HOPES Logic Model

This week we will be covering a program called the Health Outcomes through Prevention and Early Support, or HOPES.  This program is provided in several locations, but I happen to know more about the location in Amarillo, TX that is run by the Family Support Services and the Department of Family and Protective Services (DFPS). My sister-in-law’s best friend ended up in a relationship with a man who drank a LOT, and she started drinking with him all the time.  This caused her to end up going from being a wonderful mom to her two sweet little girls, to a semi-abusive and extremely neglectful mom.  This is when the HOPES program jumped in to help get her and the girls back on track.

Below is a logic model that was made using a logic model builder on the Child Welfare Information Gateway, located at https://www.childwelfare.gov/topics/management/effectiveness/logic-model/.

Logic Model
Program Name:  Healthy Outcomes through Prevention and Early Support (HOPES)
Program Vision: The HOPES program is intended to address child abuse and neglect prevention of young children by focusing on community collaboration, tailored to each community, in eight targeted high risk counties by increasing protective factors of families served. Population Served: For families with children ages 0-5 experiencing stress in the home. Population Needs to be Addressed by Services:  Services offered through project HOPES will be evidence-based or promising practice, parent education and support, home visiting services, and wrap-around services for families, with children 0-5 years of age, who are considered at-risk for child abuse and neglect.

**Services	Resources	Outcomes		Indicators	Measurement
Trained educators will meet with families in their home 1-2 times per month and address parental issues and concerns. There will be monthly parent-child play groups, equine therapy, and informational & social connections for parents.	Prevention and early intervention contractors, volunteers, trainers, and facility staff. Federal, state, and local resources	Participants know how to access formal support systems in their communities.	Participants demonstrate knowledge of the array of services available to them in the community. Participants demonstrate knowledge of their own abilities to meet theirs and their family’s needs independently.		Parent-Child Relationship Inventory Family Assessment Form Community Life Skills Scale (CLS) NCAST
		Participants demonstrate empathy and responsiveness to infant's' physical and emotional needs.		Participants provide infants with age-appropriate toys, play materials, and activities. Participants feed infants when they express hunger and stop feeding when they demonstrate satiation. Participants provide custodial care (diapering, feeding, bathing, and clothing) while positively interacting with infants.	Parent-Child Relationship Inventory Family Assessment Form
		Participants understand the nature of parent/child attachments (bonding).		Participants demonstrate knowledge of the characteristics of a healthy parent-child attachment. Participants demonstrate knowledge of the conditions that jeopardize the formation and/or maintenance of healthy attachments. Participants demonstrate knowledge of the risks associated with lack of or unhealthy parent/child attachments.	Parent-Child Relationship Inventory Family Assessment Form
		Participants access formal support systems in their communities when they need them.		Participants contact the agencies that are most likely to help them meet their family's needs.	Inventory of Social Support
		Participants understand their infant's' needs.		Participants demonstrate knowledge of the basic survival needs of infants and children.
		Participants know the importance of maintaining family and cultural traditions and routines.		Participants demonstrate knowledge of the importance of following family routines (predictable mealtimes, wake-up and bedtime routines, family meetings, etc.). Participants demonstrate knowledge of the importance of establishing and maintaining traditions and social activities that are important to their family and culture (such as birthdays, religious holidays, weddings, and other celebrations).
** Service Assumptions: The HOPES program helps stop child abuse before it happens. By teaching parents and caregivers parenting skills and helping them build the support structure they need, program participants are able to handle life's difficulties and address problem behaviors in children before they lead to abuse and neglect. HOPES offers evidence-based parent education and support for families who have children 0-5 years of age who are considered at-risk for child abuse and neglect. HOPES program services are provided at no cost to program participants.

The model includes services provided, resources, outcomes, indicators, and measurement. The services provided are excellent for all families, but especially those who are on the verge of child abuse, or who have been abusive.  These services help the parents learn how to raise their children, how to take care of them, how to “deal” with them, and what they can do when those bad feelings come up to avoid hurting their child and their family in general.  The resources cover the people and places involved to help the families.  When in the program, these people will come and check on your family at your home twice a month, and you and your family will come in to participate in classes each week. The outcomes cover what you will learn while taking these classes and learning great parenting skills.  The indicators cover everything that you have learned and hopefully passed while working on the “outcomes”. Last but not least, are the measurements, or outcome data collection, that are provided to help your family follow the life skills and development processes.  These are great to help make sure your family is on the right track.

