Advancing Social Work Education for Health Impact

Critical Perspectives: Medical Social Workers' Early Insights on Health-Related Social Needs Screening and Follow-up

GOAL

As the impact of social determinants of health on patients' health status has received greater focus, and in light of national changes in requirements for hospitals to assess and address health-related social needs (HRSN), healthcare organizations are designing and implementing formal screening and follow-up processes for HRSN. While healthcare organizations are gaining more experience with both HRSN screening and subsequent resource provisions, engaging staff who implement screening and follow-up is key to the development of sustainable and informed processes. This study sought to understand the perspectives of medical social work regarding HRSN screening and follow-up in order to help shape the design and implementation of new screening and follow-up processes. Medical social workers (MedSWs) were identified because of their position as the staff members most likely to address, identify, and follow up on HRSN. Therefore, they have useful insights into the context in which these activities take place.

METHODS

Interviews were conducted at an urban pediatric hospital in the Midwest. Eighteen MedSWs from various inpatient, outpatient, and mixed-setting departments were interviewed. All of this institution's medical social workers were invited to participate in the interviews, which were held individually or in groups based on participant preference. A semi-structured interview guide was developed, which addressed social worker background, clinic flow, current process for social needs screening and follow-up (formal or informal), and potential barriers to and facilitators of screening implementation. Interviews were recorded with participant consent and transcribed verbatim. The research team utilized a consensus coding approach to identify common themes and interpret results.

PRINCIPAL FINDINGS

Four main themes were identified from these interviews. The first described the benefits of a standardized screening process in reducing bias and more accurately identifying needs. A second theme focused on the importance of coordination and collaboration among other members of the hospital system in addressing these needs. The third theme reflected concerns raised by participants regarding their capacity for immediate follow-up with patient families. Finally, perspectives on follow-up were shared about the tailoring of resources to specific patient needs, the capacity for addressing identified needs in a timely manner, and the trusted resources that MedSWs rely on when addressing needs.

PRACTICAL APPLICATIONS

Since these interviews were conducted, their findings have been used to contribute to the process of expanding social needs screening in this hospital. Recent changes, including the option for patients to select the method of follow-up used after a positive screening, were driven by the findings of this study. Future research may expand to other members of the screening and follow-up processes to gain additional insight and revisit the perspectives of the MedSWs after these changes were made and since the rollout of HRSN screening across the institution has further progressed.

A Cross-National Comparison on Life Expectancy of Non-Hispanic White Americans

Objectives: Taking the life expectancy (LE) of Non-Hispanic White (NHW) Americans as an example to provide potential references for improving LE globally. Methods: We collected complete data from the United States (US) CDC, Office for National Statistics in the United Kingdom (UK), and the OECD publications, and described LE changes of NHW Americans by cross-national comparison and Arriaga's method. Results: LE of NHW Americans was not as optimistic as European countries from 2006 to 2018. The LE annual average growth rate was 0.04% for NHW Americans, 0.19% for the UK population, and the median of 25 countries was 0.24%. Compared with the other age groups, the age group 30-34 revealed an inferior impact on the LE of NHW people, of which accidents and intentional self-harm were likely to be the top two direct causes. Conclusion: Finding out the direct causes that affect the LE growth in different age groups is conducive to making a targeted intervention or solving the LE growth bottleneck.

The Strengthening Mechanism of the Relationship between Social Work and Public Health under COVID-19 in China

