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University-assisted community schools (UACS), which work as partnerships between schools and universities that assist the mobilization of coordinated services to children, families, and communities, can build capacity for schools and neighborhoods to better serve the needs of marginalized families, such as grandparent-headed households. Despite the increase of grandparents raising grandchildren, school staff are often ill equipped with the necessary skills and resources to support these children and their caretakers, who have multifaceted needs and complicated family contexts. In this conceptual article, the authors utilize social capital theory to propose social work practice implications for implementing UACS to support grandparent-headed families, focusing on three target areas: (1) social obligation and social trust, (2) network and information flow, and (3) norms and effective sanctions. The UACS model can be a vehicle for building social trust among grandparent-headed families, schools, and local communities that can lead to a shared model for grandchildren's academic success. Strengthened networks and information flows are necessary to enhance engagement with these marginalized caregivers. Last, details of how to create norms of cooperation that utilize grandparent-headed families as partners and experts are suggested for effective implementation of the UACS model that engages grandparent-headed families.

Chronic pain is an important comorbidity among individuals with HIV. Behavioral interventions are widely regarded as evidence-based, efficacious non-pharmacologic interventions for chronic pain in the general population. An accepted principle in behavioral science is that theory-based, systematically-developed behavioral interventions tailored to the unique needs of a target population are most likely to be efficacious. Our aim was to use Intervention Mapping to systematically develop a Social Cognitive Theory (SCT)-based intervention for chronic pain tailored to individuals with HIV that will improve pain intensity and pain-related functional impairment. Our Intervention Mapping process was informed by qualitative inquiry of 24 patients and seven providers in an HIV primary care clinic. The resulting intervention includes group and one-on-one sessions and peer and staff interventionists. We also developed a conceptual framework that integrates our qualitative findings with SCT-based theoretical constructs. Using this conceptual framework as a guide, our future work will investigate the intervention's impact on chronic pain outcomes, as well as our hypothesized proximal mediators of the intervention's effect.

BackgroundChronic pain is a common and disabling comorbidity in individuals living with HIV. Behavioral interventions are among the most effective and safe nonpharmacologic treatments for chronic pain. However, the success of a behavioral intervention is influenced by how well it is tailored to the target population's biological, psychological, and social context. Given well-documented psychosocial vulnerabilities among persons with HIV, it is critical to develop a behavioral intervention for chronic pain tailored to this population.ObjectiveTo use qualitative methods to investigate patient preferences for the structure and delivery of a behavioral intervention for chronic pain in individuals with HIV.MethodsInterviews and focus groups were used to elicit participant preferences. A thematic analysis approach, with an initial round of open coding, was used to develop the codebook and analyze the data.ResultsQualitative data from 12 interviews and 3 focus groups with patients living with HIV and chronic pain (total N = 24) were analyzed. Emergent themes fell into four major categories: perceived value of group sessions, incorporating peer leadership, and two key elements of how the intervention should be delivered: the HIV status of group participants and views on phone-delivered intervention content.DiscussionThis study provides a framework for the structure and delivery of a behavioral intervention for chronic pain in individuals with HIV based on patient preferences. We will use these results to design our intervention, and hope that our approach informs the work of investigators in other disciplines who seek to incorporate patient preferences during intervention development.

Experiential learning theory suggests that students increase their understanding when given the opportunity to experience a particular situation in addition to learning about it intellectually. This theory was used to construct an assignment to assist social work master's students in better understanding food insecurity and the Supplemental Nutrition Assistance Program (SNAP). Through coding previously collected reactions to the assignment, the researchers discovered multiple reoccurring themes: increased understanding of SNAP, feelings about the program, realizations regarding individual privilege, client stigma, the social experience of eating, and empathy for those who experience food insecurity. Through this exercise, students increased their knowledge of the program and also gained a better understanding of how food insecurity personally affects individuals and families.

Objective: Mixed‐methods research is valuable in health care to gain insights into patient perceptions. However, analyzing textual data from interviews can be time‐consuming and require multiple analysts for investigator triangulation. This study aims to explore a novel approach to investigator triangulation in mixed‐methods research by employing a large language model (LLM) for analyzing data from patient interviews. Methods: This study compared the thematic analysis and survey generation performed by human investigators and ChatGPT‐4, which uses GPT‐4 as its backbone model, using data from an existing study that explored patient perceptions of barriers to arthroplasty. The human‐ and ChatGPT‐4–generated themes and surveys were compared and evaluated based on their representation of salient themes from a predetermined topic guide. Results: ChatGPT‐4 generated analogous dominant themes and a comprehensive corresponding survey as the human investigators but in significantly less time. The survey questions generated by ChatGPT‐4 were less precise than those developed by human investigators. The mixed‐methods flowchart proposes integrating LLMs and human investigators as a supplementary tool for the preliminary thematic analysis of qualitative data and survey generation. Conclusion: By utilizing a combination of LLMs and human investigators through investigator triangulation, researchers may be able to conduct more efficient mixed‐methods research to better understand patient perspectives. Ethical and qualitative implications of using LLMs should be considered. [ABSTRACT FROM AUTHOR]

