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BACKGROUND: Limited health literacy is associated with significant morbidity and mortality in the general population but the relation of health literacy with long-term clinical outcomes among adults with chronic kidney disease (CKD) is less clear. METHODS: Prospective data from the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3715) were used. Health literacy was assessed with the Short Test of Functional Health Literacy in Adults (dichotomized as limited/adequate). Cox proportional hazards models were used to separately examine the relations of health literacy with CKD progression, cardiovascular event (any of the following: myocardial infarction, congestive heart failure, stroke or peripheral artery disease), and all-cause, cardiovascular and non-cardiovascular mortality. Poisson regression was used to assess the health literacy–hospitalization association. Models were sequentially adjusted: Model 1 adjusted for potential confounders (sociodemographic factors), while Model 2 additionally adjusted for potential mediators (clinical and lifestyle factors) of the associations of interest. RESULTS: In confounder-adjusted models, participants with limited (vs adequate) health literacy [555 (15%)] had an increased risk of CKD progression [hazard ratio (HR) 1.34; 95% confidence interval (CI) 1.06–1.71], cardiovascular event (HR 1.67; 95% CI 1.39–2.00), hospitalization (rate ratio 1.33; 95% CI 1.26–1.40), and all-cause (HR 1.54; 95% CI 1.27–1.86), cardiovascular (HR 2.39; 95% CI 1.69–3.38) and non-cardiovascular (HR 1.27; 95% CI 1.01–1.60) mortality. Additional adjustments for potential mediators (Model 2) showed similar results except that the relations of health literacy with CKD progression and non-cardiovascular mortality were no longer statistically significant. CONCLUSIONS: In the CRIC Study, adults with limited (vs adequate) health literacy had a higher risk for CKD progression, cardiovascular event, hospitalization and mortality—regardless of adjustment for potential confounders.

Heart failure is a global epidemic with debilitating effects. People with heart failure need to actively participate in home self-care regimens to maintain good health. However, these regimens are not as effective as they could be and are influenced by a variety of factors. Patients from minority communities like African American (AA) and Hispanic/Latino (H/L), often have poor outcomes compared to the average Caucasian population. In this paper, we lay the groundwork to develop an interactive dialogue agent that can assist AA and H/L patients in a culturally sensitive and linguistically accurate manner with their heart health care needs. This will be achieved by extracting relevant educational concepts from the interactions between health educators and patients. Thus far we have recorded and transcribed 20 such interactions. In this paper, we describe our data collection process, thematic and initiative analysis of the interactions, and outline our future steps.

School bullying is a serious social problem, which has received widespread public, media, and research attention over the years. The first study of bullying was published in 1969 by a school physician named P. P. Heinemann (Olweus, 1999), which was subsequently followed by extensive empirical inquiry since the 1970s in Scandinavia led by Dan Olweus (Vaillancourt et al., 2008). In subsequent decades, social scientists have developed a rich theoretical and empirical body of knowledge with regards to children and adolescents’ experiences in bullying. Scholars conceptualise bullying as a sub-category of aggression (Smith et al., 2002), characterised as being purposeful, including an imbalance of power, and being repetitive (Hunter, Boyle & Warden, 2007; Smith, 2014). Bullying has for the most part been explored from a psychological perspective, providing insights into proximal risk factors, such as individual traits and behaviours. However, bullying is a complex, multifaceted problem, and consideration of theoretical frameworks from outside psychology is necessary to fully explain why certain individuals (or groups of individuals) are involved in bullying. Scholars have therefore come to realise the importance of integrating psychological theories with social environmental perspectives (sociological, anthropological, political-economic; Lawson & King, 2012). This has the potential to broaden perspectives on the etiology and outcomes of bullying, introduce innovative methodologies, and raise important questions about new approaches to prevention and intervention (Holt et al., 2017).This chapter will provide an overview of multiple social science theories and perspectives in explaining bullying. It is divided by theories and perspectives represented by four major branches of social science: psychology, sociology, anthropology, and political-economics.

