Child welfare systems have struggled to create innovative, culturally sensitive programmes to address the multiple and pervasive barriers that exist in engaging child welfare parent clients in their service plans. Peer mentor programmes—those in which parents who have successfully navigated the child welfare system and reunified with their children, mentor parents newly entering the system—are designed to address some of these barriers, to improve reunification outcomes. Focus groups with parent clients (n = 25) and interviews with peer mentors (n = 6) were conducted to identify the characteristics of peer mentoring programmes that are critically helpful to parent clients, as well as the mechanisms that allow peer mentors to be effective in their work. The qualitative analysis uncovered three general themes to which both parents and peer mentors frequently referred in interviews—the value of shared experiences, communication and support. Additionally, the study found that peer mentorship has positive effects not only on parent clients but also on the mentors themselves. The inclusion of peer mentors in child welfare practice suggests an important paradigm shift within child welfare that could lead to culture change for the field.
Better understanding of the cognitive framework for decision making among legislators is important for advocacy of health-promoting legislation. In 1994, the authors surveyed state legislators from North Carolina, Texas, and Vermont concerning their beliefs and intentions related to voting for a hypothetical measure to enforce legislation preventing the sale of tobacco to minors, using scales based on the theory of planned behavior. Attitude (importance), subjective norm (whether most people important to you would say you should or should not vote for the law), perceived behavioral control (ability to cast one's vote for the law), and home state were independently and significantly related to intention to vote for the law's enforcement. The results, including descriptive data concerning individual beliefs, suggest specific public health strategies to increase legislative support for passing legislation to restrict youth tobacco sales and, more generally, a framework for studying policy making and advocacy.
This article reports parents' perspectives on access to mental health services for their children enrolled in a state children's health insurance program (CHIP). Little has been published about mental health services utilization in states' CHIP programs. Focus groups with parents yielded many contextual factors, confirming previous reports about the importance of the primary care interface and cultural competence. In addition, the findings pointed to the importance of taking seriously parents' perception of severity of the child's problem, reducing administrative barriers to accessing treatment, promoting education about mental health to the community, and eliciting regular input from parents about system performance.
The rubric autoimmunity currently encompasses sixty to seventy diverse illnesses which affect many of the tissues of the human body. Western medical practice asserts that the crisis known as autoimmune disease arises when a biological organism compromises its own integrity by misrecognising parts of itself as other than itself and then seeks to eliminate these unrecognised and hence antagonistic aspects of itself. That is, autoimmune illnesses seem to manifest the contradictory and sometimes deadly proposition that the “identity”: body/self both is and is not “itself”. Based on the assumption that under normal circumstances “the self” ought to coincide naturally with “the body”—or at the very least the self ought to inhabit the living location of the body more or less unproblematically—this scientific paradigm depicts autoimmune illness as a vital paradox. Yet for those of us who have lived through the experience of an autoimmune crisis, the living paradox that we embody may also lead us to question the basis upon which these medical assumptions rest. This essay raises some of these questions.
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