If we were to carry out an actual evaluation, I feel that an outcome evaluation would be beneficial as it “compares what happened after a program with what would have happened had there been no program” (Engel & Schutt, 2014, p. 251). This would cover the impact made on the families, have there been any, and make it easy to measure the “before and after” aspects and possible benefits.

There are quite a few stakeholders in the HOPES program, all over the state of Texas, that have at least “some interest in the program” (Engel & Schutt, 2014, p. 247).  These stakeholders tend to run the program so they can be involved before and during the program.  Hopefully they can be involved after the program is finished so that they can kind of keep an eye on the families involved and reach the extra hand out just in case those needs come up again.

Further research could be done to help evaluate the cause and effect of the program. If a Black Box or Program Theory were used, it may work, but we would need to cover if the program is working or not and ask something such as, “What aspects are making this program successful?”  When considering the Researcher or Stakeholder Orientation, we would have to base our study on the views of the stakeholders.  This could be positive for the families involved. When considering the use of Quantitative or Qualitative methods, I can almost guarantee that this specific program would be much better to use a qualitative method, as it is so important in “learning how different individuals react to the treatment” (Engel & Schutt, 2014, p. 277). The Quantitative method is favorable for use, but the Qualitative method adds much more practical information.  Then there is the Simple or Complex Outcomes.  When considering these, we must realize that the Simple Outcomes only look at the immediate outcomes of the program, when a lot, if not most of these families are going to need to participate for at least 2 years with the long-term aspects of the program in mind and several possible outcomes.

We feel that the program is beneficial to the families who are currently participating, and although a few changes may make it even better in the long run, it’s best to work through the available aspects for all the families in need.

By: Whitney Skierski & Brittany Culley

References:

Child Welfare Information Gateway. (n.a.). Logic Model Builders. Retrieved             from https://www.childwelfare.gov/topics/management/effectiveness/logic-model/

Engel, R. J., & Schutt, R. K. (2014). Fundamentals of social work research (2nd ed.).  Thousand Oaks, CA: Sage Publications.

Family Support Services. (n.a.).  Healthy Outcomes through Prevention & Early Support, HOPES. Retrieved from http://www.fss-ama.org/hopes.html

Qualitative Research Analysis

         

Previously, we discussed the topic of autism in the article, "Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder?"  This week we will be covering the same paper and discussing qualitative research. The social conditions under this study include examining attitudes of parents and research scientists regarding both the perceived causes of ASD and which specific issues should be further researched.  The research question itself along with the description of the social issue is somewhat vague and open-ended.  It would have been better to perhaps stick to one topic, such as perceived causes of autism.  The second part of the research question, which addresses which specific issues should be researched in the future, is lacking in clarity and seems too open ended.  Overall the research question is very relevant to social work practice, it is vital that we understand more about ASD as well as perceptions, stigmas, and what affected families feel still needs to be addressed.  

Since the literature is less than a year old, it is very current and quite significant in the topic area of autism. Inductive research is done in this article rather than being of theoretical framework. They attempted to create a theory of their own based upon the research being collected. A qualitative and exploratory study was done as the data was “collected, cleaned, and coded by CSR and entered into SPSS (SPSS Statistics Grad Pack 22.0) for analysis. Differences between parents’ and scientists’ responses were assessed via chi-square tests. The chi-square test of independence was used as we had nominal level variables” (Fischbach et al, 2016, p. 354).

Initially, participants were chosen through a data collection site, Simons Simplex Collection, that included 2,756 families involved in 12 university clinics.  Each family included one child with ASD, but neither parents nor siblings are on the autism spectrum (Fischbach et al, 2016, p. 354). After the families were asked to participate, 1,460 completed the enrollment, and then a probability sample of 554 participants were semi-randomly selected. “As our goal was to have a sample of 500 SSC parents, 554 (the primary caregiver was chosen) were randomly selected to participate in the study by the SSC@IAN” (Fischbach et al, 2016, p. 354). Of those selected, 502 completed the interview and survey.  As can be seen in Table 1, the results of the sample were 82% white and 95% female. The authors were interested in obtaining the attitudes and beliefs towards ASD from these selected participants.

 The design of the study involved a 72-item survey, conducted using a computer-assisted telephone   interview (CATI).  They first conducted a cognitive interview with 10 parents with a child with ASD. This helped them to “identify any unclear concepts, questions, or terms; and learn how to make the questionnaire flow more smoothly for the participant” (Fischbach et al, 2016, p. 354).  After the cognitive interviews, the researchers were able to update the pattern of the questionnaire to ensure the flow of the questions, and then did pretests with 20 parents of children with ASD. Although this type of study was well-balanced and sufficient, we feel that it would be more conducive had they done intensive interviews, “involving open-ended, relatively unstructured questioning in which the interviewer seeks in-depth information on the respondent’s feelings, experiences, and perceptions” (Engel & Schutt, 2014).  However, it is much costlier to perform and takes a much longer amount of time.