School bullying and peer victimization are social problems that affect African American youth across various environmental contexts. Regrettably, many of the empirical research on bullying and peer victimization among African American youth has examined individual and direct level influences in silos rather than a constellation of factors occurring in multiple settings, such as home, school, and neighborhood. As a holistic model, the social–ecological framework provides a context with which to situate and interpret findings and draw implications from a broader psychosocial framework, which can be applicable across various systems. We utilize Bronfenbrenner’s (American Psychologist 32:513–531, 1977) social–ecological framework as a springboard for investigating the accumulation of risk contributors and the presences of protective factors in relation to school bullying and peer victimization of African American youth. More specifically, we examine the risk and protective factors occurring in the micro- (i.e., parents, peers, school, and community), exo- (i.e., parental stress), and macrosystem levels (i.e., hypermasculinity, and gender role beliefs and stereotypes). We then discuss implications for research and school-based practice.

Previous research suggests that serious maternal mental illness is associated with adverse youth outcomes. However, this research is of limited ability to inform appropriate social work and social policy responses for at least two reasons. First, it is based on samples that are not racially or ethnically diverse and that do not target low‐income families; second, it does not examine whether differences in the level of father involvement or the severity of maternal mental illness matter. This study involves a low‐income, racially and ethnically diverse sample of mothers with a serious mental illness and their 11–18‐year‐old children and examines parent effects on youths. Fathers were in contact but mostly were not live‐in parents. Structural equation modeling yields three key results: better maternal functioning and more paternal involvement predict better academic outcomes; less paternal involvement and more maternal health problems predict higher youth‐reported affiliative skills; and more paternal invol...

Actively engaging community members in the revitalization of their neighborhoods is a goal of numerous planning initiatives. In this article, we provide a case example of how the solution-focused brief therapy's “miracle question” was used to engage members of a major metropolitan community in visualizing their dreams and planning strategies for change. Similar to outcomes with therapy clients, community members participated actively and were enthusiastic in communicating their outcomes. Dreams were realistic and important to participants, and suggested strategies were oriented toward first steps and recognized as involving effort by the community. Engagement and retention were sufficient to move forward with immediate actions and longer-term preparation. Benefits and suggested modifications are offered for community practitioners and researchers employing this method.

The Society for Social Work and Research (SSWR) was founded in 1994 to provide a meeting ground and support organization for individual social workers who engage in research. Over its first 14 years, SSWR has grown from a modest-sized organization that hosted an initial conference to a large and influential force that sponsors a wildly successful yearly conference. SSWR's annual conference now showcases a portfolio of awards, including a travel scholarship for a doctoral student, a named lecture, and a very competitive abstract submission process. Funding for research by social workers has grown over the years, and SSWR, in association with the Institute for the Advancement of Social Work Research (IASWR), has become a regular provider of educational opportunities about funding sources. This article presents perspectives from the first seven presidents of the organization, who describe the growing richness and diversity of SSWR's membership and projects and the increasing visibility of research conducted by social workers. KEY WORDS: infrastructure; organization; research; SSWR ********** The Society for Social Work and Research (SSWR) was founded as a membership organization in 1994 to support social workers interested in research. To preserve the history of SSWR, this article presents sections contributed by the first seven presidents, each describing, often from a personal point of view, how their efforts helped to build the organization and to contribute to the current research infrastructure in social work. PRESIDENTIAL PERSPECTIVES Janet B. W. Williams, Founding President, 1994-1996 It was 1992. The National Institute of Mental Health (NIMH)Task Force Report on Social Work Research (1991) had just been presented to the National Advisory Mental Health Council of NIMH. The report clearly acknowledged the significance of social work research by recognizing the breadth of critical problems with which social work deals and the increasing need for all human services to demonstrate the effectiveness of the services they provide. This report provided the stimulus and led to the funding that supported the establishment in 1992 of the Institute for the Advancement of Social Work Research (IASWR). IASWR was created by five leading social work organizations: Baccalaureate Program Directors (BPD), National Association of Deans and Directors (NADD), Group for the Advancement of Doctoral Education (GADE), Council on Social Work Education (CSWE), and NASW. SSWR was conceived in direct response to the NIMH Task Force Report conclusion that "[t]hroughout the profession there is insufficient organizational support for research development." As a research social worker who was not embedded in a school of social work, I had always felt somewhat professionally isolated and hungry for interaction with nay social work research colleagues. As a faculty member in a medical school department of psychiatry, I frequently attended conferences and meetings of research-oriented groups in psychiatry but knew of no similar groups in social work. Therefore, at a psychiatry research meeting shortly after the Task Force Report was issued, I discussed these thoughts with Dr. Alan Leshner, at the time the director of the National Institute on DrugAbuse (NIDA). He agreed to support the founding of such a group and to contribute to its first conference. In 1992, at an NIMH-sponsored conference in Washington, DC ("Building Social Work Knowledge for Effective Mental Health Services and Policies"), I presented a plan for a new membership organization that would provide social work researchers with a base: the Society for Social Work and Research (SSWFZ). At that conference, Betsy Vourlekis also presented a report on the development of the new IASWR, as she had been appointed head of the implementation committee. At the conclusion of the conference, Betsy approached me and asked if I would delay the initiation of efforts to establish a membership group until the new organizationally based IASWR was firmly off the ground. …

