Multiple service use: the impact of consistency in service quality for vulnerable youth

Prevalence of neurodevelopmental disorders and their impact on the health and social well-being among looked after children (LAC): a systematic review protocol

BACKGROUND

Looked after children (LAC) that are placed in either a foster, kinship, residential care setting or transition to adoption continue to develop debilitating disorders that significantly impact their overall health and social well-being. The prevalence of these disorders is often depicted under broad categories such as mental, behavioural or neurodevelopmental disorders (NDDs). Limited in research is the prevalence of what specific disorders fall under these broad categories. NDDs such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) which fall under an umbrella group in the expert field of genetics and neuropsychiatry will be explored. Unsupported, these disorders can lead to suboptimal health and social outcomes for both the child and family. In the general population, the prevalence of these NDDs and impacts on health and social well-being are relatively well documented, but for minority groups such as LAC, research is extremely limited. This review aims to estimate the prevalence of NDDs among LAC and explore how they might impact the health and social well-being of these vulnerable children. If feasible, the review will compare the prevalence rates to those children who are not looked after, to illuminate any differences or similarities between populations.

METHODS

PubMed, ASSIA, IBSS, Web of Science, PsychINFO, Scopus, Psych articles, Social Care Online, secondary, grey literature and government publications will be searched to identify any eligible studies. No restrictions will be placed on country, design or year of publication. Studies must provide primary data on the prevalence or incidence of NDDs for individuals < 25 years of age, supported by either a diagnostic code, standardised diagnostic assessment tool or survey response. The Joanna Briggs Institute (JBI) critical appraisal tools will be utilised to assess the quality and bias and the random-effects model used to estimate a pooled prevalence of NDDs.

DISCUSSION

Attaining an estimated prevalence of these NDDs and identifying any impacts on health and social well-being might inform key stakeholders in health, educational and social sectors with important information that might aid in the early identification and intervention to safeguard and meet the unique needs of these children.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD4201913103 .

Customer relationship management and patient satisfaction and loyalty in selected hospitals in Ghana

Purpose

This paper aims to examine the effect of customer relationship management (CRM) on patient satisfaction and patient loyalty, controlling for other socio-demographic characteristics.

Design/methodology/approach

The study used a two-stage sampling process and structured questionnaires to collect data from 788 patients from three health facilities (public, quasi-public and private) in Greater Accra, Ghana. The data collected was analyzed using descriptive statistics and regression via the partial least squares-based structural equation model.

Findings

The results suggest that CRM is significantly positively correlated with patient satisfaction and patient loyalty, with patient satisfaction also significantly correlated with patient loyalty. Additionally, the results suggest that the introduction of education, health facility ownership, health insurance status and gender, neither impact significantly on the relationship between CRM and patient satisfaction/patient loyalty nor influenced patient satisfaction and patient loyalty directly.

Research limitations/implications

The findings of the current paper can have substantial practice implications for operators in the health-care industry in Ghana. CRM components such as service quality, customer service, communication and the use of appropriate technology to deliver service will be fundamental if organizations operating in the health-care ecosystem in Ghana are to be able to compete effectively.

Originality/value

This is one of the very few papers on the relationship between CRM and patient satisfaction and patient loyalty in African health-care literature. Thus, the findings of the paper can constitute a great resource not only to academics but also to practitioners who are looking to be competitive in the health-care market.

Reconsidering interactive resilience processes in mental health: Implications for child and youth services

Research consistently demonstrates resilience as an interactive process, drawing on personal assets together with relational and contextual resources, to support improved outcomes in contexts of nonnormative adversity. What remains unclear are the dynamics of this process and what drives it. This article draws on a prior scoping review of the literature to conceptually explore the positioning of the individual within this dynamic interplay of risks, resilience, and sociocultural context as it pertains to child and youth mental health. The paper begins by summarizing findings from this scoping review, highlighting core resilience elements and processes. These are then considered in relational to the global meaning theory, situating meaning-making as a key mechanism that mediates the interaction between individuals and their ecologies. Drawing on the literature, this article considers how this interaction shapes the particular ways in which resilience then manifests itself in the lives of individuals and becomes available as a resource to assist in the promotion of mental health.

