Journal of Applied Social Science

To what extent might race and where one lives at service start in Monroe County, New York, influence three dimensions of caregiver strain among those caring for a youth designated as having serious emotional disturbance? We used the Caregiver Strain Questionnaire to measure our outcomes: subjective internalizing strain—negative feelings of guilt and worry associated with having a child with behavioral and emotional problems; subjective externalizing strain—negative feelings about the child such as anger or embarrassment; and objective strain—interruption of personal time, lost work time, and/or financial strain in four geographical areas (place of residence) defined by ZIP code. These places included Low Income Urban (median ZIP code household income less than $39,000), High Income Urban (median ZIP code household income greater than or equal to $39,000), Suburban, and Rural.

We found that place at service start and time predicted caregiver strain levels (though time was the only predictor for externalizing strain), controlling for several factors. Race had no detectable influence. Supports can be individualized to a greater extent to address specific factors influencing the type of strain experienced by a caregiver. Providers might begin by identifying caregiver strain by type and intensity as well as identifying the specific circumstances leading to feelings and concerns associated with each type of caregiver strain.

We propose that female methamphetamine users who live in suburbia experience risks for disease transmission stemming from their social environment that remain under the radar of public health surveillance networks. The data analyzed in this article were collected from 2007 to 2011 and were drawn from two sequential studies on methamphetamine use. The studies were conducted in the suburbs of a southeastern U.S. metropolis. We analyzed a total of 65 qualitative interviews with former and active methamphetamine-using women. Data from focus groups also were included in the analysis. The participants’ ages ranged from 18 to 51 years. We identified three major themes with regard to risk behaviors and transmission of infectious diseases: (1) setting risk behaviors such as sharing syringes and homelessness, lack of transportation, and unemployment; (2) sexual risk behaviors such as condom use and having multiple partners; and (3) service-related risks such as risk awareness and prevention behaviors as well as utilization of social services and health care. Our findings point to the pervasive nature of social influences on the risk for infectious disease transmission. We suggest that harm-reduction programs (HRPs) be implemented in suburban communities to increase access to these services. Second, our data support the concept of social recovery for drug users to better their health and social lives holistically.

We are now well into the second decade of the “outcomes” revolution, the increasing expectation on the part of funders that social and human services agencies report on the impacts or outcomes of their programs. It is no longer enough to “do good” poorly; rather, the expectation these days is that the agencies report on program outcomes and the impact they have on the communities they serve. Unfortunately, however sensible such expectations would seem to be, agencies continue to resist, and in some cases sabotage, these more complex reporting requirements. Program outcomes, it turns out, are often difficult for agencies to conceptualize and even more difficult for them to attain. This study explores the sources of agency resistance to outcomes measurement and management through qualitative interviews with directors and staff of eight human service nonprofit agencies and their one common funder in a large southeastern metropolitan area. Along with the usual logistical issues, we find that a lack of communication between agencies and funders about their intended goals leads to frustration on both sides, ultimately making it more difficult to measure community-level impact than it truly needs to be.

This article explores how we can more fully engage our students in research and social problems by creating community-based research methods courses. I describe a course I created in which students learned qualitative research methods and then conducted the majority of the interviews for a homelessness prevention program evaluation project. Showing how we worked closely with the community organization and the students were fully engaged in using their sociological imagination, I explain the details of the course and the project. I provide specific feedback from both the students and the organization, as well as explain areas of limitation and complication in conducting these types of courses.

Sexual assault self-protection programs often address either broad educational goals (e.g., alcohol awareness, gender, and safety) or are restricted to the practice of violent hands-on self-protection techniques. Enrollment is almost entirely restricted to female audiences, in spite of a high risk of assault among gay men. We describe the development of Elemental, a sexual assault protection program, wherein we undertook a sociologically grounded yet multidisciplinary approach to produce a holistic and inclusive program that teaches a variety of response options, including nonviolent physical and verbal techniques. Through the use of survey data from program participants and a control group, we present results of initial longitudinal tests of the efficacy of the program. Directions for further testing and development are discussed.