The future of social work research relies on the intellect and competence of current doctoral students. These future scholars who receive doctoral education that values qualitative inquiry will create a system where qualitative research traditions receive the same privilege as quantitative research traditions. Project-based learning provides learning opportunities that can challenge assumptions about what academia considers "real" research. This descriptive qualitative study explored key attributes of using project-based learning within two consecutive social work doctoral courses to encourage qualitative research skill development. Students and instructors participated in ideawriting and focus groups to assess the usefulness of PBL within these courses. The findings suggested that PBL may be useful for deepening knowledge about qualitative inquiry and reducing epistemological unconsciousness. [ABSTRACT FROM AUTHOR]

Background: Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage opioid misuse/use disorder excludes patients found in palliative care settings, such as individuals with serious illness or those at the end of life. Objectives: We conducted an exploratory study to: (1) Identify the challenges palliative care clinicians face when prescribing opioids in ambulatory settings and (2) explore factors that affect opioid decision-making. Methods: We recruited palliative care clinicians who prescribe opioids in ambulatory settings, which included open-ended questions and was conducted online. Results were analyzed qualitatively using a content analysis-based approach. Results: Eighty-three palliative care clinicians (mostly MDs/DOs) participated. Challenges faced when prescribing opioids included clinician differences in approach to care (eg, transitioning from another clinician with more permissive opioid prescribing), medication access (eg, inadequate pharmacy supply), resource constraints (eg, access to mental health and addiction expertise), managing problems outside the typical palliative care scope (eg addiction). Participants also discussed factors that influenced their opioid prescribing decisions, such as opioid-related harms and risks that they need to weigh; they also spoke about the necessity of considering other factors like the patient's environment, disease, treatment, and prognosis. Conclusion: This study highlights the challenge of opioid management in patients with serious illness, particularly when misuse or substance use disorder is present, and suggests areas for future research focus. Our next step will be to establish consensus on approaches to opioid prescribing decision-making and policy in seriously ill patients presenting to ambulatory palliative care. [ABSTRACT FROM AUTHOR]

Background Marijuana use is common among patients on long-term opioid therapy (LTOT) for chronic pain, but there is a lack of evidence to guide clinicians' response. Objective To generate expert consensus about responding to marijuana use among patients on LTOT. Design Analysis from an online Delphi study. Setting/Subjects Clinician experts in pain and opioid management across the United States. Methods Participants generated management strategies in response to marijuana use without distinction between medical and nonmedical use, then rated the importance of each management strategy from 1 (not at all important) to 9 (extremely important). A priori rules for consensus were established, and disagreement was explored using cases. Thematic analysis of free-text responses examined factors that influenced participants' decision-making. Results Of 42 participants, 64% were internal medicine physicians. There was consensus that it is not important to taper opioids as an initial response to marijuana use. There was disagreement about the importance of tapering opioids if there is a pattern of repeated marijuana use without clinical suspicion for a cannabis use disorder (CUD) and consensus that tapering is of uncertain importance if there is suspicion for CUD. Three themes influenced experts' perceptions of the importance of tapering: 1) benefits and harms of marijuana for the individual patient, 2) a spectrum of belief about the overall riskiness of marijuana use, and 3) variable state laws or practice policies. Conclusions Experts disagree and are uncertain about the importance of opioid tapering for patients with marijuana use. Experts were influenced by patient factors, provider beliefs, and marijuana policy, highlighting the need for further research. [ABSTRACT FROM AUTHOR]

This paper investigates access to financial services in American communities. It analyzes the access gap that the young and poor face relative to more economically advantaged and older groups in society. The paper uses data from the World Bank's Global Financial Inclusion survey to create a multi-dimensional index of financial access and estimates a menu of quantitative models to gauge financial inclusion. Results show that young and poor people face substantial gaps in access to financial services when compared with older people, higher income individuals, more educated people, and individuals who are less vulnerable to future economic shocks. These findings expand understanding of the challenges that young and poor people face in U.S. financial markets and provide insights that can inform financial and social policies for greater financial inclusion and more sustainable communities. [ABSTRACT FROM AUTHOR]