Allen-Meares and Lane (1983) authored an article in NASW s Social Work journal rifled "Assessing the Adaptive Behavior of Children and Youths," which appraised the status and use of adaptive behavior as a concept and measurement tool that would work in the school system. Adaptive behavior--or the ability of a person to function in society, in a group, or in a classroom according to specific standards of behavior and ability--is one factor practitioners consider when completing holistic assessments of the level of care and services necessary. At the time of the Allen-Meares and Lane article, adaptive behavior instruments and theories were gaining recognition and use among school social workers as they strove to accurately assess students to determine who among them was eligible for special education programming. The use of formal measurement was not an entirely novel concept within the school setting. School psychologists and special resource personnel frequently presented data from various instruments that measured or quantified performance, IQ, speech, motor skills, and other indicators. Many of these instruments were limited to the in-school behaviors or cognitive abilities of the child. However, at the time, the ability to assess a child's whole experience was trending toward a more comprehensive set of measurements as a complement to those more typically administered. Because school social workers are knowledgeable about the importance of a holistic approach and understand how environment affects behavior, they were ideally suited to assess the adaptive behavior of pupils identified as candidates for special education services. As often is the case with trends, whether societal, educational, or professional, it is prudent to examine the tools that have been developed concomitantly and the way they have been used. Although several of the assessment instruments discussed by Allen-Meares and Lane (1983) are still in use, many others have been developed. In addition, although Allen-Meares and Lane discussed one culturally sensitive instrument called the System of Multicultural Pluralistic Assessment (SOMPA), the consideration of cultural and ethnic factors in assessment has gained more importance given the increasing ethnic and racial diversity within certain school systems. Furthermore, cultural and ethnic factors are of particular relevance as the overrepresentation of ethnic minority students in special education classes has been documented by researchers whose work spans the past 40 years (Harry, Sturges, & Klingner, 2005; Hosp & Reschly, 2004). In 1998, approximately 1.5 million ethnic minority children were identified as mentally retarded, as having emotional problems, or as having a specific learning disability (Civil Rights Project, 2002), with nearly 60 percent of those children being African American or Native American. The Children's Defense Fund (2005) cited Osher, Sims, and Woodruff's (2002) report, which stated that in 39 states, African American children are twice as likely to be labeled mentally retarded. Atkins-Burnett (2006) suggested that although troubling, these statistics, taken as a whole and contextualized in light of economic status, environment, and so forth, might not be as troubling if those so identified were then provided with "adequate supports" to bolster their academic success. However, once labeled, ethnic minority children are less likely to receive instruction in a mainstream classroom, are more likely to face harsher discipline than that received by their peers, and are less likely to graduate. Outside of school, African American students, in particular, face a greater rate of unemployment and arrest (Children's Defense Fund, 2004). When ethnic minority population growth and the information regarding overrepresentation is considered in conjunction with the recent reauthorization of the Individuals with Disabilities Education Improvement Act (IDEA) (U. …

Embracing the concept that the social compact between university and community can provide a cornerstone for true social change. This article details how partnering with outside organizations in collaborative relationships can help fulfill higher education's obligation to educate for the good of a democratic and learned populace. Often the social conscience of a university, schools of social work can serve as leaders in the development or facilitation of university and community partnerships to address or intervene in areas of social need. One research institution of higher education provides successful examples.