The results of the study showed an actively present disconnect between the beliefs of the research scientists and parents concerning the cause(s) of ASD.  The conclusions do seem in line with the results as this entire study was designed with intending to show a need for better communication and understanding between the two groups studied.  There are alternative explanations offered, especially concerning the parents’ opinions of the cause(s) of ASD.  The now infamous and highly disputed Wakefield et al (1998) study that incorrectly linked vaccinations to ASD was mentioned as still being a perceived cause of ASD by at least 13% of the parents and not even one single research scientist.  There seems to be a disconnect surrounding genetics and ASD.  The majority of research scientists and parents acknowledge a genetic component to ASD, even the possibility of a gene mutation that could be the underlying cause of ASD.  Yet many of the parents still hold on to the belief that ASD is caused by vaccines or other factors.  The researchers explained this by revisiting the stigma that parents of ASD children still face today, and that of course it becomes easier to blame something external like a vaccination than to admit that it could be a part of the parent’s DNA that caused it.

The external validity could possibly be limited by the fact that the study samples were primarily white highly educated parents of ASD children with higher IQ’s than the typical ASD population.  In addition, the source of the study’s funding leaves the research scientists’ preference of a genetic component to ASD open to bias. The other main limitation the authors discuss is derived from sampling techniques, specifically the difficulty in obtaining true representative samples.  They explain that this would be a long and expensive process due to the fact that so little research exists at this point.

The study seems to be current with ethical standards, includes no trade-offs, and it has an appropriate balance. For any future studies we would highly recommend improving the sampling methods.  ASD is called Autism Spectrum Disorder for a reason, it’s a massive spectrum.  Only surveying parents of ASD children with high IQ’s (previously referred to as Asperger’s Syndrome) really does not provide the full picture.  There are ASD children on the complete opposite end of the spectrum, very low functioning, that have been diagnosed at various ages.  We also question the funding source of the entire study, if they had something to gain from proving a genetic link to ASD then the chance for bias is too great.

By: Brittany Culley & Whitney Skierski

References:

Engel, R. J., & Schutt, R. K. (2014). Fundamentals of social work research (2nd ed.). Thousand Oaks, CA: Sage Publications.

Fischbach, R. L., Harris, M. J., Ballan, M. S., Fischbach, G. D., & Link, B. G. (2016). Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder? Autism, 20(3), 353-363.

Wakefield AJ, Murch SH, Anthony A, et al. (1998) RETRACTED: Ileal-lymphoid-nodular hyperplasia, nonspecific colitis, and pervasive developmental disorder in children. The Lancet, 351(9103): 637–641. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11096-0/fulltext

Obesity and Outreach

Social Workers are constantly working with and for their clients.  In this case, a lot of the times, you may want to consider conducting surveys for clients so that you can gain a better understanding of their physical, mental, and/or social health issues. A survey was conducted in Dallas County, Texas, covering obesity and health disparities in the neighborhoods.

Goal of the Study

The Obesity and Outreach Study's general goal was “to better understand how to build capacity among mothers to reduce health disparities in their neighborhood.”  The study
was designed to help the researchers understand specific behaviors leading to obesity in certain neighborhoods and possibly even to make the mothers in the target population more aware of things they were doing/not doing that were contributing to their families’ obesity.  This was evidenced by the clear-cut questions asked in the survey itself, such as “what are some physical activities that you currently do or would like to do?” and “what types of snacks do you give your kids at home?”  We predict that by raising personal awareness of the above mentioned behaviors these mothers might be inspired to implement healthy changes in their households.  

Ethical Consideration

The totally voluntary survey was designed to protect the identities of the participants. This is demonstrated by the statements “you can choose not to answer any of these questions” and “we will not ask your name, address, phone number, or any other information that could be used to identify you.”  It is our opinion that the researchers did a thorough job in both ensuring that the individual survey results remained anonymous and that the participants had a full understanding that participation was voluntary, whether it be full, partial, or none.

Reliability and Validity

Since this is a one-time anonymous survey with no way to re-assess results over time or even to follow up with participants’ reliability may prove to be difficult.  It might be possible to increase validity using the concept of alternate-forms reliability by administering more than a single form of survey questions, as in changing the wording of the questions and offering more than one version of the survey.