Patient’s ability to understand and effectively communicate health information facilitates disease prevention, self-management of illness, the adoption of healthy behaviors, and their ability to act on important public health information. However, patients who have limited English proficiency (LEP) are significantly disadvantaged. Previous studies have shown the benefit of medical interpreter services in bridging the health communication gap between patients and providers. This qualitative study, focusing on medical interpreter utilization within obstetrical and neonatal services, provides perspectives from multiple types of providers to further explore the role of medical interpreter services and specific barriers to the use of such services. Five separate focus groups were conducted with postpartum nurses, labor and delivery/triage nurses, obstetrics and gynecology (OBGYN) resident physicians, neonatal intensive-care unit (NICU) nurses, and faculty physicians, nurse practitioners, and midwives. The data show that barriers to the utilization of professional medical interpreters can be categorized by distinct but related institutional- and individual-level factors. Further interpretation of the barriers, however, suggests that providers’ use/non-use of interpreter services is merely one piece of a much “bigger picture” regarding difficulties and challenges in delivering care to a growing culturally diverse patient population, and that these cultural challenges, not just the availability of interpreter services, may affect providers’ ability to deliver effective and efficient care. It is argued that simply adding additional communication-based resources may not be sufficient to impact providers’ attitudes and behaviors or the overarching organizational culture regarding LEP patients.

This article presents two case studies, linked together as chained projects, as examples of public sociology involving university/community partnerships. Research described here illustrates specific ways that applied sociology and public sociology can be put to work to address community problems. While the projects described here are an important focus, the article argues that they are primarily valuable in showing how a regional resource exchange network can be set up over a period of decades and how the presence of these partnerships creates the possibility for one project to chain into another. We describe this chaining as a resource exchange network and as a “virtual organization.” Virtual organizations are intentionally created, possess internal logic, and contain a set of actors who carry out interdependent roles. Virtual organizations lack formal structure and require a minimum of organizational maintenance. The chaining method and the associated virtual organization help to bring university actors and resources to bear on helping to solve community problems.

Although medical sociology has been taught at medical schools for a few decades, medical students still have difficulty in understanding the usefulness of sociology in medical practice. This article discusses how medical sociology can be taught in a way that is more practical and thus more useful to medical students and medical practitioners. By using the concept of “individualized medical sociology,” I show how medical sociologists can construct elaborated individual cases and apply relevant sociological principles to help students and medical practitioners understand the relevance of sociology and also show them how to use sociology in medical practice. Medical sociologists can effectively make use of sociological material by reviewing the basic literature of the discipline and by constructing cases along the lines of problem-based learning (PBL) so as to accord with the literature. This article challenges a main sociological argument that sociology should study social groups and societies rather than individuals and shows how to teach individualized medical sociology through PBL. By understanding the relevance and usefulness of sociology in medical practice, medical students can improve their communication skills, understand more about their patients as social beings, become culturally competent, and become better doctors.

Lay Health Workers can play a pivotal role in improving disaster response and recovery because of their potential effectiveness in enhancing the overall health of their communities, increasing disaster preparedness, supplementing the efforts of disaster responders, and building relationships of trust among all interested parties. Such activities build social capital and significantly enhance community resiliency in anticipation of future disasters. Although there are a number of different types of lay health workers, the version with the greatest potential in this area is the Community Health Worker (CHW). Recent research findings confirm that CHWs serving in the communities where they live have been beneficial in emergency management planning and disaster recovery, following both natural and technological disasters. When properly trained, they constitute a proven strategy for timely interventions aimed at reducing long-term collective trauma and building social capital. In this paper, we elaborate the characteristics and roles of CHWs as a specific type of lay health worker; review research on the utility of CHWs in health care generally, as well as in the area of emergency management; describe their potential for building social capital and enhancing community resilience; and provide an overview of essential training needed to prepare them to participate in disaster preparedness, response, and recovery efforts. We conclude with some suggestions for future research.