Home care aides (HCAs) provide housekeeping and personal care services to help older clients remain in the community. However, little is known about the health of HCAs, who themselves constitute an underserved population. The goal of this study was to investigate how HCAs’ work and life contexts manifest themselves in HCAs’ health as perceived by HCAs. Six focus groups were conducted with HCAs (N=45). Analysis revealed how HCAs’ work-and life-related stress accumulated over time and affected HCAs’ health and interaction with their older clients. Home care aides were interested in personal health promotion and client well-being. Home care aides may constitute an underused resource for the care of older adults with disabilities. Information about intricately intertwined work and life contexts should inform policymakers and home care providers in their efforts to improve the quality of publicly funded home care services.

While obesity impacts all ethnic groups in the United States, African Americans and Latinos are particularly at high risk for obesity. The purpose of this paper is to provide an analysis of the literature on evidence-based culturally competent strategies for addressing and preventing obesity and discuss roles for occupational therapists working with populations at risk for obesity in the school or therapeutic clinical environment. A review was conducted of over 80 research articles describing successful interventions conducted in schools and communities targeting African Americans and Latino children. Although unique single strategies are highlighted in this paper, obesity interventions are complex and involved a number of multilevel strategies. The results of the analysis of the literature are presented according to strategies that promote healthy eating, physical activity, and overall healthy lifestyles. Along with the cultural competent strategies, we recommend specific roles for occupational therapists in order to promote the implementation of each particular strategy. Lastly, implications for occupational therapy are discussed.

BACKGROUND: People with mental illness often experience major difficulties in finding and maintaining sustainable employment. African Americans with mental illness have additional challenges to secure a job, as reflected in their significantly lower employment rates compared to Whites. OBJECTIVE: To examine the factors that contribute to racial disparities in employment outcomes for African-American and White Vocational Rehabilitation (VR) consumers with mental illness. METHODS: This study used VR data from a Midwestern state that included 2,122 African American and 4,284 White participants who reported mental illness in their VR records. Logistic regression analyses were conducted. RESULTS: African Americans had significantly more closures after referral and were closed as non-rehabilitated more often than Whites. Logistic regressions indicated that African Americans are less likely to be employed compared to Whites. The regression also found differences by gender (females more likely to find jobs than males) and age (middle age consumers [36 to 50] were more likely to find jobs than younger consumers [18 to 35]). Case expenditures between $1,000 and $4,999 were significantly lower for African Americans. CONCLUSIONS: VR agencies need to remain vigilant of potential discrepancies in service delivery among consumers from various ethnic groups and work hard to assure as much equality as possible.

BACKGROUND: Community Rehabilitation Providers (CRPs) are not-for-profit organizations that provide employment services to individuals with disabilities as subcontracts to vocational rehabilitation (VR) offices. OBJECTIVE:The purpose of this study was to identify facilitators to successful employment among individuals with disabilities. METHODS: We analyzed 38 case files from individuals with disabilities served by CRPs that had been closed as being successfully employed. RESULTS: We found that clients who were placed in jobs lived with their families, had previous work experience, and had strong job interview skills. They also had detailed written goals and needs; VR counselors often served as advocates between CRPs and the client, and they understood the difficulties of the current job market. On the other hand, clients who had difficulties in securing and maintaining employment experienced health-related issues, lack of reliable transportation, and challenging family situations. CONCLUSIONS: Findings indicate that there is a greater need for certain services, such as career development, job coaching, and training. The implications for vocational rehabilitation research and practice are discussed.

One factor contributing to the childhood obesity epidemic is easy access to foods with high fat content available in public schools. After several years of advocacy efforts conducted by a city-wide coalition, the public schools system in an urban Midwestern city introduced fresh salad bars for lunch in three schools. Researchers have argued, however, that the introduction of salad bars in schools, without nutrition education, is not enough to produce changes in eating patterns. In this study, researchers used a target and control school to evaluate the impact of a 5-month nutrition education program. The results indicated that once the nutrition education program was implemented, the number of children consuming salad entrees and salad items doubled and quadrupled respectively, and knowledge about fruits and vegetables increased. Implications for community researchers interested in addressing childhood obesity are discussed.