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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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  • Individual Author: Camargo Plazas, Pilar ; Cameron, Brenda L.; Milford, Krista ; Hunt, Lindsay Ruth ; Bourque-Bearskin, Lisa ; Santos Salas, Anna
    Year: 2018

    In Canada, Indigenous peoples bear a greater burden of illness and suffer disproportionate health disparities compared to non-Indigenous people. Difficult access to healthcare services has contributed to this gap. In this article, we present findings from a dissemination grant aimed to engage Indigenous youth in popular theatre to explore inequities in access to health services for Indigenous people in a Western province in Canada. Following an Indigenous and action research approach, we undertook popular theatre as a means to disseminate our research findings. Popular theatre allows audience members to engage with a scene relevant to their own personal situation and to intervene during the performance to create multiple ways of critically understanding and reacting to a difficult situation. Using popular theatre was successful in generating discussion and engaging the community and healthcare professionals to discuss next steps to increasing access to healthcare services. Popular theatre and short dramas provide a venue for mirroring stigmatized care and expose racial biases in...

    In Canada, Indigenous peoples bear a greater burden of illness and suffer disproportionate health disparities compared to non-Indigenous people. Difficult access to healthcare services has contributed to this gap. In this article, we present findings from a dissemination grant aimed to engage Indigenous youth in popular theatre to explore inequities in access to health services for Indigenous people in a Western province in Canada. Following an Indigenous and action research approach, we undertook popular theatre as a means to disseminate our research findings. Popular theatre allows audience members to engage with a scene relevant to their own personal situation and to intervene during the performance to create multiple ways of critically understanding and reacting to a difficult situation. Using popular theatre was successful in generating discussion and engaging the community and healthcare professionals to discuss next steps to increasing access to healthcare services. Popular theatre and short dramas provide a venue for mirroring stigmatized care and expose racial biases in the delivery of care. The contributions of the students, their input, and their acting were to increase our awareness even more of the pervasiveness of the stigmatized care that Indigenous people experience. (Author abstract)

  • Individual Author: Sherman, Erin ; Secrist, Amy; Gidwani, Suman; Storey, Douglas; Leifer, Jess
    Reference Type: Conference Paper
    Year: 2018

    Motivation: Baltimore City experiences one of the highest infant mortality rates in the country. Although a large percentage of pregnant women in Baltimore are Medicaid recipients, they often do not take-up pregnancy and postpartum support services that are available with an appropriate referral. Particularly for high-risk pregnancies, this can lead to adverse birth outcomes. To begin accessing these services, Medicaid-eligible patients must have a prenatal risk assessment (PRA) form filled out by their provider. Without this form, women with high risk pregnancies may not be referred to services such as insurance assistance, WIC, home visits by social workers, and smoking cessation assistance. Intervention: In collaboration with the Baltimore City Health Department (BCHD), the Johns Hopkins University Center for Communication Programs (CCP) and other partners in the B’more for Healthy Babies (BHB) initiative, a package of behavioral interventions was randomized across prenatal care practices in Baltimore. The set of interventions included the...

    Motivation: Baltimore City experiences one of the highest infant mortality rates in the country. Although a large percentage of pregnant women in Baltimore are Medicaid recipients, they often do not take-up pregnancy and postpartum support services that are available with an appropriate referral. Particularly for high-risk pregnancies, this can lead to adverse birth outcomes. To begin accessing these services, Medicaid-eligible patients must have a prenatal risk assessment (PRA) form filled out by their provider. Without this form, women with high risk pregnancies may not be referred to services such as insurance assistance, WIC, home visits by social workers, and smoking cessation assistance. Intervention: In collaboration with the Baltimore City Health Department (BCHD), the Johns Hopkins University Center for Communication Programs (CCP) and other partners in the B’more for Healthy Babies (BHB) initiative, a package of behavioral interventions was randomized across prenatal care practices in Baltimore. The set of interventions included the following components: 

    • Checklist: The PRA Checklist includes execution notes for the 3 steps required to successfully complete a PRA: talking points for speaking to a patient about the PRA, steps and specific filling number for the PRA, and fax number for faxing the PRA.
    • Feedback: Three quarterly feedback reports were used to compare how many PRAs an office completed in comparison to offices like it. They provided a visual image (smiley face or exclamation point) to indicate whether the office was doing better or worse than its peers. Additionally, practices who had not submitted any PRAs in the previous year received a report indicating that they need to submit PRAs to appropriately serve their patients.
    • Testimonials: Patient testimonials included quotes from mothers who had benefitted from services referred through the PRA. They highlighted stories of mothers and babies with positive health outcomes as a result of services like home visiting and cribs. Testimonials will be sent to all treatment offices via email at intervals of 1-2 months.
    • Information: A website was developed which provides a quiz that allows clinics to see how many of the standard PRA procedures they are/are not following. The website also has a list of behaviorally informed best practices that we developed based on site visits and advice from BHB/BCHD.

