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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.

The aim of the present study was to explore whether protective factors, such as ease of communication with parents, siblings, and best friends; parental awareness of student’s friends and activities; higher numbers of best friends; positive perceptions of school climate; and teachers’ opinion of student’s academic performance, would buffer the link between peer victimization and weapon-carrying behavior among US adolescents. Data were derived from the 2009–2010 Health Behavior in School-Aged Children (HBSC) study in the US. A total of 12,642 US adolescents were included in the study sample. Analyses included descriptive statistics, bivariate correlations, and ordinary least squares regression. Partially supporting our hypothesis, we found that only mother’s awareness of students’ friends and activities ameliorated the effect of peer victimization on weapon-carrying behavior. In other words, bullied adolescents whose mothers were aware of their friends and activities were less likely to carry weapons. Mothers’ awareness of their child’s friends, behaviors, and activities is an important form of parental monitoring, and their involvement may protect their children from weapon-carrying behavior after experiencing victimization.

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.

Introduction Heart failure (HF) is a public health problem, and self-care remains poor, especially among minorities. Access to personalized educational material via an interactive dialogue agent (DA), a system intended to converse with humans in natural language, has the potential to improve self-care. This abstract outlines the initial steps of developing an artificial intelligence-based DA to assist African American (AA) and Hispanic/Latino (H/L) HF patients with their self-care needs. Hypothesis Analysis of HF education sessions between health educators (HE) and patients can provide insight into the topics that AA and H/L patients value. Method In this IRB approved pilot study, we have recorded, transcribed, and verified 20 (18 AA and 2 H/L) HF education sessions between HE and HF patients. Latent Dirichlet Allocation (LDA), a topic modeling algorithm and Empath, a text analysis tool were used to identify common discussion topics in the transcripts. An initiative analysis was performed to identify conversation drivers where each turn (unit of speech by a single speaker, without interruption from the other speaker) was classified as either a question (ending with ‘?’), a prompt (having only filler words like umm, okay) or an assertion/command (others). Lastly, we compared the transcripts against a HF ontology published by the National Center for Biomedical Ontology and the Consumer Health Vocabulary (CHV) available in the Unified Medical Language System (UMLS) to identify the term overlap. Results On average, HE took 117 turns comprising 205 sentences and 2281 words per conversation, whereas patients took 108 turns comprising 131 sentences and 850 words. Per conversation, HE asked 26 questions and had 17 prompts as opposed to 3 questions and 39 prompts by the patients. LDA identified HF and heart function, effects of HF, low salt diet, and follow-up appointment and medication as the top 4 most common topics discussed by the HE. When looking at the entire transcripts, Empath identified eating, health, and cooking as the most common topics for both the HE and the patients. Patients frequently discussed children and family, whereas HE focused on providing HF information as indicated by LDA. Lastly, only 2.1% of HE terms overlapped with the HF ontology. Our analysis revealed that 25% and 22% of the terms (without stop words such as at, the) used by the patients and HE respectively match with the ‘preferred label’ in the CHV. For both, the high frequency terms included heart, heart failure, salt, water, and fluid. This also correlated with our topic analysis findings from Empath and LDA. Conclusion Our analysis helps triangulate the kind of information HE and HF patients value. Though mostly HE dominated the conversation, it is essential to incorporate the topics that patients brought up into the DA and use culturally sensitive vocabulary while communicating them. Next, we will collect more recordings, conduct focus groups, and evaluate the usability of our prototype DA.

Despite the increasing proportion of immigrant youth in U.S. school districts, no studies have investigated their perceptions of their school. This study examines factors associated with perceptions of school safety among immigrant youth within individual, family, peer, and school contexts. Data were drawn from Wave II of the Children of Immigrants Longitudinal Study (n = 4288) and hierarchical logistic regression analyses were conducted. African-Americans, females, and youth with limited English proficiency were more likely to perceive their school as unsafe. Youth who reported that family cohesion was important and those who had close friends perceived their school as safe. Also, those who experienced illegal activities in school reported feeling unsafe. Assessment and intervention in schools needs to consider individual and contextual factors associated with perceptions of school safety. Additional research is needed to examine individual and contextual factors related to immigrant youths' perceptions of school.

A growing subset of place-based foundations in the United States have adopted an embedded philanthropic approach, in which funders “dig in” and “dig deeper” into the life of communities. Embedded philanthropy and embedded funders may change the landscape of community-building efforts in significant ways. Funding approaches and innovative efforts include the use of a “bottom up” approach to social change, a focus on helping communities to build capacity, and the building of community assets through grants that are more strategically focused. As these approaches continue to evolve and more evaluations take place, greater understanding will develop regarding the way forward for foundations in the United States to enhance effectiveness.

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.

Urban renewal has been the dominant approach to revitalizing industrialized communities that fall into decline. Detroit, with its vast majority Black population and struggling auto industry, encountered such decline. The Skillman Foundation sought to engage in a joint effort to bring Detroit back to its position of strength. With its mission of enhancing the development and well-being of children, Skillman entered partnerships with six Detroit neighborhoods with the largest concentrations of children whose well-being and development was at risk. The Foundation solicited the technical assistance of the University of Michigan School of Social Work. This book introduces readers to the environment within which the work of technical assistance began. The work is placed within a theoretical and practice context. This includes conducting needs assessments at multiple levels, engaging community members in identifying strategies for problem-solving, assistance in developing community goals for immediate and long-term success, and implementing social work field instruction opportunities. Lessons learned and challenges are described as they played out in the process of creating partnerships for the Foundation with community leaders, engaging and maintaining youth involvement, managing roles and relationships with multiple partners recruited by the Foundation for their specialized expertise, and conducting the work of technical assistance within a context of increasing influence of the city’s surrounding systems (political, economic, educational, and social). Readers will note the role of technical assistance in an evolving theory of change. Case vignettes, case-based discussion questions, and additional resources in each chapter provide an excellent opportunity for classroom use.

