This study used Photovoice methods with young adults experiencing homelessness to collaboratively identify issues that are of greatest importance in an open‐ended, exploratory, and inductive manner. Participants selected two concepts to focus their inquiry: freedom and prosperity. Within these concepts, participants discussed nature as a source of inspiration, a desire to better themselves and to change their situations, and passion for contributing to social change by exposing economic inequality and raising awareness about homelessness. These findings demonstrate that young people are keenly aware of the structural and macro‐level factors that have contributed to their risks of social exclusion and marginalization.
Objective: This study investigates barriers and promoters to delivering quality psychosocial services in 58 cancer programs across North America. Methods: Oncology care providers (n = 2008) participated in a survey in which they identified barriers and promoters for delivering psychosocial care at their respective institutions. Multilevel modeling was used to examine (a) the extent to which provider and institutional characteristics were associated with the most common barriers, and (b) associations between perceived barriers and institutional capacity to deliver psychosocial services as measured by the Cancer Psychosocial Care Matrix. Results: Across 58 Commission on Cancer-accredited programs in North America, the most frequently reported barriers were inadequate number of psychosocial care personnel, lack of funding, inadequate amount of time, lack of systematic procedures, and inadequate training for oncology providers. Overall, there were few significant differences in reported barriers by type of institution or type of provider. In general, the most frequently reported barriers were significantly associated with the institution's capacity to deliver quality psychosocial care. In particular, the lack of a systematic process for psychosocial care delivery significantly predicted lower levels of institutional capacity to deliver quality psychosocial care. Conclusions: When identifying barriers, respondents reported a greater number of institutional barriers than barriers related to individual provider or patient characteristics. These results present a compelling case for cancer programs to implement and monitor systematic procedures for psychosocial care and to integrate these procedures in routine clinical practice.
Returning citizens struggle to obtain employment after release from prison and navigating job interviews is a critical barrier they encounter. Implementing evidence-based interview training is a major gap in prison-based vocational services. We conducted a randomized controlled trial (RCT) to evaluate the feasibility and initial effectiveness of Virtual Reality Job Interview Training (VR-JIT) within two prisons. Forty-four male returning citizens were randomized to receive service-as-usual (SAU) with VR-JIT (SAU + VR-JIT, n = 28) or SAU ( n = 16). Participants reported VR-JIT was highly acceptable and usable. SAU + VR-JIT, compared with SAU, had significant improvements (with large effect sizes) in interview skills, interview training motivation, and interview anxiety (all p < .05; [Formula: see text] > .15), and greater employment by 6-month follow-up (odds ratio [OR] = 7.4, p = .045). VR-JIT can potentially help fill a major gap in prison-based services. Future research is needed to validate VR-JIT effectiveness and evaluate VR-JIT implementation strategies within prisons.
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