    Methodology: Data collection will occur between March-September 2018 with the primary outcome being the number of PRAs submitted by each practice. Cluster randomization is used to identify effects in 25 control clinics compared to 27 treatment clinics throughout the city. Results: The results, available by September 2018, will show whether this combination of peer comparison and informational interventions can impact providers’ PRA submission rates, referral rates to prenatal and postpartum support services, and the rate of accepted services by Medicaid-eligible women. Conclusion: The results of this experiment will determine whether social and informational efforts impact PRA take-up and increase support-service access for pregnant Medicaid-eligible women in Baltimore. (Author abstract)

  • Individual Author: Eismann, Emily A.; Theuerling, Jack; Maguire, Sabine; Hente, Elizabeth A.; Shapiro, Robert A.
    Reference Type: Journal Article
    Year: 2018

    This project sought to assess the generalizability, barriers, and facilitators of implementing the Safe Environment for Every Kid (SEEK) model for addressing psychosocial risk factors for maltreatment across multiple primary care settings, including a pediatric practice, federally qualified health center, and family medicine practice. The SEEK model includes screening caregivers for psychosocial risk factors at well-child visits age 0 to 5 years, brief intervention incorporating principles of motivational interviewing to engage caregivers, and referral to treatment. All practices successfully implemented SEEK, with screening completion rates from 75% to 93% and brief intervention rates from 61% to 81%. Major parental stress (14%) and food insecurity (11%) were the most common risk factors. Providers found SEEK worthwhile for improving their knowledge, skills, and ability to address psychosocial concerns and provide whole person care. Barriers included limited time and resources, incomplete resource knowledge, and lack of follow-up. Facilitators included on-site support staff to...

    This project sought to assess the generalizability, barriers, and facilitators of implementing the Safe Environment for Every Kid (SEEK) model for addressing psychosocial risk factors for maltreatment across multiple primary care settings, including a pediatric practice, federally qualified health center, and family medicine practice. The SEEK model includes screening caregivers for psychosocial risk factors at well-child visits age 0 to 5 years, brief intervention incorporating principles of motivational interviewing to engage caregivers, and referral to treatment. All practices successfully implemented SEEK, with screening completion rates from 75% to 93% and brief intervention rates from 61% to 81%. Major parental stress (14%) and food insecurity (11%) were the most common risk factors. Providers found SEEK worthwhile for improving their knowledge, skills, and ability to address psychosocial concerns and provide whole person care. Barriers included limited time and resources, incomplete resource knowledge, and lack of follow-up. Facilitators included on-site support staff to assist with communication and referrals. (Author abstract)

  • Individual Author: Spillman, Brenda C.; Clemans-Cope, Lisa; Mallik-Kane, Kamala; Hayes, Emily
    Reference Type: Report
    Year: 2017

    Many states have expanded Medicaid eligibility to reach a wider array of vulnerable and historically uninsured populations. While Medicaid cannot pay for medical services provided in prisons or jails, people who are arrested and incarcerated can enroll in Medicaid and become eligible for benefits in the community. Given the high prevalence of mental health issues, substance abuse, and chronic health conditions among criminal justice populations, providing health care services to them could improve public health and public safety outcomes. This brief highlights initiatives in New York and Rhode Island that use the Medicaid health home model to improve continuity of care for justice-involved individuals. (Author abstract)

    Many states have expanded Medicaid eligibility to reach a wider array of vulnerable and historically uninsured populations. While Medicaid cannot pay for medical services provided in prisons or jails, people who are arrested and incarcerated can enroll in Medicaid and become eligible for benefits in the community. Given the high prevalence of mental health issues, substance abuse, and chronic health conditions among criminal justice populations, providing health care services to them could improve public health and public safety outcomes. This brief highlights initiatives in New York and Rhode Island that use the Medicaid health home model to improve continuity of care for justice-involved individuals. (Author abstract)

  • Individual Author: Goyal, Neera K.; Folger, Alonzo T.; Hall, Eric S.; Greenberg, James M. ; Van Ginkel, Judith B. ; Ammerman, Robert T.
    Reference Type: Journal Article
    Year: 2016

    Objective - Determine association of home visiting with subsequent pregnancy outcomes Study Design - Retrospective study of Ohio mothers delivering their first infant from 2007–2009. First, we compared mothers enrolled in home visiting to a matched eligible group. Second, we compared outcomes within home visiting based on program participation (low < 25% of recommended home visits, moderate 25–75%, high 75–100% and very high >100%). Time to subsequent pregnancy within 18 months was evaluated using Cox proportional hazards regression; logistic regression tested the likelihood of subsequent preterm birth. Result - Of 1,516 participants, 1,460 were matched 1:1 to a comparison mother (n=2,920). After multivariable adjustment, enrollment was associated with no difference in pregnancy spacing or subsequent preterm birth. Among those enrolled, moderate vs. low participants had reduced risk of repeat pregnancy over 18 months (hazard ratio 0.68, p=0.003). Conclusion - Increased pregnancy spacing is observed among...

    Objective - Determine association of home visiting with subsequent pregnancy outcomes Study Design - Retrospective study of Ohio mothers delivering their first infant from 2007–2009. First, we compared mothers enrolled in home visiting to a matched eligible group. Second, we compared outcomes within home visiting based on program participation (low < 25% of recommended home visits, moderate 25–75%, high 75–100% and very high >100%). Time to subsequent pregnancy within 18 months was evaluated using Cox proportional hazards regression; logistic regression tested the likelihood of subsequent preterm birth. Result - Of 1,516 participants, 1,460 were matched 1:1 to a comparison mother (n=2,920). After multivariable adjustment, enrollment was associated with no difference in pregnancy spacing or subsequent preterm birth. Among those enrolled, moderate vs. low participants had reduced risk of repeat pregnancy over 18 months (hazard ratio 0.68, p=0.003). Conclusion - Increased pregnancy spacing is observed among women with at least moderate home visiting participation. (Author abstract)

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