Children of parents with mental illness are an at-risk population according to research on psychiatric outcomes using White, middle-class samples of depressed parents and infants and preschool children.The current study expands this evidence byexploringwithin-group heterogeneity across psychosocial outcomes, in a racially diverse, low-income sample of adolescent children of mothers with mental illness ( N = 166). Using measures of mental health, academics, behavior problems, and social relationships—and employing cluster analysis methodology—we identified five meaningful subgroups of these youth. Two of five identified clusters evidenced mental health symptoms (15%) or possible behavioral problems (27%).The largest cluster (30%) appeared quite socially and academically competent; another cluster (22%) presented as average in their functioning but adult-oriented. A final small cluster (4.8%) was distinguished by members' social isolation. Cluster membership related to maternal substance abuse history, father's relationship to youth, and social support available to mothers. Implications for planning preventive interventions are discussed.

Depression is relatively common in children and adolescents, and if left undetected and untreated, can have long-term negative consequences. Social workers providing services to families, children and adolescents need to understand the characteristics, and conduct developmentally appropriate assessments, of depressive symptoms. This paper provides a review of current literature related to the definition, prevalence, co-occurrence, and measurement of depression in childhood and adolescence. It also highlights relevant gender, race, and ethnic influences.

In the past few decades, deinstitutionalization and community-based rehabilitation and support programs have increased the likelihood that women with serious mental disorders will be parents and will raise their children. This review describes what is known about the parenting of these women, focusing on diagnosis, child characteristics, and other contextual effects.

Federal public assistance policy can be construed as the U.S. low-income family policy. The most recent effort at public assistance "reform," the Family Support Act of 1988 (FSA) (P.L. 100-485), is an enunciation of this policy. As chair of the National Governors' Association, then-Governor Bill Clinton helped draft the 1988 reform package ("Welfare Reformer," 1993), and secretary of Health and Human Services Donna Shalala has stated that much of the Clinton administration's reform efforts will be based on elements of the FSA (Vobejda & Balz, 1993). The current rhetoric in Congress, with its themes of personal responsibility and fear of the corrupting influence of "handouts," are echoed in the FSA as well. Given the content of this policy, this article discusses the options available to poor women and men with respect to raising families and escaping poverty and uses state demographic data from Illinois to describe the situation of low-income families. Until rather recently, only single parents and their dependents could qualify for assistance through Aid to Families with Dependent Children (AFDC), the major cash benefit program for low-income people in the United States, and the vast majority of single heads of household in this country are women. For this reason, discussions of public assistance policy often come to center on single parenthood, particularly single motherhood, and often involve pervasive behavioral and racial stereotypes of poor single mothers, with two consequences. First, dialogue concerning public assistance policy comes to center less frequently on economics and more often on how people come to have children in or out of wedlock and why they do not have a "standard" nuclear household. Second, public assistance policy itself is thoroughly embedded in a context of stereotypes and beliefs about sex, class, and race. President Clinton's promise to "end welfare as we know it" (DeParle, 1993) was intended as a commitment to new ideas and agendas for the future. The examination of public assistance policy in this article has two aims: The first is to analyze public assistance policy as family policy, making explicit the values, intentions, and biases that underlie it, and the second is to examine the consequences of the public assistance system for low-income, single-parent families and to measure the consequences against policymakers' intentions. Given the recent changes in Congress and the new calls for restructuring policy at the federal level, evaluation of the assumptions underlying public assistance and its effects is timely and necessary. For better or for worse, the public assistance system in the United States is a good part of what passes for its "family policy," at least regarding low-income families, and the public assistance system is based on assumptions and values, both implicit and explicit. In writing legislation, policymakers do more than anticipate needs; they expect certain behaviors from groups of people and incorporate their own values regarding these behaviors into policies. What options do poor women and men have under the resulting public assistance system, particularly with respect to raising families and escaping poverty? How plausible are these options in light of the earning potential for male and female workers, the costs of child care, and the income and size of the pool of potential spouses? Are the behaviors expected and promoted by public assistance policymakers realistic? Might some single parents be better off raising their children without a spouse? What are the likely financial benefits of marriage, and what can single parents expect to achieve on their own? Values Undergirding Family Policy Public policy is driven by a variety of often conflicting values and ideologies, even though all of the people involved may not agree on these values or even state them explicitly. These values include the work ethic, the family ethic, a nuclear family bias, and faith in capitalist processes. …

