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The present study examined the relationships among stress, social support, and intention to leave in 418 public child welfare workers. Workers with higher levels of stress were more likely to think about leaving, while those receiving greater social support were less likely. Social support did not buffer the effects of organizational stress, but had some effect in buffering the effects of work-family conflict. Implications for agency administration and future research are discussed.

The intervention team--a peer counselor and a master's degreed social worker--addressed multiple psychosocial and systems navigation problems to reduce potential barriers to adherence, including knowledge, attitudinal, psychosocial, psychological distress, systems communication, and resource access problems. SAFe appears highly acceptable to women and may significantly enhance medical care management following an abnormal cervical screen for a carefully targeted group of women at risk for suboptimal follow-up adherence.

Study results support the combining of interventions and the practical utility of a clinical decision-making algorithm to determine individualized nonadherence risk and to assign service intensity based on individual need. Problems in locating women for enrollment were experienced.

The results of implementing mental health screening within cancer screening and diagnostic programs serving low-income ethnic minority women are reported. Multi-phased screening for anxiety and depression was provided as part of structured health education and intensive case management services to improve abnormal mammogram or Pap test follow-up. Seven hundred fifty-three women were enrolled in the Screening Adherence Follow-up Program. Ten percent (n = 74) met criteria for depressive or anxiety disorder. Women with depressive or anxiety disorders were more likely to have cancer, significant psychosocial stress, fair or poor health status, a comorbid medical problem, and limitation in functional status. Forty-seven women with disorders were receiving no depression care.

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