Overall the validity of this survey could definitely be stronger, especially in regards to face validity.  Based on personal experiences with food, specifically related to overeating and making unhealthy food choices, it is very easy to under report how much food one has eaten and especially how much “junk food” is being consumed.  The same could probably be said in regards to physical activity, even more so for busy moms with children.  We may think and even self-report that we are being physically active and getting sufficient exercise via daily life and just trying to keep up with the kids and house when in reality it is not a consistent daily exercise regimen.  The survey itself does not provide much detail on content validity.  The fairly basic nature of the survey’s design does not seem to require expert opinions or literature review.  Instead it is a simple question and answer survey with the desired responses being solely and uniquely those of the participants.  

Survey administration

The survey is focused on mothers, so it should be self-administered and mailed out as it can reach a large number of potential respondents. “Potential respondents can be sent an electronic cover letter either with the initial or reminder questionnaires attached or with a link to an Internet-based questionnaire” (Burns et. al., 2008).  Mothers tend to be busy individuals, whether they work or are stay-at-home participants.  If self-administered or web-based, it allows them to take the survey while on break at work, while their children are napping, or any other open time frame. It also keeps them from being put on the spot when any sensitive information is being approached.

Strengths, Weaknesses, Assets, and Limitations

The wording in the survey is clear. No confusing phrasing, vague language, double negatives, double barreled questions, jargon, or leading questions are involved.  The questions included are easy to understand and answer. The survey is user friendly, as it is brief yet concise. It contains one closed-ended question requiring check marks instead of “yes or no”, and two open-ended questions regarding types of snacks and health necessities. There are no demographic questions which could be considered an issue as it states that this survey was conducted in Dallas County which is a large area containing many neighborhoods of poor class, middle class, and upper class. This survey may need to focus more on the poor to lower middle class neighborhoods as the need for certain types of food and ability to afford a gym membership is a concern.

The greatest asset of the survey is the fact that it is in both English and Spanish.  According to the United States Census Bureau (2009-2013), of those living in Dallas County, Texas, “41 percent spoke a language other than English at home. Of those speaking a language other than English at home, 83 percent spoke Spanish and 17 percent spoke some other language; 48 percent reported that they did not speak English "very well."

The biggest limitation of the survey is that there are not enough questions, so it is hard to get the point of the survey across.  The more information that is collected in a survey helps to conduct a much more efficient outreach program.

By: Whitney Skierski and Brittany Culley

References:

Burns, K. E., Duffett, M., Kho, M. E., Meade, M. O., Adhikari, N. K., Sinuff, T., Cook, D. & ACCADEMY Group. (2008). A guide for the design and conduct of self-administered surveys of clinicians. Canadian Medical Association Journal, 179(3), 245-252.

United States Census Bureau. (2013). Population and Housing Narrative Profile 2009-2013 American Community Survey 5-Year Estimates. U.S. Department of Commerce. Retrieved from http://thedataweb.rm.census.gov/TheDataWeb_HotReport2/profile/2013/5yr/np01.hrml?SUMLEV=50&county=113&state=48

Blog Post #2 - Autism

In this blog post, I will be reviewing an article by Fischbach et. al, “Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder?”  In this article, the author went over the fact that there was never any investigation that had been reported involving the attitudes and beliefs between parents and scientists about autism spectrum disorder.  To begin their research, they did a survey involving 502 parents and 60 scientists. Attached, you will see Table 2, “Survey questions on causes and research priorities asked to both parents (502) and scientists (60).

 As can be seen, 95% of scientists, and 55% of parents believe that the most likely cause of autism is genetics. 

As stated by the authors, “This empirical investigation is novel, as no comparable studies of concordance between parents and scientists could be found” (Fischbach et al, 2016, p. 354).  Most literature that has been reviewed and consists of autism, tends to focus on things such as, “Vaccine-Related Beliefs and Practices of Parents of Children with Autism Spectrum Disorders” (Bazzano et al, 2012). Constructivist philosophical paradigms seemed to be used by the authors.  The article compares the beliefs of the parents vs the scientists, and shows that many of the parents construct their understanding and knowledge through their experience.  Since the literature is less than a year old, it is very current and quite significant in the topic area of autism. Inductive research is done in this article rather than being of theoretical framework. They attempted to create a theory of their own based upon the research being collected. 

The type of study was exploratory and qualitative.

