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Despite documented racial and ethnic disparities in care, there is significant variability in representation, reporting, and analysis of race and ethnic groups in the hospice and palliative medicine (HPM) literature.To evaluate the race and ethnic diversity of study participants and the reporting of race and ethnicity data in HPM research.Adult patient and/or caregiver-centered research conducted in the U.S. and published as JPSM Original Articles from January 1, 2015, through December 31, 2019, were identified. Descriptive analyses were used to summarize the frequency of variables related to reporting of race and ethnicity.Of 1253 studies screened, 218 were eligible and reviewed. There were 78 unique race and ethnic group labels. Over 85% of studies included ≥ one non-standard label based on Office of Management and Budget designations. One-quarter of studies lacked an explanation of how race and ethnicity data were collected, and 83% lacked a rationale. Over half did not include race and/or ethnicity in the analysis, and only 14 studies focused on race and/or ethnic health or health disparities. White, Black, Hispanic, Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander persons were included in 95%, 71%, 43% 37%,10%, and 4% of studies. In 92% of studies the proportion of White individuals exceeded 57.8%, which is their proportion in the U.S.Our findings suggest there are important opportunities to standardize reporting of race and ethnicity, strive for diversity, equity, and inclusion among research participants, and prioritize the study of racial and ethnic disparities in HPM research.

BACKGROUND: Anxiety, depression, and reduced quality of life (QOL) are common problems for hospice family caregivers, but it is unknown if disparities in these experiences exist among Black and White caregivers. OBJECTIVES: To compare anxiety, depression, QOL, caregiver burden, and perceptions of caregiver-centered hospice team communication between Black and White hospice family caregivers. DESIGN: Secondary analysis of baseline data from two randomized clinical trials. SETTING/SUBJECTS: Seven hundred twenty-two Black and White hospice family caregivers ages 18+ from Midwestern and Northeastern United States. MEASUREMENTS: Measures included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Caregiver Quality-of-Life Index–Revised (CQLI-R), Zarit Burden Interview (ZBI-7), and Caregiver-Centered Communication Questionnaire (CCCQ). RESULTS: Black and White caregivers differed across demographic and socioeconomic variables. Nearly one-third of hospice family caregivers reported moderate-to-severe anxiety (32.1%) and moderate-to-severe depressive symptoms (32.0%). White caregivers reported lower QOL than Black caregivers (p = 0.04), specifically in emotional (p = 0.02) and social (p = 0.0005) domains. In multiple regression analyses controlling for caregiver and patient factors, we found no racial differences in depression, anxiety, QOL, caregiver burden, or perceptions of caregiver-centered hospice communication. CONCLUSIONS: Despite demographic and socioeconomic differences, Black and White hospice family caregivers experience similarly high levels of anxiety, depression, burden, and perceptions of hospice communication. Interventions to support hospice family caregivers across racial groups and research that identifies factors that mediate social determinants of health in this population are needed. The development and validation of culture-concordant mental health screening tools in racially diverse populations is recommended. Trial registration: ClinicalTrials.gov NCT02929108 and ClinicalTrials.gov NCT01444027.

There is significant evidence demonstrating that when done well, problem-oriented policing is associated with meaningful reductions in crime and public safety concerns. And yet, history shows that the implementation and delivery of problem-oriented policing is challenging, and that police organisations have generally not adopted it and even when they try to it is often rejected over time. This article draws on the concept of ‘diffusion of innovation’ (Rogers, E. (2003) Diffusion of Innovations, 5th edn. New York: Free Press) to unpick aspects of the processes through which problem-oriented policing has been adopted or otherwise among police forces in England and Wales. This article shows how factors related to the nature of problem-oriented policing – notably its incompatibility with prevailing norms and values of the police service, its complexity and unobservability – have influenced its adoption. Implications are also discussed.

Background: About half of hospice-eligible adults die without hospice each year. Misconceptions about hospice are frequently identified as barriers to utilization, but hospice perceptions are not well documented. Objectives and Setting/Subjects: To examine perceptions of hospice (initial and post-enrollment) among 90 U.S. patients/families actively enrolled in a large, metropolitan hospice in Texas, and to identify factors associated with participant perceptions. Design and Measurement: Concurrent mixed methods and cross-sectional design collecting data via research questionnaire with Likert scales and open-ended questions. Wilcoxon signed-rank test determined differences between recall of initial hospice perceptions at time of referral and perceptions while actively receiving services; Fisher’s exact and Kruskal-Wallis tests were used to examine bivariate relationships between perceptions of hospice and satisfaction with physician communication and demographic variables. Qualitative statements were analyzed using an inductive, content analysis approach. Results: There was a significant difference between participants’ perceptions of hospice recalled from initial conversations compared with current perceptions following hospice enrollment (z = −6.44, P < .01). Initial perceptions of hospice were significantly related to satisfaction with physician communication ( P = .011) and diagnosis ( P = .019). Qualitative themes range from negative (ie hospice = death) to positive (ie comfort, support, loving staff) with 65.6% of participants demonstrating positive increases in understanding. Conclusion: Participants’ perceptions of hospice were positively associated with satisfaction with physician communication prior to hospice enrollment, and potentially impacted by the experience of care itself. During hospice discussions, clinicians should elicit patient and family perceptions in addition to providing descriptions of eligibility and services.

This article analyses and critically reflects on the position of problem-oriented policing within England and Wales. Problem-oriented policing is a framework for improving police effectiveness. Its adoption has consistently been shown to be associated with sizable reductions in a wide range of crimes and public safety issues. However, many studies also find that problem-oriented policing is difficult to embed and sustain within police organisations. This article draws on the experiences and perspectives of 86 informed stakeholders to critically examine the position and practice of problem-oriented policing 40 years after its original formulation by Herman Goldstein in 1979. We argue that despite evidence of renewed interest in problem-oriented policing, the approach is not habitually conducted within police organisations in England and Wales. Where it is conducted, the practice of problem-oriented policing is found to lack discipline, the processes tend not to be faithfully followed, and there are weaknesses at all stages of the process. Implications of the findings for future research and police practice are discussed.

Evidence shows that the application of problem-oriented policing can be effective in reducing a wide range of crime and public safety issues, but that the approach is challenging to implement and s...

Social workers have a critical role on medical teams for facilitating effective conversations about advance care planning (ACP) in palliative and end-of-life care. Engaging patients in such conversations may be influenced by clinicians’ attitudes. During the COVID19 pandemic, the need to examine barriers to serious illness care across healthcare settings and areas of specialty practice became abundantly clear. This study examines: (1) social workers’ attitudes about ACP and (2) factors that influence the completion of advance directives (ADs). Using a cross-sectional study design, we surveyed 142 social workers on their knowledge, attitudes, and behaviors related to ADs. Using exploratory factor analyses, we identified 2 provider practice attitudes factors, 3 perceived barriers factors, and 2 perceived importance of AD factors. We then used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each of the factors in association with the frequency social workers reported educating patients about ADs. While various positive and negative attitudes and barriers toward educating patients are important factors to consider, social workers’ perceptions of the importance of engaging patients in ACP education was the most important factor that influenced their behaviors. The odds of always/often (vs. sometimes/rarely/never) educating patients about ADs in their practice were greater for those social workers who reported they see the importance of AD decision-making (OR = 3.21, 95%CI = 1.83-5.62) and confirming goals-of-care (OR = 1.76, 95%CI = 1.03-3.01). Social worker’s ACP knowledge and skills for educating patients are important in initiating conversations prior to a health crisis, especially important for developing a comprehensive care plan.

In Aging Behind Prison Walls, Tina Maschi and Keith Morgen offer evidence-based knowledge and compassionate analysis of the lives of incarcerated older people. These research scholars take a streng...

Disparities in breast cancer mortality rates among older Black and Hispanic women are due in part to low participation in cancer screening. Participation in cancer screening could be affected by an array of factors, including social support. Understanding the complex interplay between social support and breast cancer screening among older female adults, specifically among groups with higher mortality rates, is extremely important for timely and appropriate interventions to increase survival rates. Thus, utilizing the social network theory as the conceptual framework, this study aims to examine effects of social support on receiving a mammogram among a representative sample of older adults, specifically African American and Hispanic populations in the United States. Logistic regression models were conducted using the 2008 and 2012 Health and Retirement Study data. Findings from this study indicate that specific aspects of social support influence breast cancer screening participation among older Hispanic and non-Hispanic White women. However, this was not the case for the older Black women after adjusting for the sociodemographic factors. Given the role that family members play in the care of older adults, it is critical that social workers consider both the possible positive and negative interactions older women may have and how these interactions may affect their cancer screening behaviors. Findings can provide formative data to develop public health and social work interventions to increase positive social support and reduce negative social support by spouses and children to enhance breast cancer screening among older adults.

This chapter explores health equity in the context of palliative social work, focusing on an understanding and commitment to reducing and eliminating health disparities in palliative care. Health inequities are experienced by socially, economically, and/or environmentally disadvantaged groups throughout the life course. They accumulate over time and too often culminate in the experience of serious illness. Despite a long history of substantiated recognition of the need to reduce disparities in health, racially and ethnically diverse populations continue to experience inequity in healthcare accessibility and utilization, suffering disproportionately from preventable and treatable conditions. As social workers in palliative care, it behooves us to consider such health inequities across our care systems. Social work, a discipline defined by its commitment to social justice, is well situated to provide evidence-based leadership in demonstrating strategies to eradicate health disparities and promote health equity in palliative care.

A review of the literature since the year 2000 erases all doubt about the increasing cultural, racial, ethnic, and religious diversity of the United States, which has ushered in demographic trends that lead to complex sociocultural care dynamics and the likelihood that our patients’ values may not be concordant with those of traditional Western-based medicine. Palliative social workers face the challenge of implementing and evaluating healthcare practices and approaches that effectively and respectfully meet the demands of diverse populations in need of serious illness care. Moreover, care for diverse patients and families with life-limiting illness is compromised when there is a lack of understanding about culturally bound treatment preferences and or distrust for the healthcare system. This chapter recommends cultural competence in advance care planning as a means for equipping social workers with the tools needed to engage individuals and family members in conversations early and increase the utilization of advance directives among diverse populations.

This article provides an analysis of the ‘affordances’ and ‘constraints’ of technology-mediated police-community engagement in the United Kingdom (UK). Whilst there has been optimism that social me...

This volume was planned prior to the COVID-19 pandemic as the North Carolina Institute of Medicine (NCIOM) completed a yearlong task force on serious illness. Beyond the task force report, we wanted to dedicate a special edition of the NCMJ to serious illness issues. We commissioned authors who could discuss the challenges, the current practices, and the extensive personal and professional skills needed to navigate these complicated medical diagnoses that often end in death. Little did we know how timely this would be in light of the current pandemic, and we can only speculate on how the world will look as this is published. Our pre-COVID planning reflected personal experiences we all face with the common denominator of serious illness impacting and shaping our lives. As guest editors, we considered how this NCMJ edition would address personal concerns for you, our reader, as well as ourselves. A physician, a social worker, and a nurse, we each have our stories and we want to invite you to lean in and bring both your head and your heart to this reading. We start by relating two very personal experiences that shaped not only life following loss, but also career choices, clinical practices, and scholarship. As you focus on this journal's content, we hope you will also reflect on the people you care for, as well as the issues we all inevitably face.

This article draws on interview data and the concepts of organisational ‘culture’ and ‘climate’ to critically assess police officers’ perceptions of community policing in one English constabulary. In so doing, it considers the cultural, organisational and wider contextual determinants of officers’ alignment to this style of police work. With an emphasis on developing community partnerships and engaging in problem-solving, rather than enforcement of the criminal law, community policing has been seen a primary way of rendering officers more ‘responsive’ to the needs of citizens, improving police–community relations and driving down crime rates. An important reform movement in police organisations around the world, the success of community policing nonetheless depends on officers’ willingness and ability to deliver it. Accordingly, the generation of evidence about the ‘drivers’ of officers’ attitudes to inform strategies to promote the delivery of the approach is essential. Findings suggest that officers value community policing as an organisational strategy but that the approach maintains a low status and is undervalued compared with other specialisms within the organisation. This is born of an organisational culture that foregrounds law enforcement as the primary function of police work and an organisational climate that reinforces it. This has implications for community officers in terms of their perceptions of and attitudes towards the approach, self-esteem and sense of value and worth, perceptions of organisational justice, discretionary effort and role commitment. Recommendations for police managers are set out.

Police Support Volunteers (PSVs) - citizens who give their time freely to perform tasks that complement the duties of officers and staff – undertake a variety of roles across every police service in England and Wales. PSVs offer additional capacity to policing, as well as opportunities for enhanced service delivery. PSVs attach considerable meaning to their contribution, and this is found to be instrumental to motivation, satisfaction, and intention to continue. However, creating meaningful opportunities for PSVs is challenging: they are welcome donors of time and skills, but must remain non-essential. Drawing on a survey of 140 PSVs in a large urban constabulary in England, this article considers the contribution of PSVs, exploring findings through two typologies (motivation and role type), and highlighting the importance of feeling and being ‘useful’. The article calls for a more imaginative stance to involving PSVs at a time of shifting priorities and diminishing resources.

This series will focus on addressing the intersection of race and racism in palliative care through a series of roundtable discussions with interdisciplinary clinicians, researchers, educators, and leaders in palliative care. These short discussions are intended to stimulate readers to examine issues of race and racism within the field of hospice and palliative care - in the various forms that it appears - as well as serve as a continual call to action to facilitate and promote equity.

Older Latino and Black Americans experience health inequities and a lack of culturally competent clinician may influence this outcome. Community-Based Outreach (CBO) has proven to be effective in addressing such challenges. CBO is an effective approach to engaging communities that have been historically marginalized and are less likely to utilize hospice and palliative than other racial/ethnic groups. Yet, few models and modules for training are available in the literature to prepare CBO workers. This presentation describes the development, coordination, content and implementation of an Interprofessional Educational (IPE) training and curricular innovation to meet needs of diverse older adults diagnosed with a serious illness. Methods: A community-based outreach approach that integrated faith-based/spiritual care curriculum to train African American and Latino outreach workers to support older adults with serious illnesses, with a focus on advanced care planning (ACP) that explored potential barriers to equitable care. A collaboration with faith-based community representatives to design the intervention research protocol was essential. Results: The curriculum consisted of three parts: (1) a 36-hour classroom component delivered in three modules organized around eight themes: what is hospice and palliative care, spirituality and the meaning of death, understanding the dying process and decision making, goals of care, culturally responsive care; (2) weekly visits; and (3) field education/workforce development. At the end of the training, learners were able to: (a) express knowledge about culture differences; (b) demonstrate skills – listening, identifying meaning in the decision making, convey health information using patient-centered language; (c) understand cultural influencing decision making.

Background: Gerontology education has evolved from focusing primarily on the individual practitioner outcomes to promoting integrated, inter-professional team approaches to integrated care. Practicum training and service learning are effective pedagogy for paraprofessionals in integrated care settings to support clinicians and advance their effectiveness in meeting the needs of older adults. Interprofessional education (IPE) aims to enhance the capacity of practitioners to work collaboratively as integrated team members. Yet, little is known about the implementation of IPE in colleges and universities that are not affiliated with a medical center or medical school. This presentation will describe the implementation of IPE in a School of Social Work without a medical school system. We will explore students’ experiences with the implementation, facilitation, and evaluation of this workforce development model, and will discuss both challenges and successes. Methods: Narrative data collected over the past two-year period with social work student participants in IPE reflect their perspectives on the selection process for the specialized training, placement in an interprofessional integrated care setting, and the learning experience. Participants represented cohorts of more than 200 trainees. Results: Challenges of effective interprofessional health care teams include the approach taken to integrating the teams, level of knowledge and skills required to be an effective team member, and the need for supervision within integrated care experiences. Successes include increased professional self-efficacy. Participants reported post-completion of IPE, (1) desirable outcomes achieved for their patients, such as care satisfaction and role satisfaction for themselves as practitioners.

TPS4196 Background: Neoadjuvant treatment for potentially curable pancreatic cancer (PDAC) is increasing in acceptability, but a standard regimen has yet to be established. Multiple studies have demonstrated feasibility and effectiveness of the FOLFIRINOX (5-fluorouracil, leucovorin, oxaliplatin and irinotecan) regimen in the perioperative setting. However, FOLFIRINOX often requires dose modifications, delays and growth factor support due to excessive toxicity which can complicate care delivery when given pre-op. Liposomal irinotecan injection (Nal-IRI) is FDA approved in combination with 5-FU/LV with a well-tolerated safety profile in relapsed, refractory metastatic PDAC. The current study aims to substitute Nal-IRI for traditional irinotecan in the standard FOLFIRINOX regimen (NALIRIFOX) and to demonstrate safe and effective neoadjuvant delivery. Methods: This phase 2, open-label, multicenter single-arm study focuses on patients (pts) with operable PDAC without metastatic disease. Other key eligibility criteria include age ≥18 years, resectability confirmed by multiD GI tumor board (resectable vs. borderline), adequate cardiac, renal, hepatic function and ECOG performance status of 0 to 1. Pts receive NALIRIFOX regimen as per the table every 2 weeks for four months followed by disease reassessment. Pts who remain surgical candidates will undergo surgical resection within 4 to 8 weeks following last dose of therapy. The primary endpoint is to assess safety and feasibility of regimen in pre-op setting. Secondary endpoints include R0 resection rate, clinical, biochemical and radiological response rate and patient-reported quality of life during treatment as measured by the NCI validated FACT-G scale. Enrollment continues to a maximum of 28 evaluable pts to demonstrate a reduction in historical 30-day post-op complication rate. Clinical trial information: NCT03483038. [Table: see text]

Homelessness is an issue of social justice, in the United States, because it leaves people vulnerable, unsafe, and ill, while not having their basic needs for food and shelter met. Although the United States is the wealthiest country in the world, a significant number of its residence, whether citizens or not, have experienced homelessness in their lifetime. Less than 5 years ago, the U.S. Department of Housing and Urban Development (HUD) found that 564,708 people are homeless on any given night. There is a dearth of information available that puts older adults at the forefront or at the center of homelessness epidemic. Moreover, recent HUD reports claim that homelessness has decreased, in the United States, while the National Center on Family Homelessness reported that the number of residents experiencing homelessness is steadily climbing and is expected to hit an historic high, within the next 5 years. Yet, most of the attention given to homelessness as a public health issues, tends to focus on families and children. Few studies have targeted older adults and their primary risk factors experiencing homelessness. Important to note is the fact that consistent data and accurate reporting about homeless older adults are few and far between. This chapter (1) presents a practical definition of homelessness, (2) provides a social work framework for understanding and assessing risk among homeless populations, as well as, (3) emphasizes the importance of cultural competence in health practices for addressing homelessness among older adults as a public health concern.

The role of police officers can at times be turbulent and dangerous, and can impact upon their mental health and sense of well-being. Yet traditionally matters related to the well-being and mental health of police officers have not been high on the political agenda in England and Wales, a function, it seems, of an expectation that officers will be resilient to the stress that they face. However, this view has changed in recent years, and pressures are being exerted on police organisations to better support officers whose mental health and well-being may be negatively affected by their work. This chapter reviews evidence regarding the sources of stressors embedded within police work. We then consider extant evidence regarding the impact of those stressors on the psychological health, physical health and behaviour of officers. We also consider the impact that officers’ mental ill-health can have on their families and relationships. Lastly, we consider the nature of the responses of police organisations to the promotion of the well-being of their officers. Implications for practice and research are discussed in the conclusion.

Generally regarded as an institution which frustrates rather than enables the process of desisting from crime, the potential for prisoners to find redemption in prison seems bleak. Despite unpromising conditions within the prison, we find strong evidence of reform and a desire to make amends among a cohort of long-term prisoners. While these prisoners were all participating in a rehabilitation program, their narratives of reform were highly individualized and situated in the context of their various experiences of long sentences. However, we report that these individualized accounts of reform were strengthened and facilitated in similar ways through interactions established via their program participation. Specifically, the program was experienced as fulfilling, empowering, and therapeutic. This functioned to reinforce participants’ sense of control, or self-mastery, increased their self-esteem, and instilled hope and confidence that an alternative moral future may be achievable. Implications for supporting desistance in the prison are discussed.

The experiences of police officers who have retired from the police service have rarely comprised the focus of empirical studies in England and Wales. Drawing on the findings of a survey of former police officers, this article examines the circumstances within which officers leave the service and aspects of the transition to retirement. We find that that certain individual, role and organisational factors come together to explain how the transition to retirement is experienced by police officers. We conceptualise police retirement as a multi-dimensional process during which a number of factors may come into play and have different effects depending on the circumstances in which retirement occurs. Findings are considered in light of wider conceptualisations of the process of retirement and implications are discussed.

Established in England and Wales in the context of the neo-liberal governments of the 1980s and promoted through the New Local agenda of New Labour and beyond, Neighborhood Watch (NW) is a primary means through which the state and citizens may co-produce crime control. However, whether citizens have the time or inclination to co-produce is debated and it is generally believed that NW proliferates in advantaged, low crime rate areas that need it least. Drawing on analysis of the Crime Survey for England and Wales (CSEW) (1988-2010/2011) this article examines long-term trends in participation in NW. It examines the proliferation of NW, how household support for NW fluctuates once established, and the changing importance of some of the key household drivers of participation in NW. It then assesses the extent to which NW schemes are concentrated in more affluent areas, showing that this is moderated by crime risk.

Delivering correctional programmes in the prison environment has proved challenging, and desired outcomes have not always been achieved. Drawing on interview data, this article considers the mechanics through which programmes are introduced into English prisons and how the environment shapes what is accomplished. We argue that the operation of programmes is influenced by institutional features (such as values, priorities and resources), situational features (such as the challenges posed by operating in the secure environment) and interactional factors (such as the attitudes of prison staff and the nature of programme-prison staff relations).

This article reports the findings of a large scale survey (N=10,897) which sought to reveal patterns of injury on duty (IoD) and perceptions of organisational and other support amongst serving police personnel in England and Wales. We found that IoD is a multi-faceted issue incorporating wide-ranging physical and psychological injuries and illnesses. We also found that, by their own testimony, IoD is not experienced equally amongst police personnel. Reported experiences of IoD together with satisfaction with, and priorities for, support in the aftermath of injury were shaped by injury type, the role played in the police organisation and the individual characteristics of police personnel, notably, gender. Conceptual and practical implications are discussed.

Objective: The intent of this exploratory qualitative study was to examine African American Baptist clergy's pastoral care to older congregants with mental disorders. Critical Race Theory was the guiding framework in this study.Method: A purposive sample of 18 African American clergy participated in one-on-one interviews.Results: Collectively, all participants were active in the provision of mental health to older congregants with mental disorders. The primary emergent theme ‘shepherding the flock’ the central phenomenon uncovered in the data, was used to organize a model of pastoral care, which is presented in this paper. Findings from this study supported results from previous studies on the integral role of the Church and clergy in the African American community.Conclusion: Moreover, this study highlights the importance of internal ministries in the Church and the need for further study and potential partnership opportunity.

This article considers the character of engagement between UK police forces and Muslim communities and citizens. It examines, from the perspective of police personnel, a range of factors that prevent police organisations from ‘breaking out’ of constraints that currently hinder their engagement with Muslim communities, limit police officers from ‘breaking in’ to Muslim communities in ways that would improve engagement, and facilitate police officers in ‘breaking through’ barriers between them and Muslim communities. The aim of the article is to offer a critical insight into engagement between police officers and Muslim communities and citizens that may aid and enhance such engagement in the future. Enhancing positive engagement between the police service and Muslim citizens is vital in the context of contemporary concerns about Muslim communities being the focus of a multiplicity of counter-terrorism and counter-extremism strategies and, as a result, Muslims citizens retreating from participation in public life.

There has been optimism that social media will facilitate citizen participation and transform the communication strategies of public organisations. Drawing on a case study of the public police in England, this article considers whether social media are transforming or normalising communications. Arguing that social media have not yet served to facilitate interaction between constabularies and citizens in the ways that have been proposed and desired, the article considers factors that structure the transformative potential of social media. It is argued that the uses of social media are mediated by the existing organisational and occupational concerns of the police. This article reveals how an interplay of organisational, technological and individual and cultural dynamics come together to shape how social media are used in constabularies. Embedding social media into police communications is challenging and the technology itself will not bring about the organisational and cultural changes needed to transform police–citizen engagement.

Alley gates are designed to limit access to alleys and the crime opportunities they afford. Informed by the acronym EMMIE we sought to: (1) systematically review the evidence on whether alley gates are Effective at reducing crime, (2) identify the causal Mechanisms through which alley gates are expected to work and the conditions that Moderate effectiveness, and (3) collate information on the Implementation and Economic costs of alley gating. The results of our meta-analysis suggest that alley gating is associated with modest but significant reductions in burglary, with little evidence of spatial displacement. We also identified six mechanisms through which alley gates might plausibly reduce crime, and the conditions in which such mechanisms are most likely to be activated.