Social work and public health have always shared a common mission and vision in promoting human health. However, existing research tends to view social work and public health as two separate fields at both practice and policy levels, and these studies have largely neglected the consideration of how to integrate public health and social work. In the context of the COVID-19 epidemic, the link between the two has been strengthened and health social work has been given more importance. The question addressed in this article is through what mechanisms or practices the social work profession can strengthen its professional status and engage in interprofessional collaboration. Based on key informant interviews and case studies (one community and two cabin Hospitals), this study points out that three legitimacy mechanisms are needed: operationalizing policy, extending value, and completing justification. Furthermore, the future and possible limitations in relation to the development of health social work in China are discussed and specific recommendations are provided. Health social work needs to conduct practices and summarize its experiences and methods, to create a more friendly political environment by translating its results into policies that are conducive to the development of health social work through a political agenda. It needs to improve upon its practical abilities and methodologies, as well as professional education relating to professional values and ethics, in addition to identifying the deeper social needs of residents and discovering new, undeveloped areas of service. Moreover, because long-term change is difficult to justify due to China’s policy agendas, the question of whether the professional status of health social work in the post-epidemic context can be improved is something that needs to be further explored in future studies.

Social work leadership in a medical school: A coordinated, compassionate COVID-19 response

The COVID-19 pandemic has exposed the systemic inequities in our health care system and society has called for actions to meet the clinical, psychosocial and educational needs in health care settings and communities. In this paper we describe how an organized Department of Health Social Work in a medical school played a unique role in responding to the challenges of a pandemic with community, clinical, and educational initiatives that were integral to our community's health.

From Need to Policy: Community Supported Development and Implementation of the South Carolina Vulnerable Adult Guardian Ad Litem (SC VAGAL) Program

Adult guardian ad litem programs are a necessary public service to protect adults from abuse and neglect. This article describes the development and implementation of an adult guardian ad litem program. We discuss the program's impetus, pilot testing, evaluation, and implementation of the program. Our experience highlights the vital role of diverse inter-sectoral stakeholders. Furthermore, the development process highlights the need for flexibility in program development, tension negotiation among stakeholders, and engagement of aging stakeholders in nontraditional arenas.

Understanding Health Talk in Behavioral Health Encounters: A Qualitative Analysis

Although physical and behavioral health conditions commonly cooccur, best practices making behavioral health treatment responsive to clients' health needs are limited. Particularly little is known about how physical health is addressed by clinicians within routine therapeutic treatment. This study describes the frequency and type of health talk occurring within integrated behavioral health sessions, and explores how this talk functions within ongoing therapeutic work. Participants in this study included 51 dyads of clinical social workers (n = 13) and clients (n = 51) receiving therapy within an integrated community health and behavioral health center. Therapy sessions were recorded and transcribed verbatim. Content analysis determined the frequency and content of health talk in sessions. Thematic analysis was used to understand the function of health talk within these visits. Health talk occurred in 92% (n = 47) of sessions. Clients initiated the majority of discussions. Talk about sleep (40%, n = 19), diet/exercise (35%, n = 16), and chronic health conditions (28%, n = 13) were most common. Health talk either complimented or conflicted with therapeutic work, depending on the topic discussed and when it occurred during session. Health talk changed the scope of therapeutic work by integrating care coordination into routine practice. Health talk was pervasive and was frequently initiated by clients, signaling its relevance to clients' recovery. Providers leveraged heath talk to complement their therapeutic work, but these strategies were not universally applied. Care coordination activities were a part of routine therapy. Practice and policy changes that support a more interdisciplinary approach to clinical work are needed.

More than a Great Idea: Findings from the Profiles in Public Health Social Work Study

Progress in refining the definition and basic concepts of public health social work (PHSW) is central to its revitalization. Advancing PHSW further depends on understanding the roles, domains, and daily activities of current PHSW practitioners in the contemporary workforce. The goal of the Profiles in PHSW Study is to explore how public health social workers conceptualize and locate their work. Using snowball sampling, 48 PHSW subjects with four or more years of professional experience were recruited; 34 (70.8%) participated. Qualitative survey responses were compiled and thematically analyzed; six themes emerged related to the nuances of integrating public health and social work, wide-ranging practice across systems and settings, leadership, visibility and viability, and recommendations for how to move PHSW forward. Findings suggest that intentional profession-wide integration of public health approaches into social work education, research, and practice is needed to strengthen the field's impact and role in advancing population health.