzes how a national social enterprise policy encourages the social missions of social enterprises and uncovers the relationships between social enterprise governance and labor equity, an area that has been rarely studied in nonprofit governance studies.
Design/methodology/approach
The study analyzes the effects of four legal requirements for work-integrated social enterprises (WISEs) codified by the Social Enterprises Promotion Act (SEPA, 2007) in South Korea. Then, it relies on panel regression analysis (2020–2022) to examine how the compositions of the governance of WISEs are related to their hiring and wage equity.
Findings
The institutional arrangements required by SEPA have resulted in positive social impacts for most WISEs. However, the results of regression models show that individual participant groups in the WISE governance achieved mixed results depending on the labor issue.
Research limitations/implications
Generally, this research explores the concept of diversity and its utility in nonprofit governance, with a particular focus on targeted diversity policies, demonstrating that governance arrangements influence the success of these policies.
Practical implications
The findings bring new insights for policymakers about “altruistic economic entities.” For practitioners in social enterprises, the results of the regression models underscore the importance of understanding the participant composition of decision-making meetings.
Originality/value
This study sheds light on labor equity, which government-certified social enterprises should achieve from the perspective of nonprofit governance.
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Angela Crocker, Jill Titterington and Michelle Tennyson
This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and…
Abstract
Purpose
This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.
Design/methodology/approach
There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.
Findings
Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.
Research limitations/implications
This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.
Practical implications
Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.
Social implications
It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.
Originality/value
Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.
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Angela Crocker, Jill Titterington and Michelle Tennyson
This study aims to investigate the prevalence and characteristics of dysphagia among adults with intellectual disabilities (ID) referred to speech and language therapy for swallow…
Abstract
Purpose
This study aims to investigate the prevalence and characteristics of dysphagia among adults with intellectual disabilities (ID) referred to speech and language therapy for swallow assessment, providing information on the demographic characteristics, referral trends, co-occurring health conditions and reasons for referrals highlighting the complex health-care needs of this population.
Design/methodology/approach
This study used a standardised patient data extraction method over a six-month period involving 74 adults with ID referred to speech and language therapy for swallow assessment.
Findings
This study revealed a high prevalence of dysphagia among adults with ID referred to speech and language therapy for swallow assessment. Increasing age and severity of ID were associated with an increased likelihood of swallowing difficulties. Co-occurring health conditions such as mobility difficulties, epilepsy and gastrointestinal conditions were prevalent, suggesting that adults with ID and swallowing difficulties are often living with complex health conditions. Choking incidents and hospital admissions were primary reasons for referral.
Research limitations/implications
This study stresses the pressing need for strategies to mitigate risks associated with choking incidents and hospital admission among this vulnerable population. Possible limitations include a reliance on referral and the focus being on a single service over a short period which may limit generalisation to the wider ID population.
Practical implications
This study emphasises the need to understand each person’s unique profile of health needs and the value of a specialised speech and language therapy service.
Social implications
The importance of increasing awareness among caregivers and medical experts is highlighted.
Originality/value
The findings underscore the importance of tailored assessment, caregiver involvement and heightened interdisciplinary awareness to effectively manage dysphagia in individuals with ID.
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