A history of trauma is common in refugee populations and appropriate treatment is frequently avoided. Using a convenience sample of 64 patients in a Somali primary care clinic, a culture and trauma specific intervention was developed to address retention into appropriate treatment. One goal of the intervention was to improve the rate of engagement in psychotherapy after a mental health referral and to test the effect of psychotherapy on health care utilization using a staged primary care clinical tool. Forty-eight percent of patients given a mental health referral engaged in psychotherapy. Patients engaging in psychotherapy had higher baseline utilization and over 12 months trended towards less emergency room use and more primary care. Our findings suggest that the intervention improved referral and retention in mental health therapy for East African refugee women.
Objective: This study of higher education governance had three questions: (a) How does higher education attainment policy vary in type, quantity, and focus across state governance arrangements? (b) How do per capita income, population, educational development, and higher education regional compact combine with state-level higher education governance to influence attainment policy production? and (c) How does the arrangement of higher education governance shape the contribution of community colleges to foster improved state educational attainment? Method: The study employed a mixed-methods case-based research design utilizing data from the Boosting College Completion data set and McGuinness’s classification of community college governance to calculate descriptive statistics. Qualitative comparative analysis (QCA) compared the 50 states, with each case having five conditions previously found to be critical in policy formation. Results: The study found that the absence of a governing board was most influential in attainment policy outputs. State contextual conditions previously found to influence higher education policy production were not critical. The study’s findings suggest that governing board states may underutilize community colleges in raising overall college completion and educational attainment through a mismatched policy environment. Contributions: These findings are foundational for an expanded research agenda focused on community college governance, leadership, and advocacy practices. Future research should examine the policy environment mismatch of governing board arrangements and how to expand the role of community colleges in the college completion agenda.
Community colleges are essential to meet state educational attainment goals, yet the colleges are largely underfunded to serve underprepared students entering through the open door of access. As resource‐dependent institutions, community colleges need to engage in the politics of higher education through advocacy. This chapter presents results from a qualitative study of community college advocacy practices in three states with bifurcated higher education governance. Interviews with the community college system, state community college board, state president, and trustee association leaders, and college presidents and trustees were conducted to identify advocacy practices and challenges to increase state appropriations in support of the completion agenda. Findings point to three advocacy challenges, the stigma of community colleges, competition with the university system for limited state higher education funding, and getting the attention of legislators to understand the value of community college degrees and credentials. The chapter offers recommendations for expanded advocacy.
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