Teachers' Sense of Meaning Associations With Teacher Performance and Graduates' Resilience: A Study of Schools Serving Students of Low Socio-Economic Status

Adolescents from lower socio-economic status (SES) often experience distress in their personal life as well as at school. Moreover, their ability to overcome such difficulties and pave their path to a higher SES depends, to a certain extent, on their ability to develop resilience despite their disadvantaged background. Acknowledging the critical contribution of teachers to students’ development, in the present study, we focused on teachers as agents who may influence graduates’ resilience, and on their sense of meaning at work–a resource these teachers may draw upon to increase their performance and contribute to their disadvantaged students and to their relationships with them. Specifically, we postulated that teachers’ sense of meaning at work will be associated with teachers’ performance and that teachers’ relationships with their students would mediate this association, as they serve as the main vehicle through which teachers impact their students. We further suggested that teachers’ sense of meaning would have long-term effects on students’ coping abilities, reflected in school graduates’ resilience levels. The study comprised 857 participants, teachers and graduates, from 30 Arab vocational schools in Israel, comprising mainly low SES students. Teachers (N = 436) completed self-report measures of their sense of meaning at work, relationships with students, and performance. Furthermore, to reveal potential long-term effects of teachers’ sense of meaning at work, school graduates (N = 421) completed measures of their relationships with teachers and resilience. Analyses indicated a significant association of teachers’ sense of meaning with their performance, which was mediated by teachers’ reports of their relationships with students. Furthermore, teachers’ sense of meaning at work and graduates’ perceptions of their relationships with the teachers were both significantly associated with graduates’ resilience. The findings highlight teachers’ sense of meaning at work as a potential contributor to their performance, which may also contribute to students’ resilience in lower SES schools. They point to teachers’ sense of meaning as a potential resource for teachers of lower SES students and highlight the importance of nurturing and developing it in various programs and practices (e.g., teacher training, teacher development, organizational routines).

Positive youth development practices and better outcomes for high risk youth

This paper reports on the findings from a New Zealand longitudinal study of outcomes for a group of high risk, service-using youth (13-21 years, n=495). Consistent use of positive youth development practices (PYD) (rather than the total number of services used) predicted better outcomes. Patterns of risk and resilience endured over time. Individual risks undermined outcomes while resilience had a significant positive impact on outcomes. Contextual risks predicted increases in individual risks, but service delivery that adopted PYD practices contributed to reductions in levels of contextual risks over time. Youth with higher individual and contextual risks were less likely to report PYD service experiences. Individual risks were highest for indigenous youth (Māori) at entry to the study, levels which dropped significantly over time. White (Pākehā) youth had the lowest resilience and highest contextual risks over the course of the study. These differential patterns in risks and resilience indicate a need for services to adapt their responses to youth based on ethnicity and overall study findings confirm that when used consistently across service systems PYD-oriented service delivery produces better outcomes for high risk youth.

Toward a Culturally and Contextually Sensitive Understanding of Resilience

Extant theories of resilience, or the process of adjusting well to adversity, privilege the voices of minority-world young people. Consequently, the resilience of marginalized, majority-world youth is imperfectly understood, and majority-world social ecologies struggle to facilitate resilience in ways that respect the insights of majority-world youth and their cultural and contextual positioning. Accordingly, this article makes audible, as it were, the voices of 181 rural, Black, South African adolescents with the purpose of explicating which resilience-supporting processes characterize their positive adjustment to disadvantaged life-worlds, and how contextual and cultural realities shape such processes. Deductive and inductive analyses of a narrative and visual data set, generated in the qualitative phase of an explanatory mixed-methods study, revealed that universally occurring resilience-supporting mechanisms inform positive adjustment. Importantly, which mechanisms these youth prioritized, and the form these mechanisms take, are shaped by contextual realities of absent men and commonplace suffering, and a cultural reality of strong women, human and spiritual care, and valorization of education. Attention to these adolescents’ voices not only prompts specific, culturally and contextually relevant leverage points for resilience but also reinforces the importance of attending to young people’s preferred pathways of resilience in order to understand and champion resilience in socially just ways.

Social ecological complexity and resilience processes

A social ecological model of resilience avoids the reductionism of simple explanations of the complex and multisystemic processes associated with well-being in contexts of adversity. There is evidence that when stressors are abnormally high, environmental factors account for more of an individual's resilience than do individual traits or cognitions. In this commentary, a social ecological model of resilience is discussed.