Across the United States the quality of education and the need to reform schooling continue to be debated (National Commission on Excellence in Education, 1983). Many states have approached this challenge by upgrading standards for both education personnel and pupils. This upgrading has included using competency examinations and setting specific standards for employment, promotion, and graduation (Allen-Meares, 1987). Society now knows that large numbers of children are not achieving, dropout rates for some inner-city communities have reached alarming numbers, and children from low-income families are less likely to come to school ready to learn. In the midst of these developments, both social problems and problems in family-child functioning continue to escalate. Large-scale changes in the demographics of the country (for example, growing racial and ethnic diversity) and new social problems (cocaine-addicted babies, acquired immune deficiency syndrome, increased rates of youth suicide, and the juvenilization of poverty) and their consequences present new challenges for schools and school social workers (Danziger & Stern, 1990-91; Ford Foundation, 1989). Social workers have known for some time that educational outcome is determined by the interactions between societal and home conditions and school variables. Germain (1991) reaffirmed this point in her discussion of educational reform and school social work practice in the 1990s, acknowledging that the school alone cannot create equality in opportunity. There is a growing awareness that to achieve certain educational outcomes, social problems must be addressed first and that social work has a place in U.S. schools (Chira, 1991). The study reported in this article has four purposes: (1) to collect information about the demographic and organizational contexts in which school social workers work, the populations served, and other working conditions that influence practice; (2) to identify the most important job dimensions that school social workers must be able to perform as they begin to practice; (3) to determine whether these dimensions are correlated positively or negatively in frequency with which they are performed; and (4) to identify the tasks school social workers prefer to perform and those that are mandated by the school. This study is part of a collaborative effort involving the Educational Testing Service, Princeton, New Jersey; the National Association of Social Workers' (NASW) Commission on Education; and the author. This collaboration has resulted in specialist credentials for school social workers, some of whom have been required by their respective states to receive certification by completion of the National Teachers' Examination, which did not include an appropriate battery of questions for school social workers. Literature Review Analyses of school social work tasks have dominated the literature since the conception of this field of practice. Major studies were conducted by Costin (1969) and Meares (1977), and since then, others have examined the status and current definitions of school social work tasks and functions (Alderson & Krishef, 1973; Chavkin, 1985). For example, Chavkin examined the status of school social work activities and the pattern of delivery in three states and 200 school districts. She found that traditional activities (for example, direct services to individual students, work with families, liaison work, and interpretation) were performed most frequently. However, nontraditional tasks were also provided (for example, groupwork, consultation, and administrative consultation). Link's (1991) qualitative cross-national comparison study of school social workers in London and the midwestern United States found that the U.S. school social workers worked primarily to maintain the status quo, made referrals to agencies, and helped children adapt. Link blamed this state of affairs on the fact that these workers are bound by the school and its authority over them. …

School social work is a subspecialty within the social work profession. The field has been in existence in the United States for over one hundred years and is practiced in many other countries. Although the actual number of school social workers worldwide is unknown, the field serves children in most states in the United States. According to the School Social Work Association of America, “School social workers bring unique knowledge and skills to the school system and the student services team. School Social Workers are instrumental in furthering the purpose of the schools: To provide a setting for teaching, learning, and for the attainment of competence and confidence. School social workers are hired by school districts and charter schools to enhance their ability to meet its academic mission, especially where home, school, and community collaboration is the key to achieving that mission.” This entry covers introductory works on the history of school social work, important policies, and select journals that support this field of practice. Articles on interventions and empirical studies that support the work of school social workers are further highlighted in this entry.

