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Introduction Home visitor well-being is integral to delivering effective home visiting services and a core component of successful home visiting program implementation. While burnout (BO), compassion fatigue (CF), and compassion satisfaction (CS) have been studied extensively in physicians, nurses, and other health providers, little is known about the correlates of these phenomena in home visitors. Methods This cross-sectional study examined demographic characteristics (age, race, gender), health and personal experiences (anxiety, physical health, and adverse childhood experiences), and job-related factors (caseload, role certainty, job satisfaction) as correlates of BO, CF and CS among a sample of 75 home visitors employed across six MIECHV-funded agencies in New York State. Descriptive statistics were used to characterize our sample; linear regressions were employed to investigate correlates with outcomes of interest. Results Anxiety was significantly and positively associated with BO ([beta] = 2.5, p < 0.01) and CF ([beta] = 3.08, p < 0.01). Overall job satisfaction was significantly and inversely associated with BO only ([beta] = -0.11, p < 0.001). Participants who identified as white were less likely to report higher levels of CS relative to non-white counterparts ([beta] = -4.65, p = 0.014). Examinations of specific aspects of job satisfaction revealed significant associations between satisfaction with workplace operating conditions, nature of the work, and contingent rewards and select outcomes of interest. Discussion Prioritizing preventive measures that target correlates of BO and CF, such as higher levels of anxiety and lower levels of job satisfaction - particularly operating conditions - may improve workforce well-being, continuity of service delivery, and ultimately quality of care provided to clients., Author(s): Abigail M. Ross [sup.1] , Rahbel Rahman [sup.1] , Debbie Huang [sup.2] , Gwyneth Kirkbride [sup.3] Author Affiliations: (1) https://ror.org/03qnxaf80, grid.256023.0, 0000 0000 8755 302X, Graduate School of Social [...]

Background: Suicide is the second leading cause of death among adolescents; age-adjusted suicide rate increased 30% from 2000-2016. Medical illnesses are a known risk factor for suicide, establishing medical settings as a key venue for detecting suicide risk. Nurses have the potential to play a critical role in early detection of medically ill patients at elevated risk for suicide. Conducted in tandem with a larger instrument validation study, this study examines nurses' awareness of pediatric medical inpatients' experiences with being asked about suicide, their opinions about whether nurses should screen for suicide risk in the medical inpatient setting, and perceived barriers to suicide risk screening. It also examines whether nurses accurately perceived whether their patients had been screened previously for suicide risk. Methods: Data was collected adjunctive to a larger instrument validation study of the Ask Suicide Questions (ASQ) a 4-item self-report measure developed to rapidly detect suicide risk with pediatric medical inpatients ages 10-21. Patients were asked if they had ever been screened for suicide risk previously and their opinions about whether nurses should screen. Upon completion of pediatric data collection, nurses employed on the medical inpatient units from which patients were recruited completed an exit survey about whether they believed nurses should screen for suicide risk, whether they believed their patients' had ever been previously asked about suicide, the degree to which they were comfortable screening for suicide risk, and potential real-world barriers to screening. Chi square analyses were used to compare patient and nurse opinions about suicide risk screening and to examine whether nurses accurately perceived that their patients had been previously screened. Pearson's correlations examined relationships among nurse opinions about whether they should screen for suicide risk and perceived barriers to doing so. Results: Two hundred pediatric patients at the study site participated in the instrument validation study; while 81.0% of patients reporting pro-screening opinions, only 38.0% of patients reported that they had been previously screened for suicide. Of the 68 who had been asked about suicide, only 5 (6.7%) indicated that they had been asked by a nurse. Of the 64 nurses who completed the exit survey, 84.4% (n=54) supported suicide risk screening by nurses; most (64.1%) believed their patients had been screened for suicide previously, but only 4.6% (n=3) believed that screening had been completed by a nurse. Chi squared analyses showed significant discordance between nurses' beliefs that their patients had been previously screened for suicide risk and their patients' self-reported experiences (p<.001; df=1, f=19.8). While half of nurses (n=32) reported that they were at least fairly comfortable engaging in suicide risk screening, all but one reported at least one barrier to engaging in the practice. The most frequently reported barriers to suicide screening included parental presence in the room (73.4%), fear of patient discomfort (56.3%), fear of parental discomfort (51.6%), and their own level of discomfort with screening (45.3%). Implications: Consistent with previous research exploring patient opinions on whether nurses should screen pediatric patients for suicide risk, the majority of patients and nurses supported suicide risk screening in medical inpatient settings. Very few patients and nurses reported nursing engagement in suicide risk screening practices. According to nurses, the most frequently reported barriers perceived to interfere with screening behaviors included parental presence in the room, fear of parental and patient discomfort, and personal discomfort. Brief in-service interventions for nursing staff that provide training in evidence-based suicide risk screening protocols must include strategies for facilitating meetings with patients alone, ways to manage provider discomfort, and effective interdisciplinary team communication accompanied with appropriate follow up processes ensuring linkage to care.

