Objective To describe mothers’ reasons for leaving a home visiting program early. Design Qualitative descriptive study using semi-structured interviews of mothers who dropped out of the Nurse-Family Partnership (NFP) and two focus groups with nurses and nurse supervisors at an NFP site. Setting A New York State site of a NFP home visitation program for low-income new mothers designed to improve the physical and emotional care of children. Participants Participants included 21 mothers, 8 nurses, and 3 nurse-supervisors Methods Semi-structured interviews and focus groups were used to collect data, which were analyzed using content analysis. Results The program was not perceived to fit a mother’s needs when she was overwhelmed with other responsibilities, the nurse did not meet her expectations, the content was not of interest, or the mother did not desire visits after the infant was born. Nurses and mothers described need for mothers to have organizational and communication skills, such as keeping track of appointments, calling to reschedule, articulating needs, and asking for assistance. Disruptive external influences included nurse turnover and unstable living situations, including frequent moves and crowded housing. Each of these types of barriers had potential to interact with the others, creating complex combinations of challenges to retention. Conclusion NFP retention might be improved by reframing program relevance to individual mothers and increasing maternal organizational and communication skill development.

BACKGROUND: In response to continuing disparity in the employment outcomes of young adults, the Administration on Intellectual and Developmental Disabilities established an initiative to support state consortia to implement systems change with an explicit focus on policies, infrastructure, and collaboration across state agencies and other stakeholders. Eight states received 5 year grants under the Partnerships in Employment project. OBJECTIVE: This manuscript provides an overview of the initiative, and key lessons learned including the importance of a backbone organization, the need for a long term approach to change and capacity building, the role of data as a communication mechanism, integration across initiatives, linking local implementation and state policy, and intentional investment in communication. CONCLUSION: A holistic model for addressing systems change is offered that reflects the importance of intentional investment in relationships and connecting activities that link stakeholders across state governmental systems change, local implementation, and advocacy.

BACKGROUND: Project SEARCH is a successful job readiness program for high school students with disabilities, ages 18-21, and is recognized for its innovative approach and collaborative efforts between business, education and vocational rehabilitative services. Project SEARCH employment outcomes far exceed the national average rate of employment for people with disabilities, with a 68% success rate in transitioning students from high school into competitive employment. However, little is known about the long term employment outcomes for the young people who have completed the training program. OBJECTIVE: This study, that includes longitudinal data collected from three Project SEARCH sites in Upstate New York that have an impressive 83% success rate overall, provides the first longitudinal analysis of the impact of Project SEARCH. CONCLUSION: Data collected as part of this 5-year evaluation project indicate promising trends; and support the notion that the Project SEARCH model is successfully preparing young students with disabilities with the skills necessary to both obtain and retain employment in integrated work settings. While these findings are promising, further research is needed to substantiate the reported outcomes.

Immigrant women seem to have more difficulties in using contraception than Danish-born women. To address this problem, there is a need for culturally sensitive information campaigns targeting this heterogonous group of women.

Abstract. BACKGROUND:Over recent years, New York State has engaged in efforts to transform the sheltered workshop system. Through this effort, a variety of innovative models have been piloted to assess effectiveness in supporting sheltered workshop participants to train for and transition to competitive employment in the community. One particular pilot program adapted the Project SEARCH high school transition model for this purpose. OBJECTIVE: As part of a larger evaluation effort, this project aimed to document the individual growth of program participants, as well as their self-perceived readiness for employment. METHODS: Ten individuals participated in a 12-month program, where they participated in up to four internships. Participants were interviewed multiple times, beginning at the start of the program, and again at the end of each internship. Interviews were video recorded, transcribed, and analyzed to identify common themes. RESULTS:The career discovery process of exposure to community-based work opportunities, included as part of the Project SEARCH program, led to to an increased ability to express vocational strengths and self-determined career goals. Participants articulated a readiness to enter the workforce and demonstrated a desire to take on more personal and financial responsibility. The program model was successful in transitioning 63% of participants into competitive employment. However, successful transition was not achieved by participants who had been in the workshop for more than 5 years prior to entering the program. CONCLUSION: Further research is needed to assess the appropriateness of the Project SEARCH model for those with the most significant disabilities who wish to transition from a workshop into competitive employment, particularly those individuals who have been in a workshop setting for an extended period of time.

These findings are important because the low-income girls who experienced such parenting in the 1990s are now young mothers themselves. Current practice guidelines encourage new mothers to think about how they themselves were parented; the knowledge from this study may assist practitioners to engage present-day African American mothers in supportive discussions about physical and non-physical discipline methods with young children.

We assessed online health insurance plan indication of coverage and accessibility of information for recommended services for transgender youth (TY). Content analysis was performed for plans used at a pediatric Gender Clinic by reviewing information about coverage of puberty blockers, hormones, masculinizing chest surgery, and counseling. Transgender-specific exclusions and the time required for the research assistant to review each plan's online information were noted. No plan (0%; n =36) indicated coverage of all four categories of recommended services online. Forty-nine percent indicated ≥1 transgender-specific exclusion. The median time required for a research assistant to review online coverage information for each insurance plan was 50 min. Efforts are needed to ensure that online insurance information is accessible and updated in accordance with policy and coverage recommendations for TY.

This study qualitatively assesses the acceptability and feasibility of a school-located vaccination for influenza (SLIV) project that was conducted in New York State in 2009-2011, from the perspectives of project participants with different roles. Fourteen in-depth semistructured interviews with participating schools' personnel and the mass vaccinator were tape-recorded and transcribed. Interviewees were randomly selected from stratified lists and included five principals, five school nurses, two school administrators, and two lead personnel from the mass vaccinator. A content analysis of transcripts from the interviews was completed and several themes emerged. All participants generally found the SLIV project acceptable. School personnel and the vaccinator viewed the SLIV project process as feasible and beneficial. However, the vaccinator identified difficulties with third-party billing as a potential threat to sustainability.