This article explores the diminishing role of federal government following a series of legislative mandates to maximize equal educational opportunity; it also examines the escalating poverty rate resulting from the economic restructuring of the country. It calls for systemic reform in education, health, and human services followed by an integration of these services.

We live in a nation strained by racism, hostility, and hatred. Our communities and neighborhoods are overcome by violence, fear, and apathy. Our homes, which were once considered safe havens, have now become the sites of increasing acting out of frustration and anger. Due to inequities, oppressive conditions, and uncontrollable stresses, individuals are turning against themselves, their loved ones, and others to vent their feelings of helplessness and hopelessness. Many African American men are especially caught up in this cycle of violent behaviors and victimization and consequently are becoming an endangered species (Gibbs, 1984, 1988; Staples, 1987). The adverse consequences of this cycle - including major injury and death - will affect the future of African American men, their families, and generations to come. Society's level of concern says much about us as a nation. Many studies have reported on the extent of violence in the African American community, citing alarming statistics and predictions. Relatively high victimization rates of violent crimes have been reported for individuals who are African American, male, poor, young, or single. According to the Bureau of Justice Statistics (1985), African American men have an unusually high likelihood of being murdered; African Americans are more than five times as likely to be the victims of homicide as white people (Hawkins, 1986). Homicide is the leading cause of death of African American men between ages 15 and 34, and since 1960, the suicide rate for African American men between ages 15 and 24 has tripled (Gibbs, 1988). In 1992, of the 23,760 homicide victims reported, 50 percent were African American and 48 percent were white, a disproportionate amount considering that African Americans are only 11 percent of the population. Eighty-four percent of violent crimes perpetrated against African Americans were by African Americans (Bureau of Justice Statistics, 1990). Ninety percent of those arrested for homicide were men; 55 percent (10,728) were African American, and 43 percent (8,466) were white (U.S. Department of Justice, 1993). In 1990, African Americans were 35.7 percent of the prison population, compared with 50 percent for white people (Criminal Justice Institute, 1991). These figures are startling but do not examine the structural forces that engender crime: inadequate education and job training, unemployment and underemployment, and the inequitable distribution of wealth and power (Seidman & Rappaport, 1986). Because the justice system places a higher value on white men than on African American men, the latter have had disproportionately higher incarceration and death penalty rates (Poussaint, 1983). Investigations of crimes against African Americans are given low priority. Crimes against white people are more stringently punished. Excessive force, police brutality, harassment, and false arrests against African Americans are widespread (Feagin, 1986). As Radelet and Vandiver (1986) pointed out, "Equality for blacks has not yet been achieved in American society, least of all in the criminal justice system. The idea that all of us are born with an equal chance of eventually dying in the electric chair remains a myth" (p. 189). Despite the risks of school failure, family estrangement, homicidal violence, and stress-related illnesses that beset African American men from the vulnerable underclass, there is a growing number of middle-class African Americans who excel in family, community, and national leadership roles (Bowman, 1989). Since 1970, the number of African Americans earning over $35,000 a year has risen by almost one-third. Yet there was also a general decline in middle-class incomes between 1970 and 1984, resulting in an increase in lower-income families (Malveaux, 1988). Thus, the gap between economically disadvantaged and middle-class African Americans is growing. A vast majority of African Americans are excluded from the economic and political participation that would improve their standard of living. …

Children who witness parental homicides are emotionally traumatized, stigmatized, and deeply scarred by a terrifying event. They often exhibit debilitating symptoms comparable to those of posttraumatic stress disorder. As attention is focused on the deceased and on the perpetrator of the crime, the child witnesses inadvertently become the neglected victims. A case report of two such children who observed their mother being murdered by their father is presented. Theories of psychosocial development and social learning guided the assessment and intervention phases. Behavioral and expressive therapeutic treatment strategies that helped the children work through the resultant anxiety and underlying grief are delineated, and family intervention practices that served to improve interaction and communication patterns are described. Further discussion focuses on the potential intergenerational cycle of violence and on a sociocultural perspective of family violence within an ecological framework.