Defining severe and multiple disadvantage from the inside: Perspectives of young people and of their support workers

Sandu, Rebeca D.

doi:10.1002/jcop.22572

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…1 They experience disproportionately high levels of poor physical and mental health along with high levels of occupational deprivation, 1 which results in isolation and difficulty in accessing healthcare services. 2 There is also an added burden of stigma that affects their access and engagement. 3 Among people experiencing SMD, oral health problems have been highlighted as one of the major unmet needs.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review

John,

Adams,

McGowan

et al. 2024

BMJ Open

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ObjectivesAmong people experiencing severe and multiple disadvantage (SMD), poor oral health is common and linked to smoking, substance use and high sugar intake. Studies have explored interventions addressing oral health and related behaviours; however, factors related to the implementation of these interventions remain unclear. This mixed-methods systematic review aimed to synthesise evidence on the implementation and sustainability of interventions to improve oral health and related health behaviours among adults experiencing SMD.MethodsBibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, EBSCO, Scopus) and grey literature were searched from inception to February 2023. Studies meeting the inclusion criteria were screened and extracted independently by two researchers. Quality appraisal was undertaken, and results were synthesised using narrative and thematic analyses.ResultsSeventeen papers were included (published between 1995 and 2022). Studies were mostly of moderate quality and included views from SMD groups and service providers. From the qualitative synthesis, most findings were related to aspects such as trust, resources and motivation levels of SMD groups and service providers. None of the studies reported on diet and none included repeated offending (one of the aspects of SMD). From the quantitative synthesis, no difference was observed in programme attendance between the interventions and usual care, although there was some indication of sustained improvements in participation in the intervention group.ConclusionThis review provides some evidence that trust, adequate resources and motivation levels are potentially important in implementing interventions to improve oral health and substance use among SMD groups. Further research is needed from high quality studies and focusing on diet in this population.PROSPERO registration numberCRD42020202416.

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Section: Introductionmentioning

confidence: 99%

Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review

John,

Adams,

McGowan

et al. 2024

BMJ Open

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“…When referring to MD, FLIC is referring to clients that experience numerous layers of social exclusion and multiple intersecting needs including, not limited to; homelessness, substance use, contact with the criminal justice system and mental health issues (Sandu, 2021). As a result, clients can have several services involved in their care, which can feel confusing and challenging to navigate (Luchenski et al , 2018).…”

Section: The Need For a Team Around Me Approachmentioning

confidence: 99%

Team Around Me: a case coordination model for clients experiencing multiple disadvantage

Stock¹,

Campbell²,

Harries³

2022

HCS

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Purpose This study aims to present a case study about the Team Around Me (TAM) model of case coordination which was developed by Fulfilling Lives Islington and Camden (FLIC) as an action experiment. The model is a standardised tool for running case conferences for clients experiencing multiple disadvantage (MD). Design/methodology/approach Deploying a case study approach, this study explores why a TAM-coordinated approach is beneficial for people experiencing MD. Findings The authors explore why the need for effective case coordination is integral for clients experiencing MD, and how current structures fail to facilitate effective case management. The authors put forward an argument for the four core principles underpinning the TAM model: strengths-based, action-focussed, systems thinking and client involvement. The barriers to embedding and upscaling this approach are discussed, alongside the obstacles presented by the wider system that prevent wider implementation. Originality/value The TAM model is a new approach to case conferences, designed and upscaled by FLIC, and has since been adopted across two London boroughs, and training has reached services across the UK. This paper highlights the need for innovative approaches to case coordination that centre client involvement, promote a strengths-based approach and recognise system blockages as a key barrier to client progress.

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“…Indeed, 40% of people entering AOD treatment are aged under 30 (Australian Institute for Health and Welfare, 2020). Young people reporting problematic AOD use are likely to experience multiple disadvantage, including poverty, homelessness, educational disengagement, family breakdown and mental illness (Almqvist & Lassinantti, 2018; Moustafa et al., 2021; Sandu, 2021). It can be difficult to address AOD use while young people still face myriad social issues in their day‐to‐day lives, meaning young people often need ongoing and holistic care (MacLean et al., 2022).…”

Section: Introductionmentioning

confidence: 99%

‘I just wanted a change, a positive change’: Locating hope for young people engaged with residential alcohol and drug services in Victoria, Australia

Caluzzi

MacLean

Gray

et al. 2023

Sociology Health & Illness

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In this article, we investigate young people’s involvement with residential alcohol and other drug (AOD) services as part of their broader engagement with hope. This study draws on qualitative interviews conducted with 20 young people aged 17–23 from Victoria, Australia, who were either in, or had recently left, residential AOD services. Interviews explored their experiences with AOD services and included questions about their hopes for the future. We found hope located in social relationships, productive discourses and AOD settings themselves. Hope also presented differently according to the external resources young people had available to them, giving some young people greater capacity to action their hoped‐for futures than others. Given many young people seek reimagined futures as part of their use of residential AOD services, this creates a valuable opportunity for services to help shape achievable hopes and boost service engagement. We suggest that hope can materialise in a variety of ways but caution against relying on it as a motivational strategy without providing young people with other resources. A more sustainable narrative of hope may require a solid foundation of resources, allowing young people with AOD problems to gain a sense of control over their lives and their imagined futures.

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Defining severe and multiple disadvantage from the inside: Perspectives of young people and of their support workers

Cited by 7 publications

References 29 publications

Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review

Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review

Team Around Me: a case coordination model for clients experiencing multiple disadvantage

‘I just wanted a change, a positive change’: Locating hope for young people engaged with residential alcohol and drug services in Victoria, Australia

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