Enhancing Wellbeing for Older Adults With Serious Mental Illnesses: Co-Producing a Positive Psychology Course With Certified Older Adult Peer Specialists.

Compared to peers in the general population, persons aging with serious mental illnesses (SMIs) face physical health disparities, increased isolation, and decreased subjective experiences of quality of life and wellbeing. To date, limited intervention research focuses on addressing specific needs of persons aging with SMIs and no interventions targeted for that population are informed by the theory and science of positive psychology. With the aim of co-producing a positive-psychology-based program to enhance wellbeing for older adults with SMIs, the author held a series of focus groups and individual interviews with six certified older adult peer specialists.

Assessment of Integration of Disability Content into Social Work Education.

Three hundred members of the Council on Social Work Education (CSWE) responded to a survey regarding the inclusion of disability content in social work courses and supports needed to increase disability content. Although respondents generally agreed that disability content is important in social work education, its inclusion is inconsistent, with most frequent inclusion in courses on diversity and least frequent inclusion in courses on research. Respondents identified barriers to increasing disability content, including lack of resources for teaching, lack of relevant faculty expertise, and an overcrowded curriculum.

A postgraduation follow-up of social work students trained in "SBIRT": Rates of usage and perceptions of effectiveness.

Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based modality that can help social workers work with substance-using clients as part of an integrated health care approach. This study reports the findings of a post-graduation one-year follow-up survey of 193 master's and bachelor's social work students trained in SBIRT in practice courses at a Northeast urban college. Forty-three percent of the trainees who were practicing social work after graduation were using SBIRT.

Interpersonal relationship narratives of older adults with schizophrenia-spectrum diagnoses.

Shared themes connected to interpersonal relationships across the life courses of older adults with schizophrenia-spectrum diagnoses were identified in first-person life history narratives and explored in depth. Findings were developed through thematic narrative analysis of 35 interviews with 7 older adults currently in treatment for schizophrenia-spectrum diagnoses. A combination of open-ended questions, life history calendars, and time diaries were used to structure interviews, and narrative and analytical development.

"My life as it is has value": narrating schizophrenia in later years.

I used thematic narrative analysis, informed by the developmental life course perspective, to formulate a line of semistructured questioning for interviews with 6 older adults who experienced ongoing symptoms of schizophrenia. From the 31 resulting interviews and 38 observation points, I developed life history narratives that yielded findings across four shared core themes. In this article I present my findings on the theme of narrative insight into schizophrenia in later years.

"Waiting to go home": narratives of homelessness, housing and home among older adults with schizophrenia.

This study used thematic narrative analysis to develop an understanding of how older adults with ongoing symptoms of schizophrenia who have experienced homelessness understand and express their life course and present-time narratives of homelessness, housing, and home. Findings were developed from 26 individual interviews with five study participants and 33 systematic field observations of their homes, treatment environments and neighborhoods. Presentation of the participants' narratives illuminates how participants experienced shared challenges in unique ways and the meaning they assigned to experiences of homelessness, housing and home, particularly in regard to identity and ongoing challenges.

Conclusions and future directions for periodic reporting on the use of adult clinical preventive services of public health priority--United States.

The findings described in this supplement can help improve collaboration among public health and other stakeholders who influence population health, including employers, health plans, health professionals, and voluntary associations, to increase the use of a set of clinical preventive services that, with improved use, can substantially reduce morbidity and mortality in the U.S. adult population.

Rationale for periodic reporting on the use of adult clinical preventive services of public health priority--United States.

This supplement introduces a CDC initiative to monitor and report periodically on the use of a set of selected clinical preventive services in the U.S. adult population in the context of recent national initiatives to improve access to and use of such services.

Reference allocations and use of a disparity measure to inform the design of allocation funding formulas in public health programs.

Funding formulas are commonly used by federal agencies to allocate program funds to states. As one approach to evaluating differences in allocations resulting from alternative formula calculations, we propose the use of a measure derived from the Gini index to summarize differences in allocations relative to 2 referent allocations: one based on equal per-capita funding across states and another based on equal funding per person living in poverty, which we define as the "proportionality of allocation" (PA). These referents reflect underlying values that often shape formula-based allocations for public health programs.

Resource and cost adjustment in the design of allocation funding formulas in public health programs.

Context: Multiple federal public health programs use funding formulas to allocate funds to states.

Objective: To characterize the effects of adjusting formula-based allocations for differences among states in the cost of implementing programs, the potential for generating in-state resources, and income disparities, which might be associated with disease risk.

Setting: Fifty US states and the District of Columbia.

How federalism shapes public health financing, policy, and program options.

In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.

Funding formulas for public health allocations: federal and state strategies.

Public health funding formulas have received less scrutiny than those used in other government sectors, particularly health services and public health insurance. We surveyed states about their use of funding formulas for specific public health activities; sources of funding; formula attributes; formula development; and assessments of political and policy considerations. Results show that the use of funding formulas is positively correlated with the number of local health departments and with the percentage of public health funding provided by the federal government.

Public health: a best buy for America.

Public health has considerable capacity to reduce the drag of health spending on our nation by preventing the leading causes of disease, death, and disability with cost-efficient, population-based interventions and innovative, boundary-spanning approaches that link clinical care and community prevention. Public health is uniquely able to identify the burdens of disease and analyze the best strategies for addressing them. A 3-pronged strategy can help assure the value needed from our public health investments.

Clinical preventive services for older adults: the interface between personal health care and public health services.

Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings.

A working relationship model that reduces homelessness among people with mental illness.

We applied grounded theory methodology to generate a working relationship model that influences motivation for stable housing among homeless people with serious mental illness, to understand the role of a working relationship in critical service transitions. We focused on practitioners' perspectives and practices in Critical Time Intervention (CTI), a community intervention aimed to reduce homelessness through providing support during the transition from institutional to community living. We found a working relationship that highlighted "nonauthoritative" and "humanistic" features.

Analysis & commentary. The foundation that health reform lays for improved payment, care coordination, and prevention.

The Patient Protection and Affordable Care Act represents a major opportunity to achieve several key goals at once: improving disease prevention; reforming care delivery; and bending the cost curve of health spending while also realizing greater value for the dollars spent. Reform-based initiatives could produce major gains in a relatively short time. The U.

Chronic conditions account for rise in Medicare spending from 1987 to 2006.

Medicare beneficiaries' medical needs, and where beneficiaries undergo treatment, have changed dramatically over the past two decades. Twenty years ago, most spending growth was linked to intensive inpatient (hospital) services, chiefly for heart disease. Recently, much of the growth has been attributable to chronic conditions such as diabetes, arthritis, hypertension, and kidney disease.

Aligning budget with U.S. National HIV prevention priorities.

Reducing new HIV infections in the United States requires allocating public resources to interventions that will have the greatest impact on reducing the number of new infections. We report on the organizational experience of a federal agency's efforts to align its HIV prevention resources to reflect the specific priorities of a five-year strategic plan that has as its goal a fifty percent reduction in the number of annual HIV infections nationwide. Structural and other impediments encountered during the alignment process, and the steps taken to minimize their impact are described, adding to the empirical data base of strategic planning experiences in the public sector.

Accomplishments in HIV prevention science: implications for stemming the epidemic.

The past two decades have witnessed substantial advances in the science of preventing HIV infection. Although important issues remain and there is a need for continuing research, arguably the biggest challenge in preventing HIV transmission is the full implementation of existing preventive interventions worldwide.