This study informs new strategies that promote integration of peer providers into the staff of social service agencies. Executive directors, human resource managers, supervisors and co-workers at 27 agencies in New York City were interviewed in-depth. Focus groups with peers were conducted. Consistent with previous research, respondents identified attitudes toward recovery, role conflict and confusion, lack of policies and practices around confidentiality, poorly defined job structure and lack of support as problems that undermined integration. Emerging from the data are strategies related to human resource policies and practices and workgroup relationships and operations that can improve employment of peer staff.

Fear and reactions to crime have been identified as important factors shaping our communities. In response to local crime, people can become fearful of personal victimization and avoid potentially threatening situations. This response can have an atomizing effect on communities leading to out-migration. Two models have been offered to explain fear and reactions to crime: the victimization model and the social control model. This article examines the limitations of these models, and develops and tests a revised model of fear and reactions to crime. The model shows that avoidance reactions are primarily affected by crime-related factors such as the objective crime rate and the level of fear. Protective reactions are primarily affected by the social characteristics of the neighborhood such as neighboring, perceived social similarity, and social control. Finally, collective reactions are affected by both crime-related factors and the perceived social characteristics of a neighborhood.

Findings demonstrate that a strategy of training, goal setting and consultation can positively affect perceptions of inclusion, and promote implementation of practices associated with inclusive workplaces.

BackgroundThe risk for obesity is twice as high in people with serious mental illness (SMI) compared to the general population. Racial and ethnic minority status contribute additional health risks. The aim of this study is to describe the protocol of a Hybrid Trial Type 1 design that will test the effectiveness and examine the implementation of a peer-led healthy lifestyle intervention in supportive housing agencies serving diverse clients with serious mental illness who are overweight or obese.MethodsThe Hybrid Trial Type 1 design will combine a randomized effectiveness trial with a mixed-methods implementation study. The effectiveness trial will test the health impacts of a peer-led healthy lifestyle intervention versus usual care in supportive housing agencies. The healthy lifestyle intervention is derived from the Group Lifestyle Balanced Program, lasts 12 months, and will be delivered by trained peer specialists. Repeated assessments will be conducted at baseline and at 6, 12, and 18 months post randomization. A mixed-methods (e.g., structured interviews, focus groups, surveys) implementation study will be conducted to examine multi-level implementation factors and processes that can inform the use of the healthy lifestyle intervention in routine practice, using data from agency directors, program managers, staff, and peer specialists before, during, and after the implementation of the effectiveness trial.DiscussionThis paper describes the use of a hybrid research design that blends effectiveness trial methodologies and implementation science rarely used when studying the physical health of people with SMI and can serve as a model for integrating implementation science and health disparities research. Rigorously testing effectiveness and exploring the implementation process are both necessary steps to establish the evidence for large-scale delivery of peer-led healthy lifestyle intervention to improve the physical health of racial/ethnic minorities with SMI.Trial registrationwww.clinicaltrials.gov; NCT02175641, registered 24 June 2014

Results from an investigation of the role of supervisors in the process of adjusting to work with a disabling condition are presented. Workers with disabling conditions were interviewed about the responsiveness of their workplaces to their needs. Analyses showed that successful adjustment to work was related to the ability to complete job requirements, get along with others at work, see a future at work and feel good about work. Many supervisory behaviors were associated with these factors including the extent to which supervisors treat workers fairly, allow workers to participate in decisions related to their work and utilize the workers' skills. Implications for the development of workplace policy and disability management efforts are discussed.