Child abuse and neglect (CAN) is a significant and growing public health problem, yet public health approaches to eliminating CAN have not been widely embraced in the United States or in social work education. Public health approaches require a large multidisciplinary infrastructure to scale evidence-based primary prevention strategies through multiple systems. The rapid growth in the workforce projected for the next decade, combined with the increasing ubiquity of social workers across family-serving systems, position social work to be a key mechanism to implement public health approaches to CAN prevention. This article presents a rationale for expanding CAN training in social work education. We then describe the Social Work in Health Impact Model (SWHIM), an orientation to social work practice that underscores the importance of prevention and population health, and subsequently apply the SWHIM to the problem of CAN. The SWHIM suggests that social work's multilevel capacities can be enhanced, not by abandoning clinical practice but by infusing wide-lens approaches, harnessing the power of prevention, linking practice across levels, and addressing the social determinants of health. The article concludes with recommendations for U.S.-based social work education and training in CAN prevention.

The objective of this study was to explore the lived experiences of food insecurity amongst Bronx residents. Applying a community-based participatory research approach, we conducted a qualitative study, entailing 38 interviews with food pantry recipients, 4 key informant interviews with social service administrators, and two focus groups with 12 food pantry staff and social service providers in New York City (NYC). Applying a precarity framework, we identified three themes: (1) unaffordability of living expenses in NYC; (2) financial hardships during the COVID-19 pandemic; and (3) institutional and technological barriers to food access. We identified the following subthemes under theme one: rising food costs and high cost of living. Under theme two, we identified four subthemes: (a) large household size driving poverty for Bronx families; (b) vulnerabilities to food insecurity among older adults; (c) budgeting for reduced incomes during the COVID-19 pandemic; and (d) managing unstable employment. Under the third theme, we identified three subthemes: (a) lack of access to healthy, culturally appropriate foods; (b) need for wider service availability; (c) and not having smartphones for telehealth. Study findings demonstrate how precarity impacts the lived experiences of food insecurity and financial hardship for residents of the South Bronx during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Noting the importance of food assistance programs to low income families in New York City (NYC), the research questions for the present study were: (1) What are the facilitators and barriers to social service utilization for food pantry clients in the South Bronx?, and (2) Does receiving food pantry services serve as a point of entry for social service utilization? We surveyed 218 food pantry clients at a community-based, social service organization based in the South Bronx. Our findings indicate that being aware of local social services was the strongest predictor for utilizing social services. Social service utilization was also predicted by high use of the food pantry (weekly or more); high levels of food insecurity, depressive symptoms; and the ability to communicate effectively in English. Given rising inflation costs and the continued higher expenses associated with food consumption in the United States generally and in NYC specifically, our findings suggest that food pantry sites in the South Bronx bear the potential to be vital entry points for social service referral and utilization, particularly for the screening and assessment of depressive symptoms. Given these findings, nonprofit leaders and social service funders should prioritize capacity building of food pantries as sites for the delivery of health promotion interventions and social services. [ABSTRACT FROM AUTHOR]

COVID-19 has continued to bring devastation to children and families, even 1 year into the pandemic. The rise of the Black Lives Matter movement has also led to renewed attention to systemic racism in the United States and awareness of how the pandemic has further exacerbated health inequities that disproportionately affect communities of color. Pediatric hospital social workers have played a key role since the beginning of the pandemic in responding to the resulting behavioral health crisis and helping to address social disparities. There is a need to understand how the roles and experiences of pediatric social workers have evolved during the first year of the pandemic. In this qualitative study, a series of practice-setting based focus groups were conducted with social workers to capture (a) what has changed or stayed the same since the beginning of COVID-19, (b) thoughts and experiences on diversity, equity, and inclusion with particular attention to race and racism, and (c) perspectives about the long-term implications of COVID-19 on the profession of social work. The Framework Method was used to analyze data, from which six superordinate themes emerged: burnout/coping; the impact of patient acuity; awareness of racial inequity in patient care; awareness of social determinants of health; social worker inclusion in hospital decision-making and policy reform; and grief/racial inequity. An overview of what has stayed the same, what has changed, and what the future may hold for pediatric hospital social workers is reviewed. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the impact of Break Free from Depression (BFFD), a school-based depression awareness curriculum, in comparison to a wait list control group. A total of 13 eighth grade classrooms participated in either an intervention or control group and completed pre-, post-, and three-month follow-up surveys. Students participating in BFFD (N = 6 classrooms, 166 students) demonstrated enhanced knowledge of and more adaptive attitudes towards depression compared to the control group (N = 7 classrooms, 155 students). Participants in the BFFD intervention also demonstrated increases in their confidence in knowing how to seek help for depression and in their intent to seek this help if needed. Slight decreases were found at a three-month follow-up in all scales except for intent to seek help. BFFD was effective regardless of gender, ethnicity, or identification as a member of the LGBTQ community. There was a delayed effect on measured constructs for Black students with gains apparent at three-month follow-up. The findings demonstrated that BFFD had a small but significant positive impact on students' knowledge, skills, and attitudes in seeking support for themselves and for others when faced with signs of depression. The implementation of depression awareness curricula in schools hold promise in promoting student mental health, and it is important to consider factors that might have an impact on outcomes. [ABSTRACT FROM AUTHOR]

