Coordinating nonprofit children's behavioral health services: clique composition and relationships.

BACKGROUND: Why organizational cliques are associated with better performance in service delivery networks has yet to be explained. Certain properties of cliques may account for improved performance including the composition of clique members and the quality of their relationships. PURPOSE: The aim of this study is to offer insight into how organizations working through cliques improve network performance by exploring the complementarity of services provided by clique members and testing two hypotheses about trust and perceived benefits among clique members. METHODOLOGY: Survey and archival data were collected from a regional network of 36 nonprofit children's mental health agencies that belong to a coalition. First, clique analyses and network visualization were used to identify cohesive subgroups. Second, the complementarity of services provided by the groups was explored by calculating scores for each group to reflect the level of differentiation in services and client population as reported in archival data. Third, ANOVA density models were used to test whether clique relationships are characterized by higher perceived trust and benefits compared with nonclique member relationships. FINDINGS: Three groups were identified. These groups provide complementary services to similar client populations. Trust within all three cliques was higher than nonclique member relationships. Members of all three cliques perceived greater efficiency, and two of the three cliques also perceived greater access to care and service quality. PRACTICE IMPLICATIONS: Results support selecting clique partners based on service mix. To gain organizational benefits and improve network performance, partners should offer distinct services relative to one another but to similar clients.

A test of stress theory: relief workers in refugee camps.

The purpose of this paper is to apply a stress model drawn from the literature to the relief and social service workers who have been active in refugee camps for a prolonged period of time. Working in difficult environments, social service workers deliver essential services to refugee populations around the world. A model of four work-stress determinants--tasks, management, appreciation and collaboration--was tested on 274 social workers in five regions of the Middle East (Jordan, Lebanon and Syria, as well as the occupied Palestinian territories of the Gaza Strip and the West Bank). Statistical fit indices were adequate but two relationships were statistically insignificant. The collaboration variable was dropped to create a modified model with tasks indirectly and management and appreciation directly affecting work-related stress. The five direct relationships and two indirect relationships of this modified model are consistent with stress theory, and all relationships--direct and indirect--are statistically significant.

Availability of outpatient substance use disorder treatment programs in the United States.

The purpose of this study was to examine the availability of outpatient substance use disorder (SUD) treatment programs in the United States. A geographic information system (GIS) was used to spatially locate outpatient SUD treatment programs, calculate areas, and determine population density within specific areas. Urban areas were mapped using data from the US Census (2000). Addresses of outpatient SUD treatment programs were obtained from the Facility Locator Web site of the Substance Abuse and Mental Health Services Administration. A 15-mile service catchment around each outpatient SUD treatment program was drawn. The amount of urban area not covered by the service catchment represents the underserved. Total underserved urban area and population without access was computed for each state. Significant variability of underserved urban area and population was observed across the states. Moderate correlations among area and population suggest that some states are more effective in locating SUD treatment programs than other states.

Implementation of evidence-based practice and organizational performance.

Administrators of mental health services may expect evidence-based practice (EBP) to offer strategic benefits. Existing theory suggests that the benefits of implementing EBP vary by organizational characteristics. This paper presents a conceptual framework for considering how implementation impacts organizational performance. The framework is developed as a system dynamics simulation model based on existing literature, organizational theory, and key informant interviews with mental health services administrators and clinical directors. Results from the simulations show how gains in performance depended on organizations' initial inertia and initial efficiency and that only the most efficient organizations may see benefits in organizational performance from implementing EBP. Implications for administrators, policy makers, and services researchers are discussed.

A Systematic Review of Structural Equation Modelling in Social Work Research.

Structural equation modelling (SEM) is serving an increasingly important role in developing knowledge for the social work profession. Numerous advances have made the software more user-friendly, enabling users to conduct analyses without fully understanding the underlying assumptions or the implications from their analytic decisions. Unlike other fields, there have not been any published reviews in social work research that systematically describe and critique the use of SEM. This study systematically reviewed how SEM is used in social work research and the extent to which it reflects best practices. Thirty-two articles from top-ranked social work journals published from 2001 to 2007 were examined. Of the different types of SEM, the most commonly used was confirmatory factor analysis. Strengths of the research reviewed included examining models and measures not previously tested empirically and generating new insights into old topics through the use of SEM. Weaknesses included significant model modifications without theoretical justification or substantive interpretations. Suggestions are offered for improving applications of SEM in social work research. Specifically, we encourage social work researchers to test competing models, to make model modifications only when theoretically justified, to detail the process of making modifications and to use estimation procedures appropriate to the data.

Modeling the mental health effects of victimization among homeless persons.

Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

Conceptualizing and measuring disaster preparedness

Disaster preparedness has been identified with planning, resource identification, warning systems, training and simulations, and other predisaster actions intended to improve the safety and effectiveness of community response to disaster. Despite its acknowledged importance, little attention has been given to clarifying the conceptualization and strenghthening the measurement of preparedness. This paper presents and empirically based summative measure of preparedness, documents its reliability, and offers evidence of construct validity