Parents Supporting Child Wellness: Implications and Outcomes for Longevity and Treatment Adherence with Vulnerable Populations

Purpose: Vulnerable populations are social groups who experience limited resources, high rates for morbidity, and premature mortality. Vulnerable social groups are those recognized as poor, ethnic minorities, those who are politically disenfranchised and denied human rights. Social workers serve many clients who are classified within this group. Technology in the field of human services is still used to a minimal extent when compared with most segments of society. In recognition of growing use of technology in social work, the National Association of Social Work and Association of Social Work Boards developed Standards for Technology and Social Work Practice in 2005. These standards address use of technology to obtain and manage data, as an adjunct to practice, and as a complete practice modality. Teleherence is a telehealth information and communication technology (ICT) system using text messages and telephone prediction to attain intervention goals: 1) increased health literacy; 2) treatment engagement and adherence; and 3) improved health and longevity.

Method: Using the AIM model (Ability, Information, Motivation), we attempt to understand barriers to utilization of the Teleherence aspect of the intervention that affect vulnerable populations who enrolled in a 12 week hybrid modality health, wellness, and financial literacy intervention. A total of 56 participants have enrolled, with all having one or more face to face sessions, 50% utilizing at least two hybrid modalities, 44% completing one or more weekly sessions, and 30% completing at least half or more sessions. Participant ages ranged from 19-44. There were 46 females and 10 males. Race/ethnicity of participants included: African American (n=24), Hispanic (n=17), Caucasian (n=12), and Other (n=3). Eighty-nine percent of the adults in PSCWFC were involved with the court system or child protective services.

Results: A total of 56 participants have enrolled, with 100% having at least the first face to face session, 28% completing the termination session, 50% utilizing at least two hybrid formats (face to face and weekly Teleherence content related messages and daily reminders to complete their food and activity diary), and 30% completing at least half or more of the 12 telephone sessions. Our results indicate there are numerous barriers to treatment adherence and the AIM model suggests that information, motivation, and ability must be present to ensure treatment adherence. In weekly counseling sessions, participants revealed the following as barriers to treatment adherence: 1) no cellphone of their own; shares phone with a spouse, significant other, or neighbor; 2) changed number; 3) lacks the financial means to purchase an unlimited cell texting package; 4) and stressful life events, often related to poverty.

Implications/Conclusions: In an effort to decrease rates for morbidity and premature mortality in vulnerable populations, social work professionals can include these factors in initial assessments so that clients may benefit from utilizing innovative technological modalities as part of an intervention. It is crucial that as the profession transitions to keep pace with the social environment in technological advances, social workers remember to consider technological support as part of the development of implementation science.