This article describes 1 large urban pediatric hospital's partnership with a university to provide suicide assessment and management training within its social work department. Social work administrators conducted a department-wide needs assessment and implemented a 2-session suicide assessment training program and evaluation. Respondents (97.8%) indicated that the training was either helpful or very helpful in 8 suicide assessment skill-based domains. All attendees reported positive changes in perceived competence in 6 of 8 skill-based domains. A brief and time-efficient in-service training can be instrumental in augmenting hospital social worker competence in suicide risk assessment practice. This model of training program development, implementation, and evaluation is feasible, evidence-informed, and may be replicated.

Previous research indicates that one's identity relates to one's use of specific coping strategies. Exploring the relationship between self and coping in military wives is crucial to understanding how they manage military lifestyle-related stressors. The researchers hypothesized that identity status, self-concept clarity, self-monitoring, mastery, and role conflict will be related to choice of emotion-focused coping or problem-focused coping strategies. Two hundred two participants completed an anonymous online survey containing standardized scales. Ordinary least squares (OLS) regression analyses revealed that emotion-focused coping had positive relationships with achieved identity status and role conflict. Problem-focused coping had positive relationships with moratorium status, self-concept clarity, self-monitoring, and mastery. Findings provide preliminary support that sense of self is important in understanding how military wives choose to cope with particular challenges. [ABSTRACT FROM AUTHOR]

The cardiotoxicity risk of hydroxychloroquine (HCQ) and azithromycin (AZM) has been the subject of intensive research triggered by safety concerns in COVID-19 patients. HCQ and AZM have been associated with QT interval prolongation and drug-induced arrhythmias, however other cardiotoxicity mechanisms remain largely unexplored. Our group has pioneered the living heart slice preparation, an ex-vivo platform that maintains native cardiac tissue architecture and physiological electrical and contractile properties. Here, we evaluated the cardiotoxic effect of HCQ and AZM applied alone or in combination on cardiac contractility by measuring contractile force and contraction kinetics in heart slices prepared from porcine hearts.Our results show that clinically relevant concentrations of HCQ monotherapy (1-10 µM) reduced contractile force and contraction kinetics in porcine slices in a dose-dependent manner. However, AZM monotherapy decreased contractile force and contraction kinetics only at higher concentrations (30 µM).Combination ofHCQand AZM induced a dose-dependent effect similar to HCQ alone. Furthermore, pre-treating porcine heart sliceswith the L-type calcium channel agonist Bay K8644 prevented the effect of both drugs, while administration of Bay K8644 after drugs interventions largely reversed the effects, suggesting a mechanism involving inhibition of L-type calcium channels. These findings indicate that HCQ and AZM alter cardiac function beyond QT prolongation with significant contractile dysfunction in intact cardiac tissue. Our porcine heart slices provide a powerful platform to investigate mechanisms of drug cardiotoxicity. [ABSTRACT FROM AUTHOR]

