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In this article we discuss evidence-based elements of effective in-home child welfare services as a foundation for advancing the evidence base for family-centered child welfare practice. In 2009 the U.S. Children’s Bureau established the National Resource Center for In-Home Services to build the capacity of state and tribal child welfare agencies to ensure the safety and well-being of children and youth in their homes, prevent their initial placement or re-entry into out-of-home care, and to support families in their role as primary caregivers. Through a nationwide assessment of in-home services conducted over four years of research and technical assistance, we developed a set of core elements for in-home services. These core elements are supported by empirical research and are congruent with evidence-based practices and programs. We review each of the elements with its underlying research base. We also discuss five evidence-supported in-home services interventions that share many of the elements. We conclude with a discussion of how evidence-based elements can be implemented to strengthen family centered child welfare practice.

Objectives This paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access. Methods This exploratory qualitative study was conducted in Dhaka, Sylhet and Khulna City Corporations. Data collection methods included key informant interviews (20) with government and private sector leaders, in-depth interviews (30) with clinic owners, managers and providers and exit interviews (30) with healthcare clients. Results Profit generation is a driving force behind entry into the private healthcare business and the provision of services. However, non-financial motivations are also emphasised such as aspirations to serve the disadvantaged, personal ambition, desire for greater social status, obligations to continue family business and adverse family events. The discussion of private sector motivations and strategies is framed using the Business Policy Model. This model is comprised of three components: products and services , and efforts to make these attractive including patient-friendly discounts and service-packages, and building ‘good’ doctor-patient relationships; the market environment , cultivated using medical brokers and referral fees to bring in fresh clientele, and receipt of pharmaceutical incentives; and finally, organisational capabilities , in this case overcoming human resource shortages by relying on medical staff from the public sector, consultant specialists, on-call and less experienced doctors in training, unqualified nursing staff and referring complicated cases to public facilities. Conclusions In the context of low public sector capacity and growing healthcare demands in urban Bangladesh, private for-profit engagement is critical to achieving universal health coverage (UHC). Given the informality of the sector, the nascent state of healthcare financing, and a weak regulatory framework, the process of engagement must be gradual. Further research is needed to explore how engagement in UHC can be enabled while maintaining profitability. Incentives that support private sector efforts to improve quality, affordability and accountability are a first step in building this relationship.

BACKGROUND: Wellbeing and resilience are essential in preventing and reducing the severity of mental health problems. Equipping children with coping skills and protective behavior can help them react positively to change and obstacles in life, allowing greater mental, social and academic success. This systematic review studies the implementation and evaluation of universal, resilience-focused mental health promotion programs based in primary schools. METHODS: A systematic review of literature used five primary databases: PsycINFO; Web of Science; PubMed; Medline; Embase and The Cochrane Library; and keywords related to (a) health education, health promotion, mental health, mental health promotion, social and emotional wellbeing; (b) school health service, student, schools, whole-school; (c) adolescent, child, school child, pre-adolescent; (d) emotional intelligence, coping behavior, emotional adjustment, resilienc*, problem solving, to identify relevant articles. Articles included featured programs that were universally implemented in a primary school setting and focused on teaching of skills, including coping skills, help-seeking behaviors, stress management, and mindfulness, and were aimed at the overall goal of increasing resilience among students. RESULTS: Of 3087 peer-reviewed articles initially identified, 475 articles were further evaluated with 11 reports on evaluations of 7 school-based mental health promotion programs meeting the inclusion criteria. Evaluation tools used in program evaluation are also reviewed, with successful trends in evaluations discussed. Encouraging results were seen when the program was delivered by teachers within the schools. Length of programing did not seem important to outcomes. Across all 7 programs, few long-term sustained effects were recorded following program completion. CONCLUSIONS: This review provides evidence that mental health promotion programs that focus on resilience and coping skills have positive impacts on the students' ability to manage daily stressors.

This article conceptualises the role of intuition in professional judgement. It draws on findings from an empirical study of home visiting in child and family social work. The study used a psychosocial analysis of narrative interviews (n = 18) to investigate how workers constructed a professional judgement in relation to an initial home visit. In contrast to deliberative or analytic reasoning, intuition is defined as a non-conscious mode of reasoning, allowing the individual to reach a rapid judgement about a situation or person, often with striking accuracy. In this study, CFSWs’ intuitions during their first encounter with the family were an important source of information for their assessment of risk – their emotional responses, ‘niggles’ and ‘gut feelings’ sensitised them to potentially salient information before it was rationally accessible. The study identifies five patterns used by Child and Family Social Workers (CFSWs) to assess risk during the initial encounter with parents: openness, coherence, emotional congruence, child focus and personal responsibility. It is argued that intuition is a product of experience, and is an important part of CFSWs’ decision-making toolkit. However, when accepted uncritically, intuitive reasoning can represent a risk for professional judgement through the creation of bias. The article identifies specific biases relevant to judgements made on the basis of an initial visit.

Aims and Objectives\nThis review aims to examine available evidence on cultural competence in health care settings to identify key\napproaches and strategies that can contribute to improving the development and implementation of Indigenous\nhealth services and programs. The objectives are to:\n1. define cultural competency\n–– we consider the significance of cultural competence and how it has been defined in international and local\nliterature, including the use of similar terms and meanings\n2. report on the quantity, nature and quality of available evidence\n–– we look at available evidence on cultural competency in Australia, New Zealand, Canada and the United\nStates, including how cultural competence has been measured, and assess the quality of the evidence\nagainst basic methodological criteria\n3. identify approaches and strategies that are effective in improving cultural competency among health\nservices staff\n4. examine the relationship between cultural competency and health outcomes\n5. develop an evidence-informed conceptual framework of cultural competency.

This article provides insights into how the concept of vulnerability operates in welfare and disciplinary processes for young people who are considered ‘vulnerable’. It reports from empirical qualitative research conducted in a large city in England which included interviews with vulnerable young people and with professionals working with this group. Findings highlight that despite differences of opinion about what constitutes ‘vulnerability’, it is a popular and powerful conceptual mechanism which underpins the delivery of service interventions for certain young people. A relationship between vulnerability and ‘transgression’ is revealed, calling into question dichotomous representations of young people as either ‘vulnerable victims’ or ‘dangerous wrong-doers’. It is argued that whilst it can be utilised in the pursuit of more ‘caring’ interventions with those who are seen to be ‘in need’, vulnerability is also a concept relevant to debates concerning selective welfare systems and behavioural regulation.

<p>Note: The papers are not included in the fulltext online.</p><p>Paper III and V in dissertation as manuscript.</p>

Mindful of the withering of high-stakes accountability and disappointing data from pay for performance evaluations in the US, we ask why management by extrinsic incentives and organizational goal setting may have been far less powerful than designers of accountability and extrinsic incentive systems had expected. We explore how system-generated motives (e.g., attaining specific organizational goals, preventing sanctions, or garnering rewards) stack up against autonomously generated, intrinsic, or service motives.? We found through both quantitative and qualitative data that for teachers in the charter schools a constellation of public service motives pre-dominated: diffuse pro-social commitments, ideologies of fairness and equity, a belief in the moral deservingness of deprived student populations in opposition to societal neglect, and identification with one’s work as a personal calling. By comparison, monetary rewards were embraced as already deserved. Neither rewards, nor accountability, seemed to regulate behavior in a deep way. Prestige was not bestowed by official performance statuses within the accountability system, but flowed from judgments, personally communicated, by students, parents, or colleagues who had direct contact with teachers’ work.