“Data were collected, cleaned, and coded by CSR and entered into SPSS (SPSS Statistics Grad Pack 22.0) for analysis. Differences between parents’ and scientists’ responses were assessed via chi-square tests. The chi-square test of independence was used as we had nominal level variables.” (Fischbach et al, 2016, p. 354).

Genetic testing was done and questions on stigma were asked. Stigma was defined in this article as “when individuals are “made to feel inferior, shamed, isolated, or their self-image is damaged”’ (Fischbach et al, 2016, p. 357).  Levels of which can be seen in Table 3.  The independent variables in this article were simply the fact of whether or not the child has autism, as it will affect the responses.  The dependent variables include the attitudes and beliefs of both parents and scientists, as if studies done could show proof in changes, the attitudes and beliefs could quickly change.  These variables are measured through surveys conducted and are valid and reliable.

The authors covered the attitudes and beliefs of both parents and scientists quite well.  I feel that if the communication barriers were to be knocked down, those attitudes and beliefs may possibly correspond a lot more.  The issues with this article however are the facts that most of the 502 parents involved are “highly educated, predominantly White, and their children with ASD had higher average intelligence quotients (IQ) than the general population of children with ASD” (Fischbach et al, 2016, p. 361).  Therefore, I would highly recommend that the author take that into consideration for future studies.  I believe that a higher level of parents should be asked to participate, the races involved should be much more spread out instead of mostly White, and more families with a child that has ASD should be involved.  As far as scientists go, I believe that more doctors and healthcare providers should be involved as well.  One of the main issues though, again, is communication.  Just like it is stated in the article, “Better cooperation and communication between parents and scientists should improve practice,

mutual understanding, and ultimately the health and well-being of children with ASD and their families” (Fischbach et al, 2016, p. 361).

By: Whitney Skierski and Brittany Culley

REFERENCES:

Bazzano, A., Zeldin, A., Schuster, E., Barrett, C., & Lehrer, D. (2012). Vaccine-related beliefs and practices of parents of children with autism spectrum disorders. American Journal on Intellectual and Developmental Disabilities, 117(3), 233-242.

Centers for Disease Control and Prevention (n.d.). Data and statistics. Retrieved from http://www.cdc.gov/ncbddd/autism/data.html

Fischbach, R. L., Harris, M. J., Ballan, M. S., Fischbach, G. D., & Link, B. G. (2016). Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder? Autism, 20(3), 353-363.

Blog Post #1

            SOCW 5322 Blog Post #1- Hillary Clinton and Bernie Sanders Errors in Reasoning

Blog #1 will be discussing everyday errors in reasoning, found within two articles covering two political candidates; in this case, Clinton and Sanders.  The two articles being discussed are from “PewResearchCenter” Journalism & Media, as well as NBC News: Politics. The first error in reasoning would be overgeneralization, which occurs when we conclude that what we have observed or what we know to be true for some cases is true for all cases.  After reading both articles, I did not find any overgeneralization.  The second error would be selective observation, which is choosing to look only at things that are in line with our preferences or beliefs.  For this reasoning, an example can be found in NBC News: Politics, when discussing that Clinton and Sanders had agreed to work together, and when going over what their common goals were, Sanders did not choose the same goals.  This can be seen in this statement, “However, while Clinton's statement discussed "unifying the party," Sanders' made no mention of the "u" word” (Seitz-Wald, 2016).  Error number three entails illogical reasoning, which occurs when we prematurely jump to conclusions or argue on the basis of invalid assumptions. After reading both articles, I did not find any illogical reasoning.  The fourth error, resistance to change, is the reluctance to change our ideas in light of new information, is a common problem.  Unfortunately, I did not find any resistance to change.  The fifth error, adherence to authority, is given because we believe that the authority (the person making the claim) does have the knowledge.  Again, I unfortunately could not find this error in either article.

As far as the one error in which I located, it is obvious that presidents will have selective observations. I do not believe that there is anything that can be done to challenge that error. Please feel free to read these articles and let me know if you see any errors in reasoning that I may have missed!  I will certainly appreciate it!  To read these, please see the links I have listed below.

Seitz-Wald, A. (2016, June 15). Clinton, Sanders Agree to Work Together. NBC News: Politics.  Retrieved from http://www.nbcnews.com/politics/2016-election/clinton-sanders-agree-work-together-n592636

Suls, R. (2016, May 17). Clinton, Sanders supporters differ sharply on U.S. global role. PewResearchCenter. Retrieved from http://www.pewresearch.org/fact-tank/2016/05/17/clinton-sanders-supporters-differ-sharply-on-u-s-global-role/