This introductory chapter describes the Skillman Foundation’s vision for the Good Neighborhoods program and introduces the six communities that were the target of the Foundation’s work for change and the theories of change. The chapter further addresses the emergence and development of the partnership between an embedded foundation and the University of Michigan School of Social Work, which led to the creation, organization, and funding of the Technical Assistance Center (TAC). The organization, processes, and planning required for the implementation of the change process is described. The chapter provides a context for the process that evolved during the economic and social catastrophes that impacted Detroit.

Chapter 12 is organized very differently from earlier chapters in this volume. It contains a list of lessons learned from those associated with the University of Michigan School of Social Work/Technical Assistance Center (UMSSW/TAC) and includes observations from those deeply involved in the Good Neighborhoods project. These observations and insights are divided into topical areas, but the list does not reflect a rank order of lessons learned or priorities. They are instead reflections on a multiyear initiative to create better outcomes for children and youth living in an urban context undergoing vast social and economic changes and challenges, some of which were adverse (see Chapter 2).

In the 21st century, substantial advancements have been made across the globe that positively affect the ability for school-based social workers in the fields of practice, policy, and research to meet the needs of the world’s youths. Nonetheless, children continue to suffer from poverty-stricken environments, absence of basic needs, poor or no health care, and insufficient access to quality education. The purpose of this article was to review recent trends in children’s rightsto education, psychological and behavioralhealth, and physiological health and to provide social workers with a contextual landscape for progress. Specific suggestions about how school-based social workers can make improvements across the globe are offered.

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.

The Columbine High School shooting in 1999 prompted school officials and policy-makers to create and implement programs and policies that would prevent violence in school and ensure school safety. Ten years have passed since the Columbine shooting; however, debates concerning risk factors for the shootings continue to ensue. The focus of this article is to examine the Columbine school shootings within the context of Bronfenbrenner's (1994) ecological systems analysis. We examine the most commonly identified risk factors, which operate within five systems levels: chrono-, macro-, exo-, meso-, and microsystems, and draw implications for school-based practice and policy.

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...

Youth civic engagement is critical to many community empowerment initiatives. Photovoice is a popular empowerment technique for disenfranchised groups, including youth. The technique has little published empirical support. This research assesses Photovoice as a youth mobilization project within the context of an ongoing community development initiative. It was hypothesized that Photovoice participation would (a) improve students' interest in civic engagement and (b) have greater impact on older rather than younger adolescents. Thirty-three (33) youths (15–21 years of age) completed a Survey of Youth Engagement before and after Photovoice participation. Results indicate a main effect for age, with youths 18 years of age and older scoring significantly higher than youths under 18 years of age. This study suggests that Photovoice promotes significant changes in perceived civic engagement among older youths.

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.

SUMMARY With the increasing diversity in America, it is not only crucial, but ethically imperative, that social workers understand and appreciate cultural norms and variations in their consideration of the whole person. This article defines cultural competence, details related ethical requirements, and examines its importance to social work practice.

Objective: The purpose of this article was to examine how an initiative of 10 collaborative projects focused on children and youth have applied principles of participatory research, collaboratories, and technological solutions. Method: The study analyzed multiple forms of qualitative data, including semiannual formative evaluations and semistructured interviews of participating partners. Results: Both the collaborative method and the infusion of technology were central to the functioning of collaboratory projects and, ultimately, the translation from research to practice and policy. The community-based participatory nature of the research projects resulted in applicable findings that were credible with people affected by the issues studied. Conclusions: The present study suggests that when there is steadfast commitment on the part of a diverse group of partners, even simple applications of technology can make a difference.

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.

The Global Program on Youth (GPY) employs a technology-supported, collaborative framework of problem solving, called a collaboratory, to improve the lives of children and youth. Collaboratory partners use technology to share research, apply practice wisdom, and learn from the experiences and perspectives of diverse groups of people. Findings from the initiative are presented in this article, highlighting the lessons learned from each of the participating collaboratories, including the rewards, challenges, and applications of technology-supported collaboration.

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.

Cross-cultural therapeutic relationships pose a challenge to practitioners trained in traditional modes of counseling. Because of the increasing numbers of minority groups requiring mental health services, professionals must adapt and alter their orientation to the engagement process. This article explores the therapeutic relationship with African Americans, from the perspective of helpers of similar and different racial backgrounds. A guiding theoretical framework, sociocultural dissonance, explains the difficulties encountered by minority individuals as they struggle to conform to the demands of a bicultural existence. The concept is also aptly applied to the varied relationships (African American client and practitioner; African American client/white practitioner), exhibiting the effects of social dissonance and potential mediating forces.

This article reports the results of a national survey of school social workers in which respondents were asked to rate the importance and complexity of different knowledge, skills, and abilities selected by a panel of experts to reflect the breadth of content for entry-level social work practice in schools. The article discusses the implications of these findings for curriculum development and offers additional curriculum guidelines based on current trends affecting our nation's schools.

The use of Rasch analysis to elicit the structure of depression was investigated. Responses from 102 African-American and white adolescents were evaluated using Rasch analysis. Responses from African-Americans and whites were compared to discern differences in the operational definition of depression for the two groups. How Rasch analysis can be used to increase the understanding of depression for African-Americans and other minority groups is discussed.

The complexities of serving as a professional school dean in a large public research university provide unique challenges, especially in relationship to issues of gender and race.