Improving Outcomes for Families of Children With Medical Needs Known to Child Welfare: A Nurse Care Coordination Program.

Children known to child welfare are more likely to have poor health compared to the general population. Most children served by child welfare are served in their own homes. New Jersey implemented the Child and Family Nurse Program (CFNP) to provide nurse care coordination to address the health needs of children who remain in-home. Our study described: 1) families served by CFNP; 2) services provided to these families; and 3) family well-being outcomes. The study focused on the 304 families served by CFNP from 2016 to 2017. We used CFNP data to describe families served and services provided, and family baseline and follow-up surveys to assess change in family well-being over time. Families served by CFNP experienced improvements in family protective factors and health-related quality of life from baseline to follow-up. While more rigorous studies are needed to learn CFNP's impact, it is a promising approach that merits consideration by state child welfare leaders.

Using the associative imagery technique in qualitative health research: the experiences of homecare workers and consumers.

The associative imagery technique is a qualitative tool with which researchers use carefully selected photographs or images to trigger participants' responses to explain difficult behavioral and social concepts. In this article, we describe the development and implementation of the associative imagery method in focus groups to understand the complex relationships between homecare workers and their clients as part of a larger health and safety intervention project conducted by the National Institute for Occupational Safety and Health. A total of 116 homecare workers and clients were recruited for the study. We found that participants used images mainly in two ways. First, the images served to remind participants of specific persons, events, and/or objects. Second, the images facilitated recollections and reflections that allowed participants to metaphorically describe their experiences, feelings, and emotions. Both usages of imagery generated comments that answered the research question in a more relevant, descriptive, and vivid way.

The role for community-based participatory research in formulating policy initiatives: promoting safety and health for in-home care workers and their consumers.

Although community-based participatory research (CBPR) can be effective in influencing policy, the process of formulating policy initiatives through CBPR is understudied. We describe a case study to illustrate how alliances among various community partners could be united to formulate policy directions. In collaboration with partners, the National Institute for Occupational Safety and Health initiated a project aimed at improving health and safety for low-income elderly and disabled persons and their in-home care workers. Community partners and stakeholders participated in focus groups, stakeholder interviews, and meetings; they played multiple roles including identifying organizational policy changes the partners could initiate immediately, as well as broader public policy goals. Results indicated that a strong community partnership, participation, and shared values contributed to successful formulation of policy initiatives.

Formative research in occupational health and safety intervention for diverse, underserved worker populations: a homecare worker intervention project.

OBJECTIVE: The increasing numbers of minority, low-income, and contingent workers in the U.S. labor force present new challenges to occupational safety and health interventions. Formative research can be used to help researchers better understand target populations and identify unanticipated barriers to safety changes. The National Institute for Occupational Safety and Health initiated an intervention project to improve health and safety among homecare workers in Alameda County, California. Investigators conducted systematic formative research to gather information to guide intervention development. METHODS: Various qualitative methods were used including 11 focus groups (conducted in English, Spanish, and Chinese) and 10 key informant interviews. This article focuses on two picture-based focus group activities that explored workers' views on their relationships with consumers and their perceived barriers to interventions. RESULTS: Findings indicated cultural differences regarding workers' perceptions of their relationships with consumers. Chinese homecare workers mostly focused on respecting elders rather than initiating changes. Some English- and Spanish-speaking workers described efforts to negotiate with consumers. Results also identified workers' perceived barriers to interventions, such as consumers' resistance to changes and lack of resources. These findings played important roles in shaping the intervention materials. For example, given the lack of resources among consumers, the project tried to tap into community-level resources by collaborating with local stakeholders and developing community resource guides. CONCLUSION: Formative research can be a valuable step to inform the development of occupational health and safety interventions for diverse, underserved worker populations.