Although burnout has been increasingly well studied among medical (nurses, physicians, residents) and mental health providers (psychologists, psychiatrists, social workers), there continues to be a lack of attention on the well‐being of community‐based providers, such as Community Health Workers (CHWs), within the United States. Using cross‐sectional data from 75 CHWs employed in 14 agencies funded through the Maternal and Infant Community Health Collaboratives Initiative (MICHC) in New York, our study examined predictors (anxiety, physical health, adverse childhood experiences, job satisfaction, role certainty, demographic and work characteristics) of burnout, compassion fatigue (CF) and compassion satisfaction (CS). Descriptive statistics were used to characterize our sample and linear regression was employed to investigate the correlates of burnout, CF and CS. Results indicated that CHWs with higher levels of anxiety and lower job satisfaction were more likely to have higher burnout scores. CHWs with higher levels of anxiety, lower job satisfaction and fewer days of poorer health were more likely to report higher CF. Those who worked more than 35 h per week were less likely to report higher CS. The study provides recommendations for organizational‐level interventions to address risk factors of burnout and CF and promote CS among CHWs, such as bolstering supervision, encouraging greater communication, offering recognition/appreciation of CHWs and creating opportunities for self‐care. Findings should be considered when designing organizational‐level preventive measures that mitigate burnout and CF and promote CS. [ABSTRACT FROM AUTHOR]

Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child's birth on their risk for maltreatment in the first two years of life. Data from the Millennium Cohort Study, Department of Defense (DoD) operational records and Family Advocacy Program data on met-criteria maltreatment, and Birth and Infant Health Research program data on suspected maltreatment were linked for 9076 service member parents. Discrete time survival analysis showed that preterm birth increased risk of maltreatment while parents' older age, physical health, and service in the Navy or Air Force decreased risk. Building on DoD's New Parent Support Program, findings suggest the need for universal and targeted prevention efforts, beginning during pregnancy, which limit or eliminate risk factors for maltreatment in military families. [ABSTRACT FROM AUTHOR]

The prevailing model of care for psychiatric patients in the emergency room (ER) is evaluation and disposition, with little or no treatment provided. This article describes the results of a pilot study of a family-based crisis intervention (FBCI) for suicidal adolescents and their families in a large, urban pediatric ER. FBCI is an intervention designed to sufficiently stabilize patients within a single ER visit so that they can return home safely with their families. Of the 100 suicidal adolescents and their families in the sample, 67 met eligibility criteria for FBCI. Demographic and clinical characteristics and disposition outcomes from the sample were compared with those obtained retrospectively from a matched comparison group (N = 150). Statistical analyses compared group inpatient admission rates and disposition outcomes. Patients in the pilot cohort were significantly less likely to be hospitalized than were those in the comparison group (36 percent versus 55 percent). Only two of the patients in the FBCI cohort were hospitalized immediately after receiving the intervention during their ER visit. FBCI with suicidal adolescents and their families during a single ER visit is feasible and safely limits the need for inpatient psychiatric hospitalization, thereby avoiding disruption of family, academic, and social activities and increasing use of less intrusive and more cost-effective psychiatric treatment.

The long wars in Afghanistan and Iraq have presented unique challenges to military-connected families with very young children, yet few evidence-based services are available to support these families through deployment and reintegration. Although many military families have shown remarkable resilience throughout the intense demands of the wars, very young children (from birth through 5 years old) and service member parents' relationships with these children are particularly vulnerable in the face of deployment. Interventions targeted to the post-deployment period can assist families in managing the challenges of reintegration for parents and young children. The authors describe the process of developing and testing a culturally responsive home-based reintegration program for service members, their partners, and their very young children. Composite case examples are presented to illustrate the major concerns of military families and to highlight program elements aimed at enhancing parental reflective functioning and strengthening parent-child relationships.

This study reports on the development and initial psychometric properties of the Children's Saving Inventory (CSI), a parent-rated measure designed to assess child hoarding behaviors. Subjects included 123 children and adolescents diagnosed with primary Obsessive-Compulsive Disorder (OCD) and their parents. Trained clinicians administered the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), items assessing Family Accommodation and the Clinical Global Impressions-Severity index. Parents completed the CSI, Child Obsessive-Compulsive Impact Scale (COIS)-Parent Version and Child Behavior Checklist. Youth completed the COIS-Child Version, Obsessive-Compulsive Inventory Child Version (OCI-CV), Multidimensional Anxiety Scale for Children, and Children's Depression Inventory-Short Form. A four factor solution was identified; factors were named Discarding, Clutter, Acquisition, and Distress/Impairment. Internal consistency for the CSI Total and factor scores were good. One-week test-retest reliability (n = 31) from a random subsample was excellent. Known groups validity was supported vis-a-vis higher CSI scores for those endorsing hoarding on the CY-BOCS Symptom Checklist. Convergent and discriminant validity was evidenced by weak relationships with OCI-CV Checking and Contamination factors but strong relationships with the OCI-CV Hoarding factor and with hoarding obsession/compulsions on the CY-BOCS. These findings provide initial support for the reliability and validity of the CSI for the assessment of hoarding behaviors among youth with OCD. Future studies are needed to extend these